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Post by 3105 on Nov 18, 2007 5:23:31 GMT -5
JDub contacted me and wanted to know what factors should be considered when performing an MVA size-up. "When it comes to sizing up a MVA besides looking for wires down, fluids, and say bodies on the ground what else should one look for?"
Before putting in my two cents, I will caveat that I'm no expert when it comes to this topic...my skills reflect what is being taught in contemporary VX1 classes (did mine at Camden County). I'd like everyone to chime in on this one.
The only other things that came to immediate mind were airbag deployment, other vehicles, access for apparatus, vehicle stability.
My recommendation for initial MVA size-up mirrors that of structure fires: stand back and take in the entire scene from right to left, then slowly narrow your focus inward towards the center. Sounds hokey, but this technique keeps me from target-locking on the obvious while making sure there's nothing on the perimeter that gonna come back to bite me on the patootie. For buildings, that means you're making certain the damn exposures aren't ready to light off; for MVA's that means you're looking for ejected victims, wires on the street, other cars, or any other factor that could possible affect the outcome.
A lot of this goes back to something Lurker touched on in an earlier thread: remaining calm, cool, and collected while making a patient and thorough size-up. Too often IC's feel pressured into a decision simply because the first due is screaming for orders...it's a self-discipline thing that Level 1 staging can help mitigate...I hammer home to my drivers to SLOW DOWN as the approach the scene...look at the area you're about to enter, pick a good position for an engine (structure) or rescue (MVA). Take your time...it'll still be there when we get there.
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hp4l
Division Supervisor 
Remember Your Roots
Posts: 600
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Post by hp4l on Nov 18, 2007 22:24:29 GMT -5
First off, thank you for adding this thread. This is a very common incident in this county.
The size up is very crucial. The calm approach will help you in making a decent size up to help guide you through the incident. Here are some things that I look for, in no perticular order.
How many vehicles are invloved? Too many times we count vehicles that are just bystanders pulled over. Or on the other hand, we may miss a car in the woods. This can be done as you are pulling up and continued as you assess the scene after arriving.
Safety issues such as wires down, comprimised poles, fluids, etc. The safety of the personnel working the scene must be a priority.
Patients. How many, how serious, entrapment, walking wounded. Make sure all personnel have gloves. You may not be treating but you may come in contact with victims.
Resources. Do we have enough BLS and ALS coming. What is needed from the FD side? Do we have a rescue, an engine with a line ready to go in service while we are working, manpower?
If entrapment, how are we going to remove the victim? Door pop, dash roll, roof removal?
Other things to consider also would be airbag deployment, power to the vehicles, and stabilization. I know I'm missing more but that's a start.
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JDub
Forum Assistant Chief
Firefighter
Posts: 192
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Post by JDub on Nov 18, 2007 22:57:23 GMT -5
Papacheese when you say access for apparatus what are some things you mean? I have a pretty good idea but would rather you give me some thoughts first.
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Post by 3105 on Nov 19, 2007 5:54:38 GMT -5
By "access" I mean bst approach and position for the rescue and engine...can they get close enough to deply tools and a protection line? If so, what's the optimal approach route and placement? R3119 has 100 ft reels placed in the rear side compartments, which means if it has to pull nose into the scene, then the first 30 feet will be used just to get past the truck...make sure you have enough room in those situations to get close enough without endangering either the victim or the apparatus.
Another consideration is engine company placement; our procedures dictate that a 1 3/4 be stretched and manned throughout the extrication phase, so make certain you have enough room to position the engine.
Good list Jim....here's a thought I had while reading yours:
What about using a TIC as a part of your MVA size-up?
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Post by laddertruckgoes on Nov 19, 2007 8:28:10 GMT -5
A couple of points of interest I'll add or reitterate<sp?> here...
Arrival and location access tips. Make your blocking position with an engine and leave a 50-100' buffer space. This allows room for the rescue squad and an ambulance or two inside of that space. If you have an additional engine company coming in that's not needed or you need just the manpower, have them take a blocking position beyond the accident, adding a buffer against the oncoming traffic. On the same note, you can have a unit stage 500' to 1000' prior to the scene with it's lights on, on the shoulder. This unit acts as a "prealert" slowing vehicles down as they are approaching the actual scene.
If the highway is divided and/or high speed, it's not a bad idea to get additional resources started from the opposite direction, or even head through the neighborhood so you can access from the opposite side of the other responding units. How many of us have had to pass the MVA on one side of the median and it takes forever to get down to turn around and fight the traffic all the way back up the highway?
On arrival, the vehicle count for our purposes should be the ones that show obvious signs of damage. The FD isn't there for the "unharmed" autos, just the damaged ones. When sizing up, look under every involved vehicle. You should be looking for fluids or other hazards, but you also need to be looking for bodies of pedestrians and ejected victims. I was witness one time to a body found under a vehicle on the NJTP... that was looked over for at least 45 minutes. The look on the tow truck guys face when he made his discovery was priceless.
We're all taught to secure the vehicles by placing them in park and turning off the vehicle. Do you carry short zip-ties in your pockets? Try zip tying the keys to the steering wheel. This prevents them from being lost, and shows obvious that the car has secured. The police or tow drivers all usually carry pocket knives that can cut the keys free when it's time to remove the vehicles.
Vans, Cargo Vans, Box Trucks - Take a hard look at what's in the back of them. They may not carry placards but usually have something not-so-good in them. The WHITE painters vans (The RT130 corridor guys should be all to fammillier with these) usually carry good quantities of strippers, thinners, and varnishers. All of these are highly flammable and simply leaking out onto mufflers and other exhaust componets could spell disaster for the on scene crews. If you have a situation like this, or a large run off, call the county health and hazmat guys quickly. It takes them a little while to get to some places so it's better to start them early. Remember the 3 D's of spill control... Dike, Dam, and Divert.
One other thing to think about, especially during cold periods, is something as simple as where your rig's tailpipe is pointing. You don't want to aim your exhaust right at the scene, especially during cold times when the fumes hang low and don't "air out" too quickly.
Well... my minds numb now... I'm sure others have ideas to share as well!
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Post by 3105 on Nov 19, 2007 9:45:57 GMT -5
Excellent info! I especially like the zip tying of the keys...it's little things like that which can often make a HUGE difference and why this forum can be so damn useful. Sean's comment about painters van's was also right on target, but also be wary of plumbing vans...most of them have at least one acetylene or propane cylinder for soldering. Having been employed in the welding gas industry for over twenty years, it's impossible to describe how much these deadly little bomblets are underestimated: www.youtube.com/watch?v=uUmLe9WCXX0Also, Sean's point about unlabeled is because anything under 1000 lbs aggregate weight (that packaging and contents) does not have to be placarded...and to my estimation, that's a WIDE range! |
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hp4l
Division Supervisor
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Posts: 600
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Post by hp4l on Nov 19, 2007 10:20:12 GMT -5
What about using a TIC as a part of your MVA size-up? [/quote]
Great point. I have used a TIC once to scan the woods for victims. Turned out to be unfounded, but it was a different approach that worked. I think we all get tunnel vision when arriving at MVAs and go right for the rescue tools. Sometimes you need to take an extra minute and think outside of the box.
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hp4l
Division Supervisor
Remember Your Roots
Posts: 600
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Post by hp4l on Nov 19, 2007 10:22:03 GMT -5
Another thing about the vans and placards, the most dangerous trucks on the road are UPS, FedEx, etc. They have no labels and we all know that they can carry anything and everything. Even vehicles can have who knows what piled in the trunk or back seat. This is why the size up needs to start as you are arriving and continue until the assignment is complete.
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Post by 3105 on Nov 23, 2007 12:17:03 GMT -5
 OK...this one has a few wrinkles that sharp-eyed people will catch. You're the first due officer and bystanders are telling you there's a least one person in the vehicle, possibly more. Without sounding too schoolmarmish, walk us through your thought patterns for this incident.... |
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Post by thelurker on Nov 23, 2007 13:16:58 GMT -5
Figure out what those things on the ground are and if they pose an immediate danger, attempt a 360 and victim locating, make contact with the occupants, Start Lapinski for shrub removal services (LOL), Cribbing is the 1st order of business if you can do so without clearing some brush, otherwise clear brush then crib, get the back hatch of that vehicle opened up to try to get patient access, begin other cutting operations (bushes), cut the driver's door or conduct lifting operations if necessary.
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Post by WebBoss on Nov 23, 2007 13:36:54 GMT -5
Figure out what those things on the ground are and if they pose an immediate danger, attempt a 360 and victim locating, make contact with the occupants, Start Lapinski for shrub removal services (LOL), Cribbing is the 1st order of business if you can do so without clearing some brush, otherwise clear brush then crib, get the back hatch of that vehicle opened up to try to get patient access, begin other cutting operations (bushes), cut the driver's door or conduct lifting operations if necessary. Ditto... Except I know of better landscapers with more green cards then Lipinski ;D Lots and Lots of Cribbing... Lots and Lots of careful side panel removal |
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hp4l
Division Supervisor
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Post by hp4l on Nov 23, 2007 14:11:45 GMT -5
Is that rust on the vehicle or something else? Most likely rust, but with the containers in the yard you never know. Were those containers in the car? They seem to have both landed perfectly upright. If they were in the car, are there more?
This is obviously going to be an extensive operation. Do we have the resources we need? Do we have a rescue company or just an engine with a combi-tool? We need a true rescue company for this operation. Are BLS and ALS enroute or on location? Place chopper(s) on standby. Have an engine company stretch a line. I think the other guys hit the rest with brush removal, cribbing, and patient removal.
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Post by 3105 on Nov 24, 2007 6:22:43 GMT -5
Hmmm....really good thoughts perking here...I didn't even notice the containers when I chose the picture, but as everyone pointed out, they could be significant factors depending on what's in them.
The blue container is a liquid sprayer...notice the handle pump. The black container is a bit scary; see the half-circle valve protector? That indicates a gas product under pressure, and since color coding does not exist, we need to read the label before making any committments. My first inclination is acetylene, but that's just a WAG.
Jim: good eye regarding the "rust"....I'm puzzled too and would want to take a closer look...appears too "fresh" to be just rust.
Ditto the other comments: stabilization, chopper, additional rescue company (minimum).
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tootall
Special Operations Command
BurlCoFire EMS Moderator
Posts: 98
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Post by tootall on Nov 25, 2007 20:48:32 GMT -5
Lets assume that those containers are not there....and there is no possiable hazmat.
I am going simple on this one...put a floor jack under the driver rear side enough room for me to get a long 4x4 all the way through. Than using my High lift jacks I will raise the back end off its roof. I will have my crew set up Paratech struts once it is lifted since we all know how unstable High Lift jacks are.
Once that is done I am going to cut the four posts and use the roof if its still intact as a backboard to remove the patient.
Other thoughts...any other cars involved? Any one hit when it came through the front yard?
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Post by opsoverkill on Nov 28, 2007 21:52:24 GMT -5
For the picture good ideas so far. Here is another one.
I am cutting to the ops part to keep it short. Stabilize using the a tension buttress system. Place a ram into vehicle after cutting C post(rear post just incase there is a D-post). lift the vehicle and box crib as you go. This is called Clam shell method. Or you can tunnel thru the rear removing whats in your way thru the rear. (rear door,bench seat etc.)
As for the zip tying the keys to the vehicle. Good idea in the past. but with the newer vehicles they now have proximity keys that activate so of the vehicle system once the keys are close to the vehicle. That includes air bag systems. So the keys should be turned off (that deactivates the air bag systems in most newer cars.) remove keys and place on officer seat of first due engine or rescue.
Here are a few other things that need to be addressed Stabilizing a vehicle should be done with any vehicle that the pt is in and c/o neck or back pain before anyone enters the vehicle. The vehicle can move up to 7 inches while someone is entering a car.
Quick take down. Just putting pt with neck and back pain just from the driver seat to a board is only approved when the Pt is unstable and the Medic needs to have quick access. So, those green things with the fancy different color straps should be used more. Because I feel sorry for the guy who is on the stand with a lawyer holding the green thing (KED) and stating isn't this the device that is the standard of care to pt that are stable and in the vehicle complaining of neck pain?
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