Scene Size-Up
- Assess for hazards: traffic, fuel leaks, downed power lines, unstable vehicle.
- Establish scene safety and request fire/rescue if necessary.
- Control traffic with cones and warning lights.
Vehicle Stabilization
- Chock wheels and set the parking brake.
- Disable the vehicle and remove keys.
- Stabilize the vehicle before attempting access.
Access and Patient Contact
- Establish verbal contact with the patient as soon as possible.
- Provide reassurance and continuous assessment throughout.
- Use the undamaged side or door for access when possible.
Extrication Considerations
- Maintain C-spine precautions if indicated by mechanism.
- Coordinate with rescue personnel for complex extrications.
- Have immobilization equipment staged and ready.
- Establish vascular access early if patient is entrapped.
Rapid Extrication
- Indicated when the patient has an immediate life threat.
- Move the patient as a unit to minimize spinal movement.
- Continue assessment and treatment during and after extrication.
Post-Extrication
- Reassess ABCs and complete a full trauma assessment.
- Apply appropriate trauma interventions.
- Transport to the appropriate trauma facility.