Finally, the most important order of business was patient care. It was cold and windy out, the patient was in shock, and his pants were getting wet from kneeling in the snowy driveway. The NEQ paramedic initiated an IV, our EMS folks covered the patient with several blankets, and we kept his trapped hand warm with my own hand and several heat packs.
One might think extricating this patient would just be a matter of cutting the steel impeller barrel apart and freeing the hand. This was not the case since, just like in some car accidents, we had body parts to work around. The patient had limited mobility due to his arm being through the steel discharge chute and trapped deep inside the impeller housing. There was not enough room to get a saw in to cut the steel barrel, and even if there were, there was little room to maneuver, and if the saw slipped, it could injure the patient.
Therefore, this project was divided into three sectors. One was assigned to patient care, ensuring the man remained warm, alert, as pain-free as possible and out of further harm's way. The second group was in charge of disassembling the unit as quickly as possible without harming the patient or any rescuers. The third team was dedicated to safety, making sure all equipment was used in a safe manner, the area around the patient and crews was free of unnecessary equipment and cords, and any gas-powered devices were far enough away to prevent hazards to the crew.
Once the patient had an IV established and 5 mg of morphine on board, the disassembly began. We decided to cut apart the auger blades on one side to gain access to the impeller housing. After the right side of the auger was cut away, the housing was accessible. A piece of 4x4 cribbing was placed on the bottom of the impeller barrel. Using a set of hydraulic spreaders, we slowly spread the barrel open. This process took several attempts, as space was limited and the disassembly team was spreading slowly to ensure the spreaders didn't slip, the impellers were immobilized and the patient's fingers were out of the way.
After a few minutes, the housing was spread enough to allow me to pull the patient's fingers from above the impeller blades. Once freed, the fingers were wrapped in gauze in a position of use and the patient was moved to the waiting ambulance for transport. We were relieved to find all three fingers were attached, though badly crushed and mangled between the first and second distal knuckles. A few seconds after removal from the machine, they began to bleed. The patient had feeling in all fingertips, giving us hope for a good prognosis.
If you live in a place where people use snow blowers, take the time to learn about the machines. Just as with a person trapped in a motor vehicle or piece of heavy machinery, there is no standard way to remove someone entangled in a snow blower. Get familiar with any tools you have that can be used to take them apart, and simulate a few rescues. The more you know about these machines, the faster you'll be able to put a plan together to take them apart and free a patient.
Make sure you have good communication on all scenes. This is no place for freelancing or acting independently, as people, including rescuers, can get hurt. Beyond the simple problem of being entangled in machinery, additional factors such as extreme cold or heat, the patient's age and other medical conditions may necessitate prompt removal, especially if you are trying to save fingers or a hand that is still attached.
Proper training and good communications will ensure rapid, safe extrication of your patient.
A Guide to Snow Blowers
Snow blowers come in two types: Single-stage snow throwers and double-stage snow blowers. Single-stage snow throwers are often smaller and used for clearing just a few inches of dry snow, and the same blades used to gather snow also throw the snow out a chute.
Two-stage snow blowers are meant to move a lot more snow, and they demand respect. These machines are powered by gasoline engines varying from 5 to 12 HP and up. The front has a large opening to gather snow, known as a collector. The collector is occupied by a rotating auger with blades to pull the snow toward the impeller. The impeller is oriented perpendicularly to the collector and auger, and takes the snow from the front of the blower that is drawn in by the auger and, while spinning at a high rate of speed, throws the snow out through a discharge chute. Because these machines are meant to pull a lot of snow through and throw it a good distance, there is a tremendous amount of power, or torque, to maximize the throwing distance, especially of wet, heavy snow.