Coffee Table Quick Tips: Vol. 2 - Issue 18

MCI Patient Extraction and the "Mega Mover" Maneuver

Long before my time in the fire service, the job of a firefighter was just that, to respond and extinguish fires. Over the years, many agencies began to adopt new disciplines such as providing emergency medical services (EMS) and mitigating hazardous materials incidents.

Along with the increase in the types of disciplines we now obtain and practice (Paramedicine, Haz-Mat Technician, etc.), we have also had to acquire a specific skillset for operating at mass casualty incidents (MCI) such as active shooters and other acts of violence.

With that, we are now becoming proficient with the donning of tactical combat casualty care (TECC) gear and equipment, performing rapid patient assessments and extracting viable patients out of areas that are NOT conducive to focused patient care and into a designated triage area.

During the initial stages of an MCI, EMS personnel are tasked with performing rapid triage in the field that requires firefighters to properly and systematically identify the most seriously injured patients and identifying them with a specific priority level which will then determine who will receive treatment and transport in the most effective and efficient manner.

Once this initial form of triage is performed (SMART / START Triage is most common practice utilized throughout the US) and the threat has been isolated or controlled, those who are unable to remove themselves from the main incident location and to a designated triage area will need to be done by means of extraction performed by the firefighters on scene.

For this week’s Coffee Table Quick Tip, I want to briefly discuss an extraction maneuver that is extremely easy to implement in the field and requires the use of a Mega Mover and a large carabiner. A Mega Mover is designed for rapid deployment for the purpose of patient rescue, transfer and transport in areas where stretchers cannot fit or are inoperable.

The benefit of the Mega Mover is that they are both cost effective and compact which allows for them to be carried as part of your TECC ensemble and used multiple times at an incident. By simply attaching a folded Mega Mover to the rear/back of your TECC vest and equipping it with a large carabiner, this provides accessibility to a means of rapid extraction when warranted.

Once the patient is ready for extraction, place them in a supine fashion and implement the following steps and the use of the large carabiner:

Steps for one (1) or two (2) firefighter drag w/ large carabiner capture:

1. Lay the Mega Mover out adjacent to the patient.

2. Roll the patient on their non-injured side.

3. Tuck and place the Mega Mover beneath the patient.

4. Roll the patient on their back and onto the Mega Mover.

5. Secure the bottom three (3) handles as depicted in the above photo utilizing the provided large carabiner.

6. Utilizing the sewn in handles provided at the head, one (1) or two (2) firefighters can drag (using proper ergonomics) the patient from the hot/warm zone and out to the awaiting triage area.

Now with the patient secured properly, they can be rapidly dragged over a large area of real estate without becoming labor intensive as it would be to lift and carry them. This extraction maneuver with the Mega Mover and large carabiner allows for the extraction to be done by a single firefighter should the number of firefighters on scene be greatly outnumbered by those needing assistance.

By capturing the three (3) bottom handles and securing them in this manner with the large carabiner, you have essentially prevented him or her from sliding off of the Mega Mover while being dragged to safety and/or the triage area.

This CTQT is far from being earth shattering; however it is another quick tip of the trade that can easily be implemented with minimal equipment and in the end be met with a positive outcome for all parties involved, the rescuer and the patient.

AB Turenne is a 25-year veteran of the fire service and is currently the Captain of Training and Safety with a career department in Middlesex County Connecticut. As a Certified Level III 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.