Vehicles coming to rest on their side pose safety concerns for rescuers and the patient(s) inside the vehicle. In this position, the vehicle has a very narrow footprint, and it can possibly roll over onto its roof or back onto its wheels. Either one of those actions could injure rescuers or exacerbate injuries the patient(s) have already received from the initial crash.

The first way rescuers should stabilize these vehicles is to approach from a safe area (the ends of the vehicle) and utilize cribbing and step chocks to increase the vehicle's contact with the ground. Place the cribbing under the roofline and along the underside of the vehicle. Once initially stabilized with cribbing, rescuers can then proceed on to setting up their tensioned buttress stabilization system. These stabilization systems can be setup with timber, but most often they are built using manufactured aluminum rescue struts.

The struts are placed to a strong part of the vehicle, typically as high as possible to maximize stability. The struts are then secured to the vehicle with ratchet straps which completes the system. Once the system is completed, the struts essentially become an extension of the vehicle, significantly increasing the width of its footprint. Depending on the vehicle's resting position and terrain, struts may need to be utilized on both sides of the vehicle. Alternatively, the vehicle can be "tied back" towards the side with the struts. This will prevent the vehicle from rolling toward the side opposite the struts.

The operation, strengths, and limitations of struts will vary from manufacturer-to-manufacturer, so be sure to familiarize yourself with the struts that your agency uses. Safely stabilizing a vehicle is an essential task that must be performed prior to accessing, disentangling, and extricating a patient from a crashed vehicle. Don't forget about your other scene hazards as well, such as traffic, fire, utilities, undeployed air bags, leaking fluids, and more. Stay safe out there!

Bill Elder
Elder Technical Rescue Services, LLC