Firefighter cancer: An inconvenient truth

Posted on Mon, 8 Jun 2015 15:51:22 UTC

How often has someone said I will do anything not to get cancer? Or, you can put anything in place of "cancer."

Regardless, these are easy words to say but difficult actions to carry out. I remember when my wife was fighting cancer. I said if I would get cancer I would do ….

I work in the alternative health care field and often hear people say they would do anything to get rid of a condition.

Yet when the rubber meets the road and reality sets in, they won't do anything. It has suit their lifestyle or needs or whatever they want to do. People don't want to give up certain things. They often say they will do anything except give up (fill in the blank).

Occasionally, I receive emails from readers commenting on my columns. I found one comment especially interesting.

Accepted risk
The individual writes that he believes it is an accepted risk that firefighters get cancer. He continues to write how FDNY is not going to clean their gear after every incident. Respiratory protection is not worn when it should be.

Quite frankly I can't argue with these points. They are reality, not necessarily acceptable practices, but they seem to be the way things are done.

So why do we continue to be sadden every time a firefighter is diagnosed with cancer? Why do we continue to want to put legislation forward on presumptive measures that because we are firefighters it is a job hazard?

Maybe we first need to clean our own closet and do anything it takes to prevent the cancer in the first place. When presumptive legislation is put on the table, how can lawmakers pass legislation when they see firefighters sitting outside their window puffing on a cigarette or not wearing protective gear to prevent them from inhaling the toxic fumes?

Are you getting defensive yet? If so, maybe this has hit a nerve. I certainly hope so.

No more excuses
We need to stop delaying and making excuses. We need to stop turning our heads and making the inexcusable practices acceptable. Enough is enough. Let's quit saying if I would get cancer I would change. Let's quit saying that you would do anything to prevent cancer except ….

Let's take a realistic look at what we can do to prevent this horrible disease. Granted, there are circumstances where we can do everything we have available to prevent cancer yet still contract it.

If we have failed in prevention, then we need to look at how to treat it. How can so many people successful treat their cancer and live many years when others succumb to the cancer after weeks, months or a few years?

The next several columns will look at what we know causes cancer in firefighters and what can be done to prevent it. I have no intentions of sugar coating anything — by the way, cancer thrives on sugar and it has no business in anything we talk about other than getting it out of our diets.

We need to quit being politically correct and address this fast-growing killer before you become the next victim.

Firefighter mobility: 3 reasons stretching hurts

Posted on Tue, 21 Jul 2015 12:51:19 UTC

I like to joke that there are three types of personalities when it comes to stretching. The first is the one who sees and feels the benefit from stretching, so they just do it.

The second is the one who will never, ever stretch because either they do not care or because that have had multiple negative experiences from high school to the academy. The third is the one who has tried to stretch and the pain is too much, so they inevitability give up.

The first is good to go. The second is always going to be a challenge. But, the third is the one we can help.

There is no question that having good mobility — a combination of soft tissue flexibility and joint mobility — will decrease the risk of injury and its severity if it does occur. What we have to understand is that there is a lot of myth and misinformation surrounding mobility, especially how to achieve it safely.

Think back to the academy and all those stretches you did every day during physical training. Did that system instill in you a process to follow from hire to retire, allowing you to stay on the job injury-free? If not, then what good did those movements do for you?

Why stretching hurts
One day your back is tight so you try a few hamstring stretches. As soon as you get into the stretch, the pain overrides your desire to continue and you stop — or you hold the stretch, but after 15 seconds noting changes. Sound familiar?

There are a few theories as to why stretching hurts — here are three.

First, your dehydrated and dehydrated muscles do not stretch well. Research is tying firefighter cardiovascular risks to dehydration and heat dissipation under stress.

From this, we can achieve two goals with staying hydrated: reduced risk of injury and cardiovascular events. Plus, to truly get a good stretch, all stretches must be held for 60 seconds.

Next we need to look at my favorite culprit of poor flexibility — trigger points. After 16 years of clinical physical therapy practice and 10 years of training first responders, I can confidently say that most mobility issues stem from trigger points in the soft tissue.

Every person I have ever treated for pain, injury or mobility issues has had trigger points contributing to or causing the problem — and you cannot stretch a trigger point. That's why it often hurts to stretch. We can bundle old injuries, arthritis and surgery into this category as well.

Last, you suffer from tightness weakness. Yes there is such a thing and here is why it's such a problem.

You have a weakness, and to protect the muscle and joints from injury your body makes the weak muscle tight, or contracted. When you try to stretch this tight muscle, your nervous system says "nope" and you feel pain.

This sure makes the case for some structured exercise designed to strengthen the tight-weak muscles allowing better mobility, power and stability.

4-step program
For any program to be effective there has to be a system behind it; haphazardly doing work and disguising it as stretching is what has caused the issues in the first place.

In this case there is fact and there is gym — or better known as "bro science." We like science fact. Most of us know never to stretch cold, and that still holds true today. But the warm up system has changed.

1. Roll
By now I hope that all of you have seen and used a foam roller. I can still remember when the only responders that had seen a roller had gotten hurt and learned about it in physical therapy.

Now you can get them at all the big-box retailers, but responders still do not truly understand their benefit and application. We know that rolling six key areas of the body pre-shift, pre-training and pre-PT will increase the tissue temperature as much as some light cardio.

So does this mean no more calisthenics? Maybe. There six key areas that a responder must roll to improve mobility, increase tissue temperature and break up trigger points: calves, hip flexors, inner thighs, glutes, lats and upper back (thoracic spine.)

Here is how I teach foam roiling. Imagine you are an obsessive-compulsive foam roller; roll all of the tissue and then roll it again. Work the outside, inside and middle of each area.

Contort yourself into bizarre positions to fulfill your OCD foam rolling needs. Healthy tissue does not hurt to roll; unhealthy tissue hurts a lot, so seek the nasty staff and kill it. Now you are warm and ready to activate the muscles.

2. Activate
No good warm up is ever complete without activating the muscles that you just rolled. The system dictates that activation targets the commonly tight and weak muscles that cause most of our injuries and make mobility work difficult in the first place.

I like joint mobilizations, core and hip activation and carriage load exercises like farmers walks, suit case carries and kettle bell get ups.

3. Clean it up
Over the years (some 800 classes later), I have realized that after rolling and activating, we are not always done. Often there is some junk left over that we may have missed.

A few weeks ago, my exercise programming (mesocycle for the coaches out there) said that it was time for some 95 percent repetition max dead lifts — sumo dead lifts, as I feel they are more job specific and have less spinal torque than a traditional dead lift.

I followed the steps above and began pyramiding my way up in weight. As I passed the 250-pound mark, my left lower back let me know it was there. So before the next set I grabbed a tennis ball and hit the hot spots and then deeper in the hip on the side that was causing the symptom. I hit a personal best that day.

After rolling and activating, listen to your body. If it gives you a symptom, treat the symptom. I love tennis balls as they are awesome for getting more pinpoint than the roller and treat the deeper spasms and trigger points that the roller misses.

4. Work
Now it's time to do work and get your training done. By following the system before any and all physical activities, you have reduced your chance of injury and will ultimately feel better. One thing that I have learned is that pain, fear of pain and not wanting to get mocked are the primary detractors from following a system of human performance that will keep you fit, pain free, mobile and serving your communities for years to come.

Unnoticed door locks increase firefighter risk

Posted on Tue, 17 Sep 2013 09:17:42 UTC

For many departments, the first-due engine is staffed with three to four firefighters, in some cases even fewer. There are five key job functions that must occur: size up, action plan, water supply, the initial stretch and forcible entry. These items will quickly tie up a short-staffed rig.

Luckily, in many parts of the country forcible entry is fairly simple. In many communities key-in-knob locks are the primary, if not the only device keeping the "bad guys" out of peoples homes. A short throw on the locking mechanism combined with wooden doorjambs means a very basic forcible-entry effort is all that's needed.

Recent UL studies — as well as years of studies from overseas, particularly Northern Europe — all point to the importance of door control on fire progression. Smooth forcible entry not only allows us to put the line in the right place, but also provides for better door control.

For many departments, the forcible-entry team will also be on the initial hand line. Quick and easy forcible entry allows for the team to still have the energy needed to make the attack.

Barring the way
It doesn't take more than a stroll through the local big-box home store to see that are several off-the-shelf devices to make door harder to force. These cheap and easy contraptions not only sell to homeowner's fears of invasion, but also require no skill to install.

The most prevalent are bars to buttress inward-swinging doors closed. And because they don't require additional hardware on the door or jamb, you won't necessarily know it is buttressed when sounding the door.

During a recent structure fire at a center hall colonial, after performing my 360 with no visible flame or smoke on the interior, it became clear that the unlocked side door gave the easiest, most direct line of attack for the first-due engine. The homeowners weren't home yet, but luckily the fire remained external due to a lightning strike. While walking through the house we discovered a store-bought device on the locked front door.

As we discussed the event later, some things became clear. Had the fire progressed to the interior, I would likely have placed the initial line through the front door.

The likely outcome
Our first-due engine would have begun forcible entry on that door and would have met with more resistance than seemed appropriate. The front door didn't have sidelights that would have made it possible to view the device from the exterior.

These slow downs would have likely led to a change in tactics, such as heading to the side door, and possible even a change in strategy given my team would have wasted time and energy on the front door.

Worse yet, had they headed in the side door, our truck crew would have begun to soften egress points incase the interior teams had to escape. Naturally the interior teams would consider the front door at the base of the stairs a natural exit, only to find it barricaded.

A quick web search of home door security bars will show the myriad of devices out there for the general public. Don't get me wrong; we can overcome these devices.

However, the standard size up isn't going to see the device and command is likely going to create an action plan that doesn't fit the tougher forcible-entry profile these devices create.

Add that to short staffing and everything slows down except the fire growth.

Have a Plan for the Tactical

Posted on Wed, 2 Jul 2008 11:14:57 UTC

Too many candidates get sucked into concentrating too much on the check-off list for their tactical without realizing it. In the process, they lose control of the fire and their score gets hammered.

What's your best tactic for rescue or knocking down the fire? An aggressive attack on the fire! Go fight the fire with your resources. In the process you will get the necessary boxes checked off on the rating sheet, could put out the fire and get a top score.

Yes, you want to cover all the bases to make sure the boxes are checked off on the rating sheet, but again, isn’t the best tactic for extinguishment and rescue an aggressive fire attack?

However, concentrate on a solid plan. Many candidates put too much into play out of sequence early on in the exercise and make the problem bigger than what the raters have actually given them. Often, candidates will give assignments to units to place positive pressure ventilation, a crew to pull ceilings, assign more than one unit to carry out search rescue and other tasks, call the canteen truck, and add a rescue problem that wasn't given to them.

This is before they have the first line on the fire, a RIT team assigned, utilities pulled and a crew sent to the roof for ventilation. The fire gets away from them and they are out of equipment and resources before they realize what happened. How long can you tread water?

These are major areas the raters will be checking off on your scoring sheet that can rack up big points. You must come out swinging. Once you have proven you can handle the call from the beginning, you're nailing it. As soon as the raters know you got it, they will help you over the top to that next badge. It's a beautiful thing when it happens.

Have a plan
Here's a simple example of a fire problem: You give an on-scene size up at a fire involving a residence with fire blowing out a bedroom window. You order your engineer to hook up as you and your firefighter start pulling lines. If you followed this sequence, you have just lost the fire!

The problem here is you went from size up directly into tactics. Most candidates start off on the right foot with a size up of the fire. Then they make a fatal mistake in going directly into tactics without a plan. They confuse tactics with a plan. Once given the fire problem, focus all your energies on developing a plan.

Without a plan, you are out of control. What was your plan on this fire problem? By just taking a few more moments, you would have one. When confronted, candidates that go immediately to tactics regroup and say, "My plan is to confine and put out the bedroom fire." O.K., but if you didn't say it, you didn't have a plan. Size up, plan, and then tactics.

Fire chief saves child, earns F-16 ride

Posted on Mon, 9 Jul 2012 08:52:53 UTC

At two or three Gs, the pilot told him in the pre-flight briefing, it will feel like you are wrestling a couple of guys but holding your own. At five Gs, you'll feel like you are losing the fight and at 9 Gs nothing moves — wherever something is, that's where it stays. They went over the procedures to eject if something went very wrong.

This was part of several hours of pre-flight instruction that Hobart, Ind., Fire Chief Brian Taylor went through prior to his 45-minute flight in an Air Force F-16 last week. The flight was in honor of him being named Hometown Hero at neighboring Gary, Ind. air show, following a dramatic rescue late last year.

Hobart is city of less than 30,000 residents that's mostly residential with a sprinkling of retail and light industry. The fire department operates out of three stations and carries a crew of 52 career firefighters. Last year the department responded to 3,650 calls, which includes ALS ambulance runs.

The fire
One of those calls came on Dec. 10, where Chief Taylor was the second to arrive on scene at mutual-aid call for a single-family residential structure fire. A mother and her two young children were inside. The initial report was that the mother was gone, one child had been found and the other was still missing.

"On arrival I had no intention of doing anything but command," Taylor said. "Anybody with kids knows that all rules go out the window."

Chief Taylor has three children.

One side of the house was fully involved and largely destroyed. Chief Taylor entered the structure to find the child — without his SCBA. He knew better; he's a 19-year veteran about to celebrate his second anniversary as fire chief.

"I didn't take the proper steps," he said. Tunnel vision had gotten the better of him, and part way into the structure he feared he might have gotten himself in trouble.

Fortunately, Chief Taylor's left-hand search yielded the room with the child. He was lying on the floor near the bed. Chief Taylor ran with the child to a waiting ambulance (see the accompanying video).

Lake Station, Ind., Fire Department's Lt. Robert Saylor rescued the other child.

"He wasn't breathing and had been in there for a significant amount of time," Chief Taylor said. "He's a miracle."

It was his first save and he regularly visited the child in the hospital. The doctors warned him that situations like this typically ended badly. But against the odds, the child's condition continued to improve.

That save is what landed Chief Taylor on the Hometown Hero radar and ultimately in the seat of the Thunderbird's F-16.

Pulling 9 Gs
During the pre-flight briefing, pilot Lt. Col. Jason Koltes, used a model of the plane to demonstrate what they would be doing in the air. Pulling 9 Gs takes a lot out of a person not used to it; Koltes told Chief Taylor to expect to be very tired the next day.

"It was incredible," he said after the flight. "It was so much more than I anticipated; the sheer power of that aircraft is awesome."

As thrilling as the ride was, it was important to Chief Taylor that a firefighter had been selected as the Hometown Hero.

"This was more of an honor for the fire service than for me personally," Chief Taylor said. "The fire service tends to experience a lack of recognition that it deserves. Over time, a community becomes complacent and views its fire department as an insurance policy."

The lift-assist calls won't be splashed across the news like was his rescue, or even his F-16 ride, but it means the world to that person who needs the help, he said.

Photo Rick Markley
Chief Taylor and Lt. Col. Kolte taxi to the runway.

Near miss
In the end it all worked out — the children and Chief Taylor made it out of the fire and pilot eject mechanisms on the F-16 went unused. And whether Lt. Col. Koltes learned anything from their flight is unknown, but Chief Taylor learned plenty from that December fire.

In addition to learning to keep tunnel vision in check, he learned that his and neighboring departments had problems with primary search, accountability and command structure.

Since that fire, Chief Taylor and the neighboring chiefs have met to go over the incident and how they can improve their response at future mutual-aid incidents. Additionally, they've held joint department trainings to allow the firefighters to get to know and get used to working with one another.

And while Chief Taylor paid close attention to the instructions on how the body behaves at 9 Gs, so too has he paid attentions to the lessons from a fatal fire.

Firsthand account: 10 lessons from a massive flood

Posted on Tue, 15 Oct 2013 06:52:02 UTC

One of the largest disasters I have ever been involved with started in the middle of a plate of rigatoni when I heard our south units in Erie, Colo., speak of significant volumes of rain.

It was 17:30 on Sept. 11. I was in Longmont, Colo., just to the north of Erie. Mountain View Fire Protection District covers a large area, so I pushed the pasta aside and headed south in case things got interesting.

While driving, I noticed that all the irrigation and run-off ditches in the area were running high, but had not over-topped just yet. That was not surprising as it had been raining for the past two days.

The most recent rain event had caused localized flooding south of our Station 6 near Coal Creek. Blocked storm grates had increased the flooding, damaging many houses in that area.

I wasn't too worried that this would happen again. As I drove through a downpour, calls started coming in for downed power lines along a main artery into the town from the local interstate.

Multiple storm-related calls
We blocked traffic in both directions for about a mile to prevent shock while waiting for the power company to repair about six separate line breaks. We lost power to the area around 18:15 as rain continued.

As crews waited for power company reps, the volume of water running down the road increased to the point where soil from local field was being washed downstream and starting to flood Coal Creek and run into the local high school. Normally our crews would assist, but another call to the middle school's fire alarm systems had thinned out our resources.

At about 18:30, I coordinated with local police, who had set up an emergency operations center, to establish any rescue necessities in the areas that had flooded before. The storm drain that had caused issues a week before was working well at this point.

But water continued to flow into Coal Creek; the rising water had overtopped the road, effectively trapping smaller vehicles and stalling others. No rescues were called and by 20:30 the rain subsided and vehicles were able to cross the Coal Creek Bridge. Power returned around 21:00 and the local EOC stood down.

Mutual aid
I made it back to my station around 22:00 and got ready for bed. Around 02:00 I received a call from our dispatch center asking if we had any water-rescue resources that we could send up the canyons, as there were multiple collapsed structures and swiftwater rescues.

Our department has limited water rescue resources, but I called the number given me to inquire about specific needs prior to sending personnel to an unknown situation. The individual I called said that water rescue capabilities of all levels from all the surrounding fire districts had sent to Lyons or Boulder.

It quickly dawned on me that there were significant water-related disasters occurring along Boulder Creek, Lefthand Creek in Jamestown and most importantly the Saint Vrain River in Lyons. All three converge in our district.

I had to refuse to send our limited capabilities out of the region as there were no other resources left for what could be significant water rescues in the near future.

Preparing for the worst
I contacted our chief of operations who was engaged in incident management at the Boulder EOC and set in motion a plan to staff extra apparatus and ensure we could deliver service to both sides of the district once the flood waters divided it.

I also called back swiftwater-rescue certified individuals to staff another specialized rescue apparatus. Our district had recently completed surface, flood and swiftwater training to include the use of a personal watercraft (Kawasaki Jet Ski) for water rescue scenarios.

I drove the district to assess the water levels at all the bridges that crossed the two creeks and one river. At 05:30, water was up to the bridge girders and rising quickly.

About this time came emergency traffic from the incident teams in Lyons and Jamestown advising all personnel downstream to evacuate due to collapses in multiple dams. Six dams had collapsed, 20 had overtopped and that a weather system parked over the area had dumped 14 inches of rain in four days.

In some areas the sheer volume of rainwater run-off caused walls of water 20-feet high to rush down canyons that had no vegetation due to recent wildland fires. And our district was in its path.

People trapped
Water that normally running around 200 to 300 cubic feet per second had spread a half mile wide and was running 10,000 cubic feet per second. It spread out over the banks of the St. Vrain, flooding farm fields, destroying greenway paths and uprooting trees and utility poles without difficulty.

Our first call, around 08:30, was to rescue a couple trapped on their second floor as floodwaters washed through their first floor. When we arrived, the swiftwater training we recently completed had not prepared us for this level of impact.

Every few minutes, you could hear loud cracks as 12-inch circumference trees struck the bridge and shattered. You could also hear trees breaking as they fell into the creek or other trees.

Our first structure was the one with the highest risk and the greatest danger to the civilians. This home had beautiful stucco covered fence structures that funneled the water into and around their home. Horse trailers had been picked up and wrapped around trees. A pick-up truck sat abandoned 30 yards from the home with water up to its hood.

Dangerous 'rescue'
Our plan called for a three-person team to cross the torrent to reach the couple who were using their phones to video the rescue. The first team member struggled but made it across. The second and third members lost their footing, forced to use the water rescue rope to swing them into the far side of the rushing waters.

Once reached by the team, the couple was ready to leave until they saw how they were going to have to cross the water. At this point they refused and would wait until the water lowered. We advised them that the rain was expected to increase, not decrease, but they refused.

Our team reluctantly left them in their home to continue the remainder of the mission. Three other homes in the area were contacted and all persons we talked to were perfectly fine with staying in their homes.

We advised them that staying was not be the best option as the water would be constant for a few days, may increase significantly and more than their homes could be lost. Later that day, a military six-by-six had to be brought in to rescue them; the six-by-six was almost lost to the volume of moving water.

Chin pinned to the car ceiling
Over the next few days, our team rescued people stranded in homes, cars and trees. Most rescues were simple, putting personal flotation devices on our evacuees and guiding them through the water.

One rescue required using our watercraft to help extricate a young woman from her vehicle. The water had risen to her chin, pinning her head against her roof. We broke a window, pulled her out, put a PFD on her and moved her on the personal watercraft.

Our team was also tasked with accessing a gas line in a flooded field breached from repeated assaults from rushing debris. We found and secured the valve.

As we ran from call to call for water rescues, our district was evacuating areas in the flood's path. Getting from point A to point B was no longer a straight-line proposition. Road closures became required knowledge to reduce already extended response times.

Water moving at 10,000 cfs punishes structures, especially bridges. While many bridges withstood the pounding, often the water diverted around both ends of the structure and washed out the road base, collapsing the roads leading to the bridge.

Strained resources
In most cases, evacuation just required going door to door. However, those with limited mobility needed assistance being evacuated. Teams of two helped move them to a patient collection point for evacuation on busses.

To make matters worse, on day two we were advised that the water supply systems had failed. There was no water pressure and the water was considered contaminated. The pipes supplying the water district had been washed away; in some areas missing pipe sections were 300-feet long.

Associated with the no-water issue, some areas were crippled with a no-flush directive as sewage systems failed. The district had portable toilets and pallets of drinking water delivered to all stations. Our command team worked with the FEMA resources through local EOCs to hand out water to residents in our area.

During our evacuation of the mobile home park we noticed that a large amount of water reaching this area was from a failed irrigation ditch. This was the second time in two months a wall in the ditch had failed.

An excavation company hired to dig a new flow path dug through three metal pipelines. As all the gas wells in the area had been shut down for prevention, no leak occurred. All energy companies were contacted to ensure that they would assess their local wells prior to turning them back on.

Once the ditch was diverted, we used four, 12,000 gpm pumps to remove the water from the mobile home park. After approximately 18 hours, the task was completed.

As the water recedes, significant challenges lay ahead. At this time, there are only eight known fatalities and 60 unaccounted for across the entire state. Estimates put losses at more than $2 billion dollars with the number of damaged homes at 17,500. More than 11,700 individuals were evacuated.

10 lessons learned
With the event largely behind us, it is time to reflect on what went right and what went wrong. Here are the top 10 things we learned.

1. One cannot have enough water rescue equipment at a time like this. We rapidly used PFDs for the water rescues. In some cases, we forgot to retrieve them. By the time the local EOCs were able to order and replace them, we were about out.

2. Personal watercrafts work well in deeper water, but in water only a foot deep they can scoop mud into the impeller. An inflatable boat would work better in a shallow draft and has pinpoint access using ropes connected to the raft for stability and steering.

3. Swiftwater rescue training does a great job preparing an individual for water running around 500 cubic feet per second. This event was projected to be about 10,000 cubic feet per second, forcing rescue personnel to be slower and more careful.

4. During rescues our personnel were pelted with debris ranging from trees, railroad ties and barrels to colonies of prairie dogs. We also had to anticipate health impacts from failed sewer treatment plants, septic systems and collapsed or displaced oil storage battery tanks.

5. That people want to see you in times like this, doesn't mean that they want to leave with you. Some will assume they are fine under the circumstances until water or food run out, or until the level of water continues to rise as you said it would.

6. Most fire districts around us sent their water rescue capabilities into the mountains to assist areas with significant flooding. When that water ran into the foothill areas, there were very few water rescue capabilities left.

7. Emergency operations centers had to deal with looting, road closures, oil tank failures, water line breaks, electrical systems collapsing and all that water. While they faced their tasks as gracefully as possible, they were unable to meet the request for logistical needs in the field in a timely manner. Look for alternative means to gain resources or pre-negotiate contracts for equipment and services. We were lucky to be able to provide for the basic human needs of our stations early in this event.

8. Swiftwater rescues took much more time as the unit assigned to this task had to keep up on road closures to ensure initial access routes could be completed and end up at the right area in the shortest time possible.

9. While we were not faced with the violence or mass casualties, we all worked long hours under stressful conditions. After the week-long operation, crews became short-tempered, forgetful and lethargic. It is important to crews that this type of physiological response was normal. Crews should be monitored for the next few months for extended stress-related issues.

10. Many of the homes lost belonged to firefighters. These brothers and sisters should expect our support and assistance helping to get things back to as normal as they can be.

It will take a few more weeks to be able to provide running water and sewer to homes in some areas. It will take significant effort to replace the homes that were lost. We may not have road constructed to get people back to their homes before the winter arrives. It may take as long as two years to get roads and bridges back to the state they were before the 10-day rain.

But make no mistake, all the personnel involved in this event can take home the pride of a job well done. Neighborhoods, individuals, private organizations, rescue groups, local and regional fire districts and emergency management personnel came together to deal with the impacts of the greatest flooding seen in Colorado in maybe a millennium. I am proud and honored to have been able to serve with such an august group of professionals.

Looking Is Not Always Seeing

Posted on Fri, 10 Jul 2009 11:06:28 UTC

A few years ago, I gave a patient assessment lecture to a group of EMTs. Early in the lecture, I announced that my assistant would be coming around with a handout. The assistant was a portly gentleman sporting a wide, ugly tie with yellow splotches. After standing in front of each student to distribute the material, he left the room.

Midway through the lecture, I asked the participants to describe his tie, thereby emphasizing the importance of observation to patient assessment. Most participants could not describe the tie or my assistant with any degree of accuracy. About 15 to 20 percent gave a fairly precise description of the tie, generally including the term 'ugly,' and a few must have been asleep as they wanted to know, "What assistant?"

The term for this aptly demonstrated phenomenon is 'inattentional blindness' because while we look, we don’t see. The information doesn’t register because our brains are focused elsewhere and ignoring the visual input. This may not pose a huge problem during a lecture, but can prove to be quite a predicament in the field.

How does our vision work?
Light waves (electromagnetic waves) are continuously bouncing off every object around us. Those light waves in the visible range (we can’t process ultraviolet or infrared waves) that get past the cornea and pupil then hit the retina in the back of the eye. The retina creates electrical signals that are transmitted to the brain, which in turn interprets the information and produces the vision that we 'see.' Don’t believe me? Close your eyes. What do you see?

Signal interpretation
Do we 'see' all the visual signals we receive? From where you are right now, stop reading and take a 180-degree or half-circle view of your surroundings, then close your eyes and recall what you just 'saw.' Now repeat the scan slower, paying attention to details and taking note of what you do not 'see.' All of the light waves bouncing off the objects in your visual field hit the retina and produce visual signals for the brain. Why did your brain fail to give you the total picture of what you saw? Information overload in any system can decrease performance, including your brain. To a significant degree, you determine what you see by the extent of attention you apply to what you are looking at or looking for. A lot of the visual input from the eyes to the brain never gets to perform on your brain's visual screen because you do not pay attention to the content. This can be both a blessing and a curse.

Can you imagine trying to start an IV in a nice fat vein but as you start to insert the needle your vision is overwhelmed with mental images of surrounding objects such as the patient’s clothing, the cot, the blood on the floor, etc., etc., etc.? You would likely be hard-pressed to hit the vein. Our ability to concentrate visual signals on the task at hand helps us select the visual information we need to get the job done.

But what happens when we fail to recognize important visual input? Think about the last time you were providing patient care and asked yourself, "Where did THAT come from?" It might be when the visual input about your patient’s cyanotic lips and weak respirations were sidelined by the visual input of the bloody, deformed open femur fracture, or when you did not 'see' that large pool of blood on the floor before you kneeled down. Or perhaps you found yourself in such a situation after your failure to notice a weapon on the ground. All these events occurred within your field of vision, but failed to register with your brain.

Inattentional thinking
Inattentional blindness has a partner called 'inattentional thinking.' Dispatch sends you to the third intoxicated, unresponsive individual of the day or to the chronic back pain patient that you have visited too many times before. The danger is thinking that the problem is going to be the same as before, or that the scene is as safe as it was the last time you were there. If we fail to consciously evaluate the scene every time, or assess the patient every time regardless of presentation or how many times we have previously seen the patient with the same complaint, we may miss scene hazards or fail to benefit from an accurate patient assessment. What if the intoxicated patient noted above is not just drunk this time, but has a subdural hematoma that occurred from an unwitnessed fall, producing a dilated pupil that we did not think to check? What if the chronic back pain patient on this trip has an expanding abdominal aortic aneurysm that we failed to find because we did not think to examine the abdomen for a pulsatile mass? How many other 'what if' scenarios could feasibly exist?

We all fall victim to unwanted inattentional blindness and thinking. Decreasing the frequency of its occurrence requires awareness, and awareness is fueled by knowledge. If this is your first look at inattentional blindness, I would encourage further study. Resources include Blink, a book on this topic by Malcolm Gladwell, as well as print and video resources readily available by searching the Internet. In the mean time, keep your eyes open and pay attention out there.

1. Rensink RA, O’Regan JK, Clark JJ. To See or Not to See, The Need of Attention to Perceive Changes in Scenes. Psychological Science. 1997:8; 368-373.
2. Simons DJ, Chabris CF. Gorillas In Our Midst: Sustained Inattentional Blindness For Dynamic Events. Perception. 1999. 28; 1059-1074.
3. Rensink RA. When Good Observers Go Bad: Change Blindness, Inattentional Blindness, and Visual Experience. Psyche. 2000:8.
4. Rensink, RA. Seeing, Sensing, and Scrutinizing. Vision Research. 2000:40; 1469-1487.

Exclusive: Firefighter says death of fire chief 'was my responsibility'

Posted on Tue, 24 Feb 2015 16:21:38 UTC

Firefighters bear witness to tragedy. It is part of the job. Solace is often found in the idea that others might learn from our very worst moment and prevent a future tragedy from happening.

The recent death of Medora (Ill.) Volunteer Fire Chief Kenneth Lehr was such a tragedy, and it seized headlines across public safety media. A seemingly inexplicable and senseless incident, it provoked emotion and strong reactions from many.

As often happens with such incidents, the immediate reaction by some was to find someone to blame. In the case of Chief Lehr’s death, that person was Firefighter/Engineer Patrick Cullum, who drove the truck that killed his chief.

"If just one death can be prevented then something good will have come from this incident," Cullum told FireRescue1 in an exclusive interview about the incident, the aftermath and how he’s coping with the tragedy.

The incident
On the afternoon of Feb. 5, a landing zone (LZ) was set-up to a fly a patient with a significant injury to a trauma center. This LZ was deemed unsuitable and a second location was selected approximately one mile away. Cullum drove the fire engine from the first LZ to the second.

Chief Kenneth Lehr is believed to have ridden the engine's tailboard, unknown to Cullum, between the two landing zones.

As Cullum, 47, pulled the fire engine off the highway in the area being established as the second LZ, he visually located nearby personnel and took note that they were 10 to 15 yards away.

In the seconds between stopping and the putting the fire engine in reverse, Lehr either fell or stepped off the engine's tailboard. He was run over by the reversing truck, and was pronounced dead at the scene.

Bearing responsibility
Cullum says he will regret for the rest of his life not taking 10 more seconds to find a spotter before reversing the fire engine.

"Someone notified me that Chief Lehr had been on the back of the truck and fallen under before I could stop," said Cullum. "It was not an accident. It was my responsibility to ensure a safe truck."

Cullum, from his life and military experience, believes it is human nature to assign blame. Even though he doesn't know why the chief got on the back of the truck, potentially while it was moving, Cullum is accepting responsibility for his role in the incident.

"This was not an accident. It was an incident," said Cullum. "In an accident there is nothing that could have been done to change the outcome. An incident, even when the outcome is tragic, could have been prevented."

Cullum said that as the engineer, it was his responsibility to make sure the engine was safe.

"I failed in that respect and I also failed my fire department brothers and sisters worldwide," he said.

Learning from LODD and near miss incidents
Firefighter Close Calls, NIOSH line-of-duty death reports, Firefighter Near Miss reports and other training materials are created and distributed to help emergency responders learn from past incidents and avoid repeating those same incidents.

Asking questions about an incident – why, what, where, when, and how – are part of the investigative and learning process.

When asked about his initial response to an EMS1 editorial questioning how the incident occurred, Cullum clarified.

"It wasn't the questions EMS1 asked,” he said. “The questions need to be asked, but they need to be asked with more knowledge of the incident and what happened.”

The preliminary state police report and early news reports of the incident were thin on specific details about the patient's injuries, the request for an ambulance, the departments that responded, and where the landing zones were located.

Those details will likely be clear in the final OSHA report.

Loss of a friend and a department

Medora is small community. Members of Lehr's family asked Cullum not to participate in the funeral and also asked him to resign from the department a few days after the incident.

He honored both wishes.

As the department's training officer for the last five years, Cullum worked closely with Chief Lehr.

"Kenny was a friend, mentor, chief, and surrogate father figure to me and many others on the department," he said.

"We had our disagreements, but we always worked through those disagreements. That is part of being in a volunteer fire department. You have debates or arguments and then you move on to share a beer together.”

Grief and post-incident stress
Grieving is a process unique to each person experiencing a loss. As a Navy veteran and firefighter, Cullum has seen death and dismemberment before, but sleep is not coming easily to him.

"When I close my eyes, I see all of the incidents behind my eyelids," he said.

"I have seen this before. I know we need to prepare for the worst and hope for the best."

Cullum has been surprised by the thoughts that have come into his mind as he’s grieved the loss of his chief.

"I won't see Kenny at the pork chop dinner (an annual fundraiser for the department)," he said. "This was a fun event for me and all the guys. A vision of Kenny and the assistant chief standing at the grill popped into my mind, for no particular reason, a few days ago."

His experience underscores a truth about dealing with traumatic encounters: stress management is unique to the individual.

"I can only speak for myself," Cullum said. "I can't speak for the other guys on the department. Talking about the incident is helping me."

Support from the fire service
In the days since the incident, former fire department colleagues, his pastor, and many friends have visited Cullum at his home.

"I have not been alone," said Cullum. "This is hard for me and everyone. I pray to God to give me the strength I need."

Support for Cullum has extended beyond his own department, as several within the fire service have reached out to him. One retired fire chief in particular has been helpful, Cullum says, in sharing his own experience of dealing with a line of duty death at his department.

They are currently collaborating on a lesson or presentation they might give to other departments to help prevent a similar incident from occurring.

OSHA has interviewed Cullum and others about the incident. The final report has not yet been released. Cullum approached the interview knowing the investigators had a job to do.

"I did my best to be truthful about what I saw and did. The investigators were gracious in the interview and looked at the incident from all angles," said Cullum.

Hopeful that others will learn
Cullum is not the first and he will not be the last emergency responder to reverse a fire engine or an ambulance without a spotter.

"All of us have from time to time assumed it was OK (to back up) and got away with it," said Cullum.

Backing without a spotter is an example of normalization of deviance by emergency responders, similar to failing to wear a seatbelt or being distracted while driving an emergency vehicle.

Over time, when negative consequences do not occur, unacceptable practices become acceptable. A series of near misses does not change the risk of a fatal backing incident.

"My hope is to prevent another needless death by sharing with others that 10 seconds is enough to save a life," Cullum said. "This incident, maybe, can be a tragic learning tool and I will not have completely failed my mentor and friend."

Future of firefighter cancer research is in the couch

Posted on Tue, 21 Jul 2015 22:36:42 UTC

There is little doubt in the scientific literature that there is a relationship between firefighting and several types of a cancer. Obviously, cancer-causing particles are present in the smoke from fires and ultrafine particles have been found in the air even after the smoke has cleared.

Research is suggesting that carcinogens also are entering the body in other ways including through skin absorption and the eyes. Tests of firefighter equipment like bunker gear, gloves and hoods have shown that particulates often cling to the materials long after the fire is out.

Given these risks, it is not surprising that the incidents of certain types of cancer are so high.

What is less clear is how the changes in fire service practices, the safety culture and the evolving fire environment will affect cancer risks for firefighters in the future.

Some speculate that rates of cancers should decline due to the introduction of SCBAs 50 years ago and its increasing use in fires and during overhaul. The Centers for Disease Control and Prevention and NIOSH report that even firefighters who wear their SCBA correctly register chemical exposures, which highlights the importance of using the SCBA for as long as possible on the fireground.

Rates may fall
As cancer has received more attention by the fire service, other practices also may be evolving. Firefighters are being encouraged to wash their gear more often, keep bunker gear out of living areas, not transport their dirty gear inside their cars, wash their hoods regularly, and shower as soon as returning to the firehouse.

The decreasing rates of tobacco use among firefighters nationally, which were once extremely high, are lower than ever, suggests rates of cancer should be dropping.

What is less clear is what risks firefighters face today compared to the past and what impact those will have on cancer rates. Quick checks of UL's website or YouTube provide a variety of examples of the changing fire environment.

Modern structures, building materials and furniture materials lead to fires that flashover eight times faster than fires of 50 years ago. There is no doubt that today's firefighters are fighting a different fire than they would have in the past. What is in doubt is exactly what risks those fires are presenting beyond their burning faster and hotter.

Good chemicals gone bad
Testing at Duke University in 2012 found that 85 percent of the couches they tested had been treated with some kind of flame retardants identified as potentially toxic. Example chemicals were chlorinated Tris, which was banned from baby pajamas in the late 1970s, and pentaBDE, which is now globally banned due to its toxicity.

Flame retardants became wide spread after California instituted flammability standards that required furniture sold in the state to withstand a 12 minute flame without igniting.

While there has been wide concern about the negative impact of exposure to chemicals in the home from this furniture, less attention has been paid to the negative health effects of the same furniture when it is burning. In studies of lab-based live burns of a standard room and contents, UL found that several carcinogens were produced including benzene, chromium, polcyclic aromatic hydrocarbons and formaldehyde.

On the horizon, new materials are being tested and used for furniture. In an effort to reduce the amount of petroleum in furniture materials, some next generation furniture is being made with soybean oil.

The product is considered more "green" than traditional petroleum products used for foam. While the environmental impact of soybean oil may be better than alternatives, it remains unclear what the risk to firefighters may be when facing them in a fire.

The emerging evidence about the risks of the modern fireground reinforces the need for vigilance related to cancer risk. As always, firefighters should be conservative with their use of SCBAs both during the fire and overhaul wearing the equipment as long as possible to avoid exposure.

Cleaning gear and equipment also is important to reduce skin exposure. While the risks of modern furniture are not yet fully understood, the need to protect against them is.

10 ways to better respond to special needs patients

Posted on Wed, 9 Jul 2014 10:59:06 UTC

Paramedics and first responders tasks are becoming increasingly challenging with the growing number of special needs patients. According to the 2010 census, 2.8 million school age children were reported to have a disability.

In order to minimize problems and have an effective response, EMS and fire must create a stronger partnership and network with the special needs community. Here are 10 steps to successfully do so.

1. Don’t assume the patient has a mental disability based on their looks.

“Approach a special needs patient as you would a colleague,” said Pete Kelly, EMT-B, medical staff coordinator for Special Olympics Michigan. Once you have established mental and physical ability, than treat accordingly.

2. Have a Town Hall meeting with citizens and all essential resources.

Have 30 minute panel discussion with fire, EMS, law enforcement, transportation and a special needs specialist followed by a meet and greet. This is a great way to hear special needs populations’ concerns.

3. Encourage caregivers to keep information up to date.

The American College of Emergency Physicians and the American Academy of Pediatrics created an Emergency Information Form (EIF). The EIF is a valuable tool for first responders. Click here to download the form.

4. Develop a Special Needs Registry.

Emergency management agencies are creating an online registry to locate citizens with a disability during an emergency. Ohio County recently launched their website Sites are usually in the cloud and need to be secure.

5. Include people with disabilities into emergency response plans.

The U.S. Department of Justice provides an American with Disabilities Act Checklist for Emergency Shelters.

6. Don’t separate equipment from the patient.

During an evacuation or a transport to the ER, try to keep the equipment with and the patient. Separation from an object can create outburst in some patients.

7. Be familiar with the equipment.

First responders can’t always keep up with the latest wheel chairs and devices. Here are a few of the latest devices. Convaid offers a special needs wheelchair product line that has advanced design, seating and mobility combinations for a variety of special needs and physical disabilities.

A child with a TheraTogs Lower Extremity System might be a challenge to transport. The device is designed to address several alignment and functional deviations of the knee joints, developing femurs, and hip joints in a child.

8. Keep the routine.

Mary Porter, owner of Tri-Care, says when dealing with a patient that cannot verbalize a compliant, Tri-Care staff often knows there is a problem when a patient is not sticking to the routine.

9. Get trained.

In recent years there has been a surge in organizations that have created training for first responders. About 1 in 88 children have been identified with an autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network.

In addition, Autism ALERT’s mission is to educate first responders and health care professionals on how to recognize and interact with persons on the autism spectrum.

FEMA also suggests the independent study courses offered by Emergency Management Institute IS-197.EM Special Needs Planning Consideration.

10. Use the right communication.

Minimize distractions and use short explanations and use simple language, if the patient has trouble hearing. If you do not understand something the individual says, do not pretend that you do. Ask the individual to repeat what he or she said and then repeat it back. Be patient.

Creating a strategic plan before, during, and after an incident with special needs population is the most effective way to have a good response and recovery.

Protecting firefighter eye protection

Posted on Mon, 17 Aug 2015 23:14:02 UTC

Each year more than 700,000 Americans injure their eyes at work according to Prevent Blindness America.

Faceshields, safety glasses and goggles are essential components of a firefighter's personal protective equipment ensemble because work safety experts say proper protective eyewear could prevent up to 90 percent of all eye injuries.

Faceshield/goggle components that are part of the firefighter helmet must meet the performance standards in NFPA 1971: Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, 2013 Edition. To comply with NFPA 1971, faceshield /goggle components must also comply with the requirements of ANSI Z87.1-2010, the American National Standard for Occupational and Educational Personal Face and Eye Protection.

For your faceshield or goggles to be of maximum value, you obviously must be able to see through them. The following excerpt is from NFPA 1971-A.6.5.2.

Many helmet designs expose the faceshield/goggle component(s) to abrasion, heat, flame, and particulate contamination. Purchasers might wish to specify a means of protecting the component(s). This could include, but not be limited to, faceshield/goggle components that retract inside the helmet, and coverings for the component(s) that are inherently resistant to the firefighting environment. Fire departments should consider the health risks associated with contaminated goggles coming in direct contact with the wearer's face. Goggles do not have to be attached to the helmet.

From this brief section of the standard, comes four important items that need further exploration.

1. Protected goggles
Far too many firefighters still expose their goggles to the effects of heat and smoke by carrying them on top of their helmet, either up front or over the back brim. Goggles carried in such an unprotected manner will more quickly degrade over time.

In addition, the goggles are absorbing gaseous and particulate contaminants with every exposure to heat, smoke and fire gases.

2. Appropriate protection
Fire department leaders should specify the appropriate faceshield/goggle component protection during the specification process when purchasing firefighting personal protective equipment.

Further, fire department leaders should include the proper storage and care for faceshields and goggles in their standard operating guidelines for firefighting PPE.

3. Ensure compliance
In developing those SOGs, fire department leaders should seek the input of the end users to identify the protective option that will obtain the greatest degree of compliance.

In the case of faceshields, fire department leaders should give close consideration to those protective options that will enable better compliance. One example is faceshields that retract into the crown of the helmet.

4. Exposure protection
The body of knowledge concerning firefighter cancers and the skin absorption risk from PPE contaminated with the by-products of combustion is growing larger every day.

There is particular attention given to the head, neck and face — areas the structural firefighting ensemble provides only minimal protection from particulate absorption through the skin. The fire-resistant hood, which has no vapor barrier, is the weak link.

Fire department SOGs for the care and use of PPE should emphasize this exposure risk and how firefighters can minimize the potential exposure risk by keeping their protective firefighting goggles clean and unexposed to heat, smoke and fire gases.

NFPA testing
With the adoption of the 2013 edition of NFPA 1971, faceshield/goggle components that are attached to the firefighting helmet must pass the flame-resistance test in order for the entire helmet to comply with the provisions of NFPA 1971.

That test procedure takes a test specimen of the faceshield/goggle components that is then attached to the appropriate test fixture so that the lower edge of the specimen is exposed.

The specimen is then exposed to a flame from a propane-fueled Bunsen burner, which has an inner cone (of the flame) temperature of 2,192 degrees F (± 180 degrees F). The flame is maintained at the test point of the faceshield or goggle component at an angle of 45 degrees (± 10 degrees). After 15 seconds ± 1 second, the flame is removed and the duration of the after-flame is measured and recorded.

This does not mean that NFPA-compliant faceshield or goggles are designed for continual exposure to the heat and by-products of combustion. It means that those components have passed the test by demonstrating the ability to survive a catastrophic exposure to heat and flame in a very controlled environment.

Keeping clean
Whenever possible, follow the manufacturer's guidelines for the proper cleaning of you protective faceshield or goggles, including the appropriate cleaning solutions that will clean the surfaces without harming them in the process.

For example, repeatedly using ammonia-based window cleaner to clean your polycarbonate or Lexan faceshield is a sure way to eventually cause fogging that will decrease your visibility.

Commercial cleaning solutions specifically designed for cleaning protective eyewear and faceshields come in bulk containers as well as pre-packaged small moistened towels. Another option is to use an environmentally sensitive degreaser and cleaner such as Simple Green.

In response to my inquiry on their Facebook page, MSA Safety recommends Confidence Plus Germicidal Cleaner for all MSA products, including faceshields, goggles, and SCBA facepieces.

Creative ways to fund EMS innovations

Posted on Thu, 20 Aug 2015 00:14:10 UTC

"How will we pay for this?" is the question I asked again and again while attending and presenting at Pinnacle EMS Leadership forum. The sessions I sat in about the quality imperative, mobile health care integration, and the challenges for EMS leaders sparked ideas and projects that quickly filled up my notebook. But I always came back to the same question on how to pay for new programs and initiatives.

Operational and financial feasibility is a reality every EMS manager must contemplate for any project. In this economic climate, grants that are excellent proposals are being denied not because they are written poorly, but because competition for grants is so strong.

Decisions not to fund a proposal don’t necessarily mean the project has no merit or doesn’t provide a valuable contribution. We need to look beyond grantors for other creative funding sources for worthwhile EMS initiatives.

Here are two options every agency should be exploring:

1. Look to your stakeholders for launch and maintenance funding

If you are interested in initiating a mobile integrated health care project, identify the stakeholders who will benefit from the success the project. Typically the largest financial beneficiary is the local hospital that will see reduced readmissions or decreased emergency department utilization. When cultivating support for your program, create a financial plan that involves collaborating with the hospital and their funders to financially support the project.

2. Collaborate with neighboring agencies

EMS is a team-driven industry, so embrace your neighboring agencies to accomplish shared objectives. Perhaps collaboration with your mutual aid partners will lead to access to a larger group of funders. Together you might be eligible for funding from regional banks, electric/gas companies, or a community foundation. Collaboration enhances your pool of funders and creates a stronger grant application from the grant maker’s perspective.

Developing innovative mobile integrated health care programs and creating regional quality initiatives or performance measures is complex and requires extensive networking. When forming a support network, consider how other organizations are funded and opportunities for shared benefits and collaboration.

Eight Things to Do for Your Crew in 2008

Posted on Wed, 2 Jan 2008 12:23:09 UTC

With 2008 under way, it's time for us to reflect on the year past and to begin developing our plans for the future. Here are eight straightforward ideas that company officers can use right now to help their crews stay ahead in 2008.

1. Be an informer
Passing on relevant information about decisions, plans and activities to the people (your firefighters) who need it to do their work is vital. You can't expect them to accomplish goals that they know nothing about. Discuss the daily objectives at the morning briefing, including any training, inspections, pre-fire plans or scheduled community education. You can never provide too much information to your people.

2. Promote the team
Crew cohesion, or working together as a team, is an important human factor in firefighter safety and for getting things done. Problems with crew cohesion have been identified with several near-misses and tragic accidents. Look for and promote good work practices that safely and effectively accomplish team objectives. Stress the importance of how individual capabilities contribute to the team's success.

3. Create a training plan to keep your crew ready Your training goal should be to prepare your firefighters to be ready to operate safely and effectively at any intensity level, anywhere, anytime, and to return home alive. Readiness training demands teamwork, dedication and sustained practice. Create a flexible and believable training plan that addresses the training needs for your crew while prioritizing those training needs, focusing on safety first.

4. Address problems as they occur
Be willing to confront problems head on and have those tough conversations with your firefighters. A team that is comfortable talking openly with each other, and willing to air their disagreements or problems, will move forward together. Identify and remediate all performance issues immediately, understanding that everyone operates at a different level.

5. Define your expectations and keep them believable
It's pretty simple. Let your crew know what you expect of them. Here are a few examples: Be safe by responding safely, following operational policies, maintaining and operating equipment properly, and practicing personnel accountability. Be proficient by training for readiness and improvement, arriving on scene ready to work, communicating effectively, and following the chain of command. Be professional by practicing a positive image all the time, everywhere you go. Be nice to each other and everyone you meet. If your team makes an effort to follow these basic expectations, you will have a safe and rewarding year.

6. Motivate them
Recognize the likes and differences of your firefighters to help you motivate them to be a more productive team. Appeal to their individual emotions and values to generate enthusiasm for their work. Invite their participation when making decisions, and allow them to have responsibility in carrying out their work activities.

7. Recognize and praise them, at the right time
Provide praise and recognition for excellent (not ordinary) performance. If it's really good work, put it in writing. Be specific about what you are praising. Give praise for weak performance that’s improving. Recognizing their efforts shows your appreciation for the work they do.

8. Support and mentor them
Act friendly and considerate. Be patient and helpful. Do things to facilitate your firefighters' skill development and career enhancement. Be responsive to their requests for assistance or support, and set an example for proper behavior. Be their leader.

Take some time and see if you can add a few ideas to the list. Even if you can only address a few of these recommendations you'll be on the road to developing a fresh attitude and healthy approach for a new and exciting year.

How we're changing the status quo

Posted on Mon, 20 Dec 2010 14:39:32 UTC

American voters made a decision in the midterm elections in November this year. The decisions were based on a decision to change the status quo. The U.S. Fire Service apparently made a similar decision earlier in the year, too. The number of line-of-duty deaths recorded in 2010 is near the lowest in the past decade. The number of Safety Officers certified by the National Board of Firefighter Professional Qualifications (Pro-Board) through the Fire Department Safety Officers Association is at a record annual total.

The causes for the reduction in LODDs are not readily measurable. Although the number of deaths is down, the statistics do reflect a status quo or even regression in some ways. Statistics through November show that 68 percent of LODDs occurred away from the incident scene, or responding to the incident scene. Heart attack was the cause of 58 percent (46) of the deaths, vehicle collision 14 percent (11). Twenty-one firefighters who died were over the age of 61. The oldest was 86. Two firefighters were under the age of 21.

The National Fallen Firefighters Foundation's Everyone Goes Home Firefighter Life Safety Initiatives call for the certifications of firefighters. Perhaps the fire service is implementing and adopting this Initiative. The training required for certification may be a factor in the reduction of fireground deaths. However, 8 percent (6) of the LODDs involved firefighters losing their lives due to building collapse, being overtaken by advancing fire conditions or becoming disoriented.

The FDSOA, NIOSH, the IAFF and the IAFC all worked to reduce the number of LODDs in 2010. The FDSOA through safety officer training certification, NIOSH by investigating LODDs and making remedial recommendations and the IAFC's Rules of Engagement and the IAFF's Fire Ground Survival Program both show a commitment to reducing firefighter fatalities.

Technological improvements may be another LODD reduction factor. Several firefighters report "new" use of seat belts because of the strong reminders that come in the form of warning lights and buzzers in newly delivered apparatus.

Increased awareness of air management has changed the way departments treat low air warning alarms. Changes in roadway operations is apparent in most photos and videos, in the form of roadway safety vests on most (if not all) responders.

All of these improvements in safety operations and awareness may be contributing factors in the relatively low number of LODDs in 2010. Perhaps the "no fear" culture of the fire service is changing and we are entering a time when risk management prevails and we employ intellectual aggressiveness.
We still must address our biggest cause of LODDs — heart attack. We must look at age as a factor that increases risk. The Fire Service Joint Labor Management Wellness-Fitness Initiative should receive a renewed effort.

The fire service is committed to reducing LODDS, but the efforts must seriously review the statistics and make the necessary changes.

Can firefighters sue building owners?

Posted on Thu, 16 Oct 2014 12:31:43 UTC

Resurfacing with the news of two FDNY firefighter suing — one going after a homeowner for injuries to his shoulder incurred while responding to a residential fire — is the emotional debate as to whether or not the Firefighter's Rule should apply to bar lawsuits.

Here's the issue. An on-duty firefighter assumes the risk of working in conditions where the firefighter deliberately encounters certain types of hazards inherent to firefighting.

So, when the firefighter is injured in the course of an on-duty emergency response, should the firefighter be limited to worker's compensation or should the firefighter have the ability to recover against the property owner? And if so, under what circumstances?

Evolving over 120 years, under what was initially termed "The Fireman's Rule," a property owner was not liable to a firefighter for injuries sustained while fighting a fire [Gibson v. Leonard, 32 N.E. 182 (Ill.1892)].

Assumed risk
The Firefighter's Rule originated from the theory that firefighters assume the risk inherent in their job for which they are compensated with salary, disability/worker's compensation and pension benefits. This puts the burden of their financial loss on the public rather that an individual property owner.

Therefore, under this theory, lawsuits are not the correct method for compensating firefighters for injuries incurred as a result of the negligence that created the very need for their employment [Espinoza v. Schulenburg, 129 P.3d 937 (Ariz. 2006)].

Another theory supporting the Firefighter's Rule is that firefighters — unlike invited guests or business customers — are required by the nature of their job to enter premises at unforeseeable times and to enter into unusual parts of the premises, which may not otherwise be open to or accessible by the public.

Under this theory, firefighters are not considered in the same category as invited guests to the premises [Pearson v. Canada Contracting Co., Inc., 349 S.E.2d 106 (Va. 1986)].

Therefore, the Firefighter's Rule generally works to prevent a firefighter who is injured in the course of employment as a firefighter from recovering against the person whose negligence or recklessness caused the fire or other hazard resulting in the emergency response.

New York law
The Firefighter's Rule has evolved differently in different jurisdictions. Notably, in New York the legislature has effectively eliminated the Firefighter's Rule as it pertains to third-parties and allows both police officers and firefighters to bring a lawsuit against a third party when they are injured in the lawful discharge of their official duties where the injury is caused by that third party whose neglect, willful omission, or intentional, willful or culpable conduct resulted in that injury, disease or death [N.Y. General Obligation Law § 11-106 (McKinney 2001)].

Although the New York legislature opened the door to allow lawsuits previously barred by the rule, a plaintiff firefighter still has to go through the lawsuit process. This includes the potential for dismissal if the plaintiff can't come forward with evidence on all the elements of the claim — which includes establishing the culpable nature of the conduct and that the conduct was the cause of the injury.

In other jurisdictions, the Firefighter's Rule has been interpreted and applied narrowly, modified to create exceptions for the ability to sue landowners who fail to keep their premises in reasonably safe condition, or modified to create exceptions for failure to warn of an existing hazard.

How do you see this debate? Should a firefighter have the ability to bring a lawsuit against the person who caused the hazard?

Could elimination of the Firefighter's Rule adversely impact the public's willingness to call 911? Should this rule apply to volunteer or paid on call firefighters?

What other issues do you see? Continue the discussion in the comments section.

Assembly buildings: 6 safety items for your civilians

Posted on Mon, 26 Aug 2013 09:49:13 UTC

How many of your residents would drive a car down a mountain road without making sure the brakes worked or would jump out of an airplane without making sure the parachute is securely attached to their backs? The answer, I hope, is not many of them.

However, many people placing themselves in more dangerous situations everyday without even knowing it. I am talking about the life-safety risks in assembly occupancies.

An assembly occupancy is defined by the National Fire Protection Association as "An occupancy used for a gathering of 50 or more persons for deliberation, worship, entertainment, eating, drinking, amusement, awaiting transportation or similar uses."

Since many people enjoy going out, they encounter assembly occupancies on a regular basis. This could include going to a school play, attending a church service, dining at a favorite restaurant or watching a band at a nightclub with friends. In these cases, how often do our community members take the time to stop and consider:

  • Where are the exits?
  • How would I get out of here in a fire?
  • Are there enough exits for all of these people?

If they are like most people, the answer is not often enough.

History of tragedy
Each year, there are tragic news reports of fire and non-fire events in assembly occupancies with shocking death and injury tolls. Some recent incidents include:

  • Fire in the KISS nightclub in Brazil, on Jan. 28, killing 233.
  • Fire in the Cromagnon Republic nightclub, Buenos Aires, Argentina, Dec. 30, 2004, killing 180.
  • Fire in the Ycuá Bolaños Botánico Supermarket, Asunción, Paraguay, Aug. 1, 2004, killing 400.
  • Fire in The Station Nightclub, West Warwick, R.I., Feb. 20, 2003, killing 100.
  • Panic evacuation in the E2 Nightclub, Chicago, Feb. 17, 2003, killing 21.

As you can see, the issue of emergency exiting of public assembly occupancies is not unique to the United States. Here are six suggestions that can be easily performed and help your residents decide if the building may be safe.

Six steps

  1. Note the location of emergency exits when they enter a building and ensure that there is an adequate number. If the place has only one way in and out, use it at once.
  2. Ensure that exits are accessible and not locked or blocked. A business owner that allows an exit to be locked or blocked does not deserve anyone's business.
  3. See if the building has emergency lighting. If they think the room is dark during the performance, wait until the lights go out in an emergency.
  4. Gauge the size of the crowd. If the place is packed, they may want to go somewhere else — restroom lines alone can be hazardous.
  5. Be aware of their surroundings. Many assembly occupancies have dim lighting, and in a fire or power failure, it is a good idea to know where they are.
  6. Watch the alcohol consumption. Too much alcohol can impair judgment and motor skills, which can endanger one's ability to get out of a building in an emergency.

Teach your community that the few minutes needed to scan the building are well worth the time and effort. No one ever heads out thinking tragedy may lie just ahead.

Those who make plans in advance are much better prepared than those who do not. Share these thoughts with your community members at your next speaking engagement.

Should the firefighter drag device remain mandatory?

Posted on Tue, 18 Aug 2015 15:51:28 UTC

The Drag Rescue Device became a mandatory feature of firefighter protective clothing as part of the 2007 edition of NFPA 1971. The DRD was perceived as a necessary life-saving device that was could be deployed to extricate downed firefighters under difficult working fire circumstances.

This need arose after reports from several fatal fires that the lack of appropriate handholds hampered efforts to rescue an incapacitated firefighter from the structure.

Up until that time, different manufacturers had developed various harness-like systems to enable other firefighters to grab a downed firefighter and more easily move them out of the building under rugged physical conditions. Some designs were patented and still are, but before 2007, the DRD or its predecessor designs were an option.

The NFPA 1971 committee undertook a comprehensive review of the requirements needed to provide a DRD-type of feature as part of turnout clothing. Work in this area had to balance between standardizing some attributes versus not making the DRD component restrictive or infringing on intellectual property already held.

The committee determined that there was a specific need to standardize some aspects of its design — namely to enable rapid deployment as well as the overall configuration for securing the upper torso or shoulders of the firefighter so that it pulled directly on the body and not just on the coat.

The committee attempted to minimize any specific design criteria to enable manufacturers to be innovative in how they approached their design of coats with installed DRD.

Testing it
The committee also came up with a test method and performance requirement for demonstrating its use and its ability to be readily deployed.

The test involved the manikin wearing a 60-minute rated SCBA and being on its side on a concrete surface. The test technician had to wear structural firefighting protective gloves and was timed on how long it took to deploy the DRD and drag the manikin 2.5 meters.

The performance criteria included a maximum 10-second deployment/drag time in combination with no movement of the manikin's SCBA.

Because DRDs are part of the overall firefighter protective ensemble, they had to have flame and heat resistance applied to materials and heat-resistant thread used in their construction. They also had to meet certain strength requirements for the seams of the webbing or other materials and have separate labeling and user instructions.

From 2007 on, manufacturers installed DRDs into their coats with many offering several design variations to accommodate different product configurations. Each is required to meet the function test and other NFPA 1971 criteria.

Is it used?
In most cases, the DRD appears to be a figure eight where a strap attached at the junction of the loops is used as the pull tab. The two loops are fitted around both arms on between the liner and the shell. In some cases, heavy cording is used instead of webbing.

The pull strap for the DRD is typically under the back of the collar where it can be accessed above the top of the SCBA. Some form of cover or flap covers the strap's access point to prevent liquid from entering the coat.

Since its introduction, we have not been able to find any reports where a DRD has actually been deployed under emergency conditions. This lack of use comes as a surprise because it was originally argued that the DRD would be life-saving feature to prevent future fatalities.

While many departments train their members for using the DRD in an emergency, some firefighters say that it can be difficult to find and deploy under the poor visibility, confused conditions inside a structural fire. Many of these same firefighters say it is easier to grab the firefighter by their SCBA to immediately move the firefighter as needed.

In addition to deployment issues, some complain that DRDs cause premature wear to the moisture barrier, which may allow liquids into the coat.

Moreover, the DRD must be properly installed for it to work. But it is often not properly put back after it has been removed for the coat to be cleaned. There have been further questions about how the DRD should be cleaned as part of the coat.

Under review
Question about the DRD arise now because NFPA 1971 is about to undergo its revision to the next edition in 2018.

Absence statistics indicating that it has been used as intended, some pundits say the added cost of the DRD, approximately $100 per turnout set, could be spent on other things such as a second set of clothing, proper care and servicing of firefighter clothing, or other operational needs.

Some argue that fire departments should be permitted to specify other methods of extrication through their standard operating procedures and that the requirement should be part of NFPA 1500, Fire Department Occupational and Safety Program. This standard dictates the type of PPE program departments should have in place and addresses fire department operations related to safety practices.

Arguments for keeping the DRD mandatory state that it has been specified for the past two editions of NFPA 1971 (nearly 10 years) and that any downgrade in the requirements could result in fire departments not having any means of emergency extrication for their members just for saving the cost of a DRD.

Furthermore, the DRD should be required and standardized so that it has interoperability between departments, especially since mutual aid is commonplace and individuals must have similar training to work together under emergency conditions. Lastly, some say the DRD should be further standardized in NFPA 1971 to remove its current deficiencies and to promote a more recognizable, consistent design for easy deployment.

It is difficult to remove a requirement that has been in place for some time. Yet, it is hard to ignore the lack of a reported use of a DRD under actual emergency conditions.

We advocate that NFPA 1971 retain requirements for a DRD, but that it be an optional feature of turnout clothing. To strengthen this position and to ensure that the fire service still has practices in place to address emergency extrication of down firefighters, we further recommend that NFPA 1500 include requirements to address either coats having a DRD or the fire department having an appropriate SOP for emergency extrication of firefighters.

It is uncertain how this matter will be resolved. But this debate will certainly encourage rethinking how the fire services approaches some parts of its emergency practices.

Fire department tests bounce-house rescue device

Posted on Wed, 1 Apr 2015 10:01:07 UTC

POKENIOUT, Mass — With the rash of inflatable bounce houses taking flight last summer, one fire department is "aiming" to do something about it.

New Bedford neighbor Pokeniout (Mass.) Fire Department is beta testing a device one of its members invented that will make quick work of fly-away bounce houses.

The invention, dubbed Rescuepoon, incorporates a medieval crossbow and now-outlawed lawn darts tied to a spool of deep-sea fishing line.

The device works like this. When a call comes in for an escaped bounce house, the fire department will deploy its Rescuepoon crew, that will put the dart in the crossbow and fire it into the bounce house.

"If the dart seats well enough into the bounce house, we can reel it in," said Pokeniout Fire Chief Isley Fulakrap. "If not, we use the line to track it once it lands."

The device was relatively cheap to build, the chief said. The only difficulty was locating lawn darts, which were taken off the market in 1988 following a previous ban in the 1970s. Chief Fulakrap says they are working up a modified version for when they buy up all of the Ebay and Etsy supply of darts.

That version, RescuepoonXL, will use a harpoon gun to fire a four-foot pike pole, also tethered to fishing line. The XL will be heavier and harder to store, the chief said, but he believes it will have a 35 percent greater shooting distance and be less susceptible to wind conditions.

Although the chief was extremely positive about the Rescuepoon, he did say it had a few minor bugs to sort out.

"It took us a while to train up our guys on the crossbow, and there may have been one or two mishaps with passing birds," Chief Fulakrap said. "We did nick a Rescue Randy Jr. in the head one time and one of our captains lanced Engine 1's rear tire."

Chief Fulakrap said he also plans to push bounce house makers to make them safer for kids by designing them to deflate faster when pierced.

"You pop a Jart into one of those suckers and it takes on a mind of it's own," the chief said. "In our testing, we've seem 'em do four, maybe five complete high-speed 360s before slamming into the ground. We just want the manufacturers to take some responsibility for kids' safety."

The chief plans to deploy the Rescuepoon this summer.

Why rescue is a thinking person's game

Posted on Wed, 8 Aug 2007 12:38:53 UTC

Updated Jan. 19, 2015

Years ago, when I took my first search and rescue class, the instructor talked about the six-sided review of a building or incident. "Look up, look down, and make sure you look all around before committing yourself," he told us.

Over the years, I have thought of that simple saying on many emergency incidents and have passed it on to thousands of my students during training. The bottom line: Don't get sucked into something before you give it the old once over.

It's easier said than done sometimes, especially when lives hang in the balance and quick action will affect the outcome of an incident. But what about all of those other occasions when you may have the time to do it right? ?

What is your approach and thought process when you come across a technical rescue or any type of rescue for that matter? Is it a well executed series of steps or a fly by the seat of your pants operation?

Good team members, the right tools and practical training shouldn't be under valued, but that doesn't replace mentally being on your game.

To do that, you have to do something that most people hate or are too lazy to do. Rescue is a thinking game. You need to play the "what if" game. "What if a car goes over that edge, what if that building falls down, what if that place blows up, what if I have to cut that guy in half to get past him, what if I have to crawl in that hole to get that victim?"

It's not enough to just know how to use the tools, or be well practiced or to have a cohesive team. Rescue is a thinking game, and the people who can plan ahead, see something coming and are ready for it.

Organized chaos
You're always behind before you get there, that's a given. But how far ahead of the incident are you when you arrive? I used to work for a battalion chief who would say, "You don't bring a crisis to an emergency." Sure it's organized chaos at some scenes, but your level of organization and the ability to achieve the required levels under the most impossible circumstances is the real key.

How many of us can say that we are "masters" of our craft and how many want to be? Chances are, if you're reading this column, you're already a student of the trade, which makes you a cut above the rest. But there is a lifetime of learning to be done and every day is a school day in our profession.

If you think that you know it all, have seen it all or have it done it all, we're all in trouble and chances are you're probably a liability at a significant incident. Confidence should never be replaced by arrogance.

Rescue is a thinking game. The best people who have seen a thing or two tend to mostly be humbled by the experience — they don't say much, but when the going gets tough they often get going.

I love watching new firefighters, they have so much energy and so much enthusiasm, and they're great to be around. It's also fun to watch them expend all of that energy to no successful end sometimes. But with age and experience comes wisdom!

The veteran firefighter may not always be as enthusiastic, but that tempered approach, years of real world experience and knowledge of the tricks of the trade, often carry them through most calls.

But to be in the class above, you have to love it a little more to be really, really good at it. Superstars train harder, practice longer and are very, very focused.

So what does it take to be a master of disaster? Out of the box thinking, the ability to write down your first 20-30 moves on any type of rescue with a twist and a constant desire for perfection. And don't forget the lifetime of learning, listening and talking about the "what ifs" of our job.

What's the strangest thing that's ever been dropped off at your fire station?

Posted on Mon, 31 Aug 2015 12:10:10 UTC

We've all seen it in the movies before and maybe even real life.

You're leaving the firehouse, step outside, look down and there's a baby left at the doorstep. It doesn't happen all the time, but when it does it stops you in your tracks. And it's not just babies that are left at the doorstep of a firehouse.

We asked our fans on Facebook to tell us about the strangest things that have been dropped off at their fire station. Here are some of their responses.

Has your department had something strange dropped off at your door? Let us know in the comment section below.

"A bag full of stolen rifles and shotguns." — Coleman Wilson

"A homeless family, a child, mother and father, knocked on my husband's firehouse door asking for food and shelter." — Dawn Shroyer

"Four bags of pool sand … we don't have a pool!" — Charleen Tittle Foott

"It wasn't at the station, but the guys got called out because someone found a nose on the beach. Come to find out later it was a prosthetic nose from my moulage kit. The public freaked, the guys just laughed." — Leesa Berke

"Old mortar shell that was live." — Melinda Jordan

"Dynamite that was weeping nitro." — Mike Murphy

"A coral snake in a two-liter bottle." — Mike York

"A bottle of Mercury! Small bottle, but it weighed about 5 pounds." — David Morgan

"A pug with its kennel and carrier." — Jonah Sonnier