How do you prepare for managing motor vehicle accidents (MVAs)? Reading trade publications, attending classes and educational programs, practicing on the drill ground, interacting with computer-based simulations, and even surfing the Internet for background information are all excellent ways to develop our skills and abilities for mitigating MVAs. However, how many of you have attended an extrication challenge or competition? Although some focus on the word “competition,” these challenges are truly educational events and may be local, regional, national, or international. Where else can American rescue personnel gain insight into how a rescue team manages an MVA in Sweden, South Africa, or Australia and, in the same weekend, see how 20 different incidents are managed and mitigated (photos 1, 2)?
EXTRICATION CHALLENGE HISTORY
 1 Photos by author. |
In 1984, Chief Alan Dupuis of the Ontario, Canada, Office of the Fire Marshal originated the concept of the International Automobile Extrication Competition and Learning Symposium. The number of transportation accidents was increasing in Canada and the United States, as were the numbers of deaths and serious injuries. With every model year, automobile design advances were requiring a corresponding change in methods for victim removal from vehicles. To keep abreast of these changes, Chief Dupuis saw the need for a forum among agencies responsible for victim extrication, at which experts could gather and exchange information, ideas, and lifesaving techniques. In addition to gaining a wealth of information, participants would teach, learn, share, and develop lasting friendships with their peers from around the world (photo 3).
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The International Association of Fire Chiefs sanctioned the Transportation Emergency Rescue Committee (TERC) in 1986, which provided a centralized coordinating body to further extrication education and challenges and developed guidelines to govern regional, national, and international challenges. One of TERC’s goals is to develop educational components for students and instructors that meet the new challenges rescuers face at each incident. TERC has since evolved to standalone committees now in North America, TERC-US and TERC-Canada. These challenges have expanded from that beginning to local, regional, and national events held in North America, the United Kingdom, Europe, South Africa, and Australasia. International challenges are held on a rotational basis worldwide and gather the best teams globally. These overseas events are managed by various similar groups such as the UKRO (United Kingdom Rescue Organization), National Committee-Rescue South Africa, and ANRARA (Australia National Road Accident Rescue Association). The above groups have formed an umbrella organization called World Rescue Organization to facilitate the information exchange and to enhance the delivery of educational programs to developing countries.
PROGRAM SETUP AND OPERATION
These challenges are scenario based and revolve around real-world incidents and subsequent hazards discovered. Such hazards range from fixed objects (e.g., concrete barriers, guardrails, trees, street light/traffic signal poles, and fire hydrants) to “flexible” items such as power lines, gas meters, haz-mat “spills,” and other vehicles. Prop vehicles can include everything from bicycles and motorcycles to cars and large vehicles such as tractor-trailers and buses, even construction equipment. The vehicles in the scenario are then realistically “damaged” by heavy construction machinery to meet the scenario parameters (photos 4, 5). Depending on the event, brand-new vehicles may be used. Each of the scenarios, although different, is similar in complexity. The scenario is then assembled in a pit to await the team’s response to mitigate the incident.
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The tools and equipment the team will use in the scenario are set up ahead of time; this cache varies to meet the type of scenario. A team of three assessors observes and evaluates the team and the work done in the scenario using 15 criteria, including incident management and evaluation, hazard control, safety, patient care/management, tool skills, vehicle stabilization, options, and teamwork. Although each scenario has a set time limit, time is not a key component except to break ties. Time is factored in accordance with the work performed and accomplished.
TEAM SIZE
The team in each of these scenarios consists of five to six personnel. After the team has prepared its equipment, it is sequestered. Team members are not allowed to see the scenarios before responding to them; they ride into the pit usually on an apparatus once the scenario has been set up.
SCENARIOS TYPES
Unlimited Pit. In this 20-minute scenario, the team is allowed to use any type of tools in its cache: air- or electric-powered hydraulics and hand tools.
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Limited Pit. In this 20-minute scenario, the team’s tool cache is limited to air, hand/battery hydraulics, and some electric and hand-operated tools.
Rapid Pit. In this 10-minute scenario, the tool cache is unlimited, but the patient’s status changes suddenly and thus he requires rapid extrication.
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In all of these scenarios, a patient is a focus of the team’s efforts. Many times, this will be an actual person trained to simulate an injured victim and will interact with the team as such. Other times, this patient will be a simulator or dummy. Depending on the event, the team will have to mitigate one, two, or all of these scenarios.
ASSESSMENT
Following the scenario, the assessor team debriefs the team about its performance. This allows the team and the assessors to interact and evaluate the scenario and how it was mitigated. The evaluation is based on the work done during the scenario, not on what the assessor felt “should” have been done. Safety is of utmost importance and is part of all the evaluation criteria. Safety includes team and patient safety, as well as an awareness of the hazards within the scenario and posed by current vehicle technology.
Based on the evaluation of the teams’ performance, awards are presented. Although it is expected that in each scenario, and overall, there will be first, second, and third placement, most challenges also present awards for best medic, leadership, safety, spirit of the fire service, and even stabilization. At each level of challenges, the top teams move to the next level.
The educational component is an integral part of the extrication challenge. Although all the scenarios have merit as educational tools, the event also provides a program track for participants that many times revolves around the various facets of vehicle rescue. It also may take into account team building, trends, and hot topics/concerns in emergency services.
Along with top-notch programs, these events allow participants to try out and evaluate new tools and equipment in a real-world setting. Also, events featuring new vehicles allow participants to try tools and techniques on these vehicles in a controlled environment.
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Are these events just competitions or an untapped educational resource? All the participants get the opportunity to mitigate simulated incidents; see how other participants from other municipalities, regions, or even countries operate; try new equipment and techniques in a real-world setting; network with fellow responders; and facilitate the exchange of information, ideas, and concepts. Although high-scoring teams receive awards, all of the participants really are the winners, as are the communities they serve.
I urge you to attend an extrication challenge and see what it is about. Take some pictures, and talk to the participants. Go to www.terc.org for more information and find out where these events are held, or maybe even host one! Join one of the organizing bodies such as TERC-US or TERC-Canada. You will find it rewarding once you have experienced it. ■
■ DAVE DALRYMPLE is a career EMS provider for Robert Wood Johnson University Hospital/St. Peter’s University Hospital Emergency Services in New Brunswick, New Jersey. He is also a firefighter/EMT/rescue technician and former rescue services captain of the Clinton (NJ) Rescue Squad. Dalrymple is the education chair of the Transportation Emergency Rescue Committee-US and serves on the Expert Technical Advisory Board of the International Emergency Technical Rescue Institute, as the road traffic accident advisor.
