Safe Rescue from an Overturned Vehicle: Since an overturned vehicle on its roof is not a very common occurrence in vehicle extrication, rescuers need to decide, based on the patient’s condition, whether to perform a safe extrication along the patient’s long body.
A quick decision has to be made, given that in general the patient has been suspended upside down in the seat belt for 10-15 minutes up to this point.
Securing the vehicle includes securing the accident site, assessing the situation, fire safety and securing the vehicle with a sturdy support.
Due to the weight of its engine, an overturned vehicle will often come to rest with its rear end pointing slightly upward. A quick initial stabilisation with wedges positioned under the rear corners of the roof allows the “inside rescuer” to make a rapid assessment of the patient’s condition after establishing Initial contact. Initial contact can be achieved through a window broken during the accident or through a window removed at a safe distance from the patient during glass management.
Battery management must also be considered carefully for this kind of accident because it is impossible to adjust the position of battery-operated seats to facilitate the extrication without battery power.
Expanding access through the rear end for safe extrication can be done by removing the rear door or window and removing the back seats. Every action needs to be scrutinised in terms of the time involved: could there be a faster and simpler approach? At the same time, open the door next to the patient for emergency access. If the patient’s condition deteriorates, this door can be used to quickly perform an immediate extrication after freeing the patient.
As part of a safe extrication, in addition to removal of the back seat bench, the vehicle can be hinged open like a clamshell if needed in order to make more room for the patient. However, before starting work, consider whether the extrication can also be performed without the clamshell approach or which benefits compensate for the additional time required.
To free the legs, a spreader or rescue ram can be used to enlarge the footwell under the dashboard. Shortening the vehicle’s steering wheel spokes can make the later rescue easier.
The transfer to the ambulance from the vehicle calls for good coordination among the rescuers. The patient should be pressed upwards into the seat by two rescuers. At the same time, insert a spineboard or scoop stretcher into the footwell between the patient’s thighs and the dashboard. Match the upward movement of the seat by slowly pushing the stretcher upwards. When the separation between the pelvis and the spineboard or scoop stretcher is small enough, cut the belt and extricate the patient from the vehicle face-down and in the direction of the long axis of the body.
It should take around 12 minutes for an experienced team to perform the extrication from an overturned vehicle if the patient is not trapped. However, the rescue can last up to 45 minutes in the case of freeing a trapped patient.