When performing an extrication on a bus with multiple patients, access normally will not be a problem but removal and dis-entanglement of patients could present challenges. Also keep in mind that when stabilizing the bus, you need to ensure your are using the frame and areas where the body provides strength enough to support stabilization.
Chocking the tires front and rear are required as is stabilization of the bus, in this scenario the bus remains upright, so using box cribbing you want to stabilize all four points of the bus on the frame or bumper areas as you can see in the following photos;
6x6 Box Cribbing - Front, with inverted step chocks
6x6 Cribbing - Rear with step chocks. Here the bumper is connected to frame - you will need to check this on other model buses!
6x6 Cribbing - Front
When dealing with Buses, Tractor-Trailers, Cement trucks, construction vehicles or Farm machinery a roof ladder or other platform like a truck bed can be used to provide the rescuer access to areas of the vehicle that are higher then 6 feet as shown the following photo;
With the use of power tools you will be able to create space from which to extricate patients and to provide more working room. Most of the work in the following pictures was done with the use of a Sawzall and hand-tools. The rear of the bus was opened by cutting away the rear walls and on to create a larger opening on the side of the bus, the window was cut as was the sidewall. Seat-backs were removed with a cutter.
Remember if you have stabilized the bus, the body should not move when extrication is being performed. As you remove elements of the bus, you will need to readjust your cribbing to ensure it is in good contact with the bus. If you are using air-bags, they are only for lifting, you will still need to stabilize.
As you are driving through the county, look at how many different bus models there are and think about your approach and tactics. Buses range from small community bus to a Greyhound interstate bus. Bus incidents normally are MCI, so be prepared!
-Kim
