A Car Can Kill You At Zero Miles Per Houror, Rescuer safety and well-being (and the patient, too!)
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There are many hazards that can cause death or injury to rescuers in the performance of their job. In addition to these dangers, the loss of a rescue team member due to death or injury at the scene can further complicate a situation. These events can cause a team to lose its composure and concentration, compromising patient care; therefore, it is important that all rescuers be taught to recognize the problems and dangers that they face during rescue activities.
The following is an attempt to stimulate rescuers to think on their own. Rescuers should always be aware that the same dangers that put them to work can also take them out of action and make them a victim.
The readers must realize that all of the situations they will encounter as rescuers cannot be expressed in this article; however, many of the potential problem areas are mentioned.
A new type of windshield is now found on some cars. This glass has a plastic liner on the passenger side of the glass to help prevent penetration from the inside of the car.
The most common fuels are:
For these dangers we must remove the fuel, and/or remove the oxygen, and/or prevent ignition. The rescuers must also protect the patient, wear protective gear, and have ample fire suppression apparatus on hand, manned and ready to fight fire.
For the dangers of electric cars, we must protect the patient, wear protective gear, turn off the power, and neutralize the battery medium.
Wear protective gear. Be prepared to fight fire and contend with the battery medium.
The main problem that metal poses for rescuers and patients is torn or cut edges. These edges can inflict severe lacerations to those on the scene. The metal is also a source of infection in these lacerations.
Metal is electrically conductive and can create real problems when electrically charged.
Metal can deliver or absorb great quantities of heat very quickly. Hot or cold metal can inflict painful injuries to bare skin.
Cover all sharp edges and all pointed "chrome" parts, protect the patient, and wear protective gear.
A rescue involving a fire in a car should be approached with great caution. Modern cars are filled with plastics; from the dashboard to the back window, and from the headliner to the carpet, modern technology waits to kill you. Burning plastics generate many times of deadly toxic fumes, including hydrogen cyanide gas. The wiring insulation, seats, plastic dash, and all other plastic components in cars will give off these same toxic gases.
In case of entrapment, the first priority is for the rescuers; without their personal protection, they could also become victims. Fire and patient protection are the next priorities. The incident commander must decide whether to first handle the fire or patient protection, or whether to address both problems at the same time. Once these priorities are taken care of, the rescue can begin.
All present should be aware of the toxic gases, and must stay out of the smoke! Rescuers and fire fighters must wear protective breathing gear. Victims should be removed to a safe area if exposed, and oxygen administered as soon as safety allows.
After a few years, insurance companies and the government recognized the dangers of vehicles without bumpers and the advantages of the return to a functional bumper (Ralph Nader at work), which lead to the advent of the hydraulic shock absorber bumper. One bumper system is designed to take a 2.5 mph crash, and the other at 5 mph crash. The front and rear bumbers have shock absorbers.
As usual, problems for the rescuers came with improvements to the bumpers. It is possible that a bumper can be left in a "loaded mode" after an accident. This is caused by uneven pressure on the shock absorber behind the bumper. In this position, the bumber may be released to its original position by pressure on the shock absorber, a change in temperature, or by being struck by an outside force. When the bumper recovers to its proper position, it may move two inches in a millisecond. If an unfortunate rescuer happens to be against that bumber when it recovers, he may experience a serious injury. All vehicles should be checked for "loaded bumpers" and, when found, they should be identified to all rescuers.
(I personally feel that efforts to neutralize a "loaded bumper" are dangerous, redundant activities.)
The shock absorber bumper offers a special hazard in a fire. The heat can cause the shock absorbers to explode, sending the bumper out as far as 150 feet. Look for loaded bumpers and mark them. In case of fire, the fire should be fought from such a position that no one is in danger if the bumper is blown out of the shock absorber. Wear protective gear.
Lying in wait to hurt us are the shock absorbers, the fuel vapor containers, air conditioner gases, the radiator, the batteries, and burning plastics. Under the car is the exhaust system, consisting of the exhaust tubing and the catalytic converter. Let's not forget the fuel pumps located in the fuel tanks that deliver as much as 65 psi at the fuel induction system. Under the hood or deck lid, usually opposite the engine, may be a fuel tank, exposives, hazardous materials, etc.; any one of them might explode, causing injury from flying metal and plastics or a fire.
Most of the fuel systems on new cars are "closed" (not vented). In a fire, this could cause a pressure build-up in the fuel tank(s) and lines. A resulting explosion could give disasterous results, blowing blazing fuel all around the scene.
If the automatic emergency fuel shut-off doesn't activate in an accident, the fuel pumps will keep pumping fuel at as much as 65 psi. If a fuel line is ruptured, fuel will be everywhere waiting to be ignited.
The plastic fuel recovery containers in the engine compartment can cause an increase in the fire and a possible explosion.
The air conditioning system can release gases that may be dangerous to the respiratory tract.
The radiator houses hot water and steam that cause nasty burns.
The battery can cause chemical and thermal burns, and can ignite fuel.
Beneath the car, the exhaust pipes can cause burns to the unprotected skin, and the catalytic converter could start a fire. Wear protective gear and have fire suppression equipment at hand, manned, and ready to fight fire.
The weather plays a very important part in planning a rescue at the scene. Fog, rain, sleet, snow, ice, cold, and heat bear directly on the well-being of the rescuers and the victims alike. In addition to the weater, the terrain - hills, cliffs, tress, and remote areas - offer their own hazards.
Also of concern are the position of the vehicle on the roadway, concentration of traffic, bridges, tunnels, and overpasses.
Incidents in urban areas often require crowd control, while rural incidents will only host those who are involved in the rescue.
Downed power lines and broken gas mains are common dangers that rescuers face.
Fires, hazardous materials, drunk drivers that run through the barriers, the blood of AIDS victims, collapsing buildings, and numerous other items also cause scene problems.
The hydraulic cutters and rams, pneumatic bags, cutters, wrenches, and electrical saws and drills are all used as rescue tools. Whether the operator is well-trained or a novice, these tools can cause death and injury to the rescuer and the victim.
Almost any hand tool can be used as a rescue tool. As long as the tool is used within its limits, it will probably work well. However, there will come a time when, in the heat of the battle, the limits of the tool will be exceeded by the operator. The rescuer, victim, and tool will suffer from this mistake.
Be well trained. Know your equipment. Wear protective clothing.
The items inside a vehicle can cause a rescuer problems. Burning plastics, the occupant's pets, a loaded gun, the occupant, rattle snakes, and things we can't even begin to imagine line in wait to create new chapters in the life and times of the rescuer.
Wear protective gear. Carry a light.
Rescuers must be prepared to face a myriad of situations. No matter how well-trained and prepared they are. something old or new will always be around the corner waiting to challenge them. Burns, cuts, fractures, poisons, and death are too often the reward of well-meaning rescuers and their patients.
There are an infinite number of situations that can be encountered by the rescuer at the scene of a vehicle accident. This is in no way a complete list of the problems the rescuer is likely to face. Rescuers must forever be on the defensive if they are to survive their job.