This column is the first in a two-part series about dealing with patients involved in motor-vehicle collisions (MVCs). The next column, in January, will address research that has led to changes to how crews respond to patients at extrication incidents,.
In the April issue, we discussed roles of each responder and how to set a plan at a scene. No matter how simple or complex the incident, rescuers must start with a plan to assess the severity of the scene and the condition of the patient(s).
No two motor-vehicle collisions (MVCs) present the same: differences range from the vehicles involved to speed, the numbers of patients involved, and their positions in the vehicles. While it’s impossible to manage every collision scene the same way, a simple, modular approach that is scalable and uses principles of the incident management system can be applied to size-up every incident.
Let’s start from the beginning.
Rescuers should be aware of government rulings that affect the construction of vehicles so that they can adopt new extrication strategies.
My series on firefighter survival (see part 1, Canadian Firefighter, July 2017) focuses on the mayday call. A mayday call is for firefighters only, never for patients or for any other fire-ground emergency. When a mayday is called, everyone on scene knows a firefighter needs help.
In each edition of Tim-bits, I select a topic or technique that was introduced in recruit academies and became engrained as fire-service doctrine, then offer a field-tested and street-smart modification to make the practice easier, safer or more effective.
Peer pressure is present in every fire station and can contribute to dangerous situations.
For the past eight years, this column has explored the rapid intervention team (RIT) and the many aspects of that important fire-ground assignment. As we begin a new year, I want to turn our attention from rescuing other firefighters to rescuing ourselves.
In the world of technical rescue, the Stokes basket is a main piece of equipment. The basket is used for patient packaging and transfer from one elevation to another during a rope rescue, confined-space rescue, or even water rescue if it is equipped with floatation devices. Many fire departments carry Stokes baskets on their fire trucks for rescue scenarios, but this versatile piece of equipment is also valuable for the rapid intervention team (RIT).
Oct. 11, 2017 – One single ounce of oxygen. That’s all it would have taken for an explosion to have occurred at Pacific BioEnergy’s Prince George, B.C. facility in August 2017. It was Thursday, Aug. 24 when chairman and chief executive officer Don Steele found out that one of the wood pellet fuel company’s silos began smoldering overnight.Steele was hosting a group of seven guests who had flown from Nagoya, Japan for a tour of the facility. “I advised them," he explained. "I said we could go up and have a look. We might even go on the property and they wouldn’t see much. But, at that point in time we were evacuating,” Steele said.Although reported as a fire in mainstream media, the incident was a smoldering situation. Wood pellet consultancy company FutureMetrics’ John Swaan founded Pacific BioEnergy Corporation in 1994. His direction on-site is one of the main reasons why an explosion didn’t take place.What was the winning solution? Nitrogen injection. In an industry where the potential for explosions is all too common, this was the first time that a North American pellet operation successfully put out a smouldering issue. “We have a number of incidents that have happened in our industry, mostly in Europe, that have not gone successfully,” Swaan said.“There were some references that I shared with Don and his key people on-site,” Swaan recalled from the day. “And then his VP of operations gathered his key people around and took a look at what the options might be and looked at the references,” he explained. “I shared the report about how best to handle these [situations], that was done in a research centre in Sweden.” “So we did some calculations, and based on those calculations, a decision was made with Don and his people to say ‘OK, let’s bring in the nitrogen.’”“A simple reaction would be to try and open [the silo] up to put out the fire, which would have been catastrophic,” Steele said. “Any oxygen entering would have been disastrous. It was a tremendously risky proposition.”The silo holds 3,500 tonnes of pellets. Steele said that’s the energy equivalent of about 10,000 barrels of oil. The incident had the potential to have the entire surrounding city evacuated.The nitrogen injection equipment was brought to the facility from neighbouring Alberta within eight to 10 hours. Alberta’s oil fields have prompted the province’s first responders to be prepared for fire suppression missions to prevent explosions. The smouldering material in the silo was injected with nitrogen for a few days until it was safe enough to remove in small amounts. The nitrogen arrives as a liquid and needs to be turned into a vapour.“I think the first principle of it is, liquid nitrogen is an inert gas,” Steele said. “In other words, it can’t explode or burn. So you use it to push the oxygen out of the container and then try and seal it off. We tried with foam and various things, but once you’ve got the oxygen content below a certain level, [about] 10 per cent, you’ve minimized the risk of an explosion. So then you can start pulling the material out.”“We basically wetted it down, and over a course of seven days eliminated the risk, moved the material out, quenched the fire risk and then stockpiled it over in another part of our property,” Steele said.“I think the key thing is nobody overreacted… I don’t even think there was a Band-Aid.”Swaan and Steele said the cooperation between industry and first responders was what ensured a safe outcome.“This kind of incident has the potential of major, major injury. Our people knew how to safely handle the material and the first responders and fire department knew how to look after our people to keep them out of harm’s way,” Steele said. “They had the respiration equipment, they had the fire hoses, they had the ability and the technique for putting out a fire. Our people knew how to move the material through and safely evacuate the silo.”Half a million dollars-worth of material and product was destroyed and a lot of equipment was damaged, but Steele says everybody’s safety makes the situation a success. “It’s a happy beginning actually, because we’re beginning now to refit and add to our knowledge of our product and how to handle it,” he said. “And I think the whole industry is going to learn something from it too.” “I say anything that can be fixed with money is not a problem. You can’t fix people with money, particularly if they’re severely injured or killed.” “It’s not a matter of ‘if’ [a silo fire could happen] it’s ‘when,’” Swaan said. “But the good news is that we now as an industry have a lot of new learnings. We have experience that we can now share with the industry so that we can make it a safer industry for these types of situations.”Steele said, “The key thing is, think before you act, use other information, use your judgement, move deliberately, keep everybody safe.”This story was originally published in Canadian Biomass.
In the April issue, I reviewed the general flow and pressure characteristics of standpipe systems based upon the year of their installation or upgrade. For review, standpipe systems installed before 1993 are designed to produce a flow of 500 gpm at 65 psi – which produces a good combination of volume and pressure for a 65 millimetre (2.5 inch) hose with a smooth-bore tip.
In the last few issues, we have built a foundation of key firefighter survival skills and an understanding of the importance of having these skills. We will now build upon that foundation with some integral survival strategies, beginning with mayday calls.
The dispatcher’s voice crackles loudly over the pager through the late-night silence: “Possible structure fire, 2 Gilkey Dr. – Penn Mar Plaza in Mars Borough. Caller on the 7th floor can hear smoke alarms going off and reports black smoke filling the hallway – unable to evacuate. Responding units will be Engines 42, 19, 20, 21 and 22, Truck 42, Truck 228 and Rescue 16 for the RIT.
In the January issue, we examined the first three points of the basics or foundations of fire fighting that every firefighter should know: your equipment; your crew; and your response area. The last two basics are size-up and training.
In the October edition of Tim-bits, I focused on a method of leader-line deployment that has served our department well; its versatility and ease of use has found favour with our firefighters when it’s necessary to extend attack lines.
Editor Laura King spoke with Chris Fuz Schwab, the deputy chief in Smoky Lake, Alta., after he returned from Fort McMurray. This is an edited transcript of their conversation.
On Tuesday, May 3, we had heard that things in Fort McMurray were getting bad: people were being evacuated and the threat to the city was huge. In the afternoon, I had been talking with one of my captains with the High River Fire Department, Brent McGregor. McGregor had been a training officer in Fort McMurray before moving to High River Fire, and he was concerned about the city and the guys up there as this had been his home for a number of years.
The County of Grande Prairie in Alberta, in early conversations with Grande Prairie Regional Emergency Partnership (GPREP), had committed personnel for deployment for the incident occurring in Fort McMurray. This commitment was for roles specific to the Incident Management Team (IMT). (GPREP is an emergency response partnership comprising the County of Grande Prairie, the City of Grande Prairie, the Town of Wembley, the Town of Beaverlodge, the Town of Sexsmith and Village of Hythe.)
Editor’s note: This story first appeared in the September 2015 edition of Fire Fighting in Canada. It has been updated.
Vaughan Fire and Rescue Service (VFRS) was the first department in Ontario to have all its firefighters certified to the province’s firefighter curriculum after the program was introduced in 1993. Now that Ontario has transitioned to NFPA professional qualifications, Vaughan has become the first career department in which all firefighters are certified in NFPA 1006 core competencies for technical rescue – all 300 of them.
When firefighters in Come By Chance, N.L., were called to the scene of a traffic collision in October 2016, they responded, as usual, with lights and sirens. But a puzzle-piece sticker on the car’s back windshield – the international symbol for autism – alerted rescuers to change their approach.
Your crew gets a call for a working fire at a low-rise apartment complex with a person trapped. Within minutes, you are on scene. You’re told over the radio the resident is trapped on the top floor. As you and two colleagues enter the building, your core temperature begins to climb. You’re getting hot, but it’s nothing you can’t handle. You think you’re fine but you become flustered. You’re not sure why, because you’ve done this before. Your temperature begins to rise further and you can no longer focus on the search. You need to get out.
In January 2016, I was tasked to update the Vaughan Fire & Rescue Service (VFRS) standard operating guideline (SOG) for elevator rescue and creating a training program.
Much work has been done over the last three decades to improve the quality of firefighter personal protective equipment (PPE). We are long removed from the minimal protection provided by hip waders and rain coats that were used by some of Canada’s largest fire departments up to the early 1990s.Today’s PPE ensemble, combined with the latest in respiratory-protection devices, affords firefighters the best available opportunity to survive the hazards in a modern-construction dwelling containing materials that burn much more quickly and hotter than they did just 30 years ago. Even with the latest and greatest in available technology, there are situations in which firefighters are seriously injured or killed as a result of acute exposure to the intense heat associated with hotter and faster-developing structure fires.I first heard Winnipeg firefighter Lionel Crowther’s story at the 2015 Canadian Burn Symposium in Toronto. While working an overtime shift on the evening of Feb. 4, 2007, a response to a house fire produced results that have changed Crowther’s life. We now know Crowther and his crew likely encountered a change in fire conditions as a result of flow-path dynamics. Crowther suffered burns to 70 per cent of his body, 30 per cent of which were full-thickness burns. Captains Harold Lessard and Thomas Nichols died on scene and firefighter Ed Wiebe suffered injuries that put him in critical, but survivable, condition. Firefighters Darcy Funk and Scott Atchison sustained minor injuries.Crowther was exposed to extreme heat levels for an extended period of time as he was unable to make an exit when fire conditions changed; he sustained burns that may have been caused by the compression of superheated gasses trapped in his bunker gear. (For more about Crowther go to https://afterthecocoon.com/burn-survivors/lionel-crowther/)NFPA 1971 sets the minimum performance requirements for personal protective equipment (PPE) and also specifies the test methods by which the PPE is measured. The newest test is the stored energy test, which was added in 2013. Industry experts recognized the thermal protection offered by bunker gear also results in heat being stored in bunker gear. The trapped, superheated gas, when compressed at pinch points in the suit at the knees and the elbows, causes burns. Another common place where superheated gases are trapped is behind the backplate of the SCBA. Crowther’s story closely resembles that of Winnipeg firefighter Barry Borkowski, who suffered significant injuries on Oct. 9, 1994. Since retiring as a captain in 2005, Borkowski has worked to implement design changes to bunker gear.The evolution of engineering of bunker gear has resulted in significant improvements in protection of firefighters; NFPA 1971 has evolved as a result of different types of firefighter injuries, and now measures more factors. But with the improvements have come some challenges: the retention of superheated gasses inside the PPE envelope has resulted in burns during the handling of firefighters who have been removed from fires. ***Representatives from the International Association of Fire Fighters were invited to attend the 2015 Toronto burn symposium and participate as presenters. At the 2014 symposium, much of the information presented contained American-specific details. In 2015, I was asked to co-present – from a Canadian perspective – with Judy Knighton, a registered nurse and burn specialist at the Ross Tilley Burn Centre at Sunnybrook Health Sciences Centre in Toronto. Knighton and I were tasked to identify best practices in handling and managing the care of responders who sustained burns. Knighton handled to the transport and treatment priorities in her presentation titled Emergency Management and Outpatient Care of the Person with Burns. I addressed management of the patient immediately following removal from the hazardous environment in my presentation, Managing the Handling of the Rescued Firefighter.Emotions among fellow firefighters run high when a firefighter is rescued from a fire. As with all hazardous situations in which patients are involved, the primary concern should be rescuer safety. It is important that the rescuers wear full PPE when managing care for a rescued firefighter, and be purposeful and careful when handling the super-heated firefighter. The rescuers need to: Avoid off-gassing from firefighter; Avoid skin contact with hot bunker gear. Considerations and steps to safely remove the PPE ensemble: Have the firefighter remain standing• Allow some time for the PPE envelope to passively cool and off-gas or use a positive-pressure ventilation fan to speed up the process• Do not use a hose line to cool the firefighter while he or she is in the PPE ensemble.• Use two rescuers to facilitate the removal of the PPE ensemble• Protect the rescued firefighter from the stored heat in the bunker gear• Avoid sitting, laying down, bending limbs prior to dissipating stored heat Loosen the SCBA shoulder straps; communicate your planned actions and co-ordinate the loosenin Disconnect the chest strap Loosen and unbuckle the waist belt Remove and replace the neck flap Open the front jacket flap while unclasping/unzipping the coat Open the jacket Remove the stage 2 regulator Roll the coat and the SCBA over the shoulders Remove gloves and the remainder of the coat Unclasp the pants, and remove the suspenders, letting the pants fall Roll the pants over the boots, and assist in removal of boots. Remove helmet, balaclava and mask. Initial burn treatment: Rapid access to definitive care ASAP Use water to cool small minor local burns Cut away clothing if necessary to avoid debriding when fabric remains in the burned tissue Protect open burn wound with dry sterile burn dressings Facilitate rapid transport to definitive care Initial assessment of burns on scene are quite often not overly reliable; some burns that appear to be minor end up being severe while some burns that seem to be significant end up being less severe. View the embedded image gallery online at: https://www.cdnfirefighter.com/index.php?option=com_k2&Itemid=58&lang=en&layout=latest&view=latest#sigProGalleria0ee56f199f All regions in the country have burn centers associated with leading-edge hospitals that are best suited to manage the care of burn patients. It is worthwhile to ascertain where your firefighter will go when they sustain significant burn injuries. Our partners in emergency medical services will facilitate movement of firefighters to these facilities. Fire services are very good at preplanning occupancies so they are aware of the different hazards. Situational awareness training is also helping firefighters recognize and react when fire conditions are about to change. These are initiatives designed to limit the risk to firefighters when emergencies occur. Through articles like this and presentations at conferences such as the Canadian Burn Symposium, we hope to spread the word about how to manage the superheated firefighter to limit injuries to the rescuer and the rescuee. These are low-incidence, high-risk situations that need to be planned for before they happen. Ken Webb is a 22-year career fire fighter at Toronto Fire Services who is also paramedic trained. Ken served 15 years as a captain in the professional development and training division. For the last eight years, Ken has been the manager of the firefighter pre-hospital care program at the Sunnybrook Centre for Pre-hospital Medicine in Toronto.
Editor’s note: Sue Henry is a deputy chief with the Calgary Emergency Management Agency. Editor Laura King spoke with Henry following the deployment of the all-hazards Canada Task Force 2 to Fort McMurray.
What are you when you put your uniform on? Are you a fire officer, a firefighter or do you even contemplate how many different hats you wear in one shift? What if I told you that you are salesman, a communications officer, and a customer-service clerk all wrapped up in a fire helmet of whichever colour you just happen to wear? Several years ago I wrote a paper for a fire-prevention management course I was taking at the Justice Institute of BC; Rita Paine was my course instructor. I had an opportunity to use some customer-service skills the other day and it reminded me of the fictional paper on which I just happened to get an A. The purpose of the paper was to write about customer service in the fire service and describe what it meant to each of us.
I remember a few years ago one of my out-of-province firefighter colleagues telling me his fire department had just put dog and cat resuscitation kits on its rescues.
In October, insurance-industry executives told participants at a conference in Montreal that climate change is to blame for the increase in the number of storms, floods and hail events that have resulted in a surge in insurance claims filed in Canada. Martin-Eric Tremblay of the Co-operators Group Ltd.
With the closing of the Olympics and Paralympics in Beijing, it is little more than a year until Vancouver and Whistler take centre stage. As the Olympic torch was extinguished in Beijing, VANOC was hosting a celebration in Vancouver, marking the final countdown to 2010 and introducing new emblems and colours. The public face of the 2010 Olympics is about shiny new buildings, public celebrations and fluffy mascots but under the surface is the hard reality of planning for the security and safety of the Games, the participants and the local communities.
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