Stabilizing upright vehicles?

[NJWacker]

In motor vehicle crashes, when do you need to stabilize a vehicle if its upright? Recently I was on a crash and the fire department was dispatched along with us like they are on every crash. Our ambulance arrived before the fire department did. We had two vehicles involved and vehicle 1 had 1 critical pt in the car and another was out claiming to be uninjured. The second vehicle had 2 walking wounded and 1 delayed. Anyway, vehicle 1 was upright and we assessed the critical pt and began to do a rapid extrication of the pt. The fire department arrived shortly after and began stabilizing the vehicle while we were removing the pt. Do all vehicles with a pt inside technically need to be stabilized prior to pt removal? If they do, then the vehicles would need to be stabilized prior to gaining access to the pt even if the vehicle is upright. Meanwhile I was recently on another crash and the vehicle was upright and another township fire company was on location prior to our arrival and they did not stabilize the vehicle.

[IAMedic]

It depends on the fire department's SOP's. Our FD may or may not stabilize the vehicle. We will let them cut the power and block the tires, but if there is a chance of the vehicle rolling or danger to the responders in any way, we will let them stabilize the vehicle. Most, let's face, most of your vehicles that are sitting upright don't need stabilization. But, it should be determined on a case by case situation and not mandatory on each call. If you mandated it on each call, you will probably just slow EMS response times to gain access to the patient.

[chrnea]

Ditto here. fire has safety command of all accident scenes. They determine the need for stabilization. It is imperitive that we understand their guidlines for stabilization because we could arrive onscene first. (not a problem here since I am with fire as well) but typically an upright vehicle on flat surface won't be stabilized. If there is the slightest chance for roll or if we have to do any cutting then the vehicle will be chocked and stabilized.

[Weruj1]

also see here ............... this forum RULES ! http://cms.firehouse.com/forums2/forumdisplay.php?s=&forumid=290

[Dave1983]

In motor vehicle crashes, when do you need to stabilize a vehicle if its upright?

EVERYtime you are going to c-spine a patient that is still in the vehicle, regardless of the need to "cut".

[dburnemti]

If there is extrication involved the vehicle gets stabilized. Takes away from the what if scenario and makes me feel safer while doing the extrication. It doesnt take long to do put in 4 step blocks on a vehicle that is upright. That short amount of time is worth your safety and the safety of your parrtner and Pt.

[strippel]

EVERY TIME the vehicle needs stabilized.

Even today, minor chain reaction, 3 vehicle crash. 2 out walking, uninjured. One still in the car, acting "goofy". Low speed, low impact, almost no damage, all cars still drivable. No fluids down. Anyway, even before we looked in the car, made sure the car was in park, the brake on, and the engine off, which the Po had already done. Tires even were up against the curb. We had our bus and the cruiser blocking enough of the travel lane for safety.

BTW, Goofy was on his way to his workmans comp doctor appointment. I do believe he was looking for a "free ride".

[Firescueguy]

If your fire co. is taking the time to chock the car EVERYTIME, I'd say let them do it. Practice makes perfect & if they chock EVERY car EVERY time,there won't be any problem when they need to do it "for real". With the fire co. that serves my district, you're lucky if they chock the car when it IS a heavy rescue.

As long as the FC allows you to assess/treat the pt. while they are chocking (shouldn't be a problem unless the vehicle is not stable yet), I don't see a problem with it...it only makes you, your crew & the pt. safer. Considering you had a critical pt., it sounds like a good idea to get the car chocked 'cause you're gonna get a lot of people jumping into the mix & you don't want that car going anywhere...the car may seem stable without chocks but once you've got 15 people crawling all over the vehicle, you will have some movement...this is not the time to find out that the car is still mobile.

Let me say that in 19 years, I've seen several situations where chocking an unright vehicle would have been QUITE beneficial. Here's one example...minor MVA, simple door pop needed, 2-3 EMT's in car immobilizing pt., PD ESU (let's not start ragging on ESU cops now, that's not the intent here...our brother FF's have made plenty of "OOPS" over time) sticks tool in door, starts spreading the jaws & the car begins to slowly roll down the street...:eek:

Here's another..I was on this one...appeared to be relatively minor MVA, simple pt. remov al right?? WRONG...pt. became unstable, needed rapid extrication (which he got), only problem was driveshaft had snapped & car was slowly (very slowly) beginning to roll down the street...pt. was rapidly deteriorating so my chief says "get 'em out NOW, I'll hold the car" which he did...drained the front tire quick & held the bumper with his foot!! Is it a perfect solution to the problem?... NO!! Did it work??...ABSOLUTELY...we rapidly extricated the pt. (we do this a lot so we're used to doing to getting it done rapidly..hence the name...:D)...pt. was extricated, packaged & rapidly transported. I know in a perfect world we should have called the FC & had them chock the car but hey when you've got a rapidly decompensating pt. rolling down the street in an unstable car, you gotta do what you gotta do, ya know... ;)

So to just repeat myself, YES..the car whether upright or not should be chocked...if nothing else, it's practice for junior members. If we do the right thing for the everyday "little ones", then the "big one" isn't such a big deal.

Just my 2 cents...Stay Safe...and chock the car!!! :) ;)

P.S. - As a reminder, it is YOUR job as the interior rescuer to
make sure the car is turned off, keys removed (handed to PD)
& the emergency brake activated to make it safer for all
responders including yourself. Don't assume that the chief
did it!!!