Steady as You Go

Vehicle stabilization is critical at any incident

Stabilization is more than throwing a couple of step chocks under a car. It’s a component of the extrication scene that should always be done but is often overlooked because of the severity of the crash. History has shown that by not stabilizing the car, we put ourselves in harm’s way. For example: Consider the Dayton airbag incident that put two firefighters in the hospital. The car was not stabilized, and an attempt to force open the hood (to disconnect the battery) rocked the car and its injured patients. In addition, the DERM (which is the component that controls the airbags in a car) was grounded during the extrication and caused the airbags to deploy unexpectedly, knocking two firefighters from the vehicle.

Following are a few tips for avoiding this kind of scenario.

First Considerations
First, stabilize the scene with proper apparatus placement. The fend-off position is a 45-degree angle across the lanes of traffic that will protect the rescue worker from the rubber necker on their cell phone, who will run you over if you give them the opportunity. 

Next, turn off the car and take the keys out of the ignition. This is done for a multitude of reasons.  First, hybrid vehicles come in all shapes and sizes; they’re becoming more popular and harder to identify. If you don’t turn hybrid vehicles off, they can be energized and drive over you, and you will never even hear the motor—kind of like a 2,000-lb. golf cart. Second, some vehicles have “smart keys” or “key fobs” that are proximity keys. They don’t work like conventional ignition keys; instead, they just have to be close to the car to work. Third, by removing the ignition keys in most late-model vehicles, you’ll de-energize the supplemental restraint system (SRS) in the vehicle.  Make sure the keys are out of every car.

Stabilization Basics
Next, stabilize the car. Step chocks will be adequate 90 percent of the time. The problem: We’re not in the habit of stabilizing the vehicle at every crash. We must stabilize every vehicle regardless of the severity of the crash. I know it’s not done on every crash, but it should be. Think of it as muscle memory. If you always come off the apparatus anticipating how you’re going to stabilize the car, then you will always do it regardless of whether it’s a minor crash or much worse.

When stabilizing a vehicle, look for a minimum of three points of stabilization. 6 x 6 wedges work great and will almost always fit. They can be homemade and only require you to cut them at an angle, unlike homemade step chocks. There are some good commercially made step chocks on the market. What you buy depends on how much room you have to carry them, and how much you have to spend.

The rollover crash with a vehicle on its side is the most unstable position for a vehicle. The potential collapse zone is hazardous and must be secured immediately. To do this, tie off the vehicle to a substantial object and place wedges on either side. Buttress stabilization is the industry standard and should be used if available. Training in the junkyard is great, but only if you crush the vehicle and place a mannequin inside. This makes it more real. 

Be cautious when placing your stabilization components. The days when cars had frames are pretty much gone. Unibody construction is typical; dent-resistant panels are also an issue. We can’t just slide cribbing under a car and expect it to ensure solid stabilization. We must really be certain that what we are placing under a car is going to actually support the weight of the vehicle, especially when we deflate the tires.
The only way to absolutely stabilize the vehicle is to deflate the tires slowly (by pulling the valve stems) after placing cribbing under the vehicle. The lowering of the vehicle should be so slight that no one notices. Remember the standard of care: The car should be rock-solid stable, so when everyone is on the car during an extrication there is no movement transmitted to the patient’s cervical spine. 

The 90 Percent Rule
Palm Beach County Fire Rescue’s District Chief (Ret.) Daryl Newport, the inventor of the “Capabear Claw,” has a theory on stabilization. He calls it The 90 Percent Rule: If you were to throw some step chocks under the car initially, the vehicle would be 90 percent stable, making it safe for the rescuer to free the patient. The remaining 10 percent could be handled up by the second- or third-due units to the scene. This allows the operation to start quickly and not get bogged down with an unstable vehicle. 

Remember: Make stabilization a habit; commit it to muscle memory. Your rescuers and patients will be glad you did.

Brad Havrilla is a 19-year veteran with Palm Beach County Fire Rescue, where he is currently assigned to the training division. Havrilla is an international extrication judge and the past vice-chairman of the Transportation Emergency Rescue Committee. He was the recipient of the Harvey Grant Excellence in Rescue Award in 2004.