Preview F&R Q2: Should there be an international standard for vehicle extrication?

Published:  19 May, 2014

F&R asked three different professionals active in the rescue industry what their thoughts were on standardising extrication procedures internationally.

Jaap de Geus, registered nurse, ambulance paramedic and registered senior SAVER instructor for Falck, Netherlands

Yes, working with an international standard has a lot of benefits. First of all we speak the same (extrication) language. By utilising a systematic approach we can avoid the pitfalls such as invalid stabilisation techniques, knowing where the risks are during the incident, and how to create space for the patient's treatment. 

In my opinion, it is evident that firefighters and ambulance paramedics should be trained according to the same system. Our common goals are to deliver the patient into the hands of the emergency physicians as soon as possible.

By training together you create understanding for each other’s work and as well awareness of possibilities and challenges. Communication about time frames during extrication is very important, because it delivers the flexibility to adjust the plan and this is important for all disciplines in rescue.

An international standard will simplify communication between car manufacturers, who will have a frameworkby which they can communicate with firefighters and rescue teams about new developments in car construction, which in turn can be reciprocated with professional feedback used for further development of new car technologies with greater occupant safety, and which are safer to cut.

In my years as an international SAVER (Systematic Approach to Vital Emergency Response) instructor, I have been teaching the SAVER method in different countries. Every country has its own way of carrying out and instructing extrication techniques. It is a pleasure to see other ways of working, and in most cases a rescuer will take new insights home.

By teaching the SAVER method in those countries we have been able to provide people with a structural approach to extrication and rescue, while they still operate with some of their own techniques.

In conclusion, yes, there should be an international systematic approach, such as for instance the seven steps of the SAVER method. A unified systematic and global approach will still enable rescue professionals to use the techniques that they have become accomplished at, with the same competencies, rules and regulations. It is imperative that fire and rescue professionals everywhere train multidisciplinary to create a better understanding.

John Curley, Watch Manager, CSTT and partnership liaison manager, Dorset Fire and Rescue Service, UK

Pre-1960 in the UK when a serious road traffic accident in which passengers were trapped occurred a firefighter would be dependent on the availability of the local garage mechanic and his tools to extricate patients. This approach continued for many years during the 1960s and improved only because the number of vehicles on the road were multiplying year on year with the consequential rise in road traffic collisions (RTCs).

However, what became evident very quickly was the different ways in which RTCs were dealt with by the rescue services and that it was an area that needed urgent review to ensure that time spent at RTCs was efficient and effective with a successful outcome.

All the knowledge and experience that had been accrued from RTCs had further honed the techniques and training of personnel. But, more importantly, it was the sharing of this information with neighbouring services; the consequence of which resulted in each service setting up its own standard operating procedures (SOPs).

The difficulty arises when it is necessary for an individual/team to work with a different organisation and a different set of SOPs. Whilst both organisations operate to the highest levels there will always be disagreement over which way is best.

Perhaps it is time that a National Guide was produced so that all Fire and Rescue Services within the United Kingdom are working to the same standard. This could then be a springboard to improvement within rescue services globally.

An example of internationalism within the rescue services is the annual World Rescue Challenge, which is held at different venues around the world. Those countries that enter have to train and comply to an international standard on which the competitors are judged; a perfect example of international co-operation.

This can be extended in time to include other important aspects of Fire and Rescue so that eventually we will end up with a global standard and we are all singing from the same hymn sheet.

Johan van den Haak, product specialist ResQtec  Zumro, Netherlands

Worldwide the level of extrication techniques and knowledge varies enormously – not to mention the availability and capability of extrication tools. To therefore put effort in creating international standards seems logical. Because, honestly, wouldn’t we all prefer the same level of professional help should we get involved in an accident, no matter where it might occur? But let me ask you this: is the success of an extrication procedure solely set by the international standards it is based on?

From the rescuer's view, international standardisation of techniques enables efficient and effective extrication. Experience tells us that successful extrication is achieved by a combination of different elements: knowledge, skills and adequate tools. Creating international standards should add to this: they should provide the rescuer with a basic level of skills and knowledge. It then remains the manufacturer’s noble task to provide the rescuer with tools that can deal with the internationally standardised extrication approaches. In other words, only when manufacturers really add to the effectiveness of international standards can one truly achieve success.

To achieve this, manufacturers should change their approach in selling their products. They need to stop the battle for having the ‘biggest, baddest and strongest’ tool. A battle in which tools are the soldiers and specifications their weapons. Of course manufacturers would claim that tools are an important factor in any extrication operation and that better specifications mean a bigger chance of  success. But we constantly seem to ignore that tools from different brands are simply all capable of doing what they are made for. No matter what the specifications are or the pressures they operate at. True power of a tool lies not in its strength – the right application is key. A truly powerful tool is one that is capable of dealing with as many applications as possible. In other words, the more a tool becomes a true extension of the rescuer’s arms and hands, the better it is. And only manufacturers have the power to make that happen.

When establishing successful extrication standards, an important role is therefore assigned to the manufacturers; their role is to design tools that are not based on being the best on paper, but solutions that really make the difference and support standardised approaches. One such solution is the ResQtec Octopus concept; a series of integrated tools that embed the best of all worlds. Its use enables a wide approach with unlimited applications for any extrication scenario. Simple, effective and designed for doing what tools should do: help rescuers deal with the various and difficult scenarios they face. In the end it all comes down to this: only by developing tools and solutions that actually add to the effectiveness of international standards can we (as manufacturers) start raising the bar for the next generation of rescuers. Only then will international standards really contribute to an ever-growing success rate of rescue operations around the world.

  • Operation Florian

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