Blog Health and Wellness

FireFit!

What makes us fit for duty? Training.

What training are we referring to? Tasks used to perform our job. Whether it be a technical rescue, hazmat knowledge, ARFF, district familiarization or countless other avenues, as firefighters we are called upon to know an extremely wide range of skills to perform our duties and go home at the end of our shifts.

While this knowledge is part of the necessary tools needed to perform, almost half of our brothers and sisters who pay the ultimate price do so because of overexertion. When called upon to fight fires, it takes an enormous amount of physical exertion to do our job, yet we aren’t physically training for the arduous tasks we will probably encounter.

That’s where Firefit Firefighter Fitness Trainer comes in. This machine mimics the most strenuous of fireground activities in a compact unit that will fit in the corner of most fire station truck rooms. In some cases, departments are replacing the cumbersome entrance exam equipment with Firefit. It’s turn key, requires virtually no set up and is modeled after the CPAT, with a couple of exceptions of course. Just drag the machine from the truck room to the station apron, or use it inside if you have the space for it.

Firefit was created and tested by Randy Johnson, a 14 yr firefighter in the Texas Panhandle, 13 of those as a career firefighter. His personal results while doing a six-week testing program were nothing short of phenomenal. Starting with his heart rate, Day 1 resting heart rate was 66, working HR in the 180’s and recovery time to resting was 14 minutes. His body fat was 22%. Weight was 202. After six weeks using Firefit as his only training, and only on duty for a total usage of 15 times, his HR was in the 150’s during the workout; recovery time dropped to 4.5 minutes! Randy lost 7 lbs, gained back 2 (probably muscle), and lost 4% bodyfat.

While these results are amazing in themselves, the reason for the creation of Firefit, according to Randy, is to reduce the number of names we put on the wall in Colorado Springs and Emmitsburg every September and October, respectively. After all, isn’t that the goal and why we train to be the best at what we do?

 

 

 

 

 

 

 

 

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Junior Involvement in Senior Training

​I know of a few departments around me who don’t let their juniors do anything, and by anything I mean throwing ladders, stretching lines, hitting a hydrant…You know, the basic things every firefighter should be 100% efficient at.

Up at my company, we look at juniors as the future of our company. They are involved in meetings, drills, hall rentals, cleaning. Everything a senior member can do at the station, a junior member can also.

​I’m from a company in Allegheny County, Pennsylvania, called Munhall Volunteer Fire Company #5. We run a Tower-Ladder, an Engine, and a Squad. In our borough, we have four different stations, one located at each end, and two in the middle. I can’t say we are a busy company, but every time we go to a call, we do it quick, proficient, and right. I really can’t stress enough about having a junior program in your stations. When I first started out, I was 14. I joined a company in the hometown I lived in, and it was called Whitaker. They ran two Engines, a Squad, and a Foam Unit. I fell in love with it the first day I joined. My dad was and still is the Assistant Chief there, and he helped me get through everything tremendously. If it weren’t for them having that junior program, I would’ve never had as much passion for the fire service as I do now.

 

​After two years, I moved on down the street to the station I’m currently at. I joined when I was 16, and right when I joined they only allowed members 16 and up. But a few months had passed, and we changed our by-laws and are now able to allow members to join at 14. That was by far the best decision our company has ever made. We currently have seven junior members. I was the 8th, but I just recently turned 18 and have become a fully active member. When I was a junior, we had a junior officer line. I was the Junior Chief, my buddy Jake was the Captain, and the Chief’s son was the Lieutenant. Being able to already hold an officer position at that age was like winning an Emmy.

You must be thinking, “Oh, okay, they just had a title…” No, we had duties and responsibilities to handle by ourselves.

Me being the Junior Chief, my duty was to train the juniors up to my level and make sure they know the ins and outs of the fire hall. I was a pretty educated kid at that age, and I had my brother and my two uncles help me out along the way. Several times at drill, they put me as the lead guy, the front man, the role model for the other juniors to look up too. When I first started this, I would always wonder why they put a 16-year-old up on stage to teach the SENIOR guys. It took me two long years to realize why. The only way you are going to better yourself is by trying to better other people. If it weren’t for this junior program, I wouldn’t be as smart or as trained as I am right now.

When I teach at our weekly drill, I look at it from a junior’s perspective. I can see what they do and don’t understand; I was in their shoes for 99% of my time so far. No matter what we do at drill, the juniors do the same. When we cut holes in our simulator, they are right there doing the same thing. They watch us, then they do it. When they do it, we go step-by-step with them, making sure they don’t mess up, but when they do, we reassure them it’s okay. When you’re training, that is the time to make those mistakes. You learn a lot more from the mistakes than doing it right.

Many people criticize and bash juniors for being untrained “whackers.” Well, start training them. Get them involved with EVERYTHING. Every single time you’re at the station with them, go over the trucks, throw ladders, pull some lines, learn what every tool does and their names, learn the role of the officers, learn the different truck and engine duties. Teach every single junior how you would want someone coming to your house at 3 in the morning for a working fire. After all, those juniors will fill your shoes one day.

If you don’t have a junior program or you don’t train your juniors because they aren’t certified, then step up. Make a difference in a young person’s life and be their role model. Be the one that when they say they first started out, you helped them. There is no better feeling in this world than making someone’s life better, if you don’t think that is true, you’re in the wrong line of work. Every time you go to a call and see an elderly woman standing in her doorway telling you guys that the fire alarm was an accident, you check to make sure, and you smile and say have a good night to her. You just made her feel safer and one of the happiest people in this world. She now knows that when trouble occurs, people that have never even met her will drop ANYTHING to save her and that my friends is one of the greatest feelings you can have. Do not take this job lightly. Train, stay fit and treat everyone fairly. Just remember, you were a junior at one point in time also. Make sure all your other juniors act in the same manner of courtesy to that elderly woman, as you did.

– ​​​​​​​Jonathan Scripp
Munhall VFC #5

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Her First Day (Mother’s Day)

Mother’s Day is right around the corner, so it only seems fitting that I should write about women in today’s fire service. I don’t know about you, but I can’t advise messing with someone who can both endure childbirth and swing a halligan. Cheese, light-hearted humor, mild controversy, and hard truths are all present and accounted for in my bag of writing tricks this morning. Let’s begin…

You walk through the front door of your local fire department on your first day on the job. You’ve dreamt of this very moment since your dad took you to see ‘Ladder 49’ as a little girl. The bay smells like diesel exhaust and various cleaning products, and the dining area smells of coffee and fresh kitchen table BS. Yes, this is exactly what you had hoped it would be like. A crisp blue uniform and black boots with nary a scuff or blood borne pathogen to be found on them.

You went to fire school and raised ladders, humped hose, slayed simulated dragons and dragged rescue dummies (some dummies even had pulses). You attended EMT classes and had your Hollywood expectations of life-saving heroics demolished, just like all that came before you. You’ve waded through interviews, physicals, psych evals and polygraphs to earn a chance here.

Your dad gave you parting advice as you left this morning; “You’re the new guy. Be seen and not heard, always be the last to eat and the first to wash dishes. Pay attention to your LT. Love you.” Some of the guys seem distant this morning, others, jovial. The coffee must not have kicked in yet.

Your gear is issued, and you get to work.

Fast forward to one month in; You’re growing as a firefighter. The things you learned in class are finally starting to make more (or less) sense, but you still feel out-of-place. ‘Maybe it’s me,’ you’ve asked yourself once or twice. Most of your new coworkers are genuinely good guys, but a select few either treat you like a fragile porcelain doll or a hindrance that they must bear the weight of for 24 hours.

You’re becoming increasingly agitated by romantic advances from co-workers and have even heard rumors swirling about your involvement with several of the guys from other shifts. True or not, why is this news any of their concern?

There have been grumblings from out of shape firemen about your physical ability to do this job. Despite passing all of the physical requirements and being able to stretch an SCBA cylinder to its very limits, you still catch shit from a guy that perspires at the mere mention of physical exertion.

“I weigh 300lbs; there’s no way she can drag me out of a fire!”

‘So, don’t weigh 300lbs,’ you think to yourself. A lack of dietary self-control on his part has somehow morphed into a negative remark about you. Is this guy for real?

There are plenty of other whispered criticisms; she’s a distraction, some jobs are better left to the men, she only got hired to boost diversity numbers, etc.

What gives?

This isn’t what it was supposed to be like.

Why do you feel like an outsider, the constant third wheel of the firehouse?

You were told this would be the beginning of the best years of your life, working alongside people who will become like family to you. If any of this was indeed true, you are off to a slow start…

Sparing my dramatic liberties, this is what the fire service might look like to your female coworkers. Hopefully, the overwhelming majority of women reading this are scratching their heads, having never encountered this kind of issue at work. I sincerely wish for that, that all of this was simply make-believe. Unfortunately, we know that more than a few will relate quite well. On a more somber related note, a female firefighter recently committed suicide. Her actions are believed to have been sparked, at least in part, by workplace harassment. She was the topic of crude online comments, rumors, and stories. The information that was uncovered during the investigation will leave an ugly scar on the department forever, regardless of its role in her choice. Suicides rates are statistically higher in public service careers; this is not disputed. Did her “brothers” throw gasoline on a fire that was already burning hot enough on its own? Given this knowledge, any excuse you might have for the kind of treatment faced by our fictional firefighter described at the outset of this discussion is a bad one. Don’t be an ass.

How long has this gone on? I don’t know. Probably since the first woman picked up her first ax on her first horse-drawn, steam-powered fire engine.

The first known female firefighter in the United States was Molly Williams (per i-women.com Terese M. Floren 2007), a New York City slave who became a firefighter with Oceanus Engine Co. #11 in 1815. The first paid urban career female firefighter in the United States? Sarah Forcier in Winston-Salem, North Carolina in 1973. Women have been “Doin’ it” in the US of A for over 200 years, but it is still news when “insert name here,” Texas Fire Department hires their first female employee.

The reason is clear; this has been a boy’s club for generation after generation, and some opponents of change are being dragged into 2017 kicking and screaming. We all have worked with, met or know of one of these guys. Don’t play dumb. Hell, maybe you are that guy.

Ask yourself what your department looks like through the eyes of your female co-workers and their families. Why stop there? These same arguments can be made by anyone that feels disenfranchised by public service. The topic may be Mother’s Day-themed, but the message is about common decency.

So, is your department or shift one that makes them go home and tell their families about the great group of brothers they work with, or one that makes them go home and question their career choices? I have a wife. I claim sisters of the blood, marital and fire service variety. I have a mother, aunts, grandmothers. I have a daughter (love you, kid, if you’re reading this someday). If they were to follow me to work one day, would they approve of the way I treat my sisters in service? I like to think they would. Would yours?

There’s a fine line to be considered here. The line between making someone feel like a welcome member of the department, and treating someone differently in a way that makes them feel like an outsider. The line between innocent fun and downright bullying, between including them in questionable (see; fun) antics and being overprotective. If you must ask yourself if your department falls over the line, it’s probably time to change the culture of your department. The women I have met doing this job have no interest in special treatment or coddling. In fact, nearly all just want to be “one of the crew.” Nothing more, certainly nothing less. Many of them may not even like that I am writing this piece because in perhaps the very truest of firefighter fashions they don’t want to draw attention to themselves.

“I’m not changing the culture of my department, there’s no reason. They joined us, we didn’t join them.”

In the words of Maya Angelou; “if you don’t like something, change it. If you can’t change it, change your attitude.”

Folks, the time has come to change some attitudes. To provide a pleasant nudge in the right direction, here are a few guidelines to aid in your future decision-making processes. These guidelines can apply to almost all of life’s situations, I have found.

-If it wouldn’t be funny to be said about (or to) your little brother or sister, it probably won’t be funny about (or to) most of your co-workers.

-If it would be embarrassing to have your family overhear you speak that way about someone, don’t speak it.

-If it feels wrong, it probably is.

-Always assume your mother is creeping just over your shoulder, ready to pounce and twist your ear while dragging you off-screen (using your FULL NAME, of course).

-It is possible to be both a brother and a gentleman.

-You don’t get to decide what should and should not be hurtful, offensive, or irritating to another. This is a tough concept for many to grasp.

To bring it all home, let’s talk about how this affects me because that’s what’s really important here, right?

It’s a hurdle I’ll never have to worry about jumping, so why even drag it out and open myself to (mostly) good-natured heat? What, if anything, do I stand to profit?

I have skin in the game. I’ll explain;

Someday, my daughter may decide to follow in my footsteps. I genuinely hope that she inherits her mother’s brains and grows up to become a rocket scientist, but I won’t stand in her way. I do worry about what kind of legacy we might be leaving behind for her and others; it doesn’t seem fair that she should have to inherit our messes. “Painful” might not be a strong enough word to describe how it would feel to watch one of my children struggle against antiquated typecasting that I had a hand in cultivating, whether by indifference or otherwise. Lastly, my daughter will inevitably run into coworkers of mine, both past and current, if she decides to enter public service. What might they have to share about me, what kinds of stories do I want to be told about me to my offspring? Will they reinforce her (hopefully) cherished memories of Firefighter Dad, protector, and friend, or will they tarnish them?

Will she be forced to question which man was the real me, “Work Dad” or “Home Dad?”

It’s up to me, I suppose.

Yours is up to you.

Happy Mother’s Day

– Randy Anderson

 

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OWN THAT SH!T

You know, the small boy in my heart has always wanted to be a fireman, and I’ve always been a little envious of the guys that get to wear the big names on their coats i.e. Dallas, Ft Worth, Houston, New York, Boston…even Amarillo, Lubbock and so on…..
But my coat says Vernon, and you know what, we do the same job with 10% of the personnel, but 10x the heart…I couldn’t be prouder of MY dept.

 

 

We don’t need the big name, and we obviously will do this job with much less than the big city paycheck because we vowed to protect our community and our community’s belongings.

Take ownership in YOUR trucks, YOUR department, YOUR crew, YOUR name on your coat. Take pride in making those things shine like a diamond through cleaning, preparing, and training. Push through the shitty days and relish in the days that are call-free or full of the “fun stuff.” That kind of investment in YOUR department will only drive you to continue to grow and “leave it better than you found it.”

 

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On Scene Arms Race

I sit here at my desk, facing the street, typing furiously on my wife’s laptop because mine doesn’t have Microsoft Word. It is 2017. We have Drones. We have Cell phones that are essentially portable supercomputers. Why do we not have Word on every laptop? What else does one do with a laptop?

But I digress.

We have a sticky situation to look at. It seems to have cooled of late, but you can still hear whispers of it in dark corners of rural firehouses. I’m talking about carrying firearms on fire and EMS scenes. This issue reared its ugly head a few years ago, and never really died for some of us. I can walk into either of the departments I work for right now and stir up a heated debate just by mentioning this in passing. Keep in mind, I live in a mostly-rural sector of Ohio. Out here, everyone seems to be armed. You walk into any given house on a call and it wouldn’t be all that alarming to spot a rifle mounted on the wall, three shotguns in a cabinet in the corner, a pistol on the end table and one more stripped down on the dining room table. You are aware of them, absolutely, you are aware of them, but they don’t elicit the same alarm response that they might merit in another part of the country. Out here, we have become somewhat numbed to the presence of firearms on scene. I don’t want to say blind to it, but there is certainly room for complacency to gain a foothold. Given that there are so many guns around here, and we are mostly at ease with them, one could easily assume that I am a supporter of arming firefighters and EMS personnel. I am not.

Don’t even bring up personal safety on scene as a valid reason to carry. If you want to talk fireground and EMS scene safety, can we first compare the number of deaths caused by a lack of guns versus the surplus of Big Macs? According to a June, 2016 NFPA report, 51% of firefighter fatalities last year were caused by sudden cardiac arrest. It would be no surprise to learn that a not inconsiderable percentage of these cases of sudden cardiac arrest could have been avoided by dietary changes and exercise. And yet, loudly-documented, obvious health issues still don’t trigger nearly the emotional response that the topic of carrying on duty does.

Care to take a guess at the percentage of firefighter fatalities by “gunshot” or “fatal assault?” 1%. That’s right, 1%, folks. Emotionally disturbed patients and knife-wielding lunatics aren’t killing us; second and third helpings at the dinner table are far more efficient means. That’s not me, Randy the “Lefty Liberal Snowflake” telling you that. That’s the NFPA.

There’s this gnawing sensation that we have our priorities out of order. Or, maybe it’s just me. Here’s what gets me frustrated; We know that poor diet is killing us across the board. We know that a lack of training can have tragic consequences. We know for a fact that all manner of carcinogens are present in smoke and debris. Given all those known unresolved safety issues, why are guns even on our radar? If we rectify every other issue and make firefighting and EMS the safest professions in the world, save for gunshots and stabbings, then talk to me about carrying on scene. If ever death by “fatal assault” should creep into the double-digit percentages, yeah, let’s discuss it. Until then, we have not only bigger fish to fry, but whales in comparison.

Me, personally? I have no desire for myself, nor any member of my crew to be armed, assuming I have a choice in the matter.  I have two major reasons for this, perhaps unique to my situation, perhaps not:

One: It’s not my job.

This sounds simpler than it really is, it’s not my job. I am a firefighter/paramedic, I take care of people. At any given moment, I could be monitoring two IV lines (maybe an IO, I’m an IO fanboy), an advanced airway, chest compressions, any number of drugs and trying to decide if that’s fine V-fib I’m seeing, or road noise. It is not at all out of the question that someone could sneak up and catch me all unawares, and disarm me.

As we discussed before, everyone out here in the boonies is comfortable with guns. This works both ways. There is a better than average chance that the individual sneaking up on you has a strong understanding of weapons and ammunition. There is an equal chance that this individual understands your weapon better than you do.

I know I will hear that if I were properly aware of my surroundings this wouldn’t be an issue. I can assure you that I’m very aware of my on-scene surroundings. This goes back to the local issue of guns being everywhere, including strapped to my patients (open and concealed carry). Where I get hung up on this is that I am now adding another responsibility to my job description. If I bear the weight of carrying a firearm, and everything that comes with it (socially, morally, ethically, professionally, legally) something else must give. The job seems plenty wide and all-encompassing enough as it is. As we discussed before, there’s a lot going on. IV’s and airways and whatnot. Am I to become part cop at the expense of my airway skills, of my cardiac rhythm identification? No, thank you. My job is first and foremost to care for people. Anything that might take away from that is out.

Two: I’m not a cop.

Let’s review a few hard truths. I have been told that I have been afflicted with a bad case of “cop face.” I am tall-ish, and can typically be seen sporting a high fade haircut (I even had a hipster part for a little bit. It didn’t work out). My demeanor is perhaps best summed up as socially awkward, bordering on passive-aggressive. Maybe some smugness peppered in, for good measure. We can all agree that I’m at least cop-esque, if you will, per vicious stereotypes concerning our brothers and sisters in blue. On top of this, I spend roughly two-thirds of my life in a dark blue uniform. One of them even has badge embroidered on the left breast. I carry dark, oblong items with sharp, hard lines on my belt. I can’t quite match up with some of the Batman utility belts you see at conventions, but I carry a radio, pager and if I’m feelin’ froggy, a small pouch containing an extra set of gloves (those are kinda nice sometimes, don’t judge). In the dark, could one of those look like a weapon? Absolutely. I’m sufficiently cop-y without a gun.

I have been mistaken for a cop on scene. How many people are forthcoming with cops, in general? Not many. That whole “you’re under arrest” thing really ruins a party.

As a paramedic, I need people to be honest with me. The t-shirt that reads “don’t do anything you don’t want to explain the EMTs” really comes to life here. People that have no reason to hide anything may hold back in the presence of law enforcement. I have a lot of cop friends, and I still experience a brief, chilling, bolt of terror when one gets behind me. I know I didn’t do anything, but he’s a cop, right?

As fire and EMS personnel, we don’t deal with a lot of distrust from the public. Why invite it in? Maybe we would gain a better understanding of this struggle if there were more dirty firefighter movies to spin up the imaginations of the public. No, not those kinds of movies. I suppose corrupt firefighter movies would be a better wording.

Bottom line

if it looks like a cop, walks like a cop and carries a gun like a cop… is it really a paramedic or firefighter? I don’t believe so.

That’s where I stand on this issue. And if you don’t agree with me, that’s ok. Not everyone will. But I leave you with this scenario to ponder over:

What if a firefighter or EMT carrying a gun on scene accidentally shot an unarmed teenager? This still happens to police officers despite their extensive training. There have been riots. There has been political unease and general cynicism. Imagine the headlines. Is risking the public’s unquestioned trust in us worth it? Because once it’s gone, brother, it’s gone.

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Bridging the Gap: Using School Stakeholders to help you create a School Size-Up Plan

Today, Schools have had to expand on what they know about school safety and preparing for potentially dangerous events.  School Administrators have a multitude of responsibilities and many are not well versed on Emergency Planning.  Schools are complex places that can present numerous problems for first responders.  As School Administrators are expanding their knowledge on Emergency planning and looking into their plans it is also a good time for local fire departments to create a dialogue with schools and help them with their planning.

School Administrators and members of the fire service have something in common.  Time.  There is not enough time in the day to complete all the things that we want to accomplish.  When it comes to creating a pre-plan for a school this can take hours of work.  I created an in-depth one for my school.  I like to think I left no stone unturned.  I did multiple assessments of the building and looked at other sources to make sure I was not leaving something out.

I started with doing a 360 of the exterior of the building and took pictures of each side of the building.  Once complete, I gathered all of the pictures inserted them into clear plastic, labeled all the classrooms, and then inserted them into my pre-plan binder.  I went to the science lab and made a list of all the chemicals they use and then used the Emergency Response Guide, Material Safety Data Sheets, and the NIOSH guide to learn more about the chemicals and the potential harm they can do in a fire or other potentially dangerous situations.  From there, I did a walk-through of the building with the custodian to see what else I can learn about the building that I may not be thinking of.  Our walk ended on the roof where I took more photos of the location of HVAC units and the surrounding area such as the parking lot to look at apparatus placement.    While adding all of the intelligence that I gathered into my computer I went to google maps and printed out aerial photos of the school labeling important areas of the building along with hydrant locations.  I put all of my findings into a binder and gave it to my building leaders.  When all the work was done I figured this took me about 40 hours to complete.  Lucky for me I love my work.  Something such as this is very time-consuming.  It did make me realize however that this is something that does not necessarily have to be done by one person.

Fire Departments have pre-plans for schools but how thorough are they?  Depending on the size of the schools in your jurisdiction this can be a very time-consuming project.  Schools want to know how they can help first responders before they arrive but some do not know how they can help.  This is what we call in education a “teachable moment”.  Schools have safety committees and meet regularly.  Ask them if you can attend one of their meetings and let them know what kind of information you will need from them to add to your pre-plan.  When you are putting together a pre-plan it is not just simply you and members of your department walking around.  You stop and ask questions such as: How many people do you have in the building?  What are the hours of operation?  Do you have any hazardous materials in the building?  Do you have any special needs students in the building and if so, what is your evacuation plan for those students?  The list of questions goes on and on.  

Before you do a walk-through of the building for a pre-plan put them to work and have a list of these questions emailed to them prior to your arrival.  Ask that they have the answers to these questions before you arrive.  Some of those questions School Administrators may have to find out themselves and it may require them to ask a custodian or look at an outdated safety plan.   Letting School Administrators know what you will be looking for before you arrive will save you and them time and make your size-up plan more accurate.  The worst answer you want to hear is “I do not know all of the chemicals located in the science lab but I will look into it and get back to you”.  We all know that the “I’ll get back to you” does not always happen.

If you get the opportunity to meet with School Administrators and or their Safety Committee teach them what the 13 point size up is and how it is a tool that first responders use to respond to incidents.  I have encountered numerous administrators and school staff that share the same passion that first responders have for their jobs.  You will not be disappointed as to how helpful staff members in a school can be once you tell them what you are looking for and why it is important.

Below is a summary of how the Fire Service uses the 13 point size up.  I wrote this for School staff to educate them on how first responders plan and how it is used to aid in strategy and tactics.  It breaks down the size up and lets School staff know what the Fire Department needs and how they can help to provide that information.  This was designed to be shared with the layperson (school leaders) so that they will have an understanding of what first responders need so they can put together a comprehensive plan.  The Size Up details below can and should be shared with building administrators so that the dialogue you have with them will be focused on the important elements of the plan.

The 13 Point Size Up

When a Fire Department has to respond to an incident there are a number of things that officers, firefighters, and EMS members need to keep in mind when it comes to making decisions.  An emergency scene is very dynamic with many variables and a number of things that can go wrong.  First responders use Size Up to help them make informed decisions.  Size-up is the process of gathering information that will assist firefighters and fire officers in making efficient, effective, and safe decisions on the fire ground.  The more information responders have on a structures construction type, occupancy, the life hazard, the water supply, the location of the structure, possible hazardous materials, and other contributing factors, the more informed they will be to make quick decisions in scenarios where lives are on the line.

In Fireground Strategies by Anthony L. Avillo he breaks the information-gathering process into a useful mnemonic device COAL WAS WEALTH the size-up consisting of:

Construction

Occupancy

Apparatus and Manpower

Life Hazard

Water Supply

Auxiliary Appliances

Street Conditions

Weather

Exposures

Area and Height

Location and Extent

Time

Hazardous Materials

When responders use this acronym prior to an emergency incident and during an emergency incident it gives responders answers to questions about a building.  The more information that responders have about a particular building prior to an incident and during an incident at the said structure the better they will be prepared to handle the potential obstacles that come with a fire, a collapse, or disaster.  The 13 point size-up is geared toward fighting fires, however; no matter what the incident the COAL WAS WEALTH information gathering process is used for all incidents.   

When an emergency happens in your building responders are going to ask building leaders questions about the building and will want to know certain information about the building.  What they will want to know will depend on the situation.  The questions that responders will ask will be based on the 13 point COAL WAS WEALTH size up that they have been trained to use when responding to an incident.   When an emergency happens the building leader does not want to rely on their memory to answer questions when time is of the essence.  A building’s head custodian will provide a wealth of information to you and should not only be readily available during an emergency but should also be included in augmenting your emergency plans.  Prior to the incident, it is best for building leaders to have that information ready when responders show up. The building leader(s) and stakeholders in the school district can collect that information and have it available when it is needed.

 Below is a break-down of the 13 point size up.  Each step will describe what information responders want and how you can gather and provide that information. It would be best to have a collection of that data in a binder that will be with the building leader during an incident. In the binder be sure you place a date on when you completed the size up.  This will inform safety committee members and other stakeholders as to when it was complete and whether or not it needs to be updated.  

Construction

Knowledge of a building’s features enables the incident commander to decide on what strategy to use.  

What responders want to know

What the building is made of, if they are going to have problems entering, any recent renovations or extensions that may have been done.

What information school administrators can provide to first responders

Blueprints or maps of the building, locations of access to the roof.  Any information about recent construction or alterations that have been made to the building.

Occupancy

A building’s occupancy can provide responders with clues to what strategy the Incident Commander will have to take.

What responders want to know

The most important thing responders want to know about an occupancy is what and who are inside the building. A building’s occupancy can give responders an idea of potential hazards and the expected life hazard.  The buildings use and its occupants gives clues to other hazards that may impact what decisions responders make and what tools they need to complete a task.  

What information school administrators can provide to first responders

Information that administrators could have readily available that may be useful is the approximate number of people in the building.  Having exact numbers may not be important to responders, however; exact numbers could be important to school leaders for planning purposes or contingency plans.  

As  you gather  information your building and its occupants it might be helpful to answer the following questions when thinking about staff and students:

Staff

How many adults do you have in the building?  

How many teachers?  

How many administrators?

How many custodians?

How many Teacher Assistants?

Other support staff?

Having accurate numbers on the people in your building will help you in a number of situations that you can or can not anticipate.  For planning purposes knowing the number of Pupil Personnel Services (PPS) staff you have can be important.  In an emergency PPS (depending on their responsibilities) primary duties are not instruction.  Therefore you will have an adult that is not committed to supervising a classroom of students.  An administrator can find a situation where that freed up staff member can be useful.  Know what your staff members are assigned to do in the event of an emergency.  Do your best to utilize your people in a role that will put them in a role where they can be helpful.

Students

How many students do you have in the building?

Is there anything unique about your population?  

Do you have students with special needs?

Do you have students that have medical needs that need constant monitoring such as Diabetes?  

Do you have students that are in a wheelchair?

Do you have students in the building that are blind or deaf?

If you answered “yes” to any of those questions then your next questions should be What am I doing to meet their needs?  How are we going to handle students who need assistance if there is an emergency?

Building History

Do your best to become as knowledgeable about the building as you can.  Know when it was built.  If you have access to plans get a copy of them.  If alterations, renovations, or additions have been made when did the construction take place?  Do you have blueprints or plans?  

Apparatus and Manpower

An Incident commander wants to know what they have available to them during an emergency incident so that they can properly manage their resources.  

What responders want to know

How many personnel are they going to need at the incident? What additional resources are they going to need?  What kind of specialized equipment are they going to need?  Where and who will they get the resources from?

What information school administrators can provide to first responders

Pictures of the exterior of the school.  A picture of the doors will tell responders what forcible entry tools they will need to gain entry into the building.  Additional pictures of what the doors look like would be helpful to help determine what forcible entry tool would be needed.  Information provided to responders prior to the incident will allow them to determine how much personnel they will need at an emergency incident and if they need additional resources from a neighboring agency.  That information will enable the responders directly responsible for the school in question so that they can incorporate outside agencies into their response plan.   

Life Hazard

The life hazard is not often determined until responders are at the incident.  Prior to the incident Fire Departments gather this information to make it easier to determine how significant the life hazard will be.

What responders want to know

The location and the extent of the incident in order to decide how to utilize personnel and resources.

What information school administrators can provide to first responders

The locations in the building that will see a large number of students.  For instance the location of the Cafeteria, how many students in the cafeteria, the time that you begin serving lunch and when it ends.  Location of assemblies or pep rallies.   

Water Supply

In the event of a fire if the fire department does not have access to water or has difficulty ascertaining a water source this will interfere with getting water on fire quickly.

What responders want to know

The location of water sources such as fire hydrants

What information school administrators can provide to first responders

The locations of fire hydrants in the surrounding area.  If the hydrants in the area are sufficient.  Pictures of the locations of the fire hydrants.  Aerial view map from google map pointing out locations of hydrants.  

Auxiliary Appliances

What responders want to know

Whether or not a building has a sprinkler system or standpipe system.  What type of system it is, the location of the system, where the standpipe system is located, and how to shut it down.

What information school administrators can provide to first responders

Location of the systems on a map and pictures of the locations.

Street Conditions

What responders want to know

Best possible routes to get to the location. Areas under construction en route to the location of the incident.  Where to position their apparatus when they arrive at the incident.  The location of power lines that may interfere with using an aerial ladder vehicle from laddering the roof from the parking lot or the sidewalk.  

What information school administrators can provide to first responders

From the roof, you can take pictures of the parking lot and adjoining streets.  In addition, you could provide pictures of what the exterior of the building looks like at the beginning of the day when buses are in the parking lot and at dismissal.  These pictures, when provided to the responders, will help them to anticipate where to put their resources, possible traffic problems, where to place apparatus.

Weather

It is almost impossible to plan for weather.  Weather is a part of size-up during the day and during the incident.  Firefighters will be concerned with the wind because it will aid in spreading a fire. Another weather related factor is the presence of snow and ice.  A heavy load of snow on a roof that may be weak can be a contributing factor to a potential collapse.  

Exposures

Exposures are buildings located next to or behind the building.  The concern that firefighters have is the fire spreading from one building to the next.

What information do responders want

The construction type, occupancy, presence of hazardous materials, and the presence of auxiliary appliances for adjoining structures to the school.

What information school administrators can provide to first responders

Pictures from your building showing responders the adjoining building in relation to your building.  Pictures should show the proximity of the building as it relates to your building.  

Area & Height

What information do responders want

Knowing the depth and area of the building, along with potential setbacks, differences in elevations on different sides of the building, locations of stairways in relation to the entrance.  Information on the area and height will dictate what strategy to use, what resources will be needed, and potential problems.  They may also want to know potential dead spots in radio communication to the Incident Commander.

What information school administrators can provide to first responders

Exterior pictures of the building on all sides of the building.  On the pictures point out the classroom numbers, the location of stairwells, if it is a classroom where special needs students are educated include that as well. You may also want to include pictures and locations of emergency shutoff valves, location of HVAC unit, pictures of the roof, pictures from the roof of the surrounding area, and any additional information that you feel would be useful.

Location & Extent

What information do responders want

This part cannot be determined until responders arrive.  Location and extent determine the life hazard which will determine what action needs to be taken.  If a trash can was on fire on the exterior of the building responders apply water to the fire and everyone goes home.  If that same trash can was in the woodshop class of a school a host of challenges and decisions need to be made.  

What information school administrators can provide to first responders

Classrooms and locations of potentially hazardous materials.  Location of classrooms where students operate machinery.  

Time

The time of day the incident takes place will be important to responders.  If a school is on fire at 4:00 AM that changes the decisions they will make as opposed to the time being 11:00 AM on a Monday.  

What information can you provide for them

-your hours of operation.  

-when after school activities begin and end

-late bus pickups

-weekend activity hours

Hazardous Materials

What responders want to know

Knowledge of what chemical or compound is within an occupancy will help determine what actions responders will take if materials are involved.

What information school administrators can provide to first responders

If you have a school that has a science lab begin with making a list of all the chemicals that you have.  Many of these chemicals alone are probably harmless, however; if the conditions in a building change such as a fire, knowing what chemicals are present and where they are located will help responders in decisions they will have to make. Once you have a list of these chemicals locate Material Safety Data Sheets on each chemical.  You can find most chemicals on sciencelab.com.  You can also use a NIOSH (National institute for Occupational Safety and Health) guide along with an ERG (Emergency Response Guide).

Another area that you may want to pay attention to is where custodians keep chemicals they use for cleaning.  Again, make a list of those chemicals and find MSDS (Material Safety Data) sheets for those chemicals.

Building Maps

A building map can provide a wealth of information to personnel who are about to go inside to a structure to handle an emergency situation.  In the event of an emergency, the building leader will be outside of the structure with the Incident Commander answering questions about what is in their building and the location of key areas.  

A map showing the location of corridors and classrooms will be useful, however; a school map usually contains classroom numbers, the location of the cafeteria, and the gymnasium.  If you go one step further by taking that map and then labeling the classrooms that are different from your standard classroom with desks and books that will provide responders with information on potential hazards or obstacles.  On the map label:

  • Family and Consumer Science classrooms that have kitchens and appliances
  • Technology or Woodshop classrooms that contain power towels and leftover wood and other carpentry or electrical materials.
  • Location of classrooms where Special Needs students are located
  • Location of access points to the roof
  • Location of fire extinguishers
  • Location of fire doors in the hall that close automatically when the school alarm is activated
  • Location of the kitchen

It is important that when labeling additional information on the map that you take a walk around the building with the map to confirm that what is on the map is what actually is actually on the interior of the building.  You may find that classrooms are not properly labeled on the map.  This would be a good time to make those corrections. You may have a building map that has not been updated in 10 years or a map where a minor mistake was made and could not be fixed because it was too expensive to fix it.

Use of Pictures

When a Fire Department Officer arrives on scene they will try to orient themselves by getting a quick look at the exterior of the building by looking at all four sides so that they may begin to size up the scenario.  From there the Fire Officer will establish a command post where they can receive communication and monitor progress (usually towards the front of the structure).

As the building leader, chances are the Incident Commander is going to want you at or near the Command Post if they need additional information.  As the building leader, you are going to want to provide accurate information.  Having pictures of the all four sides of the building will provide a clear picture at the command post of what the area looks like and what additional resources may be needed in that area to accomplish a task.  In those pictures be sure to:

  • Provide the classroom numbers of the window(s) in the picture
  • Label, where emergency shut off valves and HVAC units, are located
  • Label locations of staircases
  • Offices
  • Cafeteria
  • Conference Rooms
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The Volunteer Solution Part 3

Before we get started on the meat of this 3rd leg… A fair amount of discussion occurred at the end of Part 1 and Part 2 which led me to an unplanned Part 3 discussing expectations. Expectations can be tricky to navigate. There are moments when expectations run parallel and other times when they meet. When and where they meet is when the engine that drives this paradigm begins firing on all cylinders.

The following are a list of expectations within the relative circle of our discussion.

  • The community’s expectation of the Fire Department
  • The Fire Department’s expectation of the community
  • The Fire Chiefs’ expectation of his volunteers
  • The Volunteer’s expectation of their Fire Chief
  • The fire department’s expectation of ourselves.

The most important expectation is that of the community.

What does the Community Expect of its’ Fire Department?

The answer is a fairly simple one. They expect that when they dial 911 for an emergency that someone will show up to help. In most cases, when it’s an emergency, whether routine or life & death, it doesn’t matter to them, at the moment, who shows up, as long as someone who can help mitigate or has a relative sense to handle the situation and/or means to communicate the problem to a higher echelon of mitigation.

The inner-workings of the fire service are largely foreign to the average citizen. I’ve responded as a volunteer where homeowners assumed their fire department consisted of paid staff and likewise, I’ve responded to calls as an EMT-Basic and the family couldn’t understand why I wouldn’t start a line and administer medication.  The general public isn’t likely aware of the numerous certifications required, the engine company/truck company rivalries, the turf wars, and the politics between career, combination, or volunteers. The public doesn’t care about the logo’s painted on the trucks, whether or not you are properly equipped or adequately funded or any of the trivial things we seem to focus on.  They don’t know the difference between TFT’s and smooth bore nozzles or even what that means for how we attack fires. They don’t understand 2 in, 2 out, or that most ladder trucks don’t have water, the list is endless. The general public, by and large, has no idea about the world we (firefighters) live in.

The hard point here is that, in a time of dire crisis, the citizens of your community care about none of our internal politics, as long as someone capable and/or anyone with flashing lights and a radio arrives to help them. What they do EXPECT, is that WE as professionals have all the backend issues figured out in order to provide a functional service. When it’s not functional, the residents of your community can pick up on that right away. It’s important to set aside the focus on our piety internal situations and realize all decisions made during the course of managing our fire department point directly to the product you provide the citizens of your community. Fire Departments don’t produce much as an organization, if anything, fire department’s naturally consume more than they produce, but in our consumption, there is value and a product we provide. Ensuring we’re providing the best possible product for the funding we’re given is our ultimate responsibility and it doesn’t go unnoticed.

The Fire Department’s Expectation of the Community.

First and foremost, the communities role with/for/in the fire department must be defined. If the community does not understand its role in supporting their fire department, then you will not be supported, plain and simple. Volunteer fire stations MUST act with calculated communication to

convey their needs, their challenges, and their situations to the residents they protect. Information and marketing campaigns are an important tool. There is power in social media, and it’s free. A community should know that without THEM there is no emergency response. Every community must provide its fire department with willing, able, and capable responders, as well as, financial backing. Without the community, there is no fire department. Understanding the role they play allows your community to better serve the needs of their fire department. Don’t be afraid to make your financial documents and spending public. For most of you this is a legal requirement, for others it’s optional. Bottom-line, transparency is critical, information is power, and it should be shared with the public.

The Fire Chief’s Expectations of his/her Volunteers’

The Fire Chief of a volunteer fire department does not have the luxury of hand-picking his/her volunteers. The Chief has to work with and develop the volunteers the community provides. Active recruiting can help bolster your roster but overall, a fire chief MUST manage the individuals who step forward. Expectations for firefighters must be defined clearly. A great place to begin in defining expectations is to create a signed agreement of the U.S. Fire Administrations Code of Ethics (here). You can alter or add to the code of ethics to fit your organization’s needs. A poster-sized code of ethics should be clearly posted in your firehouse as a reminder to the agreement. Likewise, new probationary firefighters must be provided with a roadmap establishing clear, realistic benchmarks for achieving full member status.   Likewise, a set of policies and procedures that clearly defines the parameters for membership, expectations, and requirements. No member of your organization should be unsure of his/her role within the department. Another expectation that should be sharply communicated is an overall culture of inclusion. Officers must actively participate in overcoming internal clicks and camps, it’s one team one fight all the way. Problem individuals or members who have difficulty fitting in will require more time and energy, it’s critical for leaders to lean into these individuals instead of shunning them.  We all have to work together and the sentiment of the department’s culture is set by a combined leadership. If your leaders are inciting division amongst the ranks, that leader should be professionally developed and provided a path to successful leadership within the organization. 

The Volunteer’s Expectation of their Fire Chief

The volunteer’s of your organization will have very simple expectations of the fire department and the fire chief. First, they’ll expect that you will provide them with the proper personal protective equipment and adequate training in order to keep them safe. Firefighting is risky a business and the safety of your members is paramount. They all have a living to make elsewhere. injuries while volunteering will likely affect their livelihoods.  Second, volunteer firefighters expect that their time will be respected. Running calls, attending meetings, training, classes, and the like add up to an enormous amount of time. It rivals a part-time job, if not more. Volunteer firefighters aren’t fairweather, it’s a lifestyle we’re asking them to live. As a fire chief, we have to ensure that meetings follow strict agendas and topics of discussion. Training must be planned well, be useful, and informative. Emergency calls must be emergencies. The amount of effort you give to meetings and training will be noticeable and it all amounts to having respect for the time they are giving you. The more respect you give, the more you’ll get in return. After all, time is the most precious thing a volunteer has to give, as they can never get it back.

The Fire Department’s Expectation of Ourselves

This one is really for each organization to decide for themselves. We should all expect that we’ll be part of an honorable and thoughtful organization. With its focus on developing its membership as well as the product that is provided to the citizens of the community. Every interaction with a member of the public is an opportunity to leave a lasting impression, whether routine or emergent. The most important aspect of this is to ensure you have a vision and a mission statement that actually means something and provides a beacon for your members to follow.

Be mindful, and be prideful.

Part 4 we’ll discuss clicks, camps, and divisiveness within the fire department. 

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Is Structure Fire Smoke Killing Us?

Hopefully, most Station Pride readers have seen, or have at least heard about, the results of research performed by Underwriters Laboratories (UL) to better understand the changing dynamics of contemporary residential structure fires.  To summarize, UL found that residences are now larger, have more open floor plans, contain increased fuel loads from synthetics and composites, and are made with substantially different construction materials and methods than those built just a few decades ago.  The consequences of those changes are faster fire propagation, shorter time to flashover, rapid changes in fire dynamics, shorter escape times, and shorter time to collapse.  (Kerber)  Additional UL research has identified the contaminants in today’s smoke, and their greater levels of toxicity, but the acute

Click here to Enter Storeand chronic health effects from exposure to that smoke is still being studied.  This article is intended to present currently available information so that firefighters and officers may have a more immediate understanding of the hazardous materials in today’s smoke, particularly carbon monoxide (CO) and hydrogen cyanide (HCN) because of their significant toxicity.

Fire service personnel are at least generally aware of the hazards from CO, typically because of having to respond to alarms associated with combustion-based heating systems and the resulting use of gas meters.  However, many may not be very familiar with the associated exposure limits.  The following table summarizes the legally enforceable limit from the Occupational Safety and Health Administration (OSHA), as well as recommended limits from the National Institute for Occupational Safety and Health (NIOSH).  Both agencies express those limits as an 8-hour time-weighted average (TWA) inhaled exposure, which is intended to cover a standard workday, in parts per million (ppm).  As a mental reference, 1 ppm is roughly equivalent to 7/10 of a gallon in an Olympic-size swimming pool.

CO HCN
OSHA Permissible Exposure Limit (PEL) 50 ppm 10 ppm
NIOSH Recommended Exposure Limit (REL) 35 ppm 5 ppm
Ceiling (shouldn’t be exceeded, even briefly) 200 ppm N/A
Immediately Dangerous to Life and Health (IDLH) 1,200 ppm 50 ppm

Unlike CO, my experience is that many firefighters are not familiar with HCN, even though its existence is smoke has been known for many years.  They often have no way of measuring their exposure to it, so they typically have no familiarity the associated exposure limits.  Note that OSHA’s PEL for HCN is 5-times less than that for CO, which is the same as saying they perceive it to be 5-times more toxic.  Unfortunately, that’s only the tip of the iceberg.

The Agency for Toxic Substances and Disease Registry (ATSDR), a branch of the Centers for Disease Control, has published a medical management guideline for HCN which states that it smells like bitter almond and has an odor threshold of 2 to 10 ppm (compare that to the PEL).  However, the guideline also says that the odor threshold “…does not provide adequate warning of hazardous concentrations…” because HCN causes olfactory fatigue (i.e., you stop smelling it even though the airborne concentration could be unchanged or increasing) and the fact that 10% to 20% of the population can’t smell it at all due to genetic traits.  The guideline provides ominous warnings about the health effects of HCN exposure: (1) highly toxic by all routes of exposure and may cause abrupt onset of profound central nervous system (CNS), cardiovascular, and respiratory effects leading to death within minutes; (2) exposure to lower concentrations of hydrogen cyanide may produce eye irritation, headache, confusion, nausea, and vomiting followed in some cases by coma and death; (3) hydrogen cyanide acts as a cellular asphyxiant (prevents the utilization of oxygen in cellular metabolism), and; (4) the CNS and myocardium (heart muscle) are particularly sensitive to the toxic effects of cyanide.

We should pay particular attention to the effect that HCN has on the cardiovascular system and myocardium for this simple reason: the most recent National Fire Protection Association (NFPA) statistics indicate the nature of injury for 51% of the 70 to 100 annual firefighter line of duty deaths in the United States is “sudden cardiac death.”  Furthermore, Prehospital and Disaster Medicine, the official journal of the National Association of EMS Physicians, has reported that “…cyanide exposure is: (1) to be expected in those exposed to smoke in closed-space fires; (2) cyanide poisoning is an important cause of incapacitation and death in smoke-inhalation victims, and; (3) that cyanide can act independently of, and perhaps synergistically with, carbon monoxide to cause morbidity and mortality.” (Marc Eckstein, MD, FACEP, and Paul Maniscalco, MPA, DrBA(c))  I have to wonder if at least part of those 36 to 51 annual firefighter fatalities are the result of acute and/or chronic effects of CO and/or HCN from smoke inhalation?  If that is the case, then I also wonder how we could better detect and mitigate or prevent such exposures?

The bottom line is that structure fires these days should be thought of and managed, at least in part, as a hazmat incident.  That means personnel must be trained about the toxicological hazards and their significance, air monitoring needs to occur, an appropriate level of personal protective equipment must be worn, protective zones need to be established, and decontamination needs to occur for those exiting the hot or warm zone.  If you still think that approach is even somewhat extreme, take a look at the NFPA 704 markings copied from a Safety Data Sheet (SDS) for CO (left) and HCNNFPA 704 - CO (right).  What firefighter would not NFPA 704 - HCNbe thinking they’re in a hazmat situation when pulling up to a working fire at an occupancy having those markings on its exterior?  Some may argue that each SDS is for a pure chemical, not the mixture that would be found in smoke.  To that I say the National Institute of Science and Technology’s (NIST) June 2005 report on its technical investigation of The Station nightclub fire proves that very high concentrations of these extremely toxic chemicals can develop with surprising rapidity.

The Station fire occurred in West Warwick, RI in February of 2003 when pyrotechnic devices used by a nationally popular band ignited polyurethane foam used on the stage walls and ceiling as soundproofing.  The fire then spread quickly along the walls and ceiling area over the dance floor.  Smoke was visible in the exit doorways in a little more than one minute, and flames were observed breaking through a portion of the roof in less than five minutes.  One hundred people died because egress from the nightclub, which was not equipped with sprinklers, was hampered by crowding at the main entrance to the building.  The fire’s progression was captured by a local television station’s camera crew that was filming the show, which helped NIST define a clear timeline of events.  The NIST investigation involved extensive use of real-scale mock-ups, measurement of key parameters during live-fire testing, and computer modeling.  The parameter measurements taken at stations approximately 1/3 (Location C) and 2/3 (Location D) of the distance from the stage (raised platform) to the rear of the dance floor are particularly relevant to this article (The Station’s floor plan from the NIST report is provided below).  Both locations generated very similar results, so I’ll provide only those for Location D in the interest of brevity.

Floor Plan

 NIST considered any room to be untenable when any of the following fire conditions occur: (1) temperature exceeds 120° C (250° F); (2) oxygen content drops below 12%, or; (3) atmosphere beCOO2_crop.jpgcomes IDLH.  The graphs for CO and HCN at Location D, which was 1.4 meters (4.6 feet) above the floor, paint a dramatic picture of how quickly The Station’s dance floor became untenable.  Note that the readings are expressed as percentages, and understand that 1% equals 10,000 ppm.  Thus, CO at Location D was approximately 20,000 ppm (17-times IDLH) and HCN was approximately 1,750 ppm (35-times IDLH) at 90 seconds after ignition.  Interestingly, Location C showed consistently lower HCN readings than Location D, implying that parameter’s concentration may tend to increase as distance from the fire increases.  Another graph in the NIST report showed that the rising CO and HCN levels corresponded with declining oxygen content.  Yet another showed the room was untenable due to temperature at 80 seconds after ignition.  Not surprisingly, the tests also revealed that the room would have remained tenable had it been equipped with fire sprinklers.

Fire and emergency medical services in the RI region paid understandably close attention to what the NIST HCN_cropinvestigation revealed, and became sensitized to the potential for HCN poisoning from smoke inhalation.  Then, “…in March of 2006, a firefighter in Providence, R.I., was diagnosed with cyanide poisoning after responding to a building fire.  Over a period of 16 hours, seven more firefighters were diagnosed with cyanide poisoning, including one who suffered a heart attack while working the pump panel in the front of the residential structure. It was only through a series of coincidences that emergency room physicians checked that last firefighter for cyanide poisoning.” (Rochford)

The Providence Fire Department promptly formed a committee to investigate those casualties, then issued its report in May of 2006.  They found “…overwhelming evidence exists that cyanide is present in fire smoke more commonly and in greater quantities than previously believed due to modern materials such as plastics, rubber, asphalt and polyacrylonitriles.”  They also found that “…the cyanide problem has gone unrecognized by firefighters and the medical community…” for several reasons, including: “…symptoms of cyanide poisoning are similar and commonly attributed to carbon monoxide poisoning; the blood test for cyanide poisoning is not readily available in most hospitals, [and]; doctors do not routinely order cyanide test on firefighters or smoke inhalation patients because the test results for cyanide commonly take from two hours to come back, making [them] diagnostically useless given that the half-life of cyanide in the body is one-hour.”  The committee also determined that “cyanide can cause cardiac arrhythmias and other medical conditions commonly being experienced by firefighters.” (Varone et al.)

Varone presented the Providence report at the 2007 FDIC International conference, providing greater national awareness of the problem.  Fire departments began purchasing equipment to detect and prevent exposure to HCN.  In fact, air monitoring by the safety officer at a structure fire in Terre Haute, IN revealed that the exterior HCN readings were greater than those for the interior.  That corroborates my previous observation that HCN concentration may increase as distance from the fire increases.

By now it should be quite evident that CO and HCN present a real and quantifiable health and safety problem for the fire service, and the public, because to the fire loads we are now encountering.  Fortunately, the problem can be at least mitigated, if not prevented, by incorporating a few basic hazmat practices at structure fires.  First, the problem can’t be effectively managed if it can’t be measured, so air monitoring for CO and HCN is a must.  The exterior/downwind areas should be checked during active fire suppression and/or when there is substantial drifting smoke.  The interior should be monitored before personnel may doff their SCBA.  Exterior and interior monitoring should be periodically repeated until readings are consistently below any Action Level.  SCBA should be worn whenever an Action Level is exceeded, whether interior or exterior .  My suggestions for Action Levels would be an 8-hour time-weighted average of 35 ppm or greater for CO, and a 15-minute time-weighted average of 5 ppm or greater for HCN.  Monitoring could be performed with a calibrated meter or with non-expired colorimetric tubes.  Be aware that HCN, especially the calibration gas, may not be compatible with other sensors in a multi-gas meter, so it may be most practical to get a small, 1-gas meter if such a device is preferred.  I’ll also note that calibration gas and colorimetric tubes present an ongoing expense because they have an expiration date, and that shipping the calibration gas for a meter is expensive because it’s an inhalation hazard.

Second, decontamination and PPE control requirements should be established.  Potentially exposed personnel should wash at least their hands with soap and water before eating or drinking; also washing the face would be prudent.  Turnout gear should get gross decontamination while on-scene.  A soft bristle brush and/or fog stream can be used, but try to prevent saturation.  It should then be promptly washed and dried in accordance with the manufacturer’s recommendations.  Demonstrating your experience by maintaining “salty” gear is a seriously bad idea because it enables persistent secondary contamination!  For example, volunteers often keep their gear in their vehicle and could cause ongoing exposure to themselves, their family, or their friends.  Children have far greater inhalation risk than an adult. Their lung surface area is proportionally much larger and their mass is significantly smaller, resulting in a greater dose from exposure to the same airborne concentration.

Third, personnel should be monitored for symptoms of CO or HCN poisoning, which can be delayed by up to an hour, and need to receive immediate medical treatment should they develop.  Symptomatic personnel should receive medical observation for at least 4 to 6 hours. (ATSDR)  An acceptable blood cyanide level would be 20 micrograms per decaliter (Varone et al.) , beyond which appropriate medical treatment must be immediately provided.  “The…treatment for carbon monoxide inhalation can revive the patient, however, without a cyanide antidote kit, the lasting effects of hydrogen cyanide poisoning can create enduring medical  complications.” (Rochford)

Last, it’s best to develop a written procedure and a training program so that firefighters and the emergency medical services can have a consistent understanding of the problem, how to mitigate or prevent exposure, and how to recognize and manage any symptoms that develop.  I have both a procedure and a training presentation that I’m willing to share at no cost in the interest of firefighter safety. (You can download the Powerpoint here, Training sheets here, and the Instructor sheets here)

We share a vocation/avocation that can be extremely hazardous.  Smoke inhalation has previously been thought to be fairly simple and easily treatable, but it can now have lethal acute and chronic consequences.  We need to change our mindset.  The incorporation of basic hazmat practices at structure fires can have significant positive impact on our health and safety, as well as that of those around us.  Think safety, act safely, and let’s ensure that everyone goes home!

References:

  • Stephen Kerber, “Analysis of Changing Structure Fire Dynamics and Its Implications on Firefighter Operational Timeframes,” Underwriters Laboratories
  • 29 CFR 1910, Subpart Z, Table Z-1, “Limits for Air Contaminants”
  • NIOSH, “Pocket Guide to Chemical Hazards,” September 2007
  • ATSDR, “Medical Management Guidelines for Hydrogen Cyanide,” 2017
  • NFPA, “Firefighter Deaths by Cause and Nature of Injury,” 2017
  • Eckstein & Maniscalco, “Focus on smoke inhalation–the most common cause of acute cyanide poisoning,” Prehospital and Disaster Medicine, March-April 2006
  • Airgas SDS, “Carbon Monoxide,” 5/12/2015
  • Matheson Tri-Gas SDS, “Hydrogen Cyanide, Anhydrous, Stabilized,” 12/11/2008
  • NIST NCSTAR 2: Volume 1, “Report of the Technical Investigation of The Station Nightclub Fire,” June 2005
  • Rochford, “Hydrogen Cyanide – What Every Emergency Responder Needs to Know,” National Fallen Firefighter Foundation, November 2008
  • Varone et al., “Report of the Investigation Committee into the Cyanide Poisonings of Providence Firefighters,” 5/30/2006
  • Terre Haute Fire Department, “Daily Drill – Air Monitoring”
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What are We Doing to our Future Firefighters?

A lot of older firefighters like to talk about ‘the way it used to be.’  But, does that mean that it’s the way it should be?

If you’ve ever spent any time in a firehouse you’ll inevitably hear a sentence that starts with “Back when I started…” quickly followed by a story about how things then were better, more efficient or easier to understand.

While that line of thinking is sometimes correct it goes without saying that this might not always be the case.

I’m not here to debate tactics or technical details of the fire service, I leave that to the officers.  But, what I do think firehouses should begin to reconsider is how we treat the future of the fire service.

You see, I started FirefighterNOW as a place where future and aspiring firefighters could have access to the best resources to understand what the fire service is about, learn what is necessary to be a firefighter and most importantly how to navigate the long hiring process.

It began with the intent of being a place where someone with absolutely no knowledge of the fire service can come learn and not be told they’re stupid or ‘maybe if you’re lucky someday you will be a firefighter.’

Since it’s beginning I’ve had the opportunity to speak and interact with hundreds of candidates, many of whom have since been hired by full-time departments.  One trend I’ve noticed is that many of them have experienced several less than pleasant station visits or ride times with their local department.


In fact, I know exactly where they’re coming from, as when I was in EMT school I did ride time at a local department where even if you doubled my current salary today, I would never take a job there.

We all know that one person in our department who is horrible towards students or visitors, and I’m wondering where they feel they get the right to treat the future of the fire service in that way?

Now I’m not saying we need to fall all over ourselves just to make that individual feel welcome.  But as someone who has worked with hundreds of candidates, and counting maybe we should rethink the way we treat our future firefighters.

You’d be hard pressed to meet a firefighter who claimed not to care about the fire service and the culture it has worked so hard to build and maintain.  But my question would be how much do you really care if we’re letting ‘that guy’ possibly push away some of our best candidates?Maybe instead of letting the one obnoxious guy on our shift treat someone like garbage, we should step in and stop it?

Unfortunately, I know some will read this and accuse younger generations of being ‘soft’ or ‘entitled’ and while I may not entirely disagree.  I’ve always found it prudent to take a look at our own behavior before we begin to judge someone else.

Health and Wellness

Understanding Fire Service Suicide, the Key to Prevention.

The article, PTSD, are we selling a lie, has quite a few great points and hits on so much that is true for the fire service. I could not agree more with the following quote: “We as firefighters hold greater respect and dignity in the public eye than nearly any profession on earth, and the reason is simple, we are there when you need us. It is time for the fire service to move beyond education of PTSD and psychological wellness in the fire service, and to shift its focus towards preventative measures that begin at the recruitment process and build from a foundation of personnel who are prepared for the task that lies before them, who are prepared to show up and perform, fully aware that no one else is coming if we fail.” This is the heart of the problem for those in the fire service. We are called to help folks in crisis, and as a result, we feel that we must always be prepared to be the helpers.

In as much, we fear that if we have any sort of weakness, we will be deemed unfit. However, where this article can harm more than benefit,  and what causes me to cringe is the title and the following: “According to the Firefighter Behavioral Health Alliance (2016), PTSD and its underlying consequences have taken the lives of at least 131 firefighters and EMS workers in 2016 alone (Dill, 2016), and that’s only in the United States.” When we attribute every fire service suicide to PTSD and the underlying consequences of PTSD, we silence those who are suffering from other issues unrelated to PTSD and issues that fester if left untreated into a major crisis: Depression, alcoholism, divorce, family problems, health problems, etc.

PTSD is a huge consequence of the job and is an injury that if left untreated can be devastating. We absolutely must take measures to ensure that people who have PTSD know they are having normal reactions to extraordinary situations. Treatment is available, and treatment helps! However, it is not the only cause of fire service suicide and to say that it can be damaging.  Public servants are human, and it is normal to have highs and lows in life.  However, if the lows are not cared for, they can snowball. Firefighters afraid to share their struggles tend to use unhealthy coping mechanisms such as alcohol.  However, like CO & HCN, depression and alcoholism can be toxic twins.  Alcoholism leads to poor choices and poor health which just makes everything worse and can be deadly.

So attributing 100% of firefighter suicides to PTSD only will cause members who are struggling with other risk factors to suffer in silence and be ashamed to admit the issues they are facing. Like I said, the article hit the nail on the head when it recommended that we need to shift towards preventative measures. However, these are not always going to be built during the recruitment process. Of all the work I have done and research I have conducted, Dr. Thomas Joiner has come up with a model that explains suicide. His model has yet to be disproven and is 100% relatable to the fire service. First and Foremost, Stigma = Fear + Ignorance. The stigma behind suicide is directly related to the ignorance surrounding the causes.  Fear is ok, but we must eliminate ignorance through education.

For example, science has proven that 95% of those who complete suicide had a mental disorder such as depression or alcoholism. What this tells me is, if we stop fearing treatment and learn how to admit that: “HEY, IT’S OK TO NOT BE OK!” then we will learn to ask for help when we need it, rather than suffer in the silence of our misery and continue to turn to other mechanisms.

Dr. Joiner’s theory is simple, while there are a lot of causes that lead to suicide: PTSD, Depression, Alcoholism, Divorce, Substance abuse, etc. , there is only one common final pathway that leads to suicide:  Loneliness plus feeling like a burden will create a desire to die, and this desire translates into lethal behavior only in the presence of acquired capability or a learned fearlessness. Most firefighters do not realize that the job allows us to develop this fearlessness quicker than the general population. This next quote is directly from Dr. Joiner in 2011 at the NFFF suicide summit: “Put more directly, it may well be that firefighting in itself does not increase a firefighter’s risk for suicide and may, in fact, provide some protection. But when those protections, for whatever reason, are weakened, and other factors in the firefighter’s life serve to compound risk, the capacity to actually take that final action may be greater. Accordingly, it is not necessarily that firefighters die by suicide at greater rates than others but rather that factors known to affect anyone’s life can become all the more difficult for a firefighter if the bonds and perceptions that make the occupation so attractive and compelling are lessened or lost. This provides a salient framework from which to consider the roles that fire departments and fellow firefighters can play in prevention, intervention, and survivor support.”

So yes, PTSD is a huge problem, and members must learn that it is an injury, and treatment can help. We can not try to get through on our own. BUT!!! PTSD is not the only thing that causes us to take our lives. This article, without realizing so, is just another reason for somebody who so desperately needs help for their underlying problem that may or may not be work-related to suffer in silence because they fear their problem is not worthy of help.

So what can we do?  We can encourage members to reach out for help. We can follow the amazing framework of the Illinois Firefighter Peer Support Team, http://www.ilffps.org/. Matt Olson, Executive Director, states: “I am reading this, and I think a problem with the PTSD awareness movement is it forgets that depression is a huge part of suicides. More importantly, if we look to PTSD as the “heroic” injury, it makes people with depression less likely to stand up and take care of themselves.” The ILFFPS team’s mission is to simply create a safe environment where folks can admit that they are not ok.  Peer support is available 24/7 and as a result has the ability to lessen the loneliness factor of Dr. Joiner’s theory.

Illinois Firefighter Peer Support

When peer supporters recognize that an individual needs more than just peer support, the team has access to their trained clinical team who possess the power to eliminate the burdensome component.  Feeling as though one’s death is worth more than their life is almost always a misperception that requires treatment.  A study by the American Association of Suicidology found that 78% of people who attempted suicide, had significant regret.  This means, these people simply needed help for their underlying problems and felt powerless.

As stated by Chief Dan Degryse of the Chicago Fire Department, “Suicide is just one outcome for an individual that can manifest for some time before he or she reaches the decision to die by suicide.” Intervention is key to prevention and making it ok to say you’re not ok is the key to intervention.  A seminal study was published in 1978 by Richard Seiden on 515 people who were restrained from jumping from the Golden Gate Bridge.  Of those who received mental health treatment, 95% were still alive decades after the study or died of natural causes.  Treatment works!

Spreading the message that the fire service must create a safe environment to admit when one is not ok and allow members to continue to serve while receiving assistance for their underlying issues is critical to prevention. Matt Olson and the ILFFPS are doing it right by spreading the message that it’s ok to not be ok and therapy helps. Sometimes just talking to a peer is enough and sometimes you need a little more help, but it’s ok to not be ok! And it’s ok for the reason that you are not ok to be something outside of the job.

Firefighters are human and susceptible to stress, depression, and anxiety just like every other human.  “At any given time, around 5 percent of the U.S. population is experiencing major depressive disorder. The disorder involves sadness, insomnia, loss of energy, and the like, and it causes serious distress and affects people’s lives negatively. But in the majority of the cases, it does not involve psychosis, dementia, intoxication, or delirium” Joiner, 2009.

There is no weakness in admitting you’re not ok, only strength.