Pretty Good MVA

So the other night at work we had a one vehicle accident with rollover and entrapment. With all the recent safety features on vehicles, its rare for us to actually use the things we've trained with. So the fact that we got to roll on an accident where we used multiple rescue tools, extricated a patient and went to the hospital with four medics on a major trauma was pretty cool.

This call was a great reminder that even though we don't use extrication tools, rip up many cars and even run on many major traumas, we are still expected to be proficient and save peoples lives when these situations do happen. Its just like training with fire and its actually just as dangerous.
 So here's some ideas I've picked up from the internet and the smarter guys I've worked with on how to make a gnarly MVA a successful one on the rescue side;

1. Have a Good Scene Size Up. This is where you are taking in hazards to you and the patients involved as well as painting a picture for dispatch, other guys coming to the scene and responding departments. Starting out with two main goals of patient care and safety now will set the tone for the rest of the call.

2. Patient Access and Vehicle Preparation. Here is where you get a count of how many patients you have, a quick look at their conditions and have command start getting appropriate resources for transport. Its also at this time that the vehicle needs stabilized. Learning to properly crib and chock a vehicle is an art of sorts so remember to train on that. Glass should be managed and power should be cut off ASAP at this point. Keep in mind that all the while, there should be someone making continual contact with patients and preparing to give hands on medical care (this person should not be on both knees in case the vehicle rolls).

3. Medical Treatment and Making Space. As soon as there's space in a stable vehicle, someone should be delivering hands-on care to the patients inside. Starting with c-spine is good and work toward what is necessary in treating the patient's condition while crews work outside the vehicle. Covering the patient to protect them from glass and debris is important as well. The best care you can probably give though is just being a presence thats supportive with these people in a very scary moment. Don't leave them. Also, while crews continue to work outside the vehicle gaining access, cribbing should be continually modified to keep the vehicle stable.

4. Packaging, Removal and Clean Up. When access to the patient has been achieved, its time to safely remove the patient. Whether you use a rapid roll-out technique or not is going to depend on the situation. But as a rule of thumb, extrication generally requires backboarding. If possible, cover jagged areas so rescuers and patients aren't injured. When the patient is removed, if you are not helping with care and transport, its time to help clean up debris, control and take care of spills and provide a safe work zone with lighting and manpower.

Now this isn't perfect and there's no set of rules that will be applicable to every wreck but so far, these tips have helped me put it all together on some of the scenes I've worked at.