Victims impaled on wrought-iron and metal fences

[Guest]

Firefighters rescue man impaled on fence in PA

Associated Press (September 13, 2007)

YORK, Pa. - A man trying to climb a 12-foot, wrought-iron fence into a concert venue fell onto one of the inch-thick spikes, impaling his thigh, then held on while rescuers worked to cut part of the fence away.

The man drifted in and out of consciousness as firefighters used hydraulic cutters to snap three of the spikes, but he was speaking as rescuers loaded him into an ambulance about 45 minutes later, said John Kottmyer, assistant chief of York fire and rescue service.

"He had to actually try to hold himself up there," Kottmyer said.

The man underwent surgery Wednesday night and was still hospitalized Thursday, according to David Nichols, chief of the West Manchester Township Fire Department. His identity was not released; no police charges were filed.

The fence's sharp-ended spikes rise about 8 inches above a horizontal bar, and when the man fell, one spike penetrated his leg completely. Nichols said the rescuers could not have removed the man from the fence.

"Medical protocol is you don't ... remove an impalement because it may have severed an artery or nicked an artery and it could be holding that back that blood," Nichols said.

The man and several friends had been headed to the Bad Boys of Rock concert featuring the bands Hinder, Papa Roach and Buckcherry, according to York Fair vice president Gene Schenck.

The man had a concert ticket, but officials said the group may have jumped the fence to avoid the fair's $5 entry fee. His friends jumped the fence safely.

I am curious as to how various departments would deal with this type of injury. Although luckily we have never had to respond to this type of emergency I have sat through a seminar taught by members of FDNY Rescue 3. The first priority given was support of the patient. This is usually started by witnesses to the accident and first arriving companies. Some of the recommendations made were the use of backboards on both sides of the fence to support the patient since each backboard could be supported by 2 FFs preventing FF fatigue. They also pointed out that if A Frame ladders were available they could be used to help support the backboards.

As to patient removal they discussed the potential hazards of using hydraulic cutters and reciprocating saws. Both tools cause movement in the iron/ metal posts. The final cut of a hydraulic cutter often jolts the piece being cut possibly causing more internal injuries to the patient. The reciprocating saw will cause vibrations of the metal as well, often causing more injury or extreme discomfort to the patient.

Their recommendation was the use of a cutting torch. The torch should be used with a heatsink placed between the area being cut and the patient. The heatsink could be as simple as a wet towel wrapped tightly around the post. The heatsink will absorb and dissipate the heat being created in the iron by the cutting action preventing it from being transferred to the patient. Due to the small diameter of most fence posts the cut will be quick and the heatsink should absorb all heat created. During the cutting procedure the patient should be protected by a turnout coat or welders coat if available from any slag created.

I am curious how other departments would deal with this situation. Do you have cutting torches available and have you been trained on them.

[Guest]

My experience has been limited to smaller pieces of metal. We cut a heavy duty drain auger (the end was about 3/4 in diameter, made from about 9/64 diameter wire. Seemed to be case hardened) with a whizzer tool. Lots of dressings, kept soaked with water, between the cut and the guy. The auger passed thru thru the palm of his hand, so he had to be feeling something. Keeping the whole thing still was the best way to minimize his pain.

The rest have been overtightened handcuffs that wouldn't release. Not real impalement. Do the cutting under running water.

[JetPhoto 626]

I saw a photo of this in the paper, amazing.

[Guest TOYBUFF911]

Circulating band saw. It will not tranfer heat and further injure the patient.

[Guest]

Circulating band saw. It will not tranfer heat and further injure the patient.

Thank you TOYBUFF for reminding me...that was the other option they gave at the seminar, the circulating band saw. Some if not all FDNY Rescues carry them, but that is a highly specializied tool that I would expect maybe only 3-5 depts in CT actually carry, if that many. I know I wish we had one..... as well as the Whizzer tool (mentioned by Z19) the FDNY Rescue guys talked about how many machinery extrication incidents they were able to mitigate using it. But it all comes down to funding. And how much the powers that be wants to have us specialized. And then how much money they want to spend on it.

[Guest]

The whizzer we had was probably a Harbor Freight special, what ever they cost in 87. The air supply was a Scott bottle with a regulator. (same regulator for the HP Vetter bags) Low bucks operations in the first few years of our R-1.

[firemoose827 324]

Couple of questions...Whats a Whizzer Tool? The Circulating Band saw, does anyone have pictures of this tool to post or the whizzer? Just curious to see what these tools are. Thank you!

We dont carry a torch with us so we would have to use our sawsall or carefully use our Hydraulic cutter. We have the "Brake Pedal" cutter, I dont know if it would make any difference with the "snap" of the cut or the force the PT feels. I dont have that much experience with special rescues so I wouldnt know. I would check to see if the fence comes apart, sometimes people overlook the obvious...similar to "try before you pry" concept, look to see if it comes apart with basic tools like wrenches, screwdrivers, etc. Than you prevent further damage to the pt. Might be a transport problem depending on size of piece impaled, but at least you can cut the piece on the ground now as apposed to in the air. You can stabilize the pt with IV's and make a more controlled cut. Just thinking out loud!!

We could probably special call someone like a welding contractor to bring their equipment and expertise in the field to make the cut or provide technical assistance.

[x242Steve 1]

Portable Band-Saw (Milwaukee makes the best, Porter Cable's is ok too...)

I have used this tool in non-emergency settings more times than I can remember. It makes very clean cuts, and doesn't shake the heck out of the work-piece like a Sawzall or throw off sparks like a cutting wheel. The only thing to keep in mind is that this tool does have a "throat", so you can only cut materials around 4" deep and the cut material can then become "trapped" inside the tool if there is pressure on the area that you just cut. I can definitely see how this tool would be an excellent addition to the cutting tools usually found on a Heavy Rescue. Many tool rental places have them for rent, if you ever want to try one out before committing to buy.

[firemoose827 324]

Portable Band-Saw (Milwaukee makes the best, Porter Cable's is ok too...)

I have used this tool in non-emergency settings more times than I can remember. It makes very clean cuts, and doesn't shake the heck out of the work-piece like a Sawzall or throw off sparks like a cutting wheel. The only thing to keep in mind is that this tool does have a "throat", so you can only cut materials around 4" deep and the cut material can then become "trapped" inside the tool if there is pressure on the area that you just cut. I can definitely see how this tool would be an excellent addition to the cutting tools usually found on a Heavy Rescue. Many tool rental places have them for rent, if you ever want to try one out before committing to buy.

Thank you! Anyone have pics of the Whizer tool?

[Guest]

No pic. It's a small high speed air driven abrasive cut-off tool. Uses a wheel about two inches in diameter, 1/16-3/32 inch thick.

[Remember585 815]

The Wizzer is very similar to the saws used to remove casts, if memory serves. We had one on our Rescue, but I think it has been retired and not replaced....sadly.

Here's one type I could find a pic of - not sure if this is the exact thing used by FDNY but it's close (I think).

[Guest]

585 - thanks for the picture. I had one but couldn't upload it for some reason.

[HFD23 37]

Circulating band saw. It will not tranfer heat and further injure the patient.

Greenville FD Has one on their Collapse Trailer...

great tool, no heat very little vibration.

[capt2102 64]

I have actually had several of these type of rescues over the years and the two tools used were the wizzer and the Hurst brake cutter. Both fast to set up, small and easy to use overhead. You will need manpower and tools to support the patient, and don't forget the tool operator will be exposed to body fluids (Full PPE). Also remember that the business end of a pike pole is not good for patient support. lol

[ltjay157 10]

Let's see, $50 for concert tickets, trying to jump a fence to avoid paying a $5 entrance fee= $10,000+ hospital bill. Thank god for stupid people & job security I just love cheap people. Kinda like the ones that buy a Tom Tom or some other GPS gizmo for $400+ dollars then get mad when the route they're given is blocked due to a detour. If the just spent the $25 for an atlas, they'd know how to get around it. I know this is off topic, it just amazes me that people would go to such lengths to avoid paying for the little things but blow huge amounts on crap and not think twice about it.

[JCESU 20]

We have had allot of success with two different tools when it comes to impalements. With all of the hi-rise construction and industry still left in the Hudson County area we get a fair amount of "industrial accidents"... The first tool is the makita rebar cutter. It has a single axis cutting nodule that doesn't give the object that snapping sensation after the cut. The cost is roughly $2,300.00 and its battery operated with very little maint. The other tool is the Arcair slice/pak. It will basically cut through anything without heat transfer. The negatives are: large spark showers (have to be very aware of your sorroundings), fast burning rods and a pain in the a** to keep clean. And it takes some practice to be efficient with it as well. But it is a very effective tool.

http://www.cpomakita.com/other_tools/rebar...ref=googaw1136e

http://www.brweldingsupplies.com/brands/AR...id=600&ID=3

[robert benz 344]

the rebar cutter or "lobster tool" as it is called could be very effective we carry one on each truck and rescue, as for a torch we have 2 petrogen torches (gasoline and oxygen) easy to use and learn how to use, to go along with the before mentioned

wizzer saw and band saw

[firemoose827 324]

The Wizzer is very similar to the saws used to remove casts, if memory serves. We had one on our Rescue, but I think it has been retired and not replaced....sadly.

Here's one type I could find a pic of - not sure if this is the exact thing used by FDNY but it's close (I think).

Oh, so its a "grinder" as I have known it. Its used to cut things, grind things and sand things. Auto body people use it to buff and sand out bondo, dont they? Thank you very much for the info and pics everyone!!