The Fifth Door and Modified Dash Lift extrication techniques described below will save time, require fewer tools, and produce effective results. They can be used at incidents involving vehicles with light or heavy damage. If there are one or more victims with head, spinal, fracture, or other injuries that require more room to apply necessary medical treatment, these techniques can be used in conjunction with each other to produce impressive results.
FIFTH DOOR TECHNIQUE
- Creates one large opening along the full length of the vehicle. This technique, along with a partial or total roof removal, completely opens the vehicle on one side for victim removal.
- Requires fewer cuts compared with removing doors and B post separately.
- Leaves less metal in the way of rescuers, compared with techniques in which doors are flapped down or left on.
- Can be used for larger victims who require more personnel and more room to extricate.
- Useful when access to one side of the vehicle is obstructed by a wall, another vehicle, or another stationary object.
- Useful in a T-bone collision involving head or neck injuries, when one side has heavy damage that prevents a quick door removal.
Procedure
1. Remove glass as needed.
 Photos by Robert Wadsworth |
2. Manually open the front door. If this is not possible, open the rear door with the hydraulic spreaders at the lock side, leaving the front door closed. The goal is to access the B post (photo 1).
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3. Cut the bottom of the B post deep and horizontal to the ground (photo 2).
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4. Close the front door.
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5. Open the rear door (photo 3).
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6. Finish cutting through the bottom of the B post. If there is a problem making a complete cut through the B post, try using hydraulic spreaders to tear remaining metal away from the rocker panel. Another very effective tool to use is a reciprocating saw with metal cutting blades (photo 4).
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7. Cut the top of the B post completely through the post and window frame (photo 5).
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8. Open both doors and B post as one unit. The front hinges may be cut to remove the entire unit (photos 6, 7, 8).
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MODIFIED DASH LIFT TECHNIQUE
- Requires fewer cuts than conventional dash roll.
- Provides larger, more open access to victims and passenger compartments.
- Minimal, if any, “nose diving” of the vehicle’s front end. The technique is designed to displace metal from the front passenger compartment under the dash area where victims may be trapped. If whatever the vehicle struck is still there, the conventional dash roll would push the metal toward this obstacle (another vehicle, a wall, a pole, an embankment, or the ground). The modified technique raises the metal up instead of forward.
- Minimizes chance of severing electrical wires or fuel line near the rocker panel. The dash roll requires a relief cut through the rocker panel at the bottom of the A post. Many vehicles carry fuel lines and electrical wiring near this area. The modified dash lift technique avoids this cut.
Procedure
1. Open or remove the front door to access the A post. It is not necessary to remove the front door completely; the goal is to gain access to the A post to make various cuts. Removing the door allows for an improved view of the A post area and keeps the work area clean (photo 9).
2. Make a cut through the lower portion of the A post where the A post and dashboard meet. This avoids cutting into any SRS devices in the A post (photo 10). The windshield may be included in this cut if it is laminated safety glass. Two cuts are preferable to avoid binding during the lift. The two cuts should be one fist size apart. If the two cuts sever the A post completely, the piece of A post metal will come free, leaving a fist-size void.
3. Open or pry the hood to access the top rail for access to the strut and shock absorber components. Opening the hood allows for improved vision prior to making the cuts. It is not absolutely necessary, as the top rail cut may include the hood.
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4. Cut the top rail perpendicular to the ground behind the strut/shock and in front of the firewall. Once again, two cuts are preferred to avoid binding (photo 11).
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5. Make two cuts horizontal to the rocker panel above the bottom door hinge on the A post. This will be the anchor point for the lift. The cut is preferred above the bottom hinge so the additional metal can be used as a base. These cuts should be as deep as possible and in line with the contour of the A post (photo 12).
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6. Remove or displace the metal from the previous cut to insert hydraulic spreader tips (photo 13).
7. Shore below the rocker panel underneath the A post. Always remember: Lift an inch, crib an inch.
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8. Insert the spreader tips perpendicular to the rocker panel in the A post cut (photo 14).
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9. Lift the dash area to access victims. When lifting is complete, extensive space is available for victim removal, and there are no tools in the way of victim access. (photos 15,16).
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No emergency scene is the same, and not all techniques work all the time. The two methods described here provide another way for the scene manager to visualize a solution to an extrication problem. Our challenge is to gather as many tools as possible, train our personnel, and improve our techniques. Knowledge, experience, and an open mind are our best assets.
Authors’ note: Presume that all safety issues will be controlled—including scene control and management, fuel and electrical systems, supplemental restraint devices, personal protective equipment, and vehicle stabilization. The extrication techniques described here are intended to provide additional “skill tools” for use during extrication scenes. These skill tools are designed to be modified and improved, as with any life-saving technique.
TROY BERCOT, a firefighter/EMT with Cedar Hammock (FL) Fire Rescue since 1996, is a certified Florida state fire instructor and teaches at the Sarasota County Technical Institute Fire Academy. He has taught vehicle extrication at FDIC and FDIC West.
ALEXANDER D. LOBETO has been a captain with Cedar Hammock (FL) Fire Rescue since 1987. He has taught vehicle extrication at FDIC, FDIC West, and the Firehouse Expo. Lobeto has written several articles in various fire service trade magazines including Fire Engineering and FireRescue. He is technician level vehicle and machinery rescue NFPA 1670.
