Vehicle Extrication

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Video

Long Beach 710

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m Gaining Access. Glass Removal. Stabilization. Gaining Access. Glass Removal. Stabilization. ------An Auto Extrication Overview. An Auto Extrication Overview. COURSE OUTLINE - - Why we do what do. Extrication in the S.H.A.D.E. Anatomy of an automobile. Rip and tear some cars. Why we do what do. Extrication in the S.H.A.D.E. Anatomy of an automobile. Rip and tear some cars.

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m #1 Alcohol #2 Cell Phones #1 Alcohol #2 Cell Phones accidents are… The California Highway Patrol

states the 2 main causes of vehicle

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m philosophy philosophy extricate him or her. extricate him or her. Golden Hour Golden Hour states that the patient’s states that the patient’s dictate the method used to dictate the method used to The The

immediate needs and condition immediate needs and condition

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m 10 10 Minutes Minutes Time available for transport to appropriate medical facility Time available for transport to appropriate medical facility 5 5 Minutes Minutes Time of patient removal & preparation sport for tran Time of patient removal & preparation sport for tran 30 30 Minutes Minutes Time of arrival to complete extrication of patients Time of arrival to complete extrication of patients 10 10 Minutes Minutes Time of notification to arrival of the first units Time of notification to arrival of the first units 5 5 60 Minutes (National Standard) Minutes Minutes

Time of incident to notification Time of incident to notification

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m date date - - . to to 10 10 - - Minutes Minutes Time available for transport to appropriate medical facility Time available for transport to appropriate medical facility 5 5 Minutes Minutes Time of patient removal and preparation for transport Time of patient removal and preparation for transport 30 30 s domestic cars and their s domestic cars and their ’ ’ Minutes Minutes Time of arrival to complete extrication of patients Time of arrival to complete extrication of patients 60 Minutes potential problems. potential problems. potential problems. 10 10 is realistic and can be safely met by is realistic and can be safely met by Minutes Minutes Time of notification to arrival of the first units Time of notification to arrival of the first units GOAL GOAL knowledge of today’s domestic cars and their knowledge of today knowledge of today 5 5 more reasonable time of ten to fifteen minutes This GOAL is realistic and can be safely met by This This Minutes Minutes intensive, uniform training and by obtaining up-to-date intensive, uniform training and by obtaining up intensive, uniform training and by obtaining up

Time of incident to notification Time of incident to notification

The average time for Extrication has to be reduced a

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m 25 25 Minutes Minutes Time available for transport to appropriate medical facility Time available for transport to appropriate medical facility 5 5 Minutes Minutes Time of patient removal and preparation sport for tran Time of patient removal and preparation sport for tran 15 15 Minutes Minutes Time of arrival to complete extrication of patients Time of arrival to complete extrication of patients 60 Minutes 10 10 Minutes Minutes Time of notification to arrival of the first units Time of notification to arrival of the first units (With National Average Extrication Time) 5 5 Minutes Minutes

Time of incident to notification Time of incident to notification

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m is due to long chances of survival. chances of survival. transport times between transport times between Golden Hour is due to long Golden Hour mastering our profession we mastering our profession we in turn increases the patience’s in turn increases the patience’s

appropriate medical centers. By appropriate medical centers. By

increase time for transport which increase time for transport which National Studies have shown that most of the time consumed in National Studies have shown that most of the time consumed in

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m How do we this?

By implementing a Team Approach! By implementing a Team Approach!

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m , and then , and then assigns job functions assigns job functions - - before you do it before you do it whenever possible. whenever possible. plans its moves, trains together plans its moves, trains together - - going to do, trying to follow your plan on the street. going to do, trying to follow your plan on the street. as a unit and pre as a unit and pre THE TEAM APPROACH team pre team pre The TEAM APPROACH means that the The TEAM APPROACH means that the

This is done by talking about what you are This is done by talking about what you are

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m NOT set of actions that attempt to address every conceivable situation. set of actions that attempt to address every conceivable situation. intended to be a rigid plan. set in stone. nor is it intended to be a comprehensive the way Captain would do it. the way instructor taught me. intended to be a rigid plan. set in stone. nor is it intended to be a comprehensive the way Captain would do it. the way instructor taught me. The Team Approach is … … … … … … … … … …

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m is !!! !!! … … The Team Approach the tasks that you expect to perform. the tasks that you expect to perform. well simply a way to organize in advance flexible. creative. and most of all simply a way to organize in advance flexible. creative. and most of all well communicated communicated … … … … … … … … … …

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m safe safe - - Team Approach planning for extrication, it is planning for extrication, it is - - How? How? When pre Immediately using the most fail technique for each given job to be performed. This will help reduce wasted effort and wasted time. essential to learn remove as many variables from each situation as possible. When pre Immediately using the most fail technique for each given job to be performed. This will help reduce wasted effort and wasted time. essential to learn remove as many variables from each situation as possible.

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m Video

HalmatroHalmatro 11 most most There is no such thing as a technique that 100% effective. We should judge the technique we use against a standard of 100%. Use the techniques that work best in cases in order to save time. There is no such thing as a technique that 100% effective. We should judge the technique we use against a standard of 100%. Use the techniques that work best in cases in order to save time.

REMEMBER…

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m AND AND by being well trained. by being well trained. At this point it is important to state that: … … Vehicle Extrication is Dangerous wearing full protective clothing wearing full protective clothing

We as rescuers minimize our own risk by We as rescuers minimize our own risk by

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m out jacket/Brush out pants. out jacket/Brush out pants. - - - - Helmet. Eye Protection. Turn Turn All leather gloves or extrication gloves. Optional: Hearing protection jacket. Helmet. Eye Protection. Turn Turn All leather gloves or extrication gloves. Optional: Hearing protection jacket.

P.P.E. Consists of:

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m Dangerous Dangerous any more significant damage. any more significant damage. Vehicle Extrication is Vehicle Extrication is in a controlled manner and without creating in a controlled manner and without creating

We minimize risk to our patients by extricating We minimize risk to our patients by extricating

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m scene scene will create an will create an By applying By applying S.H.A.D.E. you S.H.A.D.E. you environment to environment to better control the better control the extrication. acronym to extrication. acronym to Extrication in the S.H.A.D.E. assist you with assist you with

S.H.A.D.E. is an S.H.A.D.E. is an

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m up up – – Size Stabilization Scene Management Safety Size Stabilization Scene Management Safety

S.H.A.D.E

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m Size - up Size - up enroute enroute … … Begins with dispatch Continues Relay exact location & best egress to other incoming units Once on scene, determine the following Begins with dispatch Continues Relay exact location & best egress to other incoming units Once on scene, determine the following

S S

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m s s ’ ’ scene? scene? - - ? ? evaluate incident status evaluate incident status - - What is on What is on – – … … enroute enroute What is Is anything else needed? Apply the 5 W What is Is anything else needed? Apply the 5 W Number of patients Severity of the injuries Level of entrapment Resources Hazards present Continually re Number of patients Severity of the injuries Level of entrapment Resources Hazards present Continually re a. b. a. b.

Determine the 1. 2. 3. 4. 5. 6. Size – up… 1. 2. 3. 4. 5. 6. Determine the

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m ) and the ) and the … … vehicle(s vehicle(s long, the vehicle long, the vehicle - - a a - - ) will determine ) will determine vehicle(s vehicle(s Stabilization stabilization needs. ground/pavement. itself, air bags, high lift jacks, etc Involves increasing the number, size and total area of contact between the Orientation of Consider cribbing, come stabilization needs. ground/pavement. itself, air bags, high lift jacks, etc Involves increasing the number, size and total area of contact between the Orientation of Consider cribbing, come

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m Interior Zone Hot Zone Warm Zone Cold Zone Interior Zone Hot Zone Warm Zone Cold Zone Scene Management

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m … … Scene Management Activities inside the vehicle. Includes personnel and equipment necessary for patient care and treatment. Activities inside the vehicle. Includes personnel and equipment necessary for patient care and treatment. Interior Zone Interior Zone

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m … … Scene Management Immediately adjacent to vehicles being worked on, only those personnel directly involved in patient care or extrication operations should be inside this perimeter. Immediately adjacent to vehicles being worked on, only those personnel directly involved in patient care or extrication operations should be inside this perimeter. Hot Zone Hot Zone

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m (with (with … … Personnel and apparatus not currently involved in patient treatment or extrications Personnel and apparatus not currently involved in patient treatment or extrications Scene Management Equipment cache Firefighter with pressurized hotline Command Post Pumper supplying hotline Staging area for: Equipment cache Firefighter with pressurized hotline Command Post Pumper supplying hotline Staging area for: - - - - - air bled out) - - - - - air bled out) Warm Zone Warm Zone

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m … … Ambulance Staging Media Onlookers Ambulance Staging Media Onlookers ------Scene Management People and equipment not directly involved in the rescue effort. People and equipment not directly involved in the rescue effort. Cold Zone Cold Zone

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m Safety Spine stabilization as soon safely Spine stabilization as soon safely - - possible. All personnel wearing PPE with eye protection Lighting for night responses Identify slip/trip hazards C Cover patient before starting more aggressive maneuvers possible. All personnel wearing PPE with eye protection Lighting for night responses Identify slip/trip hazards C Cover patient before starting more aggressive maneuvers Rescuer Patient Rescuer Patient

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m Hazard Control Hazard Control

S.H.A.D.E

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m … … Hazard Control H Fuel Leaks Fire suppression Traffic Control Crowd Control Hazardous Materials Involvement Electrical Involvement Fuel Leaks Fire suppression Traffic Control Crowd Control Hazardous Materials Involvement Electrical Involvement Consists of Consists of

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m foam foam ” ” B B “ “ Hazard Control H Secure with class Control leaks if possible (wax toilet ring, golf tee or putty) Dike spill or use a small container to reduce size Secure with class Control leaks if possible (wax toilet ring, golf tee or putty) Dike spill or use a small container to reduce size Fuel Leaks Fuel Leaks

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m Hazard Control … … FIRE CONTROL FIRE CONTROL t protect our patient. t protect our patient. ’ ’ H Continuous application of foam HOTLINE Note: Foam obscures vision and slickens surfaces Note: Tests show both boosters combined do not provide enough GPM to protect the nozzle man from volume of fire produced by the amount gasoline found in a passenger vehicle, if it should ignite unexpectedly! If they will not protect you definitely won Note: Foam obscures vision and slickens surfaces Note: Tests show both boosters combined do not provide enough GPM to protect the nozzle man from volume of fire produced by the amount gasoline found in a passenger vehicle, if it should ignite unexpectedly! If they will not protect you definitely won Continuous application of foam HOTLINE

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m … … coming traffic, coming traffic, - - … … … … … … Hazard Control Trains, tow trucks, etc.. Trains, tow trucks, etc.. - - H FWY City Streets calling Cal Creating a ring around the scene, heaviest vehicle between site and on leave space for buffering in case apparatus is struck by another vehicle. FWY City Streets calling Cal Creating a ring around the scene, heaviest vehicle between site and on leave space for buffering in case apparatus is struck by another vehicle. Law enforcement responsibility on Expedite CHP/PD by Position apparatus by Law enforcement responsibility on Expedite CHP/PD by Position apparatus by Traffic Control Traffic Control

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m … … Hazard Control H Law enforcements responsibility; Military Police, Airport Security or Public Service can assist with barriers Law enforcements responsibility; Military Police, Airport Security or Public Service can assist with barriers Crowd Control Crowd Control

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m , , … … Chemtrec Chemtrec … … … … … … Hazard Control coming units of coming units of - - hill wind hill wind - - - - H They will begin required notifications Health Department, Hazmat Unit, Safe approach Up Up Responsible party, OES, etc They will begin required notifications Health Department, Hazmat Unit, Safe approach Up Up Responsible party, OES, etc Notify Dispatch May initiate calls to the Notify in Notify Dispatch May initiate calls to the Notify in Hazardous Materials Involvement Hazardous Materials Involvement

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m 15 15 – – … … … … higher higher much much Hazard Control … … ) ) Street lights are a minimum of 220 volts Street lights are a minimum of 220 volts H amps, most are Call SCE or appropriate company Call Public Service Note: Do not disconnect unless active arcing/sparking is occurring, with fuel spilled. If not, leave connected seats, for use with power door locks, windows, hatch releases and steering columns. amps, most are Call SCE or appropriate company Call Public Service Note: Do not disconnect unless active arcing/sparking is occurring, with fuel spilled. If not, leave connected seats, for use with power door locks, windows, hatch releases and steering columns. Downed Lines Damaged street/traffic lights Battery(ies Downed Lines Damaged street/traffic lights Battery(ies Electrical involvement Electrical involvement

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m Access Assess Assist Access Assess Assist

S.H.A.D.E

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m … … … … Access A TRY BEFORE YOU PRY TRY BEFORE YOU PRY Trying simple maneuvers. Remember to Utilize the vehicle, slide seats back, tilt steering wheels, power doors, etc Remove glass Note: more complex techniques accomplish the same in case simple techniques are unsuccessful goal, Trying simple maneuvers. Remember to Utilize the vehicle, slide seats back, tilt steering wheels, power doors, etc Remove glass Note: more complex techniques accomplish the same in case simple techniques are unsuccessful goal, Gain access to the patent by... Gain access to the patent by...

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m … … Access Ray Ray - - A It is the most common contaminate of patients wounds Invisible to X Once mixed with blood impossible to see visually Cannot be irrigated out of wounds Wound usually heals with glass slivers/chips still inside with continues to irritate/delay healing until the skin grows out and naturally sloughs the glass off. It is the most common contaminate of patients wounds Invisible to X Once mixed with blood impossible to see visually Cannot be irrigated out of wounds Wound usually heals with glass slivers/chips still inside with continues to irritate/delay healing until the skin grows out and naturally sloughs the glass off. Notes about Glass Removal Notes about Glass Removal

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m if the if the ” ” Assess s injuries, treatment s injuries, treatment ’ ’ Smash & Grab Smash & Grab A “ “ Example: Remove the roof and extricate patient utilizing KED board. Example: Remove the roof and extricate patient utilizing KED board. Asses the patient needed and level of entrapment Consider patients are critical without physical entrapment Asses the patient needed and level of entrapment Consider patients are critical without physical entrapment

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m Assist s s ’ ’ 2 2 IV IV A Spine stabilization Spine stabilization - - C High flow O Dress bleeding Large bore C High flow O Dress bleeding Large bore Begin Treatment Treatment should begin and continue while access is gained throughout the extrication process. Begin Treatment Treatment should begin and continue while access is gained throughout the extrication process.

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m Disentanglement Disentanglement

S.H.A.D.E

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m Disentanglement … … D

Process of removing the vehicle away from around the patient with a minimum of manipulation of the patient by Process of removing the vehicle away from around the patient with a minimum of manipulation of the patient by

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m Door vehicles Door vehicles - - Door vehicles Door vehicles - - Disentanglement technique on 2 technique on 2 ” ” Pillar Removal on 4 Pillar Removal on 4 D ” ” B Third Door B Third Door Door removal Force seats Move pedals “ “ Hatch back considerations Roof Removal Dash/Firewall Push Door removal Force seats Move pedals “ “ Hatch back considerations Roof Removal Dash/Firewall Push

Note: Disentanglement take place after simple maneuvers have failed. Note: Disentanglement take place after simple maneuvers have failed.

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m … … Process of removing the vehicle away from around the patient with minimum of manipulation of the patient by Process of removing the vehicle away from around the patient with minimum of manipulation of the patient by Disentanglement

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m Disentanglement D … …

Process of removing the vehicle away from around patient with minimum of manipulation the by Process of removing the vehicle away from around patient with minimum of manipulation the by

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Disentanglement Door Removal and Pillar/Post

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Disentanglement Roof Removal

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Disentanglement Dash Push

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m Extrication Extrication

S.H.A.D.E

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m Extrication E

Patient packaging and removal with minimal manipulation, thereby minimizing aggravation of any injuries. Patient packaging and removal with minimal manipulation, thereby minimizing aggravation of any injuries.

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m VICTIM INSIDE VICTIM INSIDE Stabilization Principles of Vehicle accident scene is because there a accident scene is because there a reason we manipulate a vehicle at an reason we manipulate a vehicle at an

It is important to remember that the only It is important to remember that the only

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m Stabilization

Principles of Vehicle

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m Stabilization There is usually more than one There is usually more than one Principles of Vehicle way to stabilize a vehicle. Most rescue way to stabilize a vehicle. Most rescue ” ” right right situations will call for multiple stabilization techniques that will evolve as the rescue proceeds. “ Remember: With this in mind lets define and explain the purpose and goal of stabilization. situations will call for multiple stabilization techniques that will evolve as the rescue proceeds. “ Remember: With this in mind lets define and explain the purpose and goal of stabilization.

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m Stabilization Principles of Vehicle

DEFINITION: The process of assessing for potential movement the vehicle followed by practical application of the necessary tools and equipment to reduce or eliminate that movement. DEFINITION: The process of assessing for potential movement the vehicle followed by practical application of the necessary tools and equipment to reduce or eliminate that movement.

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m ). ). AND AND vehicle(s vehicle(s Stabilization Principles of Vehicle

PURPOSE of: To prevent more extensive injuries to the victims involved by reducing or eliminating any further movement of the To make a safer working environment for the rescuers as they operate in or around vehicles. PURPOSE of: To prevent more extensive injuries to the victims involved by reducing or eliminating any further movement of the To make a safer working environment for the rescuers as they operate in or around vehicles.

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m ) and the ) and the vehicle(s vehicle(s Stabilization Principles of Vehicle

Primary GOAL: To increase the surface area and number of contact points between the ground to prevent further movement. Primary GOAL: To increase the surface area and number of contact points between the ground to prevent further movement.

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m Vehicle Position Terrain or Location Understanding the potential for Vehicle Movement Vehicle Position Terrain or Location Understanding the potential for Vehicle Movement Stabilization

Factors in Assessing Vehicle Stability: 1. 2. 3. 1. 2. 3. Factors in Assessing Vehicle Stability:

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m determining the determining the … … main factor main factor stabilization technique used. This is the stabilization technique used. This is the Vehicle Position Vehicle Position

Stabilization

Ch.25 Ch.25

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m … … Vehicle Position As seen before vehicles can be found upright, on their side (less than halfway over or more than halfway over), on their roofs, top of or under another vehicle, or on top of a victim. Vehicle Position As seen before vehicles can be found upright, on their side (less than halfway over or more than halfway over), on their roofs, top of or under another vehicle, or on top of a victim.

Stabilization

Ch.25 Ch.25

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m … …

Terrain or locations Terrain or locations Stabilization

Ch.25 Ch.25

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m … … A steep, muddy embankment will obviously necessitate different stabilization methods than will flat, dry ground. A car upright on flat pavement will be relatively simple to stabilize compared to a care overhanging freeway overpass. A steep, muddy embankment will obviously necessitate different stabilization methods than will flat, dry ground. A car upright on flat pavement will be relatively simple to stabilize compared to a care overhanging freeway overpass.

Terrain or Location Stabilization Terrain or Location

Ch.25 Ch.25

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m of movement as related to of movement as related to … … 5 basic principles 5 basic principles Horizontal movement Vertical movement Roll movement Pitch movement Yaw movement Horizontal movement Vertical movement Roll movement Pitch movement Yaw movement 1. 2. 3. 4. 5. 1. 2. 3. 4. 5. There are vehicle extrication. There are vehicle extrication.

Understanding the potential for vehicle movement Understanding the potential for vehicle movement Stabilization

Ch.25 Ch.25

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m : : … … The vehicle can move backwards and forwards. The vehicle can move backwards and forwards.

Understanding the potential for vehicle movement Horizontal movement Stabilization Understanding the potential for vehicle movement Horizontal movement

Ch.25 Ch.25

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m : : … … The vehicle can move up or down in relation to the ground. The vehicle can move up or down in relation to the ground. Stabilization

Understanding the potential for vehicle movement Vertical movement Understanding the potential for vehicle movement Vertical movement

Ch.25 Ch.25

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m … … s side may rock back and forth or s side may rock back and forth or ’ ’ : : The vehicle can move from side to side. A vehicle on it roll over. The vehicle can move from side to side. A vehicle on it roll over.

Understanding the potential for vehicle movement Roll movement Stabilization Understanding the potential for vehicle movement Roll movement

Ch.25 Ch.25

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m s rear end. s rear end. s front end ’ s front end ’ ’ ’ … … : : The vehicle can move up or down on its lateral axis, causing the vehicle to rise or fall in relationship it The vehicle can move up or down on its lateral axis, causing the vehicle to rise or fall in relationship it

Understanding the potential for vehicle movement Pitch movement Stabilization Understanding the potential for vehicle movement Pitch movement

Ch.25 Ch.25

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m s vertical axis, s vertical axis, ’ ’ s front and rear ends to s front and rear ends to ’ ’ … … : : The vehicle can rotate on it causing the vehicle move right or left in relation to their original position. The vehicle can rotate on it causing the vehicle move right or left in relation to their original position.

Understanding the potential for vehicle movement Yaw movement Stabilization Understanding the potential for vehicle movement Yaw movement

Ch.25 Ch.25

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m … … Cribbing Other tools Cribbing Other tools

Stabilization Equipment consists of many different tools, for ease we will break the tools into two categories 1. 2. Stabilization 1. 2. Stabilization Equipment consists of many different tools, for ease we will break the tools into two categories

Ch.25 Ch.25

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m … … Cribbing is ideally made of rough cut lumber because the rough surfaces grip together better. Cribbing is ideally made of rough cut lumber because the rough surfaces grip together better.

Cribbing Stabilization Cribbing

Ch.25 Ch.25

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m s. s. ’ ’ s and 4X4 s and 4X4 ’ ’ … … Basic pieces of cribbing carried in 24 inch lengths, and made of 2X4 Basic pieces of cribbing carried in 24 inch lengths, and made of 2X4 STRAIGHT CRIBBING STRAIGHT CRIBBING

Stabilization

Ch.25 Ch.25

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m … … inches from each end. inches from each end. Never point load unsupported wedges. Never point load unsupported wedges. ½ ½ They are used to increase surface area contact, snug up cribbing, fill voids, or take slack as needed when lifting. These need to rest on a 2X4 or 4X4 base. 24 inch pieces of 4X4 lumber cut diagonally starting 2 to 2 They are used to increase surface area contact, snug up cribbing, fill voids, or take slack as needed when lifting. These need to rest on a 2X4 or 4X4 base. 24 inch pieces of 4X4 lumber cut diagonally starting 2 to 2

WEDGE CRIBBING Warning: Stabilization Warning: WEDGE CRIBBING

Ch.25 Ch.25

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m lift jacks and air bags. lift jacks and air bags. - - … … Also referred as base plates are 24 inch by inch squares made by laminating 2 layers of one inch plywood. Base cribbing provides a platform from other rescue tools such as Hi Also, they are used in conjunction with high and low pressure air bags to provide a solid base free of sharp objects and debris. Also referred as base plates are 24 inch by inch squares made by laminating 2 layers of one inch plywood. Base cribbing provides a platform from other rescue tools such as Hi Also, they are used in conjunction with high and low pressure air bags to provide a solid base free of sharp objects and debris.

BASE CRIBBING BASE CRIBBING Stabilization

Ch.25 Ch.25

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m … … True Platform Step Cribbing True Platform Step Cribbing 1. Box Cribbing 2. 3. 1. Box Cribbing 2. 3.

Uses of and types cribbing Uses of and types cribbing Stabilization

Ch.25 Ch.25

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m tie cribs, they are tie cribs, they are - - Also referred to as cross made from dimensional lumber or STRAIGHT CRIBBING stacked on opposing layers. Also referred to as cross made from dimensional lumber or STRAIGHT CRIBBING stacked on opposing layers.

Box Cribbing: Box Cribbing: Stabilization

Ch.25 Ch.25

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m When the box crib is When the box crib is s laid side by side, the completed s laid side by side, the completed ’ ’ Are 4X4 stack is in firm contact with the vehicles frame. It is important to build the crib as square as possible to maximize stability. square, it can ONLY be built twice as high is side (2:1 ratio). Irregularly shaped crib systems are limited to a 1:1 ratio. Are 4X4 stack is in firm contact with the vehicles frame. It is important to build the crib as square as possible to maximize stability. square, it can ONLY be built twice as high is side (2:1 ratio). Irregularly shaped crib systems are limited to a 1:1 ratio.

Box Cribbing: Warning & General Rule: Box Cribbing: Stabilization Warning & General Rule:

Ch.25 Ch.25

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m When building a box crib for use with the air bags, build a solid top layer to support the air bags. When building a box crib for use with the air bags, build a solid top layer to support the air bags.

Box Cribbing: Box Cribbing: Stabilization

Ch.25 Ch.25

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m Used to as a 4 point stab ilization for the vehicle. Constructed of a 2X6 base with 2X4 stacked on top, each 5 inches shorter than the other. Used to as a 4 point stab ilization for the vehicle. Constructed of a 2X6 base with 2X4 stacked on top, each 5 inches shorter than the other.

Step Cribbing: Stabilization Step Cribbing:

Ch.25 Ch.25

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m x crib, but the lumber is x crib, but the lumber is times is necessary in heavy times is necessary in heavy laid side by across each layer so that no void the crib. It is not usually used in spaces exist within auto extrication but many It is the most material intensive cribbing. a solid platform, constructed like a bo rescue. platform, constructed like a bo laid side by across each layer so that no void the crib. It is not usually used in spaces exist within auto extrication but many It is the most material intensive cribbing. a solid rescue.

True Platform: Stabilization True Platform:

Ch.25 Ch.25

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m This is the standard complement of cribbing carried by most truck companies. It consists of: This is the standard complement of cribbing carried by most truck companies. It consists of: 4X4X24 Straight Cribs 2X4X24 Straight Cribs 4X4X24 Straight Cribs 2X4X24 Straight Cribs - - - -

STABILIZATION KIT: 20 30 15 pairs of wedges 15 pairs of 4 step cribs Stabilization STABILIZATION KIT: 20 30 15 pairs of wedges 15 pairs of 4 step cribs

Ch.25 Ch.25

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m aced with wood aced with wood … … Can be used for quick stabilization especially when a car is on its side but should be repl cribbing for an extended extrication. car is on its side but should be repl Can be used for quick stabilization especially when a cribbing for an extended extrication. Lift Jacks Lift Jacks - -

Other Tools Hi Stabilization Other Tools Hi

Ch.25 Ch.25

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m … … This is one of many new systems that have been developed in place of high lift jacks. They all have strengths and weakness. Find out what your department has and know how to use them. This is one of many new systems that have been developed in place of high lift jacks. They all have strengths and weakness. Find out what your department has and know how to use them.

Other Tools RESCUE 42 Stabilization Other Tools RESCUE 42

Ch.25 Ch.25

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m … … along along - - Can be used in conjunction with a substantial anchor point to eliminate further vehicle movement. Can be used in conjunction with a substantial anchor point to eliminate further vehicle movement.

Other Tools Cable come Other Tools Stabilization Cable come

Ch.25 Ch.25

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m s s ’ ’ … … sion and susceptibility to sion and susceptibility to … … weakest component! weakest component! These components have different strength These components have different strength All can be used to attach an unstable vehicle a substantial anchor point to eliminate movement. Warning: ratings, resistance to abra chemical degradation. All can be used to attach an unstable vehicle a substantial anchor point to eliminate movement. Warning: ratings, resistance to abra chemical degradation. Any system is only as strong it Any system is only as strong it

Other Tools Chains, cables, slings, webbing and rope Other Tools Stabilization Chains, cables, slings, webbing and rope

Ch.25 Ch.25

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m … … service after this type of service after this type of rescue rated rope, slings, rescue rated rope, slings, ” ” Life Life “ “ … … use. Remember that webbing, etc. should be used only in extreme cases and should then be taken out of should then be taken out of use. Remember that webbing, etc. should be used only in extreme cases and

Other Tools Chains, cables, slings, webbing and rope Other Tools Stabilization Chains, cables, slings, webbing and rope

Ch.25 Ch.25

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m STABILIZE STABILIZE - - … … Should only be used in conjunction with wood cribbing. It must be understood that these are LIFTING devices and not stabilizing devices, as such DE objects when ever used in a lifting evolution. Should only be used in conjunction with wood cribbing. It must be understood that these are LIFTING devices and not stabilizing devices, as such DE objects when ever used in a lifting evolution. Stabilization

Other Tools High and Low Pressure Air Bags Other Tools High and Low Pressure Air Bags

Ch.25 Ch.25

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m … … … … Tow trucks, cranes, Heavy Rescue etc Tow trucks, cranes, Heavy Rescue etc

Other Tools Auxiliary equipment Other Tools Stabilization Auxiliary equipment

Ch.25 Ch.25

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Ch.25 Ch.25

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m Specific Methods of Vehicle Stabilization

AsAs mentionedmentioned inin GeneralGeneral PrinciplesPrinciples ofof VehicleVehicle StabilizationStabilization thethe factorfactor determiningdetermining thethe stabilizationstabilization methodmethod usedused isis thethe positionposition thethe vehiclevehicle comescomes toto restrest in.in. ThisThis sectionsection willwill dealdeal onlyonly withwith specificspecific methodsmethods forfor stabilizingstabilizing vehiclesvehicles foundfound inin thethe 55 mostmost commoncommon positions.positions. quick look …A

Anatomy

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m quick look …A

Anatomy

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m Less than half way More than half way On their roofs Nose down Less than half way More than half way On their roofs Nose down Up right On a side Upside down Up right On a side Upside down a. b. a. b. a. b. a. b. The 5 most common positions…

1. 2. 3. 1. 2. 3.

Ch.25 Ch.25

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m Upright Upright

The 5 most common positions…

Ch.25 Ch.25

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m … … Less than half way Less than half way The 5 most common positions… On a Side On a Side

b. More than half way a. a. b. More than half way

Ch.25 Ch.25

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m … … The 5 most common positions… On their roofs On their roofs Upside down Upside down

b. Nose down a. b. Nose down a.

Ch.25 Ch.25

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What you could see…

Ch.25 Ch.25

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Still more…

Ch.25 Ch.25

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Still more…

Ch.25 Ch.25

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Still more…

Ch.25 Ch.25

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m What are some considerations?

Still more…

Ch.25 Ch.25

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m The most common positions… serve as a starting point in your stabilization efforts and may evolve into more complicated methods as the extrication continues. represent basic, straight forward, and well tested means of stabilizing vehicles in various positions. serve as a starting point in your stabilization efforts and may evolve into more complicated methods as the extrication continues. represent basic, straight forward, and well tested means of stabilizing vehicles in various positions.

Remember: these basic methods only The methods discussed in this section Remember: these basic methods only The methods discussed in this section

Ch.25 Ch.25

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m s hands are never to be placed on top s hands are never to be placed on top ’ ’ ABSOLUTE RULES: As cribbing is built and set in place, the rescuer Cribbing can only be stacked twice as high the base is wide. Lift an inch, crib inch. Place crib systems at strong structural components only (Frame, roof rails, etc.) not at point where the is only sheet metal. Build cribbing is to not impede access the patient. of the cribbing or directly under lad being cribbed. As cribbing is built and set in place, the rescuer Cribbing can only be stacked twice as high the base is wide. Lift an inch, crib inch. Place crib systems at strong structural components only (Frame, roof rails, etc.) not at point where the is only sheet metal. Build cribbing is to not impede access the patient. of the cribbing or directly under lad being cribbed.

1. 2. 3. 4. 5. 1. 2. 3. 4. 5.

Ch.25 Ch.25

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m … … s. s. points. points. The quickest and easiest method is using 4 step cribs. Pull or remove the valve stem. Slash the tires Build cribbing at the same Use caution with this and all other method The quickest and easiest method is using 4 step cribs. Pull or remove the valve stem. Slash the tires Build cribbing at the same Use caution with this and all other method a. b. c. d. a. b. c. d. VECHILE UPRIGHT

Four Point Stabilization: Four Point Stabilization:

Ch.25 Ch.25

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m point with step cribbing). point with step cribbing). - - Crib in front of the rear wheel wells (Similar to 4 Coming from the front of vehicle, slide one step crib or other between the two front tires until it rests under a frame cross member or under the engine block itself. Crib in front of the rear wheel wells (Similar to 4 Coming from the front of vehicle, slide one step crib or other between the two front tires until it rests under a frame cross member or under the engine block itself. b. a. a. b.

Three Point Stabilization: Three Point Stabilization:

VECHILE UPRIGHT

Ch.25 Ch.25

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m More than halfway (or resting against their roofs). More than halfway (or resting against their roofs). Less than halfway (or resting against their wheels). Less than halfway (or resting against their wheels). VEHICLE ON ITS SIDE Will come in one of two positions

Ch.25 Ch.25

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m A vehicle on its roof will have a tendency to overturn the upside down position. A vehicle on its roof will have a tendency to overturn the upside down position. A vehicle on its wheels will have a tendency to overturn to the upright position. A vehicle on its wheels will have a tendency to overturn to the upright position. VEHICLE ON ITS SIDE Will come in one of two positions

Ch.25 Ch.25

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m it into place. it into place. ” ” for the vehicle to rest in for the vehicle to rest in … … Lock Lock ” ” “ “ Cradle Cradle is important to understand this concept vehicle on its side is to build a “ and to is important to understand this concept vehicle on its side is to build a “ and to

The basic principal of stabilizing a When stabilizing a vehicle on its side it VEHICLE ON ITS SIDE The basic principal of stabilizing a When stabilizing a vehicle on its side it

Ch.25 Ch.25

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m … … . Never . Never very unstable very unstable it into place remember it into place remember ” ” person at either end of the person at either end of the - - Locking Locking “ “ push a vehicle to test is stability. Place a safety vehicle to monitor movement. Due to being on its side, fuel tank and lines may empty their contents quickly. push a vehicle to test is stability. Place a safety vehicle to monitor movement. Due to being on its side, fuel tank and lines may empty their contents quickly. Vehicle on its side is Vehicle on its side is

While While

1. 2. 3. VEHICLE ON ITS SIDE 1. 2. 3.

Ch.25 Ch.25

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m Locate where the pillars meet the roof , here the strength of the structure is best place to build a box crib. Locate where the pillars meet the roof , here the strength of the structure is best place to build a box crib.

VEHICLE ON ITS SIDE To stabilize…

Ch.25 Ch.25

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m Wedges at various points along the car does not come in contact with the ground. Wedges at various points along the car does not come in contact with the ground. VEHICLE ON ITS SIDE To stabilize…

Ch.25 Ch.25

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m … … jack jack - - lift Jacks lift Jacks - - High High … … Do not over Do not over Undercarriage side are usually the first step in stabilizing from the undercarriage side. Undercarriage side are usually the first step in stabilizing from the undercarriage side. VEHICLE ON ITS SIDE To stabilize…

Ch.25 Ch.25

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m …

If there is clearance between the tire and the ground, slide cribbing under the wheel until it is in contact with the metal wheel, not just the tire rubber. VEHICLE ON ITS SIDE To stabilize If there is clearance between the tire and the ground, slide cribbing under the wheel until it is in contact with the metal wheel, not just the tire rubber.

Ch.25 Ch.25

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m lift Jacks lift Jacks s parallel to s s parallel to s - - ’ ’ ’ ’ Place 4X4 Place 2X4 Use wedges to fill the Place 4X4 Place 2X4 Use wedges to fill the After the Hi are used: - the car body about 10 to 12 inches away from the car. - perpendicular to the car with one end under the car frame and the other resting on the 4X4. - voids. After the Hi are used: - the car body about 10 to 12 inches away from the car. - perpendicular to the car with one end under the car frame and the other resting on the 4X4. - voids.

VEHICLE ON ITS SIDE To stabilize…

Ch.25 Ch.25

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m If the vehicle is more than half over, start on the roof side. Use two jacks at the front and rear of the vehicle. Cribbing can be used as needed. If the vehicle is more than half over, start on the roof side. Use two jacks at the front and rear of the vehicle. Cribbing can be used as needed.

VEHICLE ON ITS SIDE To stabilize…

Ch.25 Ch.25

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m … … present one of two ways its roof with the nose and rear off the ground. present one of two ways its roof with the nose and rear off the ground.

A vehicle on its roof will First, resting solely on VEHICLE ON ITS ROOF To stabilize… A vehicle on its roof will First, resting solely on

Ch.25 Ch.25

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the vehicle to this the vehicle the vehicle to this the vehicle Secondly, resting with the font of hood and the front roof rail resting on the ground. position. The weight of the engine block force will position. will force will Secondly, resting with the font of hood and the front roof rail resting on the ground. The weight of the engine block

VEHICLE ON ITS ROOF To stabilize…

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m s center of s center of ’ ’ When the vehicle is positioned nose down, there are only 2 contact points between the vehicle and the ground. The vehicle gravity is now located some where between these two point. Stabilize as quickly possible. When the vehicle is positioned nose down, there are only 2 contact points between the vehicle and the ground. The vehicle gravity is now located some where between these two point. Stabilize as quickly possible.

VEHICLE ON ITS ROOF To stabilize…

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m sheet sheet ” ” unitize unitize “ “ The windshield The windshield Compromised Compromised

Construction of today's smaller , economy cars usually metal construction. has to be in place and intact order for the cars to pass government rollover tests. windshields pose a risk to patient and rescuer alike. Construction of today's smaller , economy cars usually metal construction. has to be in place and intact order for the cars to pass government rollover tests. windshields pose a risk to patient and rescuer alike. VEHICLE ON ITS ROOF To stabilize…

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m Examples of Cribbing crib some of the most common positions. crib some of the most common positions.

CRIBBING 101

CRIBBING 101 The following slides are to give ideas on how The following slides are to give ideas on how

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m This picture shows a car on its side with the bottom layer of the box crib built perpendicular to the vehicle, allowing the entire crib to be slid into place. Note: the rescuer is also showing proper hand placement; hands to the sides of the cribbing and not under the load. This picture shows a car on its side with the bottom layer of the box crib built perpendicular to the vehicle, allowing the entire crib to be slid into place. Note: the rescuer is also showing proper hand placement; hands to the sides of the cribbing and not under the load.

Cribbing 101

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m … … point point easily easily - - Vehicle on its roof Crib the center at rear window and two at the front corners where the fire wall meets the side body of the car (3 stabilization). Advantage: built up if lifting vehicle to get the patient out. Vehicle on its roof Crib the center at rear window and two at the front corners where the fire wall meets the side body of the car (3 stabilization). Advantage: built up if lifting vehicle to get the patient out.

Cribbing 101

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m … … Crib the nose of Crib the nose of st st Vehicle on roof, nose down 1 the vehicle. Wedges tapped in along the front. This is to keep the vehicle from sliding. Vehicle on roof, nose down 1 the vehicle. Wedges tapped in along the front. This is to keep the vehicle from sliding.

Cribbing 101

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m … … Vehicle on roof, nose down Another example of the same procedure using Straight Cribbing. Vehicle on roof, nose down Another example of the same procedure using Straight Cribbing.

Cribbing 101

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m ” ” B B “ “ pillar pillar ” ” C C Step cribs are used at the fire wall Jacks at the Box cribs near the “ This takes the vehicle from 2 points of contact to 6 points of contact. Pillars Step cribs are used at the fire wall Jacks at the Box cribs near the “ This takes the vehicle from 2 points of contact to 6 points of contact. Pillars 1. 2. 3. 1. 2. 3.

Cribbing 101

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m KEEP IT SAFE KEEP IT SAFE Stabilization

KEEP IT SIMPLE KEEP IT SIMPLE

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