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So now what we are going to show you is a technique that actually is quite old but using modern technology. We used to use a system for rapid extrication called the Cincinnati roll. It came from America, and it was a way of using a blanket to extricate a patient from a car crash or from any situation where speed was critical. We must remember that rapid extrication is time-critical. So, we have got to look after the patient's back and neck, but we have also got to get that patient into a position where we can work on them at speed. So if we have got somebody in a cardiac arrest who is in the car, we cannot do CPR in the car, so we need to get them out onto the road surface and we need to do that in a safe way to protect our own backs, to protect the patient and the patient's neck. But obviously, time-critical, when you are talking about cardiac arrest. The only other times you would use this technique is when potentially the patient's life is in danger due to the car catching fire, chemicals. It is basically where we need and has a legitimate reason for moving that patient at speed, with equipment that we have easily at hand and that is safe and looks after ourselves in the process.

When a patient goes unconscious, they lose muscle tone, so they become very floppy. So, anybody that has ever done this will realize that when you try to move that patient, they are dead weight and very difficult to move. And this is a technique using a 3-metre, 5-ton lifting strap, which is carried on every fire truck in the UK, to move that patient and bring them under control and protect their neck. So, for demonstration purposes, we are going to actually apply this to Rob whilst he is standing up, so you can actually see how it goes before we use it actually in the sitting position in a car itself. So, the first thing we do is we find the centre of the strop. So midpoint. Once we have a midpoint, midpoint goes to the centre of Rob's jaw around his neck, front to back. It is important it goes front to back. It will not work if you go back to the front. So, front to back is the first important point. The next thing that happens is the strap crosses around the back of the patient's neck. Now you can see what we have done is we have formed a collar. That collar, as we use the technique, will not tighten. We then come back to the front and complete the collar. So the collar now has gone all the way around Rob's neck and all the way back to the front.

And then what we do is we take the tail ends underneath the arms and come back to the back of the patient, so we finish in this position. This position gives us then a safe lifting technique and a way of holding the patient without losing control of any of the body, because wherever I go, wherever I want the patient to go, they come with me. It protects the neck, so we get C spine immobilisation, it gives me a safe pair of handles to lift the patient, it takes the arm movement and chest movement out of the equation, so at all times, I have control. Once the patient is in the loop and fixed properly, all we then do is reach around the back of the patient, grab the tail end of the strap and grab the tail end of the strap on this side of the patient and the patient is now completely in my control.

We then duck the patient's head underneath the car, so they have come underneath the headlining; totally in my control. We bring the patient towards my waist and the patient comes out of the car under control. We can then lie the patient back to the floor and the resuscitation can commence. We have put one around the upper part of the body. If we have the manpower and if we have two strops and all fire services normally carry two strops on their vehicle, we can actually do it under a more controlled manner, by placing the second strap across the lap, just above the knees, part the straps and feed one end back up through the centre, the second side back up through the centre, and we now have a perfect seat to extricate the patient. And I will now demonstrate how two people extricate the patient with two straps. So, now the second strop is in position, we get a second member of staff to help us. 

And again, the person on the legs just controls the weight. The patient comes straight out of the car in a sitting position and is then lowered, either onto a spinal board, onto a scoop or onto the surface of the floor so we can now commence CPR. The technique does not put any strain on your lower back, because you have a set of handles at waist height to move the patient's body weight. Now, we are going to show the technique in real time. Please remember the warnings that go with this. This is a rapid extrication technique. It is a technique for getting a patient who is in cardiac arrest, or who is in a life-threatening situation without them being moved immediately, out of or away from danger. So, practice, practice, practice. It is not something that you can just do willy-nilly. Also, run it past your Health and Safety before using it, because they will have to sign it off. But it does protect your back. It does protect the patient. And it gives us a perfect lifting technique or moving technique for a patient in cardiac arrest. It can be used to get people out of tanks. It can be used to get people out of the water into boats. It is a technique that brings the body under control that protects the neck, protects the airway and gives us a way of putting handles onto a patient to move them safely in their hour of need.

Also, remember the reason we say 5-ton lifting strop is because of the actual diameter and thickness of the strap itself. If we tried doing this with a piece of rope, for instance, it is too narrow and it tightens. Because of the dimensions, it is a perfect fit to the neck, so it produces a perfect collar and it does not tighten. Practice makes perfect. Be careful when using lifting techniques and remember it is for rapid extrication only.