BY LES BAKER
It’s possible to use many dif-ferent types of hand tools in vehicle extrication, and you should use them whenever possible. Most of these are the same as those used in structural firefighting and are readily available at the scene of a collision; they are useful when hydraulic tools are committed elsewhere or are not readily available. In certain instances, they can help speed up operations involving hydraulics, reciprocating saws, and chisels.
One generally overlooked hand tool is a well-maintained pair of bolt cutters, which can be used where the material must be cut in a controlled fashion and where space does not allow the use of larger tools. The bolt cutter is most effective on relatively thin material that can easily fit within the tool’s jaws. When working in close proximity to the victim, bolt cutters are generally safer than other types of cutting devices. Below are some situations in which bolt cutters can be used efficiently and effectively during vehicle extrication.
HEADREST REMOVAL
Removing the headrest can provide advantages for rescuer access and patient removal. Although the headrest can be used to help stabilize the head and spine during extrication, some headrests have a forward position that does not allow for easy backboard positioning, such as when laying the seat back for patient egress following roof removal. Always try to use the headrest’s own mechanism to remove it. If that method doesn’t work, simply clip the headrest guides and push the remaining stubs back into the seat back (photos 1, 2).
 (1) Photos by author. |
 (2) |
During patient removal after a tunnel operation, removing the headrest may allow the seat back to clear the rear seat cushion or raised floorboard area by a few more inches and provide an unobstructed path for patient removal.
Another option is removing the headrest on the seat next to the patient. Even though this sounds like a wasted effort, it provides considerable extra room for interior rescuers to work, especially if there is roof intrusion.
CUTTING STEERING WHEEL RIM
In certain situations, rescuers may operate the driver’s steering wheel or steering column adjustment mechanisms or remove the lower portion of the steering wheel rim to relieve a patient’s lower extremity entrapment, recognizing that this option may save valuable time otherwise used for dash displacements. If adjustment mechanisms are inoperable, begin removing the lower portion of the rim by cutting one side close to the hub.
Caution: With newer generation supplemental restraint systems, whether a driver’s side air bag has deployed or not, never cut into the steering column or hub. Also avoid placing the tool in a position where it could be struck if there were an unexpected air bag deployment.
If possible, place hard and soft protection between the patient and the working area. Whether you cut the left or right side of the lower portion first depends on the situation (photo 3). If the driver’s side door has been removed, it is easier to cut the left side first. This allows the rescuer to work away from a potential air bag deployment area on the passenger side and does not require working over a victim in the passenger seat. It allows for better lighting and tool manipulation while keeping the vehicle interior free for patient treatment.
 (3) |
If the driver’s door has not been removed or the planned path of egress does not require door removal, it is generally easier to begin with the right side. This allows better access than the left side with the door in position and keeps the bolt cutter away from an unexpected side air bag deployment.
Caution: Your safety is paramount! Do not operate in the deployment path of the passenger side air bag.
Regardless of which side you choose to cut first, try to displace the rim upward off the patient (photo 4) before making the second cut to relieve any pressure on the patient that causes pain or interferes with circulation. Also, first displacing the rim off the patient prevents transmitting the reaction from the second cut to the patient (photos 5, 6).
 (4) |
 (5) |
 (6) |
DOOR EXTENSION
Most victims in a motor vehicle collision are removed from the vehicle through the car door closest to the patient if it still works; if not, the door is completely removed. If the door still works and the opening is the preferred path of egress, the rescuer can create several additional inches of space by hyper-extending the door. Don’t try to force the door; instead, cut the door check to make the door open wider (photos 7, 8 insets). This technique only takes a couple of seconds using bolt cutters; if the door opens, access to the door check is not an issue. This tactic can also be used in a similar fashion when implementing a side removal and time does not allow for complete removal (photos 7, 8).
 (7) |
 (8) |
In situations where the door must be removed, the door check creates problems and slows down rescue efforts when removing the hinge side of the door using a chisel or reciprocating saw. This is because of the bending and vibration caused from the door check’s flexibility and how it is attached to the door and frame. Once the hinges are cut, space is created between the door and the frame, allowing enough room for the bolt cutter to easily cut the door check.
TUNNEL OPERATIONS
Tunnel operations are rarely used in emergency situations, but they can prove invaluable if needed. They require a thorough understanding of car construction and the necessary tools to complete the tactic. Bolt cutters have a specific place in tunnel operations given the size, strength, and location of components in the rear of the vehicle.
In the trunk compartment, many vehicles use torque rods that assist with opening a trunk lid and holding it open once raised. These rods can often be released using a large screwdriver to manipulate the rod out of the bracket assembly or by using an air chisel to cut the bracket. Some torque rods cannot be released easily and must be cut by a hydraulic cutter or a pair of bolt cutters (photo 9). If using a reciprocating saw to cut the rear deck or package tray, it may be easier to cut the rods first to provide plenty of room for the blade on the bottom side. This will also depend on the length of the bolt cutter. If the bolt cutter is more than two feet long, then access is going to be an issue. If using a hydraulic cutter or chisel to remove the package tray, it is usually easier to cut the tray, bend it up, and then cut the rods with better access (photo 10). Once rescuers have reached the rear seat attachment points, they can also be cut with a bolt cutter with minimal effort (photo 11).
 (9) |
 (10) |
null
 (11) |
BOLT CUTTER SPECIFICS
A general-purpose bolt cutter is strong, durable, and lightweight. It should have a toggle joint that converts hand pressure into cutting force to cut soft, medium, and hard metals. Lockplates keep jaws from loosening, and screw-type adjustments help realign edges. It should be able to cut steel rods, bolts, hard steel, and wire up to 400 on the Brinell and C42 on the Rockwell hardness scales. Most bolt cutters used in the fire service are at least 36 inches long. Although this length can be used in certain instances during vehicle extrication, a shorter pair of 24 inches allows better access to specific areas. Depending on the length and features, bolt cutters usually cost between $100 and $300.
To maintain the bolt cutters, avoid cutting material stronger than the blades, keep the blades in-line, clean after each use, occasionally oil the moving parts, and routinely inspect them completely.
Extricating victims from a motor vehicle collision is all about making space and enlarging openings to provide a safe and effective path of egress. Many of the techniques discussed in this article do not fully allow for disentanglement of the victim from the wreckage. They do assist with making the openings larger, which ultimately increases rescuer and patient safety.
LES BAKER, a 12-year veteran of the fire service, is an assistant engineer with the Charleston (SC) Fire department and a volunteer for the Darlington County (SC) Fire District. He has an associate of fire science degree from Pikes Peak Community College, is an adjunct instructor with the South Carolina Fire Academy, and is a member of the Darlington County Extrication Team.
