The “Extrication Boss”: Pre-Planning and Size Up for Company Officers

The “Extrication Boss”: Pre-Planning and Size Up for Company Officers

A highly promoted practice in the fire service, especially for first arriving company officers, is to conduct a size up and perform a 360 of structures upon initial arrival to incidents involving alarm activations and reports of smoke or fire. Being prepared for a successful mitigation to a working fire most often derives from pre-planning and a thorough size up. 

The same practice and efforts should also be done when responding to a reported motor vehicle accident (MVA). Adequate pre-planning (equipment checks, training, and geographical familiarization) along with a walk around and detailed size up can set the tone for the duration of the call and help to achieve a successful outcome for both your crew and those involved. 

In this brief training article, I will discuss what steps should be done prior to receiving calls for service related to MVAs as well as the critical aspects of completing the perfect size up to better assess what resources will be needed and what tactics to implement. 

Prior to the Call:

• Daily Shift Checks (apparatus/equipment)
• Task Specific Training (stabilization, extrication, etc.)
• Pre-Planning and Standard Operating Procedures (SOPs)

Daily Shift Checks: Prior to the start of every shift or tour, it is paramount that the apparatus is checked for operability as well as the associated equipment and tools stored on the apparatus. With many departments and agencies, the Ladder is assigned as the Extrication Apparatus while others are fortunate to have a designated Rescue Company that performs vehicle stabilization and patient extrication. 

Whichever apparatus is assigned this task within your agency, the following should be assessed, in addition to apparatus fuel, lights, and functions, before going into service:

• All tools/equipment are in their operable condition and desired location.
• Battery-operated equipment (lights, power tools, cordless extrication tools)
• Sufficient fuel/lubrication (saws, portable power units, etc.)
• Associated accessories (blades, cords, high pressure lines)

Task Specific Training: Like structure fires, in which we train and learn to adapt to all situations that could present themselves on scene (ventilation, search, suppression), conducting regular drills and training for motor vehicle accidents would be an advantageous move for any company that operates as an extrication team.

At a minimum, drills should consist of psychomotor skills that include the following:

• Vehicle Stabilization (cribbing and struts)
• Patient/Occupant access and removal (dash rolls, door removals, etc.)
• Electric/Hybrid Vehicle familiarization
• Mitigation of air bags, fluids, and pressurized parts
• Accidents involving heavy machinery and motorized equipment (school bus, TT unit, Bulldozer)

Those skills obtained can easily become a perishable skill when not practiced or implemented regularly. As a department or company responsible for response to motor vehicle accidents, advanced and regular training will ultimately prove to be conducive to the overall outcome of all events.

Pre-Planning / Standard Operating Procedures: Developing pre-plans for target hazards in your response districts will allow for you to better prepare responding units for the location of exposures, sprinkler systems, elevators and potential obstacles such as property access.

The same approach should be made regarding your department’s response to motor vehicle accidents. Through a well thought out and implemented combination of pre-planning and Standard Operating Procedures (SOPs), crews will be ahead of the game pulling out onto the apron with knowledge of predetermined routes and assignments.

Pre-Planning the streets and highways within your response district should focus on:

• Number of lanes for purposes of creating safe zone and staging of apparatus/equipment
• Type of construction (asphalt, gravel, etc.) to better determine stability options 
• Access/Egress routes when incidents warrant roads to be blocked or shutdown

Developing Standard Operating Procedures for MVA responses should help to ensure that:

• The appropriate compliment of apparatus/companies are responding
• Each crew member is aware of their assigned desired task upon arrival 
• Adequate resources are predetermined (heavy wrecker, additional ambulance, etc.)
• A Command Structure is established and implemented (IC, Safety, Operations, EMS)

Size-Up (INITIAL): The initial size-up of any incident sets the tone for the duration of the call which is why it is so imperative to determine precisely what you are about to be presented with. Your crew is likely to dismount the apparatus with a different mindset and demeanor after hearing a “two (2) car rear with all occupants out of the vehicles” than they would with a reported head on with extensive front end intrusion and possible fire in the engine compartment.

Your preliminary report to dispatch, arriving units, and your crew will trigger their sense of urgency, what hazards to be mindful of as well as what tools/equipment is going to be needed. 

For you, as the Company Officer, the initial size-up should include and determine the following:

• Number of Vehicles Involved
• Type of Accident/Mechanism (Rear End Impact, Head On, Roll-Over, etc.) 
• Number of Occupants (Walking Wound vs Entrapment) 
• Potential Fire/Explosion
• Presence of Hazardous Materials (contents stored and/or involved)
• Size / Weight of Vehicle (Commercial Cab, Sedan, Motorcycle)
• Potential for Mass Occupancy (School Buses, Coach Buses, etc.)
• Utilities Involved (Overhead Powerlines or Underground Services)
• Structures Involved (House, Commercial Property and Pole/Sign)
• Vehicle Submerged in Water, Ejected Occupant in the Water or Extrication Near Water
• Need for Additional Resources (Heavy Wrecker, Additional Ambulance or 2nd Tool)

Size-Up (CONTINUED): With any incident or response, size-ups are a continuous process to confirm that efforts and tactics implemented are successful towards the end goal and result. Following your initial size-up report, take charge as the Company Officer and perform a 360 of the scene from a safe distance (25-30’ from incident scene to be clear of hazards and to gain a better perspective) identify additional findings to your crew and incoming units by looking above, below and all around the vehicles involved. This will provide an insight as to whether there are more victims or hazards present than viewed initially from the cab of the apparatus upon your arrival.

Once it has been determined that you can approach for a more detailed survey, conduct an additional 360 or walk around from a closer point of the scene or vehicles involved. 

This is the point where you become the Extrication Boss and need to rapidly progress a plan of action for your crew while continuously monitoring for progress. As the Extrication Boss, you are the eyes and ears of the operation and should NOT be the hands involved. As you linger over the process, keep the following in mind:

• Consider the appointment of a designated Safety Officer
• Have a Back-Up plan should conditions warrant the needed change
• Establish Working Zones (Warm, Cold, etc.) for staging of equipment and transporting units

For most motor vehicle accidents, we tend to find ourselves approaching a group of walking wounded, engine oil on the ground and perhaps minor first aid needing to be provided. By performing the recommended pre-planning and size-up skills, you will increase the likelihood of you being able to adapt accordingly for the time you arrive to more than what was initially expected or reported. Preparing and planning in advance through progressive training is a how Company Officers prepare for operational success. 

AB Turenne is a 22-year veteran of the fire service in Eastern Connecticut. As a Certified Level II Fire Service Instructor, AB's training curriculum has proven to be conducive with the operational needs of those he teaches and in turn has improved the human capital knowledge of many. A graduate from the Master of Public Administration program at Anna Maria College, AB has continued his efforts in training and education by contributing to the Fire Engineering Training Community.