Brought to you by: Captain Edwards

It should be stressed at this time that this is It should be stressed at this time that this is not a lecture about inter service co operation not a lecture about inter service co operation at RTAs. There are other lectures which deal at RTAs. There are other lectures which deal with this subject. Simultaneous Activity at with this subject. Simultaneous Activity at

Road Traffic Accidents deals with a strategy Road Traffic Accidents deals with a strategy for improving the efficiency of what the Fire for improving the efficiency of what the Fire Service strives for at RTAs - Service strives for at RTAs - The Saving of The Saving of

LifeLife..

““Has anyone heard of the “Golden Hour”? Oh you have; can Has anyone heard of the “Golden Hour”? Oh you have; can you Define it for me please” you Define it for me please”

The Golden Hour is a term coined by the Emergency Services The Golden Hour is a term coined by the Emergency Services and Medical professions to describe the “Perfect Maximum” and Medical professions to describe the “Perfect Maximum”

amount of time that will pass from impact at a survivable* RTA amount of time that will pass from impact at a survivable* RTA through arrival of the various agencies; initial actions; through arrival of the various agencies; initial actions;

Extrication in this example by the Fire Service; until the Extrication in this example by the Fire Service; until the Casualty is in hospital under the care of a trauma team. Casualty is in hospital under the care of a trauma team.

* In this case survivable means a person with injuries that will * In this case survivable means a person with injuries that will not kill in this first hour so long as proper immediate care is not kill in this first hour so long as proper immediate care is

applied; AND they are satisfactorily “delivered to the applied; AND they are satisfactorily “delivered to the Hospital”.Hospital”.

Time Zero; The RTA occurs.Time Zero; The RTA occurs.

Hopefully within ten minutes the first Emergency Hopefully within ten minutes the first Emergency Service personnel attend; in this case, like so many Service personnel attend; in this case, like so many

it is the Police and Ambulance. This is usually it is the Police and Ambulance. This is usually because the general public don’t think of the Fire because the general public don’t think of the Fire Service when they see an accident. Quite quickly Service when they see an accident. Quite quickly

the Paramedics or Police realize that the person(s) the Paramedics or Police realize that the person(s) are seriously entrapped and require the attendance are seriously entrapped and require the attendance

of specialist extrication - The Fire Service of specialist extrication - The Fire Service

Twenty minutes into the Twenty minutes into the incident the Fire Service incident the Fire Service

attend and the Extrication attend and the Extrication proper begins.proper begins.

If the casualty (s) are lucky it may well If the casualty (s) are lucky it may well take only minutes for us to release take only minutes for us to release

them. Unfortunately it sometimes may them. Unfortunately it sometimes may well take over the limit of the hour. In well take over the limit of the hour. In

the above case the Extrication is a the above case the Extrication is a relatively easy one; only 30 minutes.relatively easy one; only 30 minutes.

To continue with this “perfect” To continue with this “perfect” scenario the released casualties scenario the released casualties are evacuated to hospital within are evacuated to hospital within

the allocated sixty minutes of the allocated sixty minutes of the hour.the hour.

Re-Iterate Re-Iterate

Many of you will have heard of or practiced the team Many of you will have heard of or practiced the team approach. approach.

Ask if anyone can define it then show the definition “This is Ask if anyone can define it then show the definition “This is the definition”. (Read out Loud) the definition”. (Read out Loud)

We pre plan for fire from day one of recruit training on the drill We pre plan for fire from day one of recruit training on the drill yard; all positions are numbered; all crew members know their yard; all positions are numbered; all crew members know their

tasks and places. This carries on to the fire ground where tasks and places. This carries on to the fire ground where many of the tasks required at an incident are instinctive. Is it many of the tasks required at an incident are instinctive. Is it not therefore possible to pre plan for RTAs in the same way? not therefore possible to pre plan for RTAs in the same way? RTA Training on a Recruits Course covers a minimum time on RTA Training on a Recruits Course covers a minimum time on

the syllabus.the syllabus.

For a Fire - Re iterate the crew positions and For a Fire - Re iterate the crew positions and tasks, perhaps you could question the tasks, perhaps you could question the

audience about the “Title” of each crew audience about the “Title” of each crew position e.g., “what does No 1 do?” then position e.g., “what does No 1 do?” then flash up the answer; and so on. Show the flash up the answer; and so on. Show the audience that they all know what one to audience that they all know what one to

fives duties are without thinking. Stress that fives duties are without thinking. Stress that this is instinctive.this is instinctive.

For a Fire - Re iterate the crew positions and For a Fire - Re iterate the crew positions and tasks, perhaps you could question the tasks, perhaps you could question the

audience about the “Title” of each crew audience about the “Title” of each crew position e.g., “what does No 1 do?” then position e.g., “what does No 1 do?” then flash up the answer; and so on. Show the flash up the answer; and so on. Show the audience that they all know what one to audience that they all know what one to

fives duties are without thinking. Stress that fives duties are without thinking. Stress that this is instinctive.this is instinctive.

For a Fire - Re iterate the crew positions and For a Fire - Re iterate the crew positions and tasks, perhaps you could question the tasks, perhaps you could question the

audience about the “Title” of each crew audience about the “Title” of each crew position e.g., “what does No 1 do?” then position e.g., “what does No 1 do?” then flash up the answer; and so on. Show the flash up the answer; and so on. Show the audience that they all know what one to audience that they all know what one to

fives duties are without thinking. Stress that fives duties are without thinking. Stress that this is instinctive.this is instinctive.

For a Fire - Re iterate the crew positions and For a Fire - Re iterate the crew positions and tasks, perhaps you could question the tasks, perhaps you could question the

audience about the “Title” of each crew audience about the “Title” of each crew position e.g., “what does No 1 do?” then position e.g., “what does No 1 do?” then flash up the answer; and so on. Show the flash up the answer; and so on. Show the audience that they all know what one to audience that they all know what one to

fives duties are without thinking. Stress that fives duties are without thinking. Stress that this is instinctive.this is instinctive.

For a Fire - Re iterate the crew positions and For a Fire - Re iterate the crew positions and tasks, perhaps you could question the tasks, perhaps you could question the

audience about the “Title” of each crew audience about the “Title” of each crew position e.g., “what does No 1 do?” then position e.g., “what does No 1 do?” then flash up the answer; and so on. Show the flash up the answer; and so on. Show the audience that they all know what one to audience that they all know what one to

fives duties are without thinking. Stress that fives duties are without thinking. Stress that this is instinctive.this is instinctive.

The Officer in Charge In many ways the OiC has all the same responsibilities as at a Fire. •Crew Safety. •Initial Situation Appraisal. •Command and Control. •Supervision. •Tasking. •Liaison with Police; Ambulance; Doctors. •Initiation and Discipline of the Two Metre Zone.

The Glass Manager / Assistant The Glass Manager / Assistant One of the primary tasks when gaining access One of the primary tasks when gaining access

to the Casualty is Glass Management. This to the Casualty is Glass Management. This does not mean that all other Crew Members does not mean that all other Crew Members “Ignore” this job; For instance the Stabilizer “Ignore” this job; For instance the Stabilizer can assist once he’s free. It’s not unusual for can assist once he’s free. It’s not unusual for

the whole Crew less the Medic and OiC to take the whole Crew less the Medic and OiC to take care of this phasecare of this phase

The Medic The Medic The most important job at an The most important job at an

incident - preserving the life of the incident - preserving the life of the Casualty and not worsening their Casualty and not worsening their condition. The Medics only task is condition. The Medics only task is

casualty care. This can involve casualty care. This can involve collaring*, to protect the Cervical collaring*, to protect the Cervical Spine; Survey, to find and treat Spine; Survey, to find and treat

external life threatening bleeds; and external life threatening bleeds; and Airway Management - inclusive of Airway Management - inclusive of

Oxygen Therapy.** Oxygen Therapy.** *Don’t forget that the head has to be *Don’t forget that the head has to be supported in the “Neutral” Position supported in the “Neutral” Position

even if a collar has been fitted. even if a collar has been fitted. **Oxygen Therapy should consist of **Oxygen Therapy should consist of at least 15 litres per minute through at least 15 litres per minute through a therapy mask, the idea being to a therapy mask, the idea being to

flood all tissues with as much oxygen flood all tissues with as much oxygen as possible, given that the blood as possible, given that the blood supply (the oxygen's “transport” supply (the oxygen's “transport”

system) may be limited due to blood system) may be limited due to blood loss through wounds sustained.loss through wounds sustained.

Tool Operator (1) / Stabilizer Tool Operator (1) / Stabilizer As the name suggests this crew member starts the incident As the name suggests this crew member starts the incident

by providing stabilization to the vehicle. This can involve by providing stabilization to the vehicle. This can involve stepped chocks, blocks, wedges and even sections of short stepped chocks, blocks, wedges and even sections of short extension ladder. No one is to mount the vehicle until it is extension ladder. No one is to mount the vehicle until it is

stabilized.* stabilized.* Once the vehicle is safe then full casualty care and Once the vehicle is safe then full casualty care and

extrication can begin. The Stabilizer then reverts to tool extrication can begin. The Stabilizer then reverts to tool operator. operator.

*Be aware that other Emergency services may already be *Be aware that other Emergency services may already be on the vehicle. Don’t be frightened to chase them off; be on the vehicle. Don’t be frightened to chase them off; be

firm, polite and insistent.firm, polite and insistent.

Tool Operator (2) Tool Operator (2) This crew member can assist in This crew member can assist in

stabilization initially; and once the vehicle stabilization initially; and once the vehicle is safe can be preparing and operating is safe can be preparing and operating

separate tools to the first Tool Operator.separate tools to the first Tool Operator.

The Incident must run in set stages: The Incident must run in set stages: Scene Safety; Scene Safety;

Extinguishing Media to Vehicle (and tested); Extinguishing Media to Vehicle (and tested); Stabilization; Stabilization;

Casualty Care; Casualty Care; Battery Disconnect. Battery Disconnect.

The above ensure that the Vehicle is “Made Safe” and the The above ensure that the Vehicle is “Made Safe” and the situation cannot worsen. situation cannot worsen.

The next phases are: The next phases are: Glass Management; Glass Management; Equipment Dump; Equipment Dump; Begin Extrication. Begin Extrication.

There is no reason why a well There is no reason why a well trained Crew cannot achieve several trained Crew cannot achieve several tasks at once during Extrication as tasks at once during Extrication as

well as during the first stages of the well as during the first stages of the incident.incident.

This is the Scenario: This is the Scenario: The vehicle shown has been involved in a side impact The vehicle shown has been involved in a side impact

and there is one Trapped Casualty; The Driver. and there is one Trapped Casualty; The Driver. By this stage the vehicle has been made safe, the By this stage the vehicle has been made safe, the

Medic is with the casualty the Glass has been Medic is with the casualty the Glass has been managed and the Extrication begins. managed and the Extrication begins.

Slide Build: Slide Build: The Assistant provides the Casualty Shield to protect The Assistant provides the Casualty Shield to protect

the trapped person from the cutting tool; the trapped person from the cutting tool; Tool Operator (1) provides the Hydraulic Cutting Tool Tool Operator (1) provides the Hydraulic Cutting Tool

to use adjacent to the Casualty. This tool is easily to use adjacent to the Casualty. This tool is easily controllable, safe and quiet enough to use close to an controllable, safe and quiet enough to use close to an injured person. Cuts - Driver Side “A” and “B” Posts; injured person. Cuts - Driver Side “A” and “B” Posts; At the same time Tool Operator (2) can be getting the At the same time Tool Operator (2) can be getting the Electrical Saw to work. Though not Casualty Shielded Electrical Saw to work. Though not Casualty Shielded the Saw is far enough away from the trapped person the Saw is far enough away from the trapped person to allow safe use. Cuts - Passenger Side “A”, “B”,“C” to allow safe use. Cuts - Passenger Side “A”, “B”,“C”

and Driver Side “C” Posts; and Driver Side “C” Posts; By this stage Tool Operator (1) will have finished with By this stage Tool Operator (1) will have finished with

the Hydraulic Cutters and can begin Door Removal the Hydraulic Cutters and can begin Door Removal with the Hydraulic Spreading tool, again shielded by with the Hydraulic Spreading tool, again shielded by

the Assistant. the Assistant. A further Crew will have arrived by now to lend A further Crew will have arrived by now to lend

support.support.

THANK YOUTHANK YOU

AndAnd

STAY SAFESTAY SAFE