Introduction
One experience that seems universal when a medic or EMT reveals their occupation, is the initial reaction of “you must love blood and guts. After sharing that in reality only 10-15% of all EMS calls nationally are trauma related, and that of those only 27% are motor-vehicle crashes they often seem confused. The sensationalized media and entertainment industry has trained the public to believe that EMS manages trauma – when we actually handle medical related emergencies more than any other.
Despite this reality, when the call for a motor vehicle, agricultural, machinery or industrial accident does come in, we must be prepared and trained to respond. In this article, we will focus on the very small portion of accidents that require extrication – statistically 1:20. But when extrication is necessary, an orchestrated execution is critical. In this article we will review some basis elements of extrication, as mastery of this skill, requires deep didactic and practical application; both of which are outside the scope of this series.
Vehicle extrication remains one of the most technically demanding and high-stakes operations in the fire and rescue service. Unlike the early days of extrication when brute force and cutting through everything was the standard, modern heavy rescue emphasizes scene safety, systematic assessment of vehicle construction, and technique selection based on injury patterns and vehicle kinematics. This article focuses on the operational perspective of the truck and rescue squad member responsible for managing extrication from initial size-up through patient delivery to EMS.