Fire Ground Fire Ground Operations for EMSOperations for EMS

Austin-Travis County EMSAustin-Travis County EMSJanuary 2005January 2005

Back GroundBack Ground There were a total of 104 incidents that There were a total of 104 incidents that

took the life of a firefighter in 2004:took the life of a firefighter in 2004: Career firefighters, those who are Career firefighters, those who are

employed full-time as firefighters, employed full-time as firefighters, comprised 29 deaths (27%) in 2004. comprised 29 deaths (27%) in 2004.

Volunteer, seasonal, and part-time Volunteer, seasonal, and part-time firefighters accounted for 78 deaths. firefighters accounted for 78 deaths.

Half of the firefighters that died in 2004 Half of the firefighters that died in 2004 died from traumatic injuries such as died from traumatic injuries such as asphyxiation, burns, drowning, vehicle asphyxiation, burns, drowning, vehicle crashes, and other physical injuries. crashes, and other physical injuries.

For every firefighter that is For every firefighter that is injured and requires rescue injured and requires rescue

from a active fire it……..from a active fire it……..takes 6 – 8 firefighters to remove a takes 6 – 8 firefighters to remove a

single firefighter from the building.single firefighter from the building.

2 firefighters are injured, 1 is seriously 2 firefighters are injured, 1 is seriously injured and the victim is usually a injured and the victim is usually a fatality. fatality.

Why?Why?The additional weight of gear adds The additional weight of gear adds

difficulty in moving the victim.difficulty in moving the victim.PPE – Modern Bunker Gear, Helmet, PPE – Modern Bunker Gear, Helmet,

Boots, Gloves, and Hood weigh Boots, Gloves, and Hood weigh approximately 50 lbs.approximately 50 lbs.

SCBA – Air pack, bottle, pass device and SCBA – Air pack, bottle, pass device and harness weigh approximately 62 lbs. harness weigh approximately 62 lbs.

Why?Why? Most victims are trapped in a Most victims are trapped in a

building collapse and wires following building collapse and wires following a traumatic event. a traumatic event.

Most victims are out of air prior to Most victims are out of air prior to being found.being found.

It takes more than one rescue team It takes more than one rescue team to remove the victim to safety.to remove the victim to safety.

EMS Participation in AFD EMS Participation in AFD Multi-Company DrillsMulti-Company Drills

EMS and AFD both respond to and work together EMS and AFD both respond to and work together at structure fires. In most cases the roles each at structure fires. In most cases the roles each agency performs are well defined and separate agency performs are well defined and separate from each other. EMS is the primary provider of from each other. EMS is the primary provider of patient care and AFDpatient care and AFD performs all fire control performs all fire control related duties. There is a potential for overlap related duties. There is a potential for overlap that does occur on a regular basis and is not that does occur on a regular basis and is not formally addressed, either in policy or through formally addressed, either in policy or through mutual training objectives. A very good example mutual training objectives. A very good example of this overlap occurs when EMS arrives, of this overlap occurs when EMS arrives, sometimes minutes before AFD at a structure sometimes minutes before AFD at a structure fire... fire...

EMS Participation in AFD EMS Participation in AFD Multi-Company DrillsMulti-Company Drills

Apparatus positioning, witness interviews to determine Apparatus positioning, witness interviews to determine fire location and/or possible need for rescues , and fire location and/or possible need for rescues , and initial radio protocols, are very important to a safe initial radio protocols, are very important to a safe and efficient fire attack. With appropriate and efficient fire attack. With appropriate guidelines, EMS and AFD can better coordinate their guidelines, EMS and AFD can better coordinate their actions and ultimately provide better service for the actions and ultimately provide better service for the fire victims.fire victims.

In addition, EMS provides dedicated medical support In addition, EMS provides dedicated medical support for AFD at structure fires. It is important that issues for AFD at structure fires. It is important that issues like, “How to treat a fully bunkered, severely injured like, “How to treat a fully bunkered, severely injured Firefighter” are practiced, reviewed, and improved Firefighter” are practiced, reviewed, and improved upon before it occurs again. upon before it occurs again.

Training ObjectivesTraining Objectives

– Importance of initial apparatus positioningImportance of initial apparatus positioning– Communicating concise fire size up informationCommunicating concise fire size up information– Conducting Witness interviews to determineConducting Witness interviews to determine

Need for additional rescue Need for additional rescue Fire location Fire location

– Guidelines for communication of concise, Guidelines for communication of concise, pertinent information to responding fire units pertinent information to responding fire units

– Practice treatment of severely injured, fully Practice treatment of severely injured, fully bunkered Firefightersbunkered Firefighters

Importance of initial Importance of initial apparatus positioningapparatus positioning

100’ aerial apparatus are rendered useless if 100’ aerial apparatus are rendered useless if not positioned in close proximity of the not positioned in close proximity of the scene.scene.

The front of the structure should be free of all The front of the structure should be free of all initial apparatus (Ambulances & Fire Engines)initial apparatus (Ambulances & Fire Engines)

““Front” meaning, where the main action will Front” meaning, where the main action will take place. Many times the addressed side.take place. Many times the addressed side.

Corners of close by side streets should also be Corners of close by side streets should also be avoided if possible.avoided if possible.

Importance of initial Importance of initial apparatus positioningapparatus positioning

Ambulances should consider:Ambulances should consider:– Stopping close by the front to drop off Stopping close by the front to drop off

equipment, personnel.equipment, personnel.– Have one person move vehicle away Have one person move vehicle away

from the front of the structure.from the front of the structure.– Many times around the corner will work.Many times around the corner will work.

Communicating concise Communicating concise fire size up informationfire size up information

The primary fire tactical channel should only be The primary fire tactical channel should only be used by EMS when:used by EMS when:– EMS is first on scene with no fire apparatus close EMS is first on scene with no fire apparatus close

by (cannot see or hear responding fire apparatus)by (cannot see or hear responding fire apparatus)– There is important incident information which There is important incident information which

needs to be communicatedneeds to be communicated Size-up informationSize-up information Report of victims still insideReport of victims still inside

– There is available radio timeThere is available radio timeKeep reports brief, if message is longer in Keep reports brief, if message is longer in

nature, ask to meet with an Officer on nature, ask to meet with an Officer on arrival.arrival.

RETURN TO REGULAR ASSIGNED CHANNEL RETURN TO REGULAR ASSIGNED CHANNEL AFTER AFD IS ON SCENEAFTER AFD IS ON SCENE

Communicating concise fire Communicating concise fire size informationsize information

What is important incident (size-up) information?What is important incident (size-up) information?• Type of structureType of structure

Residence (Small, large)Residence (Small, large) ApartmentsApartments Commercial (warehouse, store, business office)Commercial (warehouse, store, business office) Hi rise (over 4 floors)Hi rise (over 4 floors)

• Number of floorsNumber of floors• Fire conditionsFire conditions

Fire showingFire showing Smoke (Heavy,light)Smoke (Heavy,light) Nothing ShowingNothing Showing

• Access Directions (if needed)Access Directions (if needed)

Communicating concise fire Communicating concise fire size informationsize information

What is important incident information?What is important incident information?• Locate victims that have exited from the fire Locate victims that have exited from the fire

building. During treatment ask:building. During treatment ask: Is everyone is out? How do you know.Is everyone is out? How do you know. “ “How many are still inside. How do you know.How many are still inside. How do you know. Where are they located? How do you know.Where are they located? How do you know. EXACTLY where is the fire located? How do you know.EXACTLY where is the fire located? How do you know.

• Asking “How do you know”, is needed to establish the Asking “How do you know”, is needed to establish the credibility of the witness. I person across the street credibility of the witness. I person across the street reporting victims inside does not carry the same weight reporting victims inside does not carry the same weight as the Mother.as the Mother.

Communicating concise fire Communicating concise fire size up informationsize up information

Radio Report Example:Radio Report Example:– Medic 1 on scene, light smoke showing from Medic 1 on scene, light smoke showing from

a small single story residence. ORa small single story residence. OR– Medic 1 on scene, heavy smoke showing Medic 1 on scene, heavy smoke showing

from 2 story office building, people from 2 story office building, people evacuating.evacuating.

After interviewing occupantsAfter interviewing occupants– Occupant reports no victims inside OROccupant reports no victims inside OR– Occupant reports child inside, meet me in Occupant reports child inside, meet me in

front of structure for victim and fire location front of structure for victim and fire location info.info.

Thing Thing NotNot to do: to do: Cancel AFD units on a structure fire call.Cancel AFD units on a structure fire call. Reduce to code one.Reduce to code one. Communicate size-up info when fire units Communicate size-up info when fire units

are using the radio.are using the radio. Give long radio transmissions. (It is better to Give long radio transmissions. (It is better to

meet first on-scene Officer and discuss face-meet first on-scene Officer and discuss face-to-face).to-face).

Park in the way of responding fire apparatus.Park in the way of responding fire apparatus. Stay on fire tactical channel after first AFD Stay on fire tactical channel after first AFD

unit on scene.unit on scene.

EMS Paramedics and Commanders EMS Paramedics and Commanders become proficient in removing Self-become proficient in removing Self-

Contained Breathing Apparatus Contained Breathing Apparatus (SCBA) and Personal Protective (SCBA) and Personal Protective

Equipment (PPE) while maintaining Equipment (PPE) while maintaining spinal movement restriction in an spinal movement restriction in an

unconscious fire fighterunconscious fire fighter

Objectives with PracticalObjectives with Practical"" Demonstrate the mechanics of removing Demonstrate the mechanics of removing

an air mask and helmet while maintaining an air mask and helmet while maintaining spinal movement restriction in an spinal movement restriction in an unconscious or critically injured fire fighterunconscious or critically injured fire fighter

"" Demonstrate the mechanics of removing Demonstrate the mechanics of removing personal protective equipment while personal protective equipment while maintaining spinal movement restriction in maintaining spinal movement restriction in an unconscious fire fighteran unconscious fire fighter

"" Understand the importance of recording Understand the importance of recording the mask fit, tank pressure, and PPE for the mask fit, tank pressure, and PPE for safety review investigationsafety review investigation

SCBA and PPE Removal SCBA and PPE Removal The following is a recommended step The following is a recommended step

by step process to safely remove an by step process to safely remove an SCBA and PPE from an injured SCBA and PPE from an injured firefighter without causing more firefighter without causing more injury and supporting spinal motion injury and supporting spinal motion restriction. restriction.

Step 1Step 1Support the firefighter’s head and remove Support the firefighter’s head and remove

the face piece mounted regulator.the face piece mounted regulator.

Step 2Step 2Remove the firefighter’s helmet, slide the Remove the firefighter’s helmet, slide the

hood back, and loosen the straps on the hood back, and loosen the straps on the face shield.face shield.

Step 3Step 3Remove the face shield and open the throat Remove the face shield and open the throat

strap on the bunker coat.strap on the bunker coat.

Step 4Step 4 Loosen the straps on the SCBA (shoulder Loosen the straps on the SCBA (shoulder

and waist strap) and prepare to remove and waist strap) and prepare to remove the SCBAthe SCBA

Step 5Step 5Remove the strap on the SCBA and the Remove the strap on the SCBA and the

sleeve of the coat on the upward side sleeve of the coat on the upward side of the firefighter.of the firefighter.

Step 6Step 6Remove the SCBA by guiding the SCBA Remove the SCBA by guiding the SCBA

around the firefighter’s head and off the around the firefighter’s head and off the other arm remove the coat.other arm remove the coat.

Step 7Step 7Remove the boots and pants after logging Remove the boots and pants after logging

rolling the firefighter onto a long spine rolling the firefighter onto a long spine board. The suspender may be cut or board. The suspender may be cut or unattachedunattached

Step 8Step 8

Collar, package, and finish Collar, package, and finish assessment of patient and begin assessment of patient and begin transport.transport.

Multi-Company Drills Multi-Company Drills EMS will participate in the scenarios. EMS will participate in the scenarios. They will:They will:

– Be first on sceneBe first on scene– Communicate a brief size-up reportCommunicate a brief size-up report– Park in appropriate locationPark in appropriate location– Interview Occupants (if available) to Interview Occupants (if available) to

obtain fire location and victim obtain fire location and victim informationinformation

– Toward the end of the drill, treat a fully Toward the end of the drill, treat a fully bunkered Firefighter bunkered Firefighter

Question 1Question 1What is the recommend location of What is the recommend location of

parking an ambulance when it parking an ambulance when it arrives simultaneously with the first arrives simultaneously with the first arriving fire apparatus? arriving fire apparatus?

a.a. In front of the burning buildingIn front of the burning buildingb.b. On the nearest cornerOn the nearest cornerc.c. Approximately 1 block awayApproximately 1 block awayd.d. Close so you don’t have to carry Close so you don’t have to carry

equipment very far.equipment very far.

Question 2Question 2Most firefighter fatalities occur on the Most firefighter fatalities occur on the

fire ground, of this fatalities the fire ground, of this fatalities the majority is from either majority is from either

a.a. Medical CauseMedical Causeb.b. Traumatic InjuryTraumatic Injuryc.c. 50/50 (1/2 Medical and ½ Trauma)50/50 (1/2 Medical and ½ Trauma)d.d. UnknownUnknown

Question 3Question 3When removing protective equipment When removing protective equipment

from a unconscious firefighter, the from a unconscious firefighter, the improper removal of the mask by improper removal of the mask by rapidly pulling the mask without rapidly pulling the mask without loosening the straps may cause?loosening the straps may cause?

a.a. Spinal traumaSpinal traumab.b. Pull their hairPull their hairc.c. Make a strange sucking soundMake a strange sucking soundd.d. Increase intercranial pressureIncrease intercranial pressure

Question 4Question 4The availability for EMS to rapidly have The availability for EMS to rapidly have protection from PPE while at a fire protection from PPE while at a fire standby is accomplished by: standby is accomplished by:

a.a. Leaving the gear in the side Leaving the gear in the side compartment of the truckcompartment of the truck

b.b. Taking the gear out of the bag and Taking the gear out of the bag and leaving it on the truckleaving it on the truck

c.c. Don’t worry about it you can have the Don’t worry about it you can have the firemen bring your victims to youfiremen bring your victims to you

d.d. Put on the PPE (preferred) or have it Put on the PPE (preferred) or have it ready for donning beside you.ready for donning beside you.

Question 5Question 5A firefighter wears @ 100 additional A firefighter wears @ 100 additional

pounds during interior firefighting. pounds during interior firefighting. This additional weight will _______ This additional weight will _______ his/her heat stress causing a need for his/her heat stress causing a need for more assessment during rehabilitation.more assessment during rehabilitation.

a.a. increaseincreaseb.b. decreasedecreasec.c. no changeno change