Developing an Extrication Sequence

The time was 2:35am as the crew of Squad 4 was being diverted off a previous call. Dispatch relayed the information, “Squad 4 respond to a MVC involving three vehicles, with a confirmed entrapment.” This stretch of Interstate 95, has been a consistent location for bad entrapment crashes. As the officer on Sq-4, it was the moment of truth. Climbing off the rig, among a maze of damaged vehicles, I remained focused on the task at hand. Each member of the crew had a task.  After grabbing the cutters and placing them on the tool tarp, I started my walk-around filling out my mental checklist. Several frantic bystanders were surrounding the heavily damaged vehicles. As I glanced back towards the apparatus, I saw my crew working without direction; a tool tarp full of equipment, stabilization complete, battery secured, light tower on the rise, hose-line being pulled and posts being checked for airbags. In the late night hours there was no applauding audience, but I was proud of my crew.

The only “always” in extrication is that each call will be different than the last. Many times the extrication process must be rapid while at other times a more methodical approach must be used. Whether you are a career or a volunteer firefighter, both of these types of operations will flow if you develop a consistent and efficient extrication sequence.

One remark I routinely hear from departments is, “We don’t have access to cars, so we can’t regularly train on extrication techniques.” In my opinion, that type of mentality is totally off base and usually needs followed up with a question. “Does your crew ever train on increasing their overall efficiency on scene?” Consistently the answer is “no”. If anyone is familiar with my training programs, you will understand that I am a big advocate on making extrication training as realistic as possible. In my opinion extrication incidents, due to their high number, provide excellent opportunities for firefighters to “save a life”. The more the company training mimics real incidents, the more prepared crews are for what awaits them when the tones go off.

When setting up an extrication sequence, I prefer to separate training into two categories: skill practice and efficiency practice.

SKILL PRACTICE

Skill practice is just as it sounds. Practice is the foundation that we must build upon in order to be consistently successful. Quality training gives you efficiency, muscle memory, confidence and an enhanced concentration level. It is the training that focuses on the individual skills and knowledge that are necessary in extrication. Training covers the how’s, the whys, and the equipment that will facilitate the extrication process. Instructor experience also will play a huge role in this training. Without skill practice, efficiency will not be possible. Knowing the skills will allow the individual to stay ahead and keep you ready for the next move. 

EFFECIENCY

Efficiency is being competent at a specific job or practice.  Practicing efficiency will put each piece of the extrication puzzle together (refer to my upcoming article: (“Efficiency Breeds Speed”). When a fire department responds to a working fire, does your crew know what their role will be? Do they know what tools to take or do you have to say it enroute? It takes practice, but your crew will respect having a general plan in place and it will show through your actions on scene.

I cannot stress enough, that being able to operate efficiently and consistently is one of the most important factors necessary to provide a successful outcome. When dispatched to an emergency, there are always variables that are not present in training. Entrapment types and patient conditions will vary which may alter the crews tactics and rhythm. Sometimes the operators of the extrication tools will need to take a faster approach, while other times the process must be slower and more technical in nature. This flexibility in timing needs to be learned in practice, so it can be applied realistically in the field. While training, mix it up and proceed as if you only have a small window of opportunity to free trapped victims. Questions such as “Can we make up time, can some methods be bypassed, or what has to be done in regards to safety, should be considered.  Accelerate your extrication sequence and concentrate on those skills that are mandatory. Make sure all of the bases are covered in regards to the safety of your crew and trapped patients. Altering the timing of your routine will prepare you to make critical decisions when lives hang in the balance.

PUTTING IT ALL TOGETHER

There are many components to a skilled crew for extrication operations, but one of the most important elements is developing a strong foundation upon which to build upon. Begin your extrication program by spending time developing flexibility in your decision making and mastering efficiency. If you reduce the amount of unneeded actions to accomplish the goal, the results will quickly show on the scene. Crews need to focus and execute, pulling from muscle memory each time. As you enhance your efficiency and skills level, so will your confidence.