Glass management is more than breaking glass
There are a lot of different ways rescuers deal with glass management at the scene of a vehicle accident with entrapment. The decision to remove or break glass is one that should center on the needs of the patient and what needs to be done to make the necessary space to remove the patient. Breaking tempered safety glass and cutting laminated safety glass both create hazards that have to be considered. With tempered safety glass you have the many pieces of the broken glass and with cutting laminated safety glass you have the glass dust. What other aspects do you need to consider when managing glass on scene?
Will the outcome outweigh the risk?
The first question you should ask yourself in a glass management situation is: “Does removing the glass in this door or window have a positive effect on the condition of the patient and their removal from the vehicle?" If the answer is no, then why create the broken/cut glass hazard and waste the time that could be used in a way that will be more positive for the patient’s condition?
Good glass management considers the weather
In the winter you may choose not to break or cut out any windows, in order to protect the patient from the cold temperatures, wind, sleet, or snow. In summertime on the other hand, breaking or cutting out a window could be done to provide a breeze that may keep the patient from overheating.
Appropriate glass management
Glass management does not necessarily mean removing all glass, and it is not only weather conditions that can change the game plan. Especially with preventing glass dust in mind, I would like to propose the option of managing appropriate glass. What does this mean?
Take for instance a road traffic accident where a car is so deformed that the doors won’t open and all the windows are still intact. You could then decide to break only a single window, as far away from your patient as possible in order to gain access. Then you can work with self-adhesive plastics to cover windows inside and/or outside. If this is done the right way, we can operate normally and use our hydraulic tools to remove car parts without having fear of glass particles flying around.
Another example of appropriate glass management is choosing alternate extrication methods to free the patient. Keeping the windows in one piece and not having to take out the glass means you need to look at different ways of removing the doors and roof. For instance by cutting the hinges instead of spreading them. Or by folding the roof forward instead of fully removing it. When you arrive at the scene of an accident, take a moment to carefully consider what the best options with regard to glass management are.
The future is laminated glass
Lastly, you will begin seeing more and more passenger vehicles involved in accidents where all the windows will be laminated safety glass. With the exception of needing to take out the glass for patient access, this glass does not need to be removed prior to spreading or cutting operations. Where laminated safety glass is located in the doors, you can use your spreader to remove the door as you normally would and the glass will not shatter. It may crack, but for the most part it will stay intact. This change in the safety standards for passenger vehicles provides you with a time saving opportunity.
Breaking glass: What about PPE?
Once you have concluded that glass does need to be cut or broken, make sure to do so safely. Generally we see most rescuers taking good care of themselves and the patient trapped in a vehicle when it comes to glass management. Nowadays pretty much everybody knows that cutting laminated windows will produce a lot of glass dust with inhalable particles. Some researchers say this can be marked as a carcinogenic substance, whereas other research shows no link between glass dust and health problems. We need to think about our options.
When traveling the world we see a lot of rescuers using filter masks in order to protect themselves from inhaling glass particles. Yes, even when breaking tempered safety glass, which generally only breaks into granulated chunks of glass. I have personally seen glass dust taking off in the air when breaking a tempered safety-glass window. So glass dust is possible when breaking any type of glass. My advice? Better to be safe than sorry! Wear appropriate respiratory protection when breaking or cutting glass, such as breathing apparatus or filter masks. And try not to touch broken glass, not even when wearing gloves. Glass particles may be trapped in the gloves’ outer layer and can hurt you or your patient when touching the skin. Better to use something over your hands, like a Sharp Edge Protection cover, when you need to push the glass away.
Important: Communicate what you are doing
When you choose to break or cut glass, make sure everyone working around the vehicle and the rescuer inside it are made aware of what you are about to do. This is especially important for the rescuer who is inside the car with the patient, to tell them what is about to happen and reassure them that you are protecting them from further harm. Good glass management is about communication as well.
glass management: Conclusion
Glass management is much more than deciding to remove the glass. It is a challenging process that requires careful consideration. New developments like laminated glass in all windows offer new options. With a lot of training and open discussions on working methods we can ensure to deal with glass management effectively, always with the end goal in mind of getting the patient quickly and safely removed from the vehicle and on their way to the hospital.
Remember, don’t train till you get it right, train so you never get it wrong. Stay safe.
I welcome your feedback in the comments
Dan Crowbridge
Holmatro Rescue Consultant