BY STUART GRANT
On Friday, April 11, 2008, at approximately 2:30 p.m., a driver was traveling south on State Highway 183 near Interstate 35E in Texas with a full load of cement in his truck, estimated to be more than 98,000 pounds. He was en route to a cement pour when, according to him, he swerved to avoid a car that had cut in front of him. This simple act set off a chain reaction that cost one life, sent three people to the hospital, and required the response of urban search and rescue (USAR) specialized equipment and personnel.
State Highway 183 is a six-lane highway divided by a three- to four-foot concrete median. When the driver swerved, his truck struck the median, flipping over it and landing in the highway’s northbound lanes. As the truck landed in the northbound lanes, the cab of the truck was crushed to the hood level and the barrel of the mixer struck a motorcyclist going northbound in the inside lanes. This knocked the motorcyclist off his motorcycle; he ended up on the inside shoulder of the roadway. The barrel of the cement truck also landed directly on a red 2000 Ford Expedition, pinning the driver behind the steering wheel and a five-year-old girl in the floorboard of the back seat. They were later determined to be a mother and daughter on their way home.
With the cement truck upside down, cement began to pour from the barrel onto the vehicle’s hood, into the passenger compartment, and around the front of the car.
THE CALL AND RESPONSE
Dallas (TX) Fire-Rescue’s Dispatch Center received a call of an accident with people pinned at 2:39 p.m. and immediately dispatched Engine 47, Truck 11, Truck 36, and Rescue 73 (a mobile intensive-care unit with two paramedics) under the command of Acting Battalion Chief Troy Carsten, riding Battalion 9. As the accident scene became visible, Carsten called for the Dallas County Sheriff’s Department and the Dallas Police Department to shut down all traffic on the highway northbound. Carsten completed a 360° scene size-up, which assisted him in making a variety of decisions. He called for two heavy-duty wreckers; the activation of the USAR task force, Texas Task Force 2; and two additional rescues.
The motorcyclist was severely injured and lying on the roadway. The driver of the truck was in the cab and also injured but not trapped, and the occupants of the Expedition were trapped in the vehicle with the truck on top of them. This was going to be a lengthy extrication that would require the use of all the additional resources requested. While these additional resources were en route, Engine 47 laid a preconnected hoseline to protect the scene and began treating the injured motorcyclist.
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| (1) As the cement truck came over the highway median, it struck a motorcycle and came to rest on an SUV. Massive damage was done to the front of the vehicle and passenger compartment. [Photos by Billy Bennett, Dallas (TX) Fire Rescue.] |
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| (2) The barrel and rear axles of the cement mixer came to rest on the passenger compartment of the vehicle. The force of the impact trapped a mother and daughter inside the SUV. |
Truck 36’s crew, divided into two teams, began efforts to remove the driver of the cement truck and stabilize it. Since the Sheriff’s Department blocked the roadway, Truck 11 was brought up to the scene to assist in stabilizing the truck with its air bags and cribbing. Both trucks used all of their equipment, but the truck still was not stable.
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| (3) Air bags were positioned on each side of the cement mixer to help stabilize the truck and prevent it from moving from one side to the other. They were also used to lift the truck a few inches to access the patients. |
During these operations, the evaluation of the Expedition revealed that the driver had expired in the accident, but the firefighters heard the cries of a child from somewhere within the Expedition. When the barrel and rear axles of the cement mixer came to rest on the passenger compartment of the vehicle, the driver, the child’s mother, was thrown to her right with the roof of the vehicle sandwiching her upper body between it and the console, crushing and asphyxiating her. It also trapped the lower part of her body between the dash, the pedals, the seat, and the floorboard. Her daughter was riding in the back seat directly behind her and was unrestrained. The force of the impact from the cement truck threw the girl to the floorboard; the front seat, back seat, door, and floorboard were wrapped around her to form a very small void area. She had some cuts from the metal, which ended up being her only injuries. At this point, any movement of the cement truck would have crushed the void area and eliminated any chance of her rescue.
OBJECTIVES
The USAR Task Force, consisting of USAR 15, Truck 15, Rescue 15, USAR 19, Truck 19, Rescue 19, and Battalions 3 and 6, arrived on the scene and were briefed on the ongoing operations. Command of the incident was transferred to Battalion Chief Rudy Valles (Battalion 6), who assigned Acting Battalion Chief Larry Morris (Battalion 3) as the assistant task force leader and Carsten as the safety officer.
The Command officers held a quick meeting to lay out the objectives of the incident and to formulate them into a plan. While this was happening, the motorcyclist and the truck driver were treated for their injuries, packaged in accordance with spinal restrictive measures, and transported to Parkland Memorial Hospital.
The objectives were to stabilize the cement truck, remove the spilled cement, provide victim reassurance, disentangle and remove the child, and recover the mother’s body. These objectives necessitated the involvement of all personnel on the scene. The objectives, broken down into tasks, were the following operations: (1) cribbing, (2) air bags, (3) tunneling, (4) cutting, (5) lifting, (6) extrication, (7) patient assessment and comforting, and (8) body recovery.
Cribbing
The first task was to use cribbing to stabilize the cement truck. All available cribbing off the first two truck companies was already in use, but it wasn’t enough. The cribbing off the two USAR vehicles and the two additional trucks was brought to the scene and used to reinforce what was already being used. This shoring/cribbing effort necessitated some unique shoring because of the angles the mixer of the cement truck created. To accomplish the different types and lengths of cribbing needed, the USAR Task Force set up a cutting operation with its saws and cutting table on both sides of the truck. Lookouts were positioned around the truck so they could watch for any movement and listen for any cracking or movement of the crib stacks.
Air Bags
Air bags were inflated to assist in the stabilization of the truck, but the truck had to be lifted a small distance to create room for the attempted extrication of the little girl. Air bags were positioned on both sides; one person acted as the raising coordinator along with personnel cribbing the truck as it was being raised. The truck was lifted a couple of inches, which the Command officers determined was enough room to attempt the extrication. The cribbing was placed to stabilize the cement truck in this position. Additional air bags were added to keep the barrel of the truck in position instead of rolling to the left or right.
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| (4) Rescuers had to work in a tight space, which made it necessary for them to lie flat on the ground and to basically tunnel their way to the child. The universally accepted practice of maintaining a three-point stance had to be overlooked in this instance. |
Tunneling
The liquid cement had poured out of the back of the cement truck into the vehicle passenger compartment and had spread out in the area around the vehicle, in the direct path of the rescuers who were going to attempt the extrication. A company was assigned to shovel and scoop this material away. As the area was cleared, the extrication operation began.
This was a tedious operation. There wasn’t room to use the tools in the traditional fashion. You could not just “pop” the door or “roll” the dash. This part of the vehicle had been crushed, and pieces of it had to be pried away and then cut from the vehicle. The vehicle was literally being removed piece by piece. As each piece was removed, the rescuers were getting closer and closer to the child. They had to work in a tight space, necessitating that they lie flat on the ground and basically tunnel their way to the child. The universally accepted practice of maintaining a three-point stance had to be overlooked in this instance. The incident safety officer had several assistants monitor the truck, the cribbing, the air bags, and the rescuers.
Cutting
Two heavy-duty wreckers contracted by the TXI Corporation arrived on-scene after approximately an hour. The drivers of the wreckers met with the incident commander (IC) and devised a plan to lift the cement truck so that the car could be pulled from underneath. The lifting capacity of both of these wreckers was more than enough to lift the truck with most of its load still onboard. Large cable slings were positioned around the mixer barrel and the truck frame. They were then secured to each other to make a “lifting” cradle. A lifting officer was designated. He and the safety officer supervised this operation.
Once the slings were in place, the wrecker drivers again met with the lifting officer, the safety officer, the assistant task force leader, and the IC. They discussed all hand signals, evacuation signals, and last-minute directions. Once everyone was ready, the lifting operation commenced.
Lifting, Patient Comforting, Extrication
The wreckers lifted the truck to a height of about four feet. Once at that height, another smaller wrecker pulled the car from underneath the cement truck. This allowed considerably more room to work and extricate the young girl. The roof, door, floorboard, and structural framework were removed using rescue tools. The child was removed from her encapsulated area. Two firefighters were in contact with the child at all times. They rotated to a position on the opposite side of the vehicle and talked to the child to reassure her and explain what was going on around her and what all the noises were. They were able to squeeze through a very small opening and touch her hand to let her know that she wasn’t alone and that someone was always with her. The child and these firefighters were always in a precarious position, because if the truck rolled either way or slipped, they could all be crushed underneath its massive weight.
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| (5) The drivers of the wreckers and the incident commander devised a plan to lift the cement truck so that the car could be pulled from underneath. |
Once the child was removed from the vehicle, the rescuers breathed a sigh of relief. She was turned over to the paramedics, who provided patient care and gave her a stuffed teddy bear. She clutched the bear and wouldn’t let it go. This simple act further eased her fears and helped her make the transition to the new faces and voices. She was transported to Children’s Medical Center. She had minor injuries and was admitted for observation.
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| (6) Large cable slings were positioned around the mixer barrel and the truck frame. They were then secured to each other to make a lifting cradle. |
Body Recovery
The crews vowed to remove the little girl’s mother with as much care and dignity as they had her daughter. The extrication was a challenging process. Again, pieces of the vehicle had to be cut away: The firefighters had to push up the dash, push down the floorboard, and remove the seat mounts. After another hour of struggling and labor-intensive work, she was removed from the vehicle. The finality of the situation had set in. Rescuers knew that nothing could have been done for her, but there was a satisfaction in knowing that her daughter was spared in this tragic incident.
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| (7) After discussing all hand signals, evacuation signals, and last-minute directions, the lifting operation commenced. The wreckers lifted the truck to a height of about four feet. |
LESSONS REINFORCED
• The incident command system (ICS). Use it to some degree at every incident. It may be the company officer overseeing his company or a chief officer overseeing a major emergency. This incident demonstrated that with an effective command system in place, the incident was proactive and maintained accountability throughout. Assignments were given to group commanders based on functional tasks (i.e., cutting team, shoring, lifting, rescue, and so on).
• Company integrity. Maintain company integrity, pairs as a minimum. The best practice is to work as companies. It is the job of the officer to keep account of his crew, and it is the job of the crew to keep up with the officer.
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| (8) Another smaller wrecker pulled the car from underneath the cement truck, allowing rescuers considerably more room to work and extricate the young girl. |
• Accountability. Firefighters must adhere to an accountability system—no exceptions! It is the job of the officer to ensure that this happens. It is also the job of the firefighters to adopt and use the accountability system. This is not hide-and-seek.
All responding personnel should train on and use a consistent system. The accountability systems that responding departments use must be interchangeable so that there is no confusion regarding what department is there, what companies are there, and who is on those companies. The accountability system must indicate the number of personnel on the scene and their identity. Accountability should be faces, not just numbers. The ICS will indicate where those personnel are working.
• Personal protective equipment (PPE). PPE protects the firefighters from the elements they encounter. Make sure all PPE is donned correctly to provide the protection required. Firefighters are the greatest resource we have; make sure that they are completely and consistently protected.
• Resources. Call for the resources you need to handle the situation. Three people cannot do what six people can. Be sure you have enough to accomplish the tasks and fill all of the positions you need. Be sure you can replace and rotate crews during a lengthy operation; good ICs plan for the “what ifs.”
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| (9) The roof, door, floorboard, and structural framework were removed with rescue tools, and the child was removed from the encapsulated area and turned over to paramedics. |
• Rapid intervention team (RIT). ICs must have a committed RIT because the rescue scene is a rapidly changing environment. We lose too many of our people on the roadway and at the scene. We must have a fully equipped team available to come to our rescue. No one else is coming to get us. To the firefighters operating on the scene, RIT members are the most important people on the scene.
• Safety. Assign a safety officer early. Incidents go bad early and unexpectedly. An exclusive set of eyes that has no other duties greatly enhances safety on the scene and helps reduce firefighter injuries. If the incident warrants it, appoint several safety officers to completely cover the scene and ensure the safety of all the rescuers.
• Critical incident stress management. When stress gets out of control, it becomes a destructive force that has a devastating impact on our health, our personalities, our jobs, and our families. A critical incident stress debriefing is an organized approach to supporting personnel to assist in mitigating long-term effects, promoting recovery and return to duty, and preventing stress trauma syndromes.
A debriefing provides a format in which personnel can discuss their thoughts, reactions, feelings, and concerns. As a result, it reduces the stresses that they may be feeling from the exposure to critical incidents.
STUART GRANT, a 30-year veteran of the fire service, is a battalion chief with Dallas (TX) Fire Rescue. He is certified as a master firefighter and fire instructor with the Texas Commission on Fire Protection. He has served as the department’s academy commander, a hazmat officer, a paramedic, and a rope rescue member. He is a leader for the Dallas regional and state US&R TX-TF-2. He also has been an instructor at FDIC; Collin County Community College in McKinney, Texas; and Texas A&M University Municipal Fire School. He has two associate degrees and a bachelor’s degree in fire administration. He has also been recognized by the Center for Public Safety Excellence as a “Chief Fire Officer.”
