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BOX 1 Extrication procedures assessed and method of assessment

From: Assessing spinal movement during four extrication methods: a biomechanical study using healthy volunteers

Roof removal: The A, B and C posts and the roof removed facilitating a vertical extrication technique (Fig. 1)

Study car preparation: the vehicle was stabilised, all posts were cut, the roof was removed and sharp edges were made safe

Study vehicle: Peugeot 307 5 door, 2004

Technique: The participant was provided with Manual In-Line Neck Stabilisation (MILNS) throughout, the back support of the driver’s seat was reclined mechanically and the Long Spinal Board (LSB) inserted to the seat base. The participant was then slid up the board until they were horizontally situated (securely) on the LSB

B-post rip: The B-post, drivers and drivers side rear door are removed to facilitate patient access and horizontal extrication (Fig. 1)

Study car preparation: The vehicle was stabilised, B-post was removed completely using two cuts and all sharps were made safe

Study vehicle: Peugeot 307 5 door, 2006

Technique: The participant was provided with MILNS throughout. The back support of the driver’s seat was reclined mechanically. The LSB was inserted at an oblique angle (pointed towards front centre console) and inserted to the seat base. Participant was then slid up the LSB until fully on the board at which point the LSB is rotated 45 degrees and placed horizontally onto the floor, next to the vehicle

Rapid: The driver’s door is opened and the casualty assisted with a lateral extrication technique

Study car preparation: The driver’s door was opened and the maximal opening angle enhanced using firefighter body weight only

Study vehicle: Seat Ibiza 5 door, 1999

Technique: The drivers door is opened. The participant was provided with MILNS throughout. The LSB was inserted under the right thigh and hip, through an open door on the driver’s side. Hereafter, the participant wasthen lifted up the LSB in a lateral position until the feet are released from under the steering column, allowing rotation onto back and then finally, slid into position further up the LSB (Fig. 1)

Self-extrication: The casualty leaves the vehicle without assistance

Study car preparation: The drivers door was opened

Study vehicle: Seat Ibiza 5 door, 1999

Technique: The participant is asked to get out of the vehicle and take one step away. The fire crew offered no instructions on how the participant should exit the vehicle