By Joe Poulton, MTI Contributor
In 2019 on the Wildfire Lessons webpage Travis Dotson wrote an article titled How We Roll. In it he brought up that fifty-nine percent of 2018 rollovers were Dozers and Water Tenders in that 2018 year there was also a UTV and an ATV. At the end of his article, he suggested to “discuss ways to prepare for and prevent rollovers.” With the increased use of UTVs through the addition of Rapid Extrication Module Systems as a resource on Wildland Fires looking specifically at UTV rollovers was appropriate.
Between 2012 and 2022 there were 13 UTV roll over incidents recorded in the Wildland Fire Incident database. During that time the Rapid Extrication Module has evolved to utilize UTVs. Two specific incidents in the database stand out, the Howard Fire Bridge Collapse in 2013 and the Pigeon Creek Fatality in 2021. The Pigeon Creek Fatality was an incident involving rapid acceleration of the UTV with no specific fault determined to have caused the incident and resulting in fatal injuries when Selinde Roosenburg became pinned under the side of the UTV. The lessons learned include a note that “doors should be installed and properly functioning on all UTVs. Like seat belts, properly secured doors help ensure that neither driver nor passenger are ejected from the vehicle.” This specific incident points out the necessity of UTV design to fully and properly protect all passengers, this includes the patient and the attendant but with current allowable designs they have an increased exposure during a rollover incident.
The Howard Fire bridge collapse also shows a need for UTV design to better protect the patient being carried on a REM. In the incident review it notes that crews became comfortable with the bridge despite the initial apprehension of a number of crew members they chose to continue with its use. If a REM makes a similar crossing to access a work area with current UTV designs that have the patient stokes placed off the back end of a UTV exposing the attendant and patient to increased potential trauma. Furthermore, some designs also include tool racks on the side of the stokes areas that are not an integrated roll cage and will induce additional trauma as well if not fatal ones.
Also of note, is data from a 2016 research paper on the Characteristics of Side Crashes and Related Injuries from the University of Iowa. In that data set gathered from nine states between 2009 to 2011 their findings noted that “over two-thirds of SxS crashes included a fall/ejection from the vehicle in the sequence of events. Almost half of all SxS crash victims were struck or pinned by the vehicle. Twenty-eight SxS crash victims were noted to have died from their injuries in the newspaper reports.” While also noting “a rollover was the primary mechanism in 53% of SxS crashes”
The current REM typing in the California Firescope REM ICS 223 has the UTV as optional with no other specifications which leaves open many design possibilities where a patient could be placed. In a communication with the Forest Service about REM typing the response was that “there are currently no National Wildland Coordinating Group (NWCG) interagency standards, which would include the Forest Service, for Rapid Extraction Module Systems (REMS). Therefore we currently do not have any typing. There is a unit under NWCG Emergency Medical Subcommittee that may begin discussions on standardizing REMS, and that could include typing those resources. That group is aware of the Fire Scope standards and their typing from California.”
Based on the potential for UTV rollovers mitigation through training and awareness of the capabilities along with limitations of a given UTV should be fully understood by the crew operating. The design could also be specific in the typing for wildland fire use as a way to better prepare for the potential event of a rollover. In a number of hypothetical scenarios that could occur while a REM was transporting a patient, the patient and attendant location would be a vital consideration. Even while an operator was proceeding with caution in the variety of fireline terrain the REM accesses urban EMS lessons have always included to expect the unexpected. In the wildland environment, that could be a soft shoulder, terrain type change or rut encountered incorrectly, a log or boulder rolling, wildlife jumping out. A rollover could result while ejecting the attendant and pinning the patient against a tree or boulder when using a rear bed mount.
A possible way to prepare and mitigate a patient pinning and attendant ejection is a design where the stokes basket could be slid into the middle of a modified 6 seater UTV or a design that places the patient and attendant inside the roll cage. The Phoenix REM crew had modified theirs this way back in 2017 when we met on a deployment and it’s design made functional sense with increased safety for the patient which had the patient fully restrained inside the roll cage down the middle. It also allowed for up to 3 additional REM crew members to monitor the patient, this could be vital with certain types of multiple injuries sustained by a patient.
The placement of patients on a UTV has been a conversation point among REM crews in the field. Considering the reported incident data and lessons learned from these events. The design specifications of where the patient is placed even while UTVs remains optional should be considered in relationship to an increase of UTV use by REMS in a function not widely used before which in theory could result in an increase of rollover incidents by the multiplying effect of increased use.
A change of this nature in UTV design requirements would utilize the lessons learned with the Pigeon Creek Fatality and better prepare and protect against assessment errors like the bridge collapse. This style of preparation for a rollover event would be beneficial while at the same time improving training to impact the human error aspect by improving awareness of UTV capabilities. By slowing down, considering what is occurring in each moment and making clear decisions like in urban EMS, Code 3 driving is only a request for right of way not an excuse to drive fast. Training to remove that inclination that emergency means driving fast is always beneficial.
With the 2022 season wrapping up and the snows about to hit. This could be an ideal time to add this to the conversation for 2023 REM typing. Or if you’re managing an agency with a REM consider the design for improved overall safety.
Joe Poulton has worked in EMS for 12 years with the last 8 being on the Reach and Treat team in Clackamas County OR.
Interested in being a paid MTI Contributor? Email rob@mtntactical.com a current resume and 3 topic ideas.
Notes:
https://firescope.caloes.ca.gov/ICS%20Documents/ICS-223.pdf
Forest Service:
There are currently no National Wildland Coordinating Group (NWCG) interagency standards, which would include the Forest Service, for Rapid Extraction Module Systems (REMS). Therefore we currently do not have any typing. There is a unit under NWCG Emergency Medical Subcommittee that may begin discussions on standardizing REMS, and that could include typing those resources. That group is aware of the Fire Scope standards and their typing from California.
You may want go directly to the NWCG Emergency Medical Subcommittee for more information:Emergency Medical Committee | NWCG
https://wildfirelessons.blog/2019/03/05/how-we-roll/
Civilian incidents with injuries from being in UTV bed:
https://www.kxxv.com/news/local-news/atv-accident-off-hwy-14-leaves-2-in-critical-condition
“Overturning is a common hazard for all types of OHVs. An overturning vehicle report may indicate the vehicle overturning forward, backward, sideways (rollover), or in an unknown direction. Forward and backward overturns often occur while descending or ascending steep terrain. On flat terrain, when an OHV operator attempts to make a sharp turn, the OHV may roll over due to factors such as high rate of speed, change in the terrain surface type (e.g., from gravel to sand), and/or improper loading. Rollovers may also occur due to slanted or uneven5terrain. Rollovers are especially consequential for ROVs. Based on 801 investigations of ROV fatal incidents, staff determined that more than two-thirds involved rollover of the ROV. About one-fifth of ROV fatalities in the same investigated sample involved an attempt on level terrain to make a turn prior to rollover. Staff’s review of historical ATV data found that the involved ATV overturned in at least 65 percent of fatal incidents, but this includes incidents with other events (such as collisions) that may have preceded the overturning of the ATV. Staff’s review finds overturns as the primary hazard in about 38 percent of ATV fatalities.”
Manufacturing challenges
https://pdfs.semanticscholar.org/a75e/b205f8bbad4f4c2c732ca6adebf72f9f8fab.pdf
“a rollover was the primary mechanism in 53% of SxS crashes”
“Over two-thirds of SxS crashes included a fall/ejection from the vehicle in the sequence of events. See Table 4. Almost half of all SxS crash victims were struck or pinned by the vehicle. Twenty-eight SxS crash victims were noted to have died from their injuries in the newspaper reports.”
“Half of all fatalities involved a rollover as their primary crash mechanism”
“Similar to ATVs, a majority of the SxS crashes were rollovers. The CPSC in their analysis of collected ROV incidents found that about two-thirds of the cases, including about 90% of those severely injured were in a lateral rollover [1]. Of those for which the terrain was known, just over half occurred on flat terrain “
“SxSs are typically equipped with lights, but it was still surprising to see that nearly two-fifths of ROV crashes in the study occurred during compromised light conditions, all at night except for one occurring at dusk. Certainly, off-road driving is particularly hazardous at night when it may be even more difficult to appreciate changes in terrain and the presence of obstacles.”
“Moreover, proposed standards as initiated by the CPSC to engineer improved vehicle safety regarding lateral stability, vehicle handling and occupant protection performance should be adopted.”