El Estado tácito, los silencios también que cuentan

Consideration should be given to such aspects as vehicle construction and materials used. Working at heights from platforms, operating tools overhead and manual handling are issues of importance when carrying out surveys and formulating an extrication plan.

Issues with regard to stabilisation include height, size, weight and uneven load distribution. The nature of the load is also a very important consideration with regard to the carriage hazardous goods and materials. It is of utmost importance that the crew working on a particular vehicle have a clear understanding of the plan and of what has to be done in order to carry out an effective extrication.

The main problems with extrication of casualties from HGV’s is the strength of materials used in vehicle construction and the height of the vehicle above the ground.

With a front impact, the driver of the vehicle may be trapped, and extrication usually involves cutting the A –posts and conducting a dash roll, using a number of rams and chock wedges or pulling the dash with the aid of a winch. It is important at this stage to highlight the importance of identifying and using good anchor points within the vehicle construction in order to effectively force the area to be released.

Stabilisation.

It may be necessary to first stabilise the load before vehicle stabilisation can occur. Loads can become very unstable as a result of a collision. They can shift left or right or back and forward. The load may also be forced forward to such an extent that they enter the cab from the rear, thus trapping the passengers.

Once the load has been stabilised and crew safety assured the vehicle can be stabilised. This may be highly technical and may require specialist equipment such as struts or power-shore. Once the load and vehicle have been stabilised a safe working platform can be established. The cab of the vehicle may be extensively damaged and the locking mechanism may be broken. It may be therefore necessary to secure the cab to the chassis with a ratchet strap in order to eliminate free-play from the vehicle suspension unit. Care must be taken when ratchet strapping to avoid unnecessary movement of the cab but also to ensure that the straps do not impede rescue at a later stage in operations.

When stabilising a vehicle it is important to identify moving parts and to find a stable base to eliminate the chances of movement occurring at a later stage. As with all vehicles it is important to check stabilisation continuously during an extrication and where available consideration should be given to assigning a crew member the task of continuously checking stabilisation during the extrication.

Figure 4.30 Cab stabilisation

Doors can be removed using the traditional door removal technique. The important points to consider are:  Strength of hinges.  Weight of door  Working at heights  Working over-head  Manual handling. Dash roll.

 Cut the top of the A–posts first.

Figure 4.32 Cut any strengthening cross members if they can be easily accessed. Remember

some materials used in modern construction may be difficult to cut with conventional cutting tools.

Figure 4.33 A dash–roll can now be executed a number of ways – manually, with the aid of

telescopic rams, or pulled with the aid of a winch. Ensure that the casualty is protected at all times and that the roll is conducted in a controlled manner. When using rams ensure that good anchor points are used and that the correct ram supports are used.

Buses

Figure 4.32

Buses and coaches

Buses are often put in the category of heavy vehicles, but have a different construction when compared with trucks. The bus compartment is very vulnerable in the case of a collision. It is positioned on a chassis consisting of longitudinal beams and a criss-cross pattern of pipes or beams, welded together, on which the outside cover (steel plate or fibreglass) is fixed. The construction often fails to withstand the forces exerted on it in the event of a crash. This can lead to the potential entrapment of large numbers of casualties. The seats inside the bus often fail due to the forces of the crash, further entrapping casualties.

Figure 4.33

Gaining access

After the stabilisation phase, the next obvious task is to gain access to the bus. This can be achieved in various ways, the simplest of which would be to use the doors, windows or emergency exits on the roof. Gaining access allows the Incident Commander opportunity to evaluate the severity of the incident, and will enable assessment of the number of casualties and nature of the injuries sustained to those involved. It should be ensured that a check is carried out of the luggage compartments, as well as the beds and toilets, if the bus is

equipped with these.

Scene management

Due to the fact that in many bus incidents there are a large number of casualties, it is important to define roles in the rescue team and to detail clear working zones. Effective triage will enable treatment of the most appropriate casualties first.

Extrication operations

Extrication operations on such large bus or coach incidents normally consist of creating space for both initial access and casualty retrieval. Once access is gained, the disentanglement of occupants from between the seats can be commenced.

Strategic handling of the operation inside the bus should be focused on maintaining clear access and egress routes for casualties and stretcher patients throughout the incident.

Long haul coaches

The long distance luxury coach has developed over recent years, allowing holiday travel over great distances throughout continents. Generally, these coaches are well equipped with such facilities as video presenters, drinks machines and on-board toilets.

Most of the heating systems on such coaches are powered by liquid hydrocarbon fuels

and are activated by timer switches that can power up the system even when the vehicle is empty.

Driver sleeping compartments

To enable long distance coaches to be economically used and to allow almost continuous travel, a driver-sleeping compartment is utilised. Two drivers can then take shifts, one sleeping whilst the other drives.

4.4 Agricultural and other heavy machinery