Croton on Hudson Car vs. Backhoe Extrication 2/27/09

[TR54 239]

Photos By TR54. Driver removed prior to my arrival. Minor injuries , transport to Phelps BLS.

[TR54 239]

Photos By TR54

[TR54 239]

EMTBravo Incident Alert http://www.emtbravo.net/index.php?showtopic=30631

[xfirefighter484x 234]

After reading the description in the IA section, was the backhoe driving when it was rear-ended? I would assume that the backhoe deployed its outriggers to lift the rear bucket off of the car??

Just curious how this happened.

[x129K 1,393]

Mandatory CHEVRONS for backhoes...thats it!

[x635 4,066]

GREAT shots, Tim!!!!!!!!!!!!

[Remember585 815]

From what we're told the driver of the car was travelling southbound and rear-ended the moving backhoe. When we determined it was safe to do so, and EMS was in the car stabilizing the patient, we had the backhoe operator put down the outriggers and pick the bucket up. After that, and a little debate with OVAC, we cut off the driver's door and removed the patient to EMS.

Nice pics Tim, good seeing you again!

Tim, can we use these pics on our websites?

Edited February 27, 2009 by Remember585

[Patch6713 18]

Nice pictures.

Even the camera crews have gotten the mandatory vest thing down.

[markmets415 524]

Great shots, nice to see the protection of the on scene personnel provided by the vehicles. Is that EmtBRAVO's own remember585 providing an update to the media?

[Remember585 815]

Great shots, nice to see the protection of the on scene personnel provided by the vehicles. Is that EmtBRAVO's own remember585 providing an update to the media?

Yeah that's me. They had to use the panoramic view camera to fit my head in the shot!

[Guest alsfirefighter]

A few good points can come out of the pictures.

1. Some would jump the gun looking at the damage to the car and the type of vehicle it collided with and start thinking medevac (although in that location ground is faster to WMC.) Nothing replaces a solid physical exam in conjunction with what the INTERIOR of the car looks like. The car exterior responded the way it was designed to crumple.

2. Communication between Fire and EMS is imperative. While some don't like it..the main purpose of the FD is to mitigate risks to patients, others (traffic, etc) and to facilitate access to the patient(s) if needed. Its more of a glorified EMS assist, you must be a team..not one in front of the other. If there in no console..which most cars have huge ones today...the passenger side door is still an option. Here through communication they made a decision.

Look at ya lookin all serious with the mic in your face. Guess someone wasn't there today or I'd be reading a medevac IA...lol.

[RocklandFires 44]

It has certainly been a while since I buffed a job in Westchester, but thanks to meeting Tim at his firehouse this afternoon, I was able to take this job in. Woman was lucky she wasn't killed. Additional photos can be viewed on my website:

http://www.brianduddy.com/g/croton022709

http://www.brianduddy.com/g/croton022709

[Stealthmedic1 5]

A few good points can come out of the pictures.

1. Some would jump the gun looking at the damage to the car and the type of vehicle it collided with and start thinking medevac (although in that location ground is faster to WMC.) Nothing replaces a solid physical exam in conjunction with what the INTERIOR of the car looks like. The car exterior responded the way it was designed to crumple.

2. Communication between Fire and EMS is imperative. While some don't like it..the main purpose of the FD is to mitigate risks to patients, others (traffic, etc) and to facilitate access to the patient(s) if needed. Its more of a glorified EMS assist, you must be a team..not one in front of the other. If there in no console..which most cars have huge ones today...the passenger side door is still an option. Here through communication they made a decision.

Look at ya lookin all serious with the mic in your face. Guess someone wasn't there today or I'd be reading a medevac IA...lol.

Hey Tommy, from what I understand someone did put the bird on standby...did you see 74-05.......guess who??? Although I don't think he called...

[JRS2817 1]

Nice shots

[xfirefighter484x 234]

From what we're told the driver of the car was travelling southbound and rear-ended the moving backhoe. When we determined it was safe to do so, and EMS was in the car stabilizing the patient, we had the backhoe operator put down the outriggers and pick the bucket up. After that, and a little debate with OVAC, we cut off the driver's door and removed the patient to EMS.

Thanks for that bit of info Chief!

[FDVA356 23]

5512 Croton EMS LT. put the bird on standby, after listening to reports from CPD on scene of heavy entrapment and to expedite EMS, after hearing that I placed the helicopter on standby. Can't hurt to have them ready just in case. Rather get the ball rolling rather then delaying repsonses later on. In this incident injuries were minor, but in other cases could have been severe. I'm one that is confident in my skills and my members, but after hearing the original reports, I decided to Cover my a--. When in doubt call them out.

All agencies did a job well done.

Edited February 27, 2009 by FDVA356

[Guest alsfirefighter]

5512 Croton EMS LT. put the bird on standby, after listening to reports from CPD on scene of heavy entrapment and to expedite EMS, after hearing that I placed the helicopter on standby. Can't hurt to have them ready just in case. Rather get the ball rolling rather then delaying repsonses later on. In this incident injuries were minor, but in other cases could have been severe. I'm one that is confident in my skills and my members, but after hearing the original reports, I decided to Cover my a--. When in doubt call them out.

All agencies did a job well done.

Bro..no one is faulting you..and we always talk about stuff in person...but I will chime in with this as an overall point...not directly towards you (you know this as we're friends anyway).

1. Its quicker to drive from there and there is nothing they are going to do that a competent ALS provider isn't going to do. Extrication or not..that is a straight shot down 9A. "When in doubt...call them out..." leads to unnecessary waste of medevac resources, unnecessary bills to patients and puts a flight crew and the patient at risk. I can honestly say that the few times I have used a medevac...there was no doubt in my mind...I knew exactly why I was calling them and EMS providers should know the same when they make that decisions as well.

2. With my above point in mind...you CYA with those skills you have and ones you definitely should be well confident in.

3. I make no decisions based on another agency blurting out "expedite" on the radio. Expedite is a word that should be banned from emergency services use. As if we stop to take breaks or I'm going to be able to levitate there. The discussion here points out further why this usually holds little merit. The patient went BLS...so the expedite I bet was solely based on having a vehicle that struck a piece of construction equipment.

Finally I have to ask this as I get more into my whole psychology education and I think more deeply into certain human behaviors.

How was this woman "lucky?" Was it luck? Or was it simply that the safety features of the vehicle...seat belt, airbag?, and the design of the crumple zones defused the energy in the way it was designed to do? Was she lucky she chose that car model?

Or how about if she was that lucky...she wouldn't have been doing whatever to cause her to smash into the backhoe. Why isn't the guy in the backhoe the lucky one. Little upper body support in those vehicles that are solid construction....

Just food for thought.

[khas143 13]

While your overall points on calling for a bird are warranted, (I once heard a chief call for one on a call that was 1.5 miles from WCMC with no prolonged extrication) what is the problem with putting the bird on standby. If this was going to be a very prolonged extrication, wouldn't having STATFLIGHT on standby reduce their response time if they were needed?

I may be a little ignorant in this but I was under the impression that STATFLIGHT crews could provide a higher level of care than a paramedic on scene. In addition, I would think that the crew on the bird would have a higher level of experience than a ground medic. (Obviously this is not in all cases but I would think most)

Anyways, great job by all involved especially Remember585 for his News12 interview.

Bro..no one is faulting you..and we always talk about stuff in person...but I will chime in with this as an overall point...not directly towards you (you know this as we're friends anyway).

1. Its quicker to drive from there and there is nothing they are going to do that a competent ALS provider isn't going to do. Extrication or not..that is a straight shot down 9A. "When in doubt...call them out..." leads to unnecessary waste of medevac resources, unnecessary bills to patients and puts a flight crew and the patient at risk. I can honestly say that the few times I have used a medevac...there was no doubt in my mind...I knew exactly why I was calling them and EMS providers should know the same when they make that decisions as well.

2. With my above point in mind...you CYA with those skills you have and ones you definitely should be well confident in.

3. I make no decisions based on another agency blurting out "expedite" on the radio. Expedite is a word that should be banned from emergency services use. As if we stop to take breaks or I'm going to be able to levitate there. The discussion here points out further why this usually holds little merit. The patient went BLS...so the expedite I bet was solely based on having a vehicle that struck a piece of construction equipment.

Finally I have to ask this as I get more into my whole psychology education and I think more deeply into certain human behaviors.

How was this woman "lucky?" Was it luck? Or was it simply that the safety features of the vehicle...seat belt, airbag?, and the design of the crumple zones defused the energy in the way it was designed to do? Was she lucky she chose that car model?

Or how about if she was that lucky...she wouldn't have been doing whatever to cause her to smash into the backhoe. Why isn't the guy in the backhoe the lucky one. Little upper body support in those vehicles that are solid construction....

Just food for thought.

[Guest]

Nice pics thanks for sharing

[Tanker 10eng 140]

I think we can say she is lucky she hit, or ran into, a backhoe instead of a truck or car traveling at the backhoe's speed... the hoe bucket was up and in the lucked travel position, when she ran into it, the arm was rocked and moved upward towards the operator, as the cable holds it up, thus absorbing the force of the 60 mph crash...It was a car, she would had a more direct hit, and transfered more force to the " slow " driver in front of her...

[Remember585 815]

I think we can say she is lucky she hit, or ran into, a backhoe instead of a truck or car traveling at the backhoe's speed... the hoe bucket was up

Had to get 'Hoe in there right Bill?

Luck was on her side as far as I'm concerned. 4-5 inches more towards the middle of the windshield and her injuries would of been worse, as it happened the A-post area took most of the shock.

The car she replaced yesterday was lower to the ground, and I don't doubt that it would of went under the bucket and potentially decapitated her.

I like when Luck is in town...

[Guest alsfirefighter]

While your overall points on calling for a bird are warranted, (I once heard a chief call for one on a call that was 1.5 miles from WCMC with no prolonged extrication) what is the problem with putting the bird on standby. If this was going to be a very prolonged extrication, wouldn't having STATFLIGHT on standby reduce their response time if they were needed?

I may be a little ignorant in this but I was under the impression that STATFLIGHT crews could provide a higher level of care than a paramedic on scene. In addition, I would think that the crew on the bird would have a higher level of experience than a ground medic. (Obviously this is not in all cases but I would think most)

Anyways, great job by all involved especially Remember585 for his News12 interview.

I want to point out that I am not taking anything away from the flight crews of Stat Flight as I am friends and teach with a few of them.

With that said...Prehospital trauma care...is prehospital trauma care. A Paramedic in a bird is one that came off a bus somewhere. Lets also keep in mind that most flight crews never come close to the scene as the patient gets extricated then put into the bus and then transported to the landing zone. Years ago before Westchester awoke up (yet again like 911 and many other issues) and started getting ALS throughout the county, the flight crews were often the only ALS in most areas...this isn't so anymore. In some area they might be able to RSI where a medic might not be able to, but even that is controversial as to its benefit. If you ever notice or talk to them...most flight crews either live on the graces of the medic or have to achieve what they feel needs to be done at the LZ before loading the patient in the bird as their is no room to do much of anything in there. Prolonged extrication as far as I can remember isn't one of the listed considerations for medevac use. Treat your patient...and other then managing critical life threats, particularly airway and hemhorrage, the best treatment is rapid extrictation and transport. Once they get in the bus...keep moving to the trauma center when your close enough. I work slightly north of the department in this incident and I can count with both hands how many times I've used the medevac in 10 years. Even with a medevac they are still going to get into the back of the ambulance, assess the patient, get a report, get the patient on their stretcher, get them in the bird, get settled, lift off and then fly down. If you just load and get moving once out...at those distances there is no real net gain in arrival. That is my main point.

I want to clarify something..I'm not faulting anyone for any decision they made and I know the person who made that decision personally and have been close friends and co workers for over 10 years. Some of you take some things said as gospel or as if its personal. I'm generating discussion.

Ger...you got a point there brother. Like I said..just generating discussion...I still say if she was that lucky she wouldn't have hit dick! LOL. Great job as usual with CFD with great scene management.

[Danger 160]

I drove by this today, looked like the bucket was about 6 inches from the pt's face, lucky enough.

[FDVA356 23]

ALS I thank you for the comments, as always take them and hopefully use the comments to better help myself in the future at incidents.

Def good feedback coming from all on this thread. Keep it going.

[helicopper 1,050]

STAT-FLIGHT, LIFENET, or whatever you call your medevac where you're from is nothing more (I'll say it again for emphasis) NOTHING MORE than an air ambulance. Protocols may be slightly different but as ALSFF already said some of the differences are a bit controversial. Requesting an air ambulance when you've got a ground ambulance at a prolonged extrication does little for the patients transport time to more definitive care. In fact with prolonged extrications the helicopter crew will often shut down the aircraft adding to the transport time. A running ambulance 11 miles from the medical center will probably be just as quick as the helicopter sitting idle at the scene.

I've also heard requests for medevac from areas within spitting distance from a trauma center too. Just doesn't make sense.

From what I've read here, the patient in this case was BLS to the hospital anyway. Why add a $10,000 ambulance bill to the miserable day she's having?

Mind you I am a strong proponent of medevac services used properly!

These are general comments and not directed at any of the responders involved in the case from this thread. It is not criticism but food for thought and discussion.

While your overall points on calling for a bird are warranted, (I once heard a chief call for one on a call that was 1.5 miles from WCMC with no prolonged extrication) what is the problem with putting the bird on standby. If this was going to be a very prolonged extrication, wouldn't having STATFLIGHT on standby reduce their response time if they were needed?

I may be a little ignorant in this but I was under the impression that STATFLIGHT crews could provide a higher level of care than a paramedic on scene. In addition, I would think that the crew on the bird would have a higher level of experience than a ground medic. (Obviously this is not in all cases but I would think most)

Anyways, great job by all involved especially Remember585 for his News12 interview.

[ny10570 745]

I never liked putting stat flight on standby based on other peoples radio transmissions or calls into 911. Things often look much worse than they really are and when you're stuck on scene with an injured person and can't do anything for them it ups the urgency in your own mind. A perfect example was a trauma on the Bruckner tonight. First calls had it coming in as a rollover involving up to 8 cars. Then, car torn in half many cars involved. PD got on scene and was asking for "multiple EMS for a whole lot of serious injuries". Turns out we had minivan vs sedan w/ 3 critical and 1 doa. Not 8 cars, never even declared an MCI since multiple units had been assigned due to the variety of locations coming in from callers. While the issue here isn't so much about putting stat flight on stand-by t does put other things in motion that weren't necessary and made things more complicated rather than simplifying the situation.

[ex-commish 490]

Finally I have to ask this as I get more into my whole psychology education and I think more deeply into certain human behaviors.

So tell us ALS...when do the counseling sessions start....LOL

[TR54 239]

Tim, can we use these pics on our websites?

Yes , sure. I'll send you a PM.

[Tapout 42]

From ALS Firefighter: "How was this woman "lucky?" Was it luck? Or was it simply that the safety features of the vehicle...seat belt, airbag?, and the design of the crumple zones defused the energy in the way it was designed to do? Was she lucky she chose that car model?

Or how about if she was that lucky...she wouldn't have been doing whatever to cause her to smash into the backhoe. Why isn't the guy in the backhoe the lucky one. Little upper body support in those vehicles that are solid construction....

Just food for thought."

She was lucky for many reasons, ALS... first and foremost, she did not die and didn't even lose any (major) body parts. Second, given the make of car, she's lucky her parents sprung for such an economical yet overall well-built vehicle. Third, she's lucky she was NOT miserable backhoe-driver guy. This pic breaks my heart-before all this, he was happily driving along at like 4mph... and he's thinking, "Woohoo! TGIF to ME! I'm off at 3pm, at happy hour by 4pm, tanked by 5... then BAMMMMM! What the ---- was that?!"

Seriously, look at this poor b---tard suffering over in front of the fire truck. You think he's feeling lucky right now? Hardly! Now HIM I feel sorry for... NOT the driver who didn't even notice the enormous yellow construction vehicle doing all of 5mph in front of her.

Edited February 28, 2009 by Tapout

[Tapout 42]

On a much more serious note than my previous post, I have to chime in from the viewpoint of the receiver of ground vs. ALS transport victims to the medical center ED. In a nutshell: it barely affects the overall patient outcome either way.

I, as the road wreck receiver, prefer the patient to come to us by ground, for the following reasons: in the hands of whichever medic is on scene (and thanks to him or her) we get the patient stabilized, with fat bilateral large bore IV's and a bag-o-bloods, along with a comprehensive head-to-toe assessment of exactly what needs to get fixed in-house. That equates to 20 minutes I DON'T need to spend doing all of the same things and means I get road wreck up to the O.R. 20 minutes sooner.

Save the bird for the really, really, really almost DOA cases. Everything else should be left in the more-than-capable hands of the local EMT-P's and their awesome -B's.