BY DAVID SWEET
In most motor vehicle accidents involving victim entrapment, the use of basic extrication techniques such as door removal, roof removal, and dash roll are usually all it takes to free a victim. Every now and then, however, you will respond to one vehicle accident where the basics just won’t work and an advanced or unorthodox technique will be needed to free the victim. One such technique is the High Dash Lift, described below.
This technique should not replace the traditional dash roll but should be used in those situations where the traditional dash roll won’t work effectively.
Some instructors may tell you that a high dash lift can be accomplished in less than five minutes every time. Don’t be misled. Keep in mind that every vehicle is not the same and that conditions at motor vehicle accidents vary. You can go to a junkyard and cut 100 vehicles that are in near-perfect condition, but that experience will never compare with that of cutting that one mangled vehicle you may encounter at an accident scene.
THE TRAINING EXERCISE
Make your training evolution environment as realistic as possible. Position mannequins inside the cars, and smash the vehicles before you start practicing techniques. Time and time again, you see rescuers practicing on vehicles that are in perfect condition. Even more discouraging is that some extrication training videos show instructors demonstrating techniques on perfectly good vehicles. This is not what we face in the streets.
Make the training challenging. Present the evolution as an actual accident scene. Training in this manner will enhance rescuers’ skills and abilities, increasing their understanding of how specific techniques work on heavily damaged vehicles.
With the assistance of Margate (FL) Fire Rescue’s Extrication Team and with donated hydraulic tools, we staged two similar motor vehicle accidents with a patient trapped under the steering/ dash area. The scenario was constructed to demonstrate that under certain circumstances the High Dash Lift can be a more effective option than the traditional dash roll.
The High Dash Lift can be a very involved procedure, but it is very effective when done correctly. Keeping an open mind toward learning new techniques will give you a repertoire of multiple techniques so you will be better prepared for those tough calls when they present themselves.
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Preparing to perform the traditional dash roll technique to gain access to the victim trapped under the steering/dash area. (Photos by author.)
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After performing the tasks of stabilization, glass removal, roof removal, making relief cuts, and the like, place the hydraulic ram into position.
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As the ram was being extended, the movement of the dash became impeded by the retaining wall (which was tightly up against the vehicle’s front end), and the entire front end of the vehicle started to come off the ground. The retaining wall here is a prop, but you can face the same situation in a front-end collision that leaves the vehicle up against a tree, a utility pole, or another vehicle. These conditions can interfere with accomplishing a traditional dash roll.
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The ram is at full extension. Although some access has been gained, it will be difficult to remove the patient because of the minimal displacement of the dash area.
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The second evolution: The same accident situation was staged, but the High Dash Lift technique was used to gain access to the victim trapped under the steering/dash area.
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After stabilizing the vehicle and removing all the glass, the next step is to remove the roof completely or create a roof flap.
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The front door is removed. You can accomplish this in several ways: by prying the door off using the hydraulic spreader (for example) or by exposing and cutting the door’s hinges, if your hydraulic cutter is capable of performing this task. I prefer cutting the hinges. You can save valuable time by accessing and exposing the door’s hinges using the hydraulic spreader and then cutting through the hinges with the hydraulic cutter.
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Using the hydraulic cutter, cut into the front wheel-well area, directly behind the strut tower. The primary objective here is to cut into or through the “upper rail,” a metal support area that runs on top of the front wheel well, where the hood and the front wheel well meet. This is the most important part of the technique. This cut allows the dash/firewall area to move independently of the vehicle’s front end.
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The strut tower is easily recognizable.
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Now take the hydraulic spreader and remove the metal sheet/panel to expose the area in which rescuers will be working. This panel, usually attached at the bottom by a screw or spot weld, can be removed within seconds.
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Once the panel has been removed, make a pie cut (section removal) between the top and bottom hinges.
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Support the rocker panel (just below the bottom hinge) with cribbing (if you have not already done so).
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Insert the tips of the spreaders into the removed section/pie cut just completed. Open the spreader slowly. Keep the tips of the tool between the top and bottom hinges (the strongest push points in that area). You may have to readjust the tool to get the best leverage.
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As the tool opens, the entire dash area tears apart and folds into the section that was cut into the upper rail, totally taking the vehicle’s front end out of play.
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When done correctly, this technique can create a tremendous amount of room for patient access/removal.
DAVID SWEET has been a member of the City of North Lauderdale (FL) Fire/Rescue since 1985, where he serves as a fire lieutenant/paramedic on an engine company. He is a state-certified instructor. Sweet also is vice-president of Wreck Rescue Extrication Consultants (W.R.E.C.), which provides basic to advanced vehicle extrication courses and seminars.
