Showing posts with label rehab. Show all posts
Showing posts with label rehab. Show all posts

Thursday, April 21, 2011

Volunteer Fire Departments 2.0 (3 of ?) Communications

This is the third installment in a series and the first in which I discuss the critical challenges facing Volunteer Fire Departments. If you missed the first two parts, you can find Part One Here and Part Two Here.
 Just to be clear, I'll repeat the ground rules here: 1) we are trying to have a discussion. Let's pile on the comments, but keep them civil. 2) I am not holding myself up as an expert here. My Department has it's own problems and challenges like every other Department. What appears here is what I have learned from traveling to and visiting with many Departments that have gotten some things down really well. I intend to share those best practices I have seen. You may, and likely have, seen something better. I encourage you to share it with all of our readers here.
 COMMUNICATIONS has been selected here for the simple reason that I have seen this cripple many Departments, and I have also seen Departments that handle it well reap the benefits of that skill. The Communications I am focusing on here is not the 'on-scene' form, which most Departments have down pat, or at least in a workable format. What I am referring to are the internal communications within your Department.
 Best practices I have seen:
EMAIL: Having someone in the Department that is 'the email dude'. This person's job is to get all the information out to the members in an accurate, timely, and ordered format. In the best case, there are only one or two emails sent to all members each month that have all events, meetings, training, and other information in chronological order. These emails must be clean, concise, and without editorial comment. Having more than one or two per month can tend to overload the members and they will start to ignore them. Including a printable calendar each month allows members to print it out and stick it next to the family calendar, this cuts down on the household conflicts. You can also add response call data or other specific items to keep the interest up. (In my Department, we include this along with a comparison to previous years stats for the same month, folks look forward to seeing how we are doing and it makes them read all the way to the bottom of the note.) Making one person responsible for this means every Officer that adds something on the schedule has a single person to contact and get the word out. This person, by default, becomes the 'calendar coordinator'.
TEXT MESSAGING: Some Departments have used text messagin to send out reminders to their memebers of drills, meetings, and other events. They usually have one person as the central point for this task. With everybody, almost, having a cell phone these days, it just makes sense to use the communications systems they themselves use all the time.
OPERATIONAL PROCEDURES:  Does your Department have everything in writing? This is important so that the members have a document(s) which they can refer to for the proper procedures or recommendations for everything from responses to discipline. You cannot expect people to know the rules if they are not written down somewhere. Simply having this will eliminate a lot of arguments, hurt feelings, and confusion. Folks want to know where they stand and a document like this allows them to do that. If you don't have it, you will be facing endless problems over the 'correct way' to get things done. In addition, much of this is required under the NFPA guidelines in a properly organized Department. When there are no rules in writing, there are no rules. This leads to folks making things up as they go and using terms like 'well, it's not written down, but EVERYONE knows that' Well ,excuse me, but just how are 'they' supposed to know that if it was never written down?
 NEW MEMBER INFORMATION: All Departments should have a new member program which includes some sort of book that gives them all the basic expectations and information. What is the chain of command? Who do I see when I need gear? How do I get training? What meetings should I go to and when are they? The new member WILL have a million questions that deserve good answers. Doesn't it make good sense to put this all down in a document? Doesn't it make good sense to have an Orientation training event which includes the probies as well as a few experienced members to discuss all the issues, procedures, and make them feel welcome? I spent my first two years in the Department learning how things are NOT done, by making all the mistakes and getting yelled at. Why they didn't just tell me everything up front is still a mystery to me. (We've since fixed that and have a good program working now.)
TRAINING EVENTS: Most areas have training conducted on several levels; Department, . inter-Department, County, State, and Special opportunities (such as guest lecturers). How is this information delivered to your rank and file members? Do you have a central person responsible for gathering this stuff and getting it to the calendar coordinator? Do you get it to the members with enough lead time that they can adjust their personal calendars to make room for these? There are few things that make me angrier than sitting down to dinner at 1800 and having my pager go off to announce a drill taking place that night at 1830 hours, which NOBODY knew about until this very moment. I do not attend these drills, EVER. My feeling is that if they can't give me the courtesy of a little notice, then I cannot re-arrange my life to make their drill. I know I am not alone in this thought. Giving your people advance notice and time to plan for non-emergent events is more than a simple courtesy, it is NECESSARY to ensure that people will show up. Why put all the effort into a drill and only have 4 people show up? If people DO show up because they have to, for whatever reason, well then you are just being abusive of their time and will quickly lose any respect people had for you.
 TACTICAL AND REGULATORY INFORMATION: We get a fair amount of this in our business and it pays to have a disciplined method to deal with it. Procedural changes within the Department, new hazard information or law changes that comes to us from Local, State, and Federal sources should be given to all the members in print. Ideally, every member should have a mailbox at the station where these bulletins can be dropped into each one so that EVERYONE has the latest information. Having informed members makes everyone safer and better able to do their job. Sending this type of information through email may be easy and quick, but there is no assurance that it will be read because of email overload. Not everyone reads email in a comprehensive manner. It boggles my mind in this day and age, but many think that email doesn't really count and expect something more substantial if it is 'really important'.

 In summary, knowledge is power and information is king in our business. There is a lot of new information coming out all the time and things change fairly quickly. If something is important to pass on to the members, it should be given in a readable format with as much advance notice as possible. If you don't get the information out there, people will not go looking for it. Rumors and hearsay will become the method everyone uses to get their information. If you want them to make meetings and training events, the least you can do is let them know about it in plenty of time. It is much more than a courtesy to let them know what is going on. If you don't work on this, you will consistently be wondering why people don't show up, or don't get the 'word'. Verbal information is worth the paper it is printed on. Many Departments fail to understand how important good communications are, and they get off on the wrong foot with their members while finding themselves always playing 'catch up'.
 Nature abhors a vacuum, if you leave an information vacuum, it will likely get filled with problems.

NEXT UP: LEADERSHIP
UU

Sunday, March 27, 2011

It's About Damned Time!

I finally did it. I've been walking past my weight bench and not looking at it for 6 months (OK, OK, it's been a year, maybe more) now, always telling myself that "tomorrow I will get back to it".  I sort of had it cleaned off a month or two ago, but just couldn't get my fat ass to work. I should have been on it a year ago.
 Well, now that I have gotten a clean bill of health on some issues that were 'causing me concern', I have no excuse. If I am going to make a change, today was the day.
 So I started by recording all my vitals and baseline statistics. No, I am not going to share them with you. I am not going to set goals with hard numbers, that's not the point.
 Instead I am going to set this goal, and you will just have to take my word for it, if it comes up again. I am going to work out in some manner or form at least 4 days a week, even if it's only 20 minutes, and I am going to record any progress. My goal, if there is one, will be to get myself in better shape and increase my wind capacity and strength so I can last longer and go further, and feel better on incidents. My stretch goal is being able to do the 5k run at FDIC next year, if I can figure out a way to get there (to Indy, that is). 5k may not seem like much, but for me, it's something new.
 I have let myself go to pot, and the age thing is taking over. I plan to drop a few pounds (10 would be good) and add on some muscle, and keep it that way. I'm also hoping that the B/P will come back down and I can drop the Simvastatin. The cholesterol should also follow suit.
 I got in my first workout a few minutes ago and my hamstrings are tighter than the G-string on a 5 string banjo. I can barely walk upstairs. My biceps and gut feel about as bad. I have a long way to go, but at least I am off my ass and on my way. In an odd way, the pain feels kind of good.
 Some of you should think about doing the same.
 I also spent the day taking a hard look at myself in other ways. Beginning Tuesday you will learn a little bit more about me and my issues if you have an interest. I am going to ask your help in figuring out what to do with my life going forward. Think of it as another weird Blog contest, but with no prizes.  It could be an interesting experiment, or not.
UU

Saturday, February 26, 2011

I'll Live

 For those who were following, I got a short form letter from my PA yesterday regarding my Stress/Echo test earlier in the week. He had checked the box that said "No Problems Found".
Guess it's time to clean off the weight bench and get back to work.
UU

Wednesday, February 23, 2011

I couldn't help but notice.

 I track the FF fatalities carefully. This year I am logging them and keeping notes for the classes I will teach next year.
 So far this year, in about 7 weeks, we have experienced 22 Firefighter Fatalities. That's TWENTY-TWO. Last year by this time we had 10. Ten is too many, but TWENTY-TWO?
 For the last couple of years the numbers have been, thankfully, going down. This year might be the next 'blip' on the chart.
 I can't help but wonder if the trend for us to do 'more with less' is having an effect on the numbers. Crews driving further, pushing harder, reaching beyond what is normally expected. and coming up short more often than usual.
 I'm just speculating here as a watcher of the gruesome statistics, that we are seeing either an anomaly, or a direct result of massive down-sizing, budget squeezing, and robbing Peter to pay Paul. (Paul being the brother-in-law of the Mayor who has a construction company which employs the Mayor's son.)
 I am also noticing what seems to be an enormous rise in the number of apparatus accidents. Now this may be due to the 'winter from hell' that many parts of the country are experiencing, but I suspect there is something else at the root cause. I don't collect or follow the data on these because, unfortunately, there are just too many of them and nowhere I can find to cull the data off of an Official site that might have good numbers.
 Anyway, I couldn't help but notice. Maybe it's time for a safety stand down?

 Just sayin'.

UU

Tuesday, February 22, 2011

Update to previous

Well, I got through the test (glad I had time to study), and I don't know what I was so worried about. I didn't see anything on the ECG that stood out, but there is the more important issue of what was on the sonogram. I can take a stab at the ECG, but can't even lay a guess on the sonogram. All the valves appeared to be functional and flapping around as I would expect. But the Doc says he needs time to study them before offering a report.
 So I survived the test, but now I need to wait and hear from my primary care Dude to see what they really think. Waiting.... it sucks.

Monday, February 21, 2011

Cowboying Up

 I wasn't going to write about this because it is as personal as it gets and I didn't think it had any interest to anybody. But as I sit here now looking into the face of my fears, I think it might be time to 'walk the talk'.

  In just under 2 hours I go down to the local test center for a Stress Echo cardiogram. It seems my PA is slightly concerned about these little chest pains I have had that come out of the blue and go away. It's nothing really big. They don't hurt, I just 'notice them' a little and they only last 5 minutes. No, it's not angina, and I won't give you any more details because I know you will all start focusing on a differential diagnosis. Thanks, but I'll get that covered elsewhere. Really, thanks.
 No, the reason I'm writing this is because I am a bit scared and worried about how this might go, and what the outcome will be. Will I get pulled off the truck, will they take away my interior certification, will I wind up being one of those 'proper diet and medications guys'? Am I done?
 I don't want this test. I don't want to know. I have too much to do yet.
  On the other hand, I have read too many NIOSH reports about responders who die in the hours after an incident of SCA and their only complaint was "not feeling well". I have taught dozens of classes where I implore the participants to stop the 'hero crap' and take care of themselves and their co-workers. So many Firefighters die in their beds either from the stress of the job, or their genetic pre-disposition that it is just stupid not to look into it when something 'doesn't seem right'.
 One of the things I admire about Chief Billy Goldfeder is that he 'walks the talk'. If you ever spent time with him you will know that several years ago he realized he was headed in the wrong direction with his health. He changed that direction in a big way. This took a hell of a lot of courage. He lost weight, eats a good diet, gets his regular cancer screenings, and preaches to anyone in earshot so that they too might be around longer.
 So in 2 hours I go in to face my fears. I was going to blow it off, but then I thought about Chief Billy, what he said, and what he DID. I thought that if he could do it, so could I. At my age, which quite frankly is an age where I should be taking a step back, I really need to be more careful. I don't want my Department planning my funeral, really. I'd rather have my wife do it long after I've retired from the Department.

 So, I'm scared, but I'm going to do this. I hope when your time comes you can do the same, if not for yourslef, then at least for the folks whose photos you carry in your wallet.
 Wish me luck. I'll let you know what comes of it.
UU

Monday, January 24, 2011

Homesick

 Have you ever been homesick for a place you've never lived? Sounds pretty sick, doesn't it? Yeah, well, that's where I am now.
 Those of us lucky enough to travel a bit have most likely been to places where we've found ourselves saying "Wow, wouldn't it be great to actually LIVE here?". Climate, people, environment, whatever, there is something about these places that appeals to something inside us that draws us in. On our return home we find ourselves daydreaming about this magical place. Perhaps in years to come our minds wander back there. It is a very real draw that goes beyond a simple fancy.
 I count myself fortunate to have two such places. The first is my families homeland, Norway. I am drawn there by the family, the beauty, the history, and the sheer adventure of exploring the country my Grandparents came from. My day dreams here have me in an extended visit lasting several months, perhaps a year.
 But tonight, for some reason, perhaps the weather, or my current troubling issues, my mind wanders elsewhere. Someplace stateside, someplace with less harsh winters, and memories about only good and wholesome things. I'm dreaming of an 'escape' where 4-6 months of immersion would cleanse my soul and rejuvenate my body with health and strength.
 It's only a daydream of course, and I know there is no way it will actually materialize, but it is good to dream. If I had no 'connections' and my wife suddenly left me (who could blame her, have you been reading some of my stuff?), and I had no where to turn, I think I would look to the southwest. The Sangre de Cristo Mountains hold special memories for me and I would dearly love to be able to go and heal there.
 I searched the interwebs to find a piece that seems to be no longer available, but here is something that gives a little inkling toward my feelings as I write this.

I have no idea why, whether it is the high desert, the solitude, or the danger involved in camping with the big bears and mountain lions, but the mountains of New Mexico make me feel at peace, even though each day brings it's own work to survive. I have hiked several places around the world, but New Mexico is different for me.  I have hiked those mountains enough, laid on my back in natural meadows and felt awed by the absolute blanket of stars above, to know that I have to go back someday before I die.
 This all has nothing to do with the Fire Service, except to say that sometimes, we all need a reset. I am wondering if I am due for mine, that's all.
UU

Monday, November 29, 2010

Things heard on the job

Thanks to the Burned Out Medic for triggering another thought stream in my head. Here are some things I've heard on the job, in random order. Many of these I would prefer to never hear again.
==============
OK folks, as soon as we move Charlie onto the backboard, I'd like to get a little extra help in locating his hand. It's got to be around here somewhere.
========================================
 Chief, I think we're going to need a lot more tankers.
========================================
RESPONDER #1: OK, it's your call, how do you want to get this guy out?
RESPONDER #2: What are the options?
RESPONDER #1: By Boat, 15 to 30 minutes; By chopper 20 minutes, plus rigging time; By foot, 40 minutes; or by Six-Wheeler and chainsaw, which is enroute now, about 20 minutes.
RESPONDER #2: Let's go with the Six-Wheeler, can we get TWO chainsaws working?
=======================================
RESPONDER #1: Could you move your left foot?
RESPONDER #2: Why? I'm working here.
RESPONDER #1: You're standing on another body.
RESPONDER #2: Cripes! How many people were in this car?
=======================================
Chief, have we had any luck identifying the green liquid coming out of this building? It's been and hour since we've been working this fire and it's still flowing out. Some of the crews are getting nauseous.
=======================================
We can't do the recovery until the investigators get in there and map everything out.
=======================================
RESPONDER #1: Wow, that's a lot of blood, what do you make it to be, about a liter?
RESPONDER #2: I think it's closer to 2 liters at this point. Ready? One, Two, THREE.......
=========================================
MAYDAY-MAYDAY-MAYDAY
====================================
DISPATCH TO CAR ONE: Chief, we just got in touch with the property owner, he  advises us that there is an unknown quantity of explosives stored in that building.
====================================
 RESPONDER : He fell from up THERE? And yet he's conscious?
====================================
MAN, That's a BIG hornet's nest!
====================================
DISTRAUGHT TAXPAYER: I'll have your JOB!
LINE OFFICER: Ma'am, we're volunteers, just here to help you. We got the water out of your basement, but we aren't qualified to restart your furnace.
DISTRAUGHT TAXPAYER: Yes, you CAN. Now finish the job!
LINE OFFICER: Ma'am, you need to call your Oil company. Your furnace was under 2 feet of water and it will need a lot of work.
DISTRAUGHT TAXPAYER: I'll have your JOB!
LINE OFFICER: Ma'am, at this hour of the morning, and after doing 8 basement pumps, You can HAVE my job.
====================================
What do you mean, you can't find the driver? SOMEBODY rolled this truck over!
====================================
Hey, doesn't that chimney look like it's leaning away from the house?
====================================
FIRST DUE OFFICER TO DISPATCH: We've got at least 7 patients, but we're not done counting yet. Please give me at least 2 more ALS units and a 2nd alarm for EMT's to the scene.
====================================
STOP! I think I feel a pulse! Yeah, look at the monitor!
====================================
Hey man, you don't look so good.
====================================
TAXPAYER: Did you really NEED to bring all these trucks and people?
CHIEF: Yes sir, we do.
====================================
 I love this job!
====================================
I hate this job!
====================================
 Wow, I never thought you could actually crack a fire helmet like that!
====================================
DISTRAUGHT TAXPAYER: I want to talk to your Chief!
CHIEF: Ma'am, I AM the Chief.
DISTRAUGHT TAXPAYER: Not YOU, I mean the BIG Chief, let me talk to him.
CHIEF: Ma'am, I may not be very tall, but I am the biggest Chief we have and I am STILL not going to let you back into that house.
===================================
Man, you got enough sheet rock on your helmet to build a wall!
===================================
I HATE it when my gloves freeze solid.
===================================

One thing I've learned on this job is that you will never live long enough to hear it all, or see it all.
UU

Wednesday, October 13, 2010

Really folks, we should know this.....

...... And I'm gonna do my best to help. Yes, I know it seems I am focused on this rehab kick of late, but we all know this is important and I am convinced that all of us working together to spread the word CAN make a difference. So just like my hound when she gets a rawhide bone, I'm not letting it go just yet.
 Over on Command Safety, Chris Naum just posted a nicely written summary of the newly released USFA report on Firefighter Fatalities in 2009. As an instructor this is what I use every year to 'fill in the blanks' on my presentations and justify for my classes WHY the stuff I present is relevant. You can get your very own copy of the report HERE
 But getting back to rehab and what I am tying to sell as the most important function any of us can provide I would like you to go give Chris's summary a good look then come back. If you are really pressed for time, here is the section I would like you to focus on:

Fifty firefighters died in 2009 as a result of stress/ overexertion:
  • Thirty-nine firefighters died due to a heart attack.
  • Eight firefighters died due to CVAs.
  • One firefighter died from heat exhaustion.
  • One firefighter died from a pulmonary embolism.
  • One firefighter died from damage to a heart valve, an acute event caused by the extreme physical exertion.
Now there were 90 Firefighters who died in the line of duty in 2009 and 50 of them were the result of 'stress/overexertion'. That's 55%. Now you would have a very hard time trying to convince me that there was nothing that could be done to reduce that number by at least half. With the exception of firefighters that went down IN the fire, there had to be some warning signs. The reports bear this out in many cases. The problem was that nobody heeded these signs, and if they saw them, they did nothing about it. Most likely, they asked, and the victim said, "nah, I'm fine". I've done this myself, and probably you have to. We came to do a job and we expect to get it done. We can lick our wounds later. But maybe not.
 Look, I'm not one of those 'safety nuts' that believes we can make everything perfectly safe or nearly so. Firefighting is a damned dangerous business. Some of us will die every year and many will be injured, others will suffer debilitating illnesses. This is the deal and there is no way to stop it. I would like to believe that every time somebody makes a serious sacrifice, it is because the risk they took was worth the benefit. Life safety is primary of course, and I personally am willing to take almost any reasonable risk in that situation with my own security. I'm a lot more careful with my crew of course. But that's just me. We have to do that analysis every time we take the leap, "is the risk worth it?". For an empty structure? Hell no! During training? Again, Hell no! Trapped occupants? Maybe, well actually almost every time. But the point is to look at the risk before you jump in and have a plan.
 If I could get one message in the head of every Firefighter and EMS provider in the world, it would be this: Look at yourself and your crews honestly and without prejudice. If you feel like crap, DO something about it! If a member of your Crew looks like crap, DO something about it! If a firefighter you are rehabbing looks like crap, DO something about it! Have the COURAGE TO DO SOMETHING ABOUT IT! For what is, by all accounts, a group of courageous people, we sometimes lack the courage to save ourselves. What's wrong with that picture?
UU

Monday, October 4, 2010

Live Burn Training: Whats YOUR standard?

 Every year, as part of our training cycle, we review and share the previous years Firefighter Fatality Reports. The latest report is available here. Everybody in this business should make it regular reading every year. Almost every year there are several deaths which occur during training, sometimes these are related to the stress induced during live fire training. The Lairdsville incident is a horrible example of what can happen due to poor planning and lack of knowledge. As a consequence of this and other incidents, my sate has invoked a very strict list of requirements to conduct live fire training evolutions.
 Both my Training Center and my Department has adopted this standard as the baseline for us as a minimum standard. To summarize it includes the basic requirements to have an attack line and a backup line from independent sources capable of delivering at least 120 GPM, having a 3,500 gallon static water supply available, having EMS and rehab active on the scene, and several other basic requirements. In addition, there are instructor requirements such as having at least one live fire qualified instructor for each 5 participants. Live victims are not permitted for any reason. We also supply an instructor to be with each crew as they move through the evolution.
 Eeven with all these precautions, we have had a few 'injury free events' which we were able to mitigate quickly and effectively before any lasting effects occurred. Some of these could very easily have been serious, including one true mayday for a man out of air on the second floor who panicked. Why someone would go in, know his bottle wasn't full is a good question, but the subject of another post.
 All the requirements that are to be met for a live burn evolution means that many Departments in the Volunteer service lack the ability to put on their own training. As we depend on our mutual aid being up to the task for structure fires, we have found it necessary to put on live fire training for as many as 5 other Departments besides our own. We seem to be the only Department with the resources. Ironically, we are using a burn building in one of these districts. They have nobody in their own Department certified by the AHJ to run burns in their building and rely on us to do their in service training.
 In this age of dwindling volunteers, difficulty in getting proper training, and limited funds and resources, I am wondering what other areas are doing to keep their personnel combat ready. Have you compromised the standards? Do you have what you need to pull of the live fire evolutions? What about your mutual aid Departments, are they up to the task? Is live fire training going ut of fashion because of the obstacles? When was the last time you had your crew in a burn building and feeling the heat?
UU

Saturday, July 31, 2010

We don't need no Stinking Standards

Rhett over at the Fire Critic is Hosting this months edition of the First Due Blog Carnival. As this is both a Fire and EMS blog page and I have already put in a submission or two on the EMS side, I felt obliged to contribute something on the Fire Side of things, although this subject: What should the minimum standards be for firefighters?, is not as "simple" as Rhett would have us think. This subject also feels a lot like work for me because I teach this stuff and should really be working on my lesson plans (read: 'Select a subject and get moving') for next season's round of OSHA classes.
Currently, as Rhett points out, there are no consistent standards throughout the USA for Firefighters and some states have no stated minimums at all. These states mostly leave the setting of standards to the Authority Having Jurisdiction (AHJ) which in most cases are something like a Board of Fire Commissioners, or Executive Board in a in private Department.
I am a volunteer and can only speak to that area. In most states, there are minimums for career Firefighters as far as I know, but in my state, it is left up to the AHJ to decide what requirements they place on Volunteers. This passes the responsibility onto the AHJ so they can get sued instead of the State.
I have seen it run the gamut from requiring Nationally certified as a Firefighter II (pro-board cert) AND EMT-B for the minimum entry level, to having a pulse and being able to fog a mirror. I know of a Department not far from me that requires 3 airpack drills to be certified as interior qualified. I hate running calls in their district, I never feel safe.
For Volunteers, I feel that the equivalent of a nationally certified Firefighter one is acceptable as ENTRY LEVEL into the firefighting game, but it should not stop there and certifications should continue over time. There should also be a continuing ed program which can be rolled up into normal training cycles to keep the firefighter abreast of changes in technology, new threats and tactics. This stuff never ends and we all need to stay up on the things that can kill us. If you don't have time to train, you don't have time for the job either.
What's more important to me is the training our Officers receive and how well they stay up on what is current or even have basic scene management and decision making skills.
I have seen Officers at the assistant chief level and ABOVE that could not find their way around a scene is they had a map glued to their nose. These people scare the hell out of me because my ass is in their hands when I am on their job. Officers need to have required standard training because what I see in the volunteer service shows me that too many of the LODD's are caused by poor leadership.
That adjacent Department I mentioned has NO pre-plans! On a working fire job they shoot from the hip. They assign a water supply officer(WSO), interior attack officer, and a few others, but none of them are held accountable, nor do they talk to each other. I spent 5 minutes at a recent fire trying to find out who was the WSO only to find him at the REAR side of the structure advising the interior attack crew. He had tankers lined up coming in from both ends of a single lane road and we had no way to move water through. It was a mess. They also did not call a RIT team or a rehab crew in until after the fire was knocked down and their rehab crew staged at the end of the road 'waiting for patients'. This is all training related and the lack of working fires to tune up on.
All the ICS stuff is required and makes sense even if it is overplayed a bit, but what about managing a simple Single Family Dwelling fire? This is where many of us get killed or hurt. Why can't we come up with a practical exam that covers this basic skill and make sure EVERY Officer passes it with 98% accuracy? Lets put less emphasis on friction loss calculations and more effort into making sure any Officer in Charge can run a basic scene and put the right teams, apparatus, and support in place.
While we're at it, lets also teach all our Officers how to do a look test on their people and have the courage to pull them out when they don't pass. This would knock our LODD's down by 50%. Don't believe me? Read the next 6 LODD reports that come out and tell me if that Firefighter would not be here today if SOMEBODY had looked at them and recognized that something was wrong and MADE SURE they got the help they needed right then and there. I'll bet you a nickel that half of them would have survived if that simple function would have been completed. But that's a subject for another (long) post.
UU

Monday, November 30, 2009

A Culture of Safety, Suppression, or Stupidity?

At the last FDIC Lt. Ray McCormick of the FDNY gave an absolutely wonderful presentation on the current ‘Culture of Safety’. His presentation was so thought provoking and ‘out of the box’ that it caused a bit of an uproar and Fire Engineering pulled the video off the FDIC site within a day and the FDNY had a lot to say about how the good Lt. does not represent the views of the FDNY. Therefore I can not offer you a link to the video, although I wish every Chief Officer would be forced to watch it 3 times. I watched it 3 times before it was pulled. I should have grabbed a copy. Great stuff.
So I will give you the Cliff Notes version. The Lt. brought up the point that we have swung so far in the direction of being safe that perhaps we have forgotten why we are here in the first place. That is ‘TO PUT OUT THE FIRE’. He suggested that perhaps, we might consider taking a little more risk, early in a fire event, to actually extinguish the fire, and we just might in effect, make the scene safer for everyone. In other words, he was challenging our current effort to make the scene as safe as possible, and interjecting the thought that we just MIGHT have gone a little too far.
I am all with the good Lt. and having an open mind. I am also fully in favor of keeping our people alive and put a LOT of effort into getting NFPA 1584 widely used in our area. Rehab is where we SHOULD find problems before they become a fatality. Some day I’ll do a thoughtful and well footnoted post on rehab. Right now I’m pissed off and don’t have time for all the good teaching moment stuff.
Each year in the United States Fire Service we loose around 100 people in the line of duty. About half are due to stress induced by the demands of the job which lead to cardiac arrest. Check the sidebar for the USAF Fallen Firefighters in 2009 on the right of this page and read the causes of death for the fine men and women we have lost this year. Among the names you will find two of my friends.
So it is with no small interest that I do my best every week to carry the message and reduce the number of wakes and funerals I attend each year.
By now you are wondering where I am going with this rambling line of thought.
We are running a recruit class in our volley department this fall. It is being taught by a State Fire Instructor with help from other State Fire Instructors for the evolutions and classroom sessions. Lately they have been getting a lot of work done on the actual evolutions. The lead Instructor is a Deputy Chief in a career department in the adjacent small city. In addition, he spends a lot of time working at the Stat Fire Academy. He believes in the persona of the firefighter of the 60’s. He thinks most volunteers are sissies and he needs to ‘break them down so he can build them back up’. I call him the ‘Drill Sargent’. The last live burn they did with the class, our Department supplied an Engine with a Pump Operator and a Rehab Crew. When the Rehab crew showed up and asked where to set up, the Sargent said, “out there in the woods, I don’t want any of these guys to even see you. They’ll keep running over for water and bullshit every 5 minutes.” Now I ask you, the reader, is this what we expect from a Nationally Certified Fire Service Instructor? I am trying to keep these people alive, not make it easy to die. This particular class had two individuals pulled before completing all the evolutions because their pulses never dropped below 125 and their B/P’s remained elevated after about 10 minutes in the burn building. The Sargent got ticked off. I spoke with one of the other instructors who let it be known that he clearly did not agree with the lead instructor and had grave concerns about putting people in the building that had medical issues.
Now we finally get to why I am pissed of, and spent the evening typing this instead of (just for once) being able to watch ‘TRAUMA” on TV instead of the little web screen.
This coming weekend is another live burn for the class and the lead instructor asked our Department liaison to the class for an Engine and an Operator, but he told him to “keep the damn EMS people away, all my instructors are EMTs and one is a medic”. Now besides the obvious point that Instructors who are involved in the evolution are NOT doing any medical oversight, and having EMTs on the ground does not mean that you are MONITORING the condition of the students. In addition, they will not have the tools with them anyway, no rig, no toys, no tools.
As an Instructor myself, I can tell you that the Instructors themselves usually take the brunt of the physical abuse. They are in gear ALL day long while the student crews rotate through and get some breaks. The instructors only stop when they need a bottle change. I have stood at my post during a recruit class on a hot August day for over four hours at a clip, pushing students through, pulling those out who had issues, watching every one of them, and at the end of the evolution just pouring water out of my mask. No way could I start tending to a patient at that point.
There are reasons most States have very strict checklists for running live burns. This guy is one of them.
The only question is, do I put the guy out of business, or defer to those who say ‘hey, we need the classes, and this guy puts on the classes..’?
UU