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Extrication for the EMT?

I hope everyone’s summer went well. You know we tend to do less training in the summer, due to the heat, vacations and other family things. Now that fall and winter are here, our training will probably pick up some, as it should. Of course, when you read this, we will be into or finishing the holidays and the winter months will be upon us. You want to be prepared for the season as vehicle crashes tend to pick up during this time. We see more increment weather along with the increase of intoxicated drivers. You need to be safe out there as well.

I have taught EMT and paramedic classes for quite awhile. Now I am taking an EMT refresher class, because I got busy and let my CE hours slip up on me. The ironic thing is, our lead Instructor was a student in a class I helped teach a while back. The Instructor has now become the student, and the student the Instructor. Although even as an Instructor, I am always learning from my students. Oh, and by the way, my EMT Instructor is actually doing a pretty good job, which says a lot coming from an old critical rascal like myself.

When I was teaching EMT some years back, we dedicated an entire day to vehicle extrication. I also did a 12 hour block in the paramedic curriculum on vehicle extrication. But now, over the past few years, this has pretty much been removed from the course outline. I do realize that some schools and Instructors still teach some of this, but it is not really required any longer. My question is, should it be? My personal feelings on this matter, yes it should. Now, I am going to explain to you why I think so.

When we take our EMT class we spend an entire chapter on the human body along with terminology. When we are certified and begin working in the field, we use only a small portion of what we learned. However, it gives us the ground work for a lot of the assessments and treatments that we perform. So having this background knowledge is essential in what we do as an EMT. As an EMT, you will perform lifesaving functions at vehicle crash scenes and assess many patients over your career. Having some basic extrication knowledge will make you better at this and help you make better decisions at the scene. Most importantly, it will help you work better with the team performing the extrication and have a better understanding of what they are doing and why.

First, the EMT needs to understand the basic types of crashes and the anatomy of a vehicle. Understanding how a vehicle is constructed and especially newer vehicles, could help save your life and prevent injury to the rescuers, or further injury to your patient. With new technologies of today, we are dealing with a multitude of airbags in a single vehicle and they all do not deploy utilizing power from the battery system. We also have seatbelt pre-tensioners that can utilize pyrotechnic devices. Having a better knowledge of this could help you and your patient.

Now, what about understanding the basics of vehicle extrication and the tools used to perform these extrications? Is the patient just trapped or are they pinned? Is there a difference in the two? I think a good base knowledge of these things is pertinent to the job as an EMT, even if it is not your responsibility to do the actual extrication work. You need to understand what is being done and why. This opens up your ability to assist if needed and know what is going on at the time.

I think that spending at least 8 hours learning about basic extrication is a must for all Emergency Medical Technicians, especially if they don’t get it in their EMT class. We are seeing more and more Fire Departments taking over rescue as the medical side becomes more advanced and involved. Both fire and EMS need to work hand in hand to get the job done for the benefit of the patient. Each group questioning the other is not the best way to achieve the greater outcome, it is a combined effort. So how can we make this situation better?

Well, I don’t see the EMT curriculum changing on my account or opinions, so I guess we have to look at making the change at the local level. How do we do that? First, we make sure our own training is up to par. Then, we invite our local EMS folks to our departmental extrication classes and let them participate in some of the hands on evolutions. This will aid them in understanding how difficult things can be sometimes. Invite them to classroom training as well, especially if you are covering new vehicle technologies. The more we strive to work together, the better we will all perform on the street.

We may not be able to change things on a grand scale, but we can sure start by changing things on a local scale. Perhaps over time, folks making those important curriculum decisions will see to add some things back into the outlines they produce. Always keep safety first, and don’t be afraid to “think out of the box.” Feel free to email me at Reds100@aol.com and you can, visit our website at www.RedsTeam.com. Hope everyone had a very merry Christmas and may God bless you and your family this coming year.

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