Vehicle extrication

Vehicle extrication is the process of removing a person from a vehicle that has been involved in a motor vehicle accident when conventional means of exit are impossible or unadvisable. This is typically accomplished by utilizing the Jaws of Life.

Operations

The extrication consists of four steps:

the protection of the zone, to avoid a risk of collision (marking out the zone, lighting) and of fire (switching off the ignition, disconnecting the battery, absorbing powder on oil and gasoline pools, fire extinguisher and fire hose ready to use) ;

the stabilisation of the vehicle, to avoid the movements of the vehicle itself (e.g. falling in a ditch), and the movements of the suspension (risk of worsening of an unstable trauma) ;

the opening of the vehicle and the deformation of the structure to release a possible pressure on the casualty, and to allow the intervention of a first responder, of a paramedic or of a physician inside the vehicle ;

the section of the cabin (usually removal of the roof) to allow an extrication in good conditions, especially respecting the head-neck-back axis (rectitude of the spine).
In less complicated cases, it is possible to extricate the casualty from the side door.

As soon as possible, best before beginning the mechanical operation, a rescuer enters the cabin to perform the first aid to the casualty: assessment, stopping the bleeding, putting a cervical collar (these operation are likely to provoke vibrations), providing oxygen first aid. In France, this rescuer is called the "squirrel" (écureuil).

The deformation of the structure and the section of the roof take several minutes; this de-extrication time can be used for medical or paramedical acts such as intubation or placing an intravenous drip. When the casualty is in cardiac arrest, cardiopulmonary resuscitation can be performed during the freeing, the casualty being seated. The use of this incompressible duration is sometimes called play and run, as a compromise between scoop and run (fast evacuation to a trauma center) and stay and play (maximum medical care onsite).

The last step is usually performed with a long spine board: the casualty is pulled up on it. An extrication splint (KED) can help immobilising the spine during this operation.

Additional risks with new technologies

Active systems such as airbags make the operations more complicated: when they did not explode (e.g. shock from the rear or vehicle on the roof), the activation can occur any time during the operation, and cause additional trauma to the victim or to the rescuers.

New hybrid technologies also include additional high voltage batteries, or batteries located in unusual places. These can expose occupants and rescuers to shock, acid or fire hazards if not dealt with correctly.

Some vehicles have an additional LPG tank; as the system was not built in, there is a risk of damaging the pipe which is often under the car, releasing the pressured fuel.

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