SOP 206.14 EXTRICATION SECTOR

The Extrication Sector is utilized in multi-patient medical incidents and in situations that require physical extrication of trapped victims. The Extrication Sector is responsible for locating, removing and transporting patients to appropriate treatment areas. The Extrication Sector is also responsible for any patient treatment that is necessary prior to removal of the patient.

An important decision must be made whether to provide tri age at the actual site or to move the patients quickly to a separate treatment area. This wil1 depend on the safety of the site and the arrangement of the patients. It may be necessary to remove the patients on backboards after only a brief examination (ABC's), if they are located in an unsafe area.

The Extrication Sector responsibilities may be summarized as follows:

Determination of location, number and condition of patients.

Determination whether triage is be conducted “on site” or at a treatment area.

Evaluation of resources needed for extrication of trapped patients and removal of patients to the Treatment Area.

Evaluation of resources needed for triage and preliminary treatment of patients.

Communication of resource requirements to Command.

Allocation of assigned resources.

Supervision of assigned companies.

Establishment of Assembly Area for “Priority 3” patients to await delayed transportation.

Reporting of progress to Command and “all clear” when all victims have been removed.

Coordination with other-sectors as required.

EXTRICATI.ON GUIDELINES

The Extrication Officer should assign personnel to help size-up the situation .An evaluation of the number of patients involved and the complexity of extrication requirements is an immediate priority. An initial commitment of one company per five (5) victims is reasonable for extending initial and immediate care when numerous patients are involved.

The Extrication Officer should be positioned in a readily visible location that is accessible to arriving companies and has a view of the scene. Face-to-face communications should be used within the sector. Company officers should use messengers to relay information to the sector officer. The sector officer shall wear an orange vest for identification purposes.

Ambulatory (Priority 3) patients who do not need urgent medical assistance should be removed from the scene as soon as possible to reduce confusion. This may require-the assignment of one or more companies to assemble these patients and remove them to an area where they will receive medical attention if needed. These patients will initially be gathered together at an "Assembly Area''. A school bus may be used to transport these people from the assembly area to a suitable location.

If the patients are spread out in a large area, companies should be assigned to a specific area or group of patients. The-company officer assigned will have to determine the immediate needs of those patients and request assistance if necessary. The company officer has responsibility for all those patients until they are delivered to a treatment area or assigned to another company. This company would then become available for reassignment and report back to the Extrication Sector.

When the scene is stable, patients should be triaged and tagged in the Extrication Sector. The first priority for removal to the Treatment Area will be "Priority I" patients followed by "Priority 2" patients. "Priority I" patients should be moved to a treatment area without delay.

All non-ambulatory patients should be moved on backboards, with cervical collars if indicated. Companies may be assigned as "litter bearers" to assist in this movement. Pick-up trucks, rescue vehicles, baggage carts or similar conveyances may also be used.

Trapped patients requiring prolonged extrication should be triaged by paramedics and provided ALS treatment if needed during extrication.

When victims require forcible extrication, 1adder companies should be assigned. Ladder apparatus should be brought in close to the scene while other apparatus is parked at a distance to avoid congestion. If the extrication requires specialized equipment (i.e. wreckers, cranes, cutting. torches) these must be requested through Command.

The Extrication Officer is responsible for assuring the safety of the area where patients are being extricated. This will require the commitment of personnel with protective lines and extinguishing equipment where a fire risk exists. If fire is involved, coordination with firefighting sectors will be required. The safety of patients and Fire Department personnel must be a primary concern.

If the incident site involves a large area, it may be necessary to create more than one Extrication Sector. Responsibility should be divided geographically.