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MVA- What’s your action plan?

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The photo illustrates significant vehicle body damage. Consequently, emergency responders should expect decesased occupants or serious occupant injuries and a potentially lengthy extrication time. This car was involved in a high speed accident; the car hit two trees and came to rest against a third tree. This photo was taken in a salvage yard.

Photo by author

1. How will you use your resources?

2. What is your plan to make the scene safe?

3. Access the patient(s)?

4. Extricate the patient(s)?

5. Can you think of additional resources requiring “special call”?

Post your response in the Comments section. Let’s hear what you, and others, think about this extrication challenge!

A few of my thoughts:

1. My resources will be devoted to controlling hazards and determining if there are any survivors.

2. Expect hazardous fluids (gasoline, antifreeze, etc.) to be released in this accident. Are power lines involved? Control the hazards and increase responder safety.

3. Accessing portions of the vehicle to determine if anyone survived (back seat passengers) may be difficult. Tearing and/or cutting away portions of the vehicle may be necessary for access. Also, consider the need to remove the bodies of those not surviving the accident to allow access and/or extrication of survivors.

4. Expect a longer than normal extrication time and more paramedic and patient interaction. The vehicle has extreme body and frame damage. An advanced extrication consideration would be to make selective cuts to the vehicle and allow the frame and body to move, opening up the passenger compartment and allowing for more rapid patient extrication.

5. Special resources I would consider may include persons with advanced extrication knowledge and skills and a tow truck to assist with extrication operations.

Posted in command-leadership, Education/Training, fire-rescue-topics, firefighting-operations, patient-management, rescues, special-operations, Training

September 20, 2012 • 4 comments

“I hate you, papa.”

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Those were the last words of a dying child, beaten for hours by her mother’s boyfriend. The man beat the child for most of a day; when EMS and law enforcement were finally summoned, the limp child was found in her bed. Hospital staff worked to revive the child; however, she succumbed to her severe injuries. A law enforcement officer in the ER noted the girls last, powerful words in his incident report. Another article told the story of a child beaten to death by both her mother and father. When brought to the hospital, the child was covered in bruises, old and new. X-rays showed current and old broken bones. Neighbors said the child was constantly screaming in that house. The grandparents said they were concerned for the child’s safety. No one, neither family nor neighbor, intervened for these children.

As firefighters, many of us wear our leather helmets with pride and see the fire service as protectors of all people. Without a search warrant, we have unique opportunities to see what other agency representatives rarely get to see: the inside of a home, bared to us without much attempt to whitewash living conditions. Firefighters are in houses for medical calls, public service calls, and fires. We are able to see how people are in their day-to-day lives.

On your next medical call, when examining and caring for a child, will you look a little harder at what you see? Will you assess the child and try to determine his/her wellbeing?

1. Is the child overly dirty and uncared for?
2. Condition of diapers? Changed, as needed?
3. Child look in good physical condition and well fed?
4. Appear to have an exceptional number of bruises and/or other injuries?
5. For age, appear to appropriately respond to stimuli?
6. Living conditions: acceptable or unsafe squalor?

Today, at the kitchen table, discuss this article. Ask if any member has run across anything similar in his/her past work. How was the problem handled? Does your organization have a method to report child and/or elder abuse? If there is not a policy or other method, does your organization need one? What do you think should be in the policy? Until the policy is developed, how will you and your crew handle a call similar to those in the above paragraph?

Children don’t have the necessary skills to communicate in the adult world. It’s up to us, as adults and as firefighters, to speak for those without a voice. Will you have the courage to protect a child and report a situation to social services?

Silence is acceptance; inaction is approval.

Posted in administration-leadership, Education/Training, ems-topics, Motivation, patient-management, Thoughts

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September 7, 2012 • 4 comments