RTC End Index Exam

Question 1

Q. You are the first pump in attendance at the scene of an RTC involving two cars. The collision has taken place on a busy rural road just 10 minutes from your station and it looks pretty serious. As the 2nd pump is just 1 minute away the lC has asked you to go and stand and wait for the arriving appliance and marshal it into the correct fend off position, as the road needs to be closed.

How would you go about doing this and why has the lC seen this as a priority?

Once you have done this you immediately help the crew put out a set of cones. How and
why are you doing this?

Answer 1

Answer:
First appliance to fend off 25m prior to the incident (unless traffic prohibits) initially
within the confines of the affected lane. If the first attending appliance has arrived from
the opposite direction - they should pass the Incident and fend off the affected lane.
The IC is to ensure that both the scene and crews are protected from traffic coming
from al directions, taking into account the road layout, junctions, bends, brow of hills,
hedges etc. and decide if the carriageway should be closed in both directions.
Traffic management should be a consideration at every incident.

Where possible keep traffic flowing but request attendance of the Police and hand over
responsibility for traffic management at the earliest opportunity.

When using cones for traffic management, the minimum distance from the working
area should be:
Up to 30mph road - 25m
40 to 6Omph road - 75m

Cones should be placed in a straight line across the width of the carriageway, not
tapered.

Question 2

You are in attendance at an RTC where a car has come off the road on a bend and hit a tree head on.
The IC has asked you to go and assess the driver as currently there is no medical agency present.

What methodology would you use to begin the assessment process?

Explain this method and why the result of the assessment is important to the IC decision making.

Answer 2

KINEMATICS - allows us to understand what is happening during and just following a collision.

The car hits a solid immovable object.

The occupant hits the vehicle structure/seat belt.

The occupant’s internal organs continue to move causing tearing before impacting on the abdominal wall.

Unrestrained objects in the vehicle continue to travel and may strike the occupant causing further injury.

Knowing the sequence of events or vital to understanding internal and external injuries, will allow the IC to formulate the best suited extrication plan.

Question 3

You have arrived at an RTC involving multiple vehicles, the RSU and the police are en route with their collision investigation team. The IC has asked all those at the incident to preserve the scene and record any evidence.
You are part of a crew who has been given the task to extricate a casualty from a car who is trapped.

What will you need to record and take note of and why is this important?

Answer 3

It is important to realise that a crime may have been committed resulting in an RTC therefore we must take care to preserve and/or record evidence at the scene.

Be aware of:
- impact points on the road surface
- debris (it’s location)
- tyre pressure
- tyre marks on grass or on road
- seat belt friction on marks
- over use of water
- was the casualty wearing seat belt or did we release it.
- Moving of vehicles without first marking the position they were in.

Question 4

Understand the principles of planning and prioritising extrication methods.

You are positioned in the rear of a four door car that has just been involved in a RTC; all doors can be manually be opened but the casualty is complaining of pain in their back and neck.
You hand over to the paramedic who has just arrived. Following a medical assessment, the paramedic informs you that the casualty is fairly stable at present; what would your actions be as the casualty carer at this point?

A crew begin to create space by preparing to remove the roof, the paramedic tells you that the casualty’s condition is worsening;

• why is this information important and how many this affect the ICs extrication plan?
• How might your role as casualty carer change?

Answer 4

Where possible, the final extrication path should allow for the casualty to exit the vehicle head first.
This makes the management of the C-spine easier.

Although removing the casualty head first is the desired way to remove a casualty this is not always possible.
The IC should decide on the extrication path that is most sympathetic to the needs of the casual players.

Extrication considerations for the IC are:
- does the casualty need to be extricated immediately e g. the casualty has gone into cardiac arrest and needs to be removed for medical intervention.

• is the casualty’s condition starting to worsen if so there may need to be a rapid extrication e.g. within 5 minutes.
  During this stage clinical needs of the casualty must be prioritised over extrication procedures.
• If the casualty remains relatively medically stable an Urgent extrication should be carried out using the preferred golf standard methods.
  The casualty remaining neutral alignment minimising rotation of the spine/pelvis. Ideally any extrication should be completed in 20 minutes or less