Part 1 You are dispatched to a motor vehicle crash between a passenger vehicle and a tractor-trailer tanker truck

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Part 1

You are dispatched to a motor vehicle crash between a passenger vehicle and a tractor-trailer tanker truck. Upon your arrival, you notice a four-door passenger vehicle crashed into the side of the tanker truck. The tanker truck is resting against an electrical pole. The driver of the passenger vehicle is trapped behind the steering wheel.

1.         What safety hazards can be expected on this scene?

2.         What personal protective gear should be used by the EMTs at this scene?

 

Part 2

The fire department incident commander advises that the tanker truck is leaking gasoline. Rescue units have been dispatched but are 10 minutes away. The driver of the passenger vehicle appears to be unconscious. The driver's door is jammed, and the rear window is broken out. A blanket of foam is placed beneath the tanker truck and around the vehicle by the fire department.

3.         Is the scene safe enough for you to enter?

4.         If the area is determined to be safe, should you attempt to gain access to the patient?

Part 3

The rescue unit arrives on the scene, assesses the situation, and begins extrication. The driver's door is removed, the dash rolled, and the roof opened. The patient is turned over to you for continued care and transport to a medical facility.

5.         What safety concerns remain at this scene?

6.         What initial emergency care should be provided to the trapped driver?

 

Summary 

The incident involving an accident between a passenger vehicle and a tanker truck provides a variety of challenges to emergency responders as a whole and, more specifically, you. 

A variety of safety issues exist at this scene:

•       Traffic: Oncoming traffic is a concern at all motor vehicle incidents.

•       Electric: The tanker truck's position against the electric pole may have caused power lines to fall.

•       Hazardous material: The tanker truck itself may be leaking an unknown substance. Both the tanker truck and the passenger vehicle may be leaking diesel fuel, gasoline, or another type of hazardous product. 

Safety equipment can limit the potential for injury. At this scene, turnout gear should be used: helmet, coat, pants, boots, gloves, and eye protection. Respiratory protection should be used if a hazardous substance is leaking.

The incident commander will advise you when the scene is safe to enter. In this case, the foam from fire department hose lines should allow you to gain access through the broken rear window. There remains a continued concern about leaking gasoline and the potential for electric lines to fall. In addition, the extrication process can cause injury from flying glass, jagged metal, and the rescue tools themselves.

Initial emergency care will involve manual cervical spine immobilization, ensuring an airway, providing adequate ventilation, and providing high-flow oxygen. In addition, you should control significant bleeding and check for critical injuries.