Access
Take the time to access and look at the seriousness of injury and level of entrapment . This is important because it may be easier or more difficult to free the casualty than first thought .
• What is the extent of injury ?
• What are the priorities of the medical team ?
• Do you actually need to lift ? Is it possible to free a limb through manipulation , cutting and removing a shoe , digging around the area ?
Plan
Talk to the medical team and provide them with extrication options with consideration to their needs , and develop a PLAN A , PLAN B and PLAN C :
PLAN A
PLAN B
PLAN C
Develop and communicate this plan first ! is textbook , taking time to ensure careful release and the best possible casualty outcome .
is a quick extrication where spinal alignment is cared for and controlled but the priority is release .
is the time critical extrication , it is the plan you need to present to the paramedic from the start , because you need a ‘ get out of jail card ’ for when everything turns for the worse and the paramedic says “ ok people we are now time critical and we need to move the casualty immediately !”
• You should develop PLAN C first , followed by PLAN B and finally PLAN A . Discuss these with the paramedics as they are developed : o “ If we need to get the casualty out urgently , we could implement PLAN C ( describe the plan ), but it may have these risks or impacts ( briefly describe ). o If we have more time , we could do PLAN B ( briefly describe the plan ) instead . It will take X minutes longer . There are still these issues ( briefly describe ). o If we have as much time as we need to do this as well as possible , we will go with PLAN A ( briefly describe the plan ). This will take X minutes , but we believe will eliminate all detrimental impacts to the casualty or risks to the casualty .
• Developing PLAN C first may seem counterintuitive , but once the rescue starts and the team become task-focused it will be harder to discuss alternatives . You have PLAN C ready from the start even though it appears that the casualty is conscious and talking with no obvious or critical injuries and you most likely have sufficient time for a more methodical rescue . At any stage you should be able to revert to PLAN C if the casualty ’ s condition deteriorates and they require emergency release . Having a suitable PLAN C is key to reducing the pressure and stress if and when the casualty ’ s condition deteriorates .
• Call the rescue team in together and quickly run through PLANS A , B and C and then confirm if anyone has any concerns or suggestions because you may have missed something obvious .
• Within all the plans , there are backup plans , but these are more focused on techniques . For example , if the high-pressure air bags are too big to fit into a limited space , then the backup may be a hydraulic bottle jack , if it is not possible to place the bottle jack and lift vertically because the ground is solid but uneven , then the next plan might be to use carefully placed cribbing to allow for this .
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