By Dave Dalrymple
As rescuers, we must have rapid access to remove the door in front of our patients. As time has progressed, door displacement operations have gone the route of cutting door hinges, which makes things better for the patient and tool operator. Another trend these days is the need to move the dashboard and the footwell wing more. These evolutions–door removal and dash movement–are commonplace, shouldn’t we set up to perform these from the beginning?
那么为什么Fender解锁呢？许多人会说：“戴夫，这只是在剥皮。”是和否。是的，出于实际目的，如果您卸下挡泥板部分后门打开。不，因为心态是不同的。除了此操作的简单机械末端外，您会发现心态的目标是更好的患者结果。
Let’s shift our operational tool focus首先打开挡泥板。如果挡泥板从患者启动的车辆侧面移开，则可以使我们有更多选择。首先，它露出前门铰链，以促进使用我们的电力液压切割器切割它们。迄今为止，这种门去除技术是患者最不动力的，对于所有有关的人来说，最安全，也是最快的时期。
考虑一下当我们切开那些门铰链时会发生什么：由于门闩锁仍在互动，因此门以一定角度掉落到地面。但这是可以的，因为它已经真正被打开了！如何？门的角度将导致前锋从闩锁中旋转。如果我们在内部或外部（或同时或更好的更好的是）尝试将快乐的压力球楔入外门把手的技巧。）进入患者。
越快we gain access to our patients, the better the chances for a positive outcome. Faster access also means faster understanding of our patient’s care needs, disentanglement-wise and management-wise.
除了立即访问的好处外，我们还能得到什么？我们可以更轻松地查看是否需要创建更多的破折号/脚步空间。通过更早获得更好的访问，我们可以更好地提出合适的战术行动计划。患者始终驱动我们的行动计划在场景中所做的事情，准确的信息是关键。
If we need to move the dash or the footwell or both, we are in a great position to go to work. Why go to this fender displacement (or “unlock”) as your first operation after stabilization and glass removal, basically vehicle prep for tool evolutions? With the advent of stronger high-strength alloys and composite materials and reinforcements, it has become more difficult to perform these tactics, thus cutting into the patient’s Golden Hour and shredding their Platinum 10 when it comes to survival. This tool operation is done with the mindset of saving time, putting us back into both the Golden Hour and Platinum 10. It also allows us to be proactive by making rapid access to our patient from the outside and allow visual inspection of the patient’s legs, pelvis, and feet early in the rescue, enabling us to plan accordingly. This also allows us the ability to decide how we will attack the dash and footwell. Will a dash lift work? Perhaps just horizontally push the footwell, or simply cut the footwell, grab the flap, and pull it outward.
重新审视您现有的工具的演变，寻找实现同一演变的新方法。我们需要继续尝试取代或删除车辆组件的新方法。电力液压公羊的出现，尤其是可以适应更紧密空间并进一步扩展的望远镜类型的出现。不管工具的演变如何，请记住要始终保护您的患者和内部救援人员 - 使用它们之间的耐碎防护罩和正在进行的工具工作，并且每当折断玻璃杯以保护它们免受飞行碎屑的影响时进行软保护。
David Dalrymple，AIETecRI, is a firefighter/EMT/rescue technician for Clinton (NJ) EMS/Rescue. He has been actively involved with emergency services for 34 years, having taught transportation rescue topics for over 22 years. He is the executive educator for RoadwayRescue LLC, a dynamic educational team for transportation rescue training. He has taught at FDIC since 2003, and was team captain when Clinton’s team won the world vehicle rescue challenge in 1998. He is certified as an International level extrication assessor and has taught and assessed in North America, Europe, the UK, and South Africa. In 2007, he received the coveted Harvey Grant award for excellence in rescue education. Dave is also a member of the Society of Automotive Engineers (SAE) task force on hybrids and electric vehicles for first and second responders. He volunteers as a fire/rescue technician for the Sports Car Club of America-Northern New Jersey region and is actively involved in emergency response at performance rally events with American Rally Association. He is a member of the International Council on Motorsport Science and his ESRS rally rescue program holds SFI accreditation. Besides writing for fire rescue publications, he is a contributing author for the PennWellFirefighter I & IItextbook and is featured in a three-DVD educational series on vehicle rescue from PennWell/Fire Engineering.He is also the host of three seasons of extrication Training Minutes videos.
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