Responding to vehicle accidents poses numerous hazards, some unknown or unseen. Unfortunately, most first responders, including EMS personnel, aren’t well-educated in new vehicle technology, which increases the chance of severe injury and death.
Drawing near
Cautiously approach the scene of a motor-vehicle accident, looking for primary and potential hazards clues. Don’t get tunnel vision in terms of looking at all of the trauma and gore. This prevents you from thoroughly assessing the scene and from maintaining awareness of all dangers.
Use your vehicle to block oncoming traffic, parking at least 50 feet from the incident. (Over the past five years, there has been an issue of Tesla vehicles running into parked emergency vehicles on roadways when the automobile is in autonomous mode.)
Probably the most significant dilemma, particularly for EMS personnel if they are the only emergency services on location, is that accident vehicles don’t get chocked.
Chocking is the first step in stabilizing a vehicle. No first responder should gain access to or get inside of a vehicle that isn’t stabilized and the powerplant of which isn’t shut down. This applies in the case of an internal combustion engine or an electric drive system. All vehicle batteries must be disconnected. A vehicle is “hot” if any light remains on.
Airbags and seatbelts
Airbags can deploy from numerous areas inside of the automobile at any time. (Steering wheel airbags deploy 10 inches from the column; front passenger airbags deploy more than 20 inches; and side airbags deploy 5–6 inches. They all deploy in a fraction of a second at a speed of as much as 210 mph.)
Passenger-car steering wheel airbags mostly still are inflated via the use of sodium azide. The inflation process gives off heat, which can cause first-degree burns to a patient’s upper chest, neck and face. All other airbags in vehicles use pressured gas, usually argon gas, to inflate.
All airbag systems deflate rapidly after they inflate except for side-curtain airbags, which don’t deflate once they inflate. For access, cut side-curtain airbags with a knife or scissors.
Seatbelt pretensioners are common. They activate in a frontal collision and automatically tighten a three-point restraint system. You will find the seatbelt tight against your patient, with no slack. The seatbelt must be cut to unrestraint the patient.
Struts and ROPs
Struts assist in raising hoods and trunks. When in the closed position, struts are energized and will erupt explosively when under pressure or heat. These devices usually come directly forward or backward from the vehicle. Many first responders received penetrating injuries from these devices.
It also is a good practice never to approach a vehicle from the front or rear. Always approach at an angle. There are several reasons for this. Most importantly, most electric vehicles don’t make a sound when they move, which means that they can strike you without warning. Also, modern automobiles don’t have mechanical devices that shift the transmission; computers do it. So, you never know what gear a vehicle is in or if the transmission still is engaged.
Roll-over protection (ROP) is a typical safety device. This system deploys a roll-over device when two or more of a vehicle’s wheels leave the ground in any direction. The roll-over device doesn’t retract. ROPs will protrude from a convertible’s soft top in a frontal collision.
EVs and carbon fiber
Electric vehicles (EVs) pose their own unique dangers to first responders. High-voltage systems must be shut down, along with the 12-volt battery system(s). Most systems during an accident will shut down and isolate the high-energy systems to their battery, but I have seen that not to be true. I witnessed vehicles that back-fed the 12-volt system from the high-energy output, making the vehicle “hot,” which can deploy an airbag, endangering both patients and responders.
Also, any damaged high-energy battery or one that’s on fire gives off toxic gas chemicals, including cobalt. Respiratory equipment protection is a must.
Most responders don’t understand the concept of carbon-fiber automobiles. This category of vehicles includes a lot of sports cars and luxury vehicles. Carbon core, when cut, gives off fibers that get into an airway, which can cause chronic respiratory illness or cancer. Respiratory protection is needed for you and for your patients.
Seek knowledge
Any EMS system that doesn’t do vehicle rescue should train alongside technical teams to better understand new vehicle construction and tools. Doing so will assist in better patient extrication and overall safety.
Richard Bossert
Richard Bossert is a retired operations chief for the Philadelphia Fire Department. He started in the fire/rescue services in 1970, volunteering for the Warminster, PA, Fire Department. He worked for three career fire departments: Chester, Bensalem and Philadelphia. Bossert became a certified EMT in 1973, then paramedic in 1980. He received a bachelor’s degree in pre-med from Pennsylvania State University in 1977 and a master’s degree in public safety administration from St. Joseph’s University in 2003.
