What is killing firefighters?

Dr. Robert Krause is a battalion chief with the fire department in Toledo, Ohio. His research involved 11,000 data points culled from 149 NIOSH reports and 176 firefighter deaths from the years 1998-2017. From this, he created an algorithm to predict fatality. The average age at time of death was 37, but most often 34 with a median of 28, and mostly after serving two years with the organization. Firefighters were typically perishing in residential fires. Training is at the heart of many of the prevention lessons from these deaths.

He found four key recurring themes in the investigations. Numbers 3 and 4 were the largest contributors.

1. Incomplete adoption of the Incident Command System
2. Inadequate staffing (under-resourcing)
3. Sub-optimal personnel readiness
4. Inadequate preparation for/anticipation of adverse events on the fire ground

From these themes, let’s look at the conclusions and recommendations from the types of incidents accounting for the lion’s share of fatalities.

Apparatus crashes

Of the 56 who died, 39 were not wearing a seat belt. Krause emphasized the need for a training policy and procedure for driving emergency vehicles, personal vehicles and apparatus. Drivers should note that 30 per cent of siren projection is lost laterally. He recommends moderating response speeds, EVOC training, and extra caution at controlled intersections.

Fire ground operations

This represented the largest percentage of deaths and the study looked at traumatic death, not medical emergencies. Fifteen firefighters ran out of air and 22 died due to rapid fire progression as a result of multiple flow paths created by uncoordinated ventilation by fire attack teams.

“Whose responsibility is it to get the firefighters ready,” said Krause to the room of delegates attending the Maritime Fire Chiefs Association’s annual conference. “You, chiefs!”

He said training can help firefighters react better to sudden changes on the fire ground and the development of mental modules through training will make reaction times faster. Of note, he pointed out that firefighters are continuing to perish on the fire ground in predictably identifiable ways. He recommended stress inoculation training to increase preparedness in high anxiety situations and warned that longevity in the service should not be confused with experience.

Technical/specialized operations (HM, CS, Dive, etc.)

Nineteen firefighters lost their lives because they didn’t understand the hazards involved. Oxygen depleted spaces like manure pits, where methane gas is a liability, were particularly problematic. Krause said conversations about methane gas need to be part of training, and that the role of firefighters as all hazards responders is requiring more diverse and specialized training.

Road and traffic accidents

Ten fire departments lost 12 firefighters because they were struck or run over on a road during a response. No perimeter or safe zone had been established.

“You have to have a policy,” he stressed. He pointed to the US Fire Administration’s Traffic Incident Managements Systems guide as a free resource at the read to help departments ensure they have this in place.

Training

Training deaths are preventable deaths, he said. “No one should go home from a training day in a body bag or by ambulance.”

But how do you minimize the risks? Keep in mind that training is highly physically stressful, and an unexpected medical emergency could happen. The presence of a safety officer or EMS is a reasonable and beneficial plan. Always use full PPE and adopt the crawl, walk, run methodology. Keep hydration at the ready and maintain supervision to prevent free-lancing.

Krause delivered a poignant presentation in Halifax on July 8 that was accompanied by video footage showing the many preventable accidents that have happened. He closed with the sad sentiment that the “same events occur year after year.”

His bottom line: “Training is the way out of this.”