Chapter 37: Vehicle Extrication and Special Rescue

Vocabulary terms and definitions covering vehicle extrication phases, safety systems, hybrid vehicle precautions, technical rescues, trench rescues, and tactical EMS operations.

Extrication

The removal of a patient from entrapment or a dangerous situation or position.

Entrapment

A condition in which a person is caught within a closed area with no way out, or has a limb or other body part trapped.

Loaded Bumpers

Shock-absorbing vehicle bumpers that remain compressed following a collision and can suddenly release, causing severe injury to rescuers' knees and legs.

Airbag Lubricant Haze

A harmless cloud of cornstarch or talc powder released inside the passenger compartment when airbags deploy, which can cause lung and eye irritation.

Spider-Web Pattern

A characteristic circular pattern of shattered glass on a windshield indicating that an occupant's head, face, or neck likely struck the glass during a collision.

360-Degree Walkaround

A complete walk around a crash scene conducted during size-up to identify hazards, assess mechanisms of injury, and determine the number of vehicles and patients involved.

Danger Zone (Hot Zone)

The unsafe perimeter immediately surrounding a hazard, such as downed power lines or leaking fuel, which emergency medical personnel must remain outside of until it is secured.

High-Voltage Cables

Typically orange-colored electrical cables in hybrid and electric vehicles that carry lethal current and may require up to $10\text{ minutes}$ to de-energize after the main battery is disconnected.

Support Operations

An extrication phase consisting of scene lighting, designating equipment staging zones, and establishing and marking helicopter landing areas.

Rapid Extrication Technique

A team procedure designed to move an urgent, non-entrapped patient from a sitting position inside a vehicle to a supine position on a backboard in $1\text{ minute}$ or less.

Simple Access

Gaining entry to a trapped occupant quickly and directly without utilizing any tools or forcible entry methods, such as opening an unlocked door or rolling down an unjammed window.

Complex Access

Gaining entry to an entrapped occupant using specialized force and tools, such as hydraulic spreaders, pneumatic cutters, or window glass removal techniques.

Preparation Phase

The first phase of the extrication process, which involves ongoing responder training and routine inspection of tools and response apparatus before dispatch.

Termination Phase

The tenth and final phase of extrication, involving returning units to service, checking and sanitizing equipment, restocking medical supplies, and completing necessary documentation.

Confined Space Rescue

A technical rescue operation requiring specialized equipment and training to extricate individuals trapped in restricted enclosures with limited egress, such as grain silos, pipes, or underground tanks.

Trench Collapse

An excavation cave-in where falling dirt weighing approximately $100\,\text{lb}$ per cubic foot covers victims, preventing chest expansion and rapidly causing hypoxia.

Trench Rescue Staging Distance

A mandatory perimeter requiring all emergency vehicles to park at least $500\,\text{feet}$ away from a cave-in with their engines shut down to prevent vibration-induced secondary collapse.

Shoring

Specialized timber or mechanical supports placed along trench walls to prevent further soil collapse before rescue personnel enter to perform extrication.

Tactical Emergency Medical Support (TEMS)

Medical care provided by specially trained clinicians integrated with law enforcement SWAT teams to treat patients in high-threat or hostile environments.

Tactical Command Post

A secure coordination site established out of a suspect's direct line of sight and out of firearm range where EMS units stage during police tactical operations.