2811 Ch 8 PowerPoint

1. Chapter 8 — Health Care and High-Risk Populations
Strategic and Tactical
Considerations on the Fireground
4th Edition

2. Hospitals (1 of 9)
‣ Question to ask students:
‣ What is the maximum amount of patients that
the local hospitals could treat?

3. Hospitals (2 of 9)
‣ Occupancy
‣ Preplans
‣ Hospital codes
‣ Code Red—fire
‣ Code Blue—adult medical emergency
‣ Code White—pediatric medical emergency
‣ Code Amber—infant or child abduction
‣ Code Yellow—bomb threat

4. Hospitals (3 of 9)
‣ Hospital codes
‣ Code Gray—security emergency/patient
elopement
‣ Code Silver—hostage situation
‣ Code Orange—hazardous material situation;
where decontamination is needed
‣ Code Triage—external disaster situation
‣ Code Clear or Condition Green

5. Hospitals (4 of 9)
‣ Hospital staff
‣ Laboratories
‣ Oxygen and medical gases
‣ Magnetic resonance imaging (MRI)

6. Hospitals (5 of 9)
‣ Hospital fires
‣ Protecting the patient
‣ Evacuation
‣ Restrained patients
‣ Calling for help

7. Hospitals (6 of 9)
‣ Command and control
‣ Firefighting
‣ Operating rooms
‣ High-energy electrosurgical units (ESU)
‣ Ventilation

8. Hospitals (7 of 9)
‣ Size-up factors for hospitals
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather

9. Hospitals (8 of 9)
‣ Auxiliary appliances
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

10. Hospitals (9 of 9)
‣ Considerations for fires in hospitals
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system/solutions for an
offensive attack
‣ Strategic goals and tactical objectives for a
defensive attack
‣ Incident management system
considerations/solutions for a defensive attack

11. Nursing Homes and Assisted Living
Facilities (1 of 7)
‣ Question to ask students:
‣ Have students select a nursing home and an
assisted living facility in their community, and
have them describe the type of building
construction.

12. Nursing Homes and Assisted Living
Facilities (2 of 7)
‣ Fires in nursing homes and assisted living
facilities will tax every fire department.
‣ Most fires are small and controlled very quickly.
‣ These are labor-intensive assignments and
require rotation of personnel.

13. Nursing Homes and Assisted Living
Facilities (3 of 7)
‣ Regulation
‣ Preplanning
‣ Construction
‣ Protective systems
‣ Life safety
‣ Evacuating or protecting in place
‣ Bed restraints

14. Nursing Homes and Assisted Living
Facilities (4 of 7)
‣ Incident considerations
‣ Ventilation
‣ Salvage
‣ Incident management system

15. Nursing Homes and Assisted Living
Facilities (5 of 7)
‣ Size-up factors for nursing homes and assisted
living facilities
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures

16. Nursing Homes and Assisted Living
Facilities (6 of 7)
‣ Weather
‣ Auxiliary appliances
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

17. Nursing Homes and Assisted Living
Facilities (7 of 7)
‣ Considerations for fires in nursing homes and
assisted living facilities
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system/solutions for an
offensive attack
‣ Strategic goals and tactical priorities for a
defensive attack
‣ Incident management system/solutions for a
defensive attack

18. Mass Casualty Incidents (MCI) (1 of 14)
‣ Question to ask students:
‣ What is the level of training of the members of
the local fire department and emergency
medical personnel should a mass casualty
incident occur?

19. Mass Casualty Incidents (MCI) (2 of 14)
‣ A mass casualty incident is one in which:
‣ There are a large number of patients.
‣ Responding units are not sufficient.
‣ Nearby hospitals will be overloaded.
‣ Significant implementation of emergency
medical services (EMS) personnel is required.

20. Mass Casualty Incidents (MCI) (3 of 14)
‣ Communities can classify MCIs at different levels.
‣ Level 1
‣ Level 2

21. Mass Casualty Incidents (MCI) (4 of 14)
‣ Incident requirements
‣ Standard operational guideline
‣ Level A or Level 1
‣ Level B or Level 2
‣ Level C or Level 3

22. Mass Casualty Incidents (MCI) (5 of 14)
‣ Trauma centers
‣ Four levels of trauma centers in the United
States
‣ Level 1—Full range of specialists and
equipment
available 24/7
‣ Level 2—24/7 service for essential
specialties, personnel,and equipment

23. Mass Casualty Incidents (MCI) (6 of 14)
‣ Trauma centers
‣ Four levels of trauma centers in the United
States
‣ Level 3—No full availability of specialists,
but resources for emergency resuscitation,
surgery, and intensive care of most trauma
patients
‣ Level 4—Provides for stabilization and
treatment of severely injured patients

24. Mass Casualty Incidents (MCI) (7 of 14)
‣ Hazardous materials
‣ Terrorism-related MCIs
‣ Mass casualty vehicle
‣ Communications

25. Mass Casualty Incidents (MCI) (8 of 14)
‣ Critical incident stress debriefing
‣ Simulated exercises
‣ Command
‣ Operations
‣ Staging
‣ Logistics
‣ Medical group or medical branch

26. Mass Casualty Incidents (MCI) (9 of 14)
‣ Triage
‣ First step—Primary scan of all the victims
‣ Second step—Treat those injuries where the
person has a chance of survival (not an in-
depth treatment)
‣ Third step—Thorough examination, followed
by tagging of the individual

27. Mass Casualty Incidents (MCI) (10 of 14)
‣ Triage
‣ Color classifications
‣ Red tag—first priority—immediate transport
‣ Yellow tag—second priority—transport as
soon as possible
‣ Green tag—third priority—minor/delayed
transport
‣ White tag—fourth priority—no injury
‣ Black tag—deceased—no transport

28. Mass Casualty Incidents (MCI) (11 of 14)
‣ Triage form
‣ Treatment
‣ Transportation
‣ Need for coordination
‣ Mass casualty incident considerations

29. Mass Casualty Incidents (MCI) (12 of 14)
‣ Size-up factors for mass casualty incidents
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather

30. Mass Casualty Incidents (MCI) (13 of 14)
‣ Auxiliary appliances
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

31. Mass Casualty Incidents (MCI) (14 of 14)
‣ Considerations for mass casualty incidents
‣ Strategic goals and tactical priorities
‣ Incident management system/solutions

32. Houses of Worship (1 of 12)
‣ Question to ask students:
‣ What are the three ways that a timber truss
roof on a house of worship will typically react
when attacked by fire?

33. Houses of Worship (2 of 12)
‣ Building inspection
‣ Construction features
‣ Interconnected buildings
‣ Access

34. Houses of Worship (3 of 12)
‣ Delayed alarm
‣ Building usage
‣ Converted building
‣ Fire prevention
‣ Fire causes
‣ Problems
‣ Firefighting

35. Houses of Worship (4 of 12)
‣ Communications
‣ Ceilings
‣ Hanging ceiling
‣ Problems associated with hanging ceilings

36. Ceilings
‣ Figure 8-9 This diagram shows how the
hanging ceiling is supported. Used with
permission of Pearson Education.

37. Houses of Worship (5 of 12)
‣ Ventilation
‣ Steep, sloped roofs
‣ Roof venting should be done from a
platform or a main ladder.
‣ Breaking stained glass windows
‣ First break one or two to see if breaking
more would
assist in ventilation.
‣ Lexan® covering or wire screening requires
the use of a power saw.

38. Houses of Worship (6 of 12)
‣ Valuable artifacts
‣ Defensive attack
‣ Roof failure

39. Houses of Worship (7 of 12)
‣ Lessons learned and reinforced
‣ Get a full 360-degree view of the church and
exposures.
‣ Call for help early.
‣ Stop the upward spread of the fire in wall
voids.
‣ Overcome the fear of breaking stained glass
windows.
‣ Feedback is essential.

40. Houses of Worship (8 of 12)
‣ Set realistic goals.
‣ If an offensive attack does not quickly control
the fire, consider switching to a defensive
attack.
‣ Monitor the amount of time involved until the
fire is under control.

41. Houses of Worship (9 of 12)
‣ Churches of frame construction
‣ Date back to the 19th century and lack fire
protection systems.
‣ Fire-stopping in these buildings is rare.
‣ Wood frame churches with lightweight trusses
‣ Fast-spreading fires and very short failure
times

42. Houses of Worship (10 of 12)
‣ Size-up factors for houses of worship
‣ Water
‣ Area
‣ Life hazards
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather
‣ Auxiliary appliances

43. Houses of Worship (11 of 12)
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

44. Houses of Worship (12 of 12)
‣ Considerations for fires in houses of worship
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system
considerations/solutions for an offensive attack
‣ Strategic goals and tactical priorities for a
defensive attack
‣ Incident management system
considerations/solutions for a defensive attack

45. Penal Institutions (1 of 7)
‣ Question to ask students:
‣ What potential problems could exist between
the warden and the fire department personnel
at a fire in a penal institution?

46. Penal Institutions (2 of 7)
‣ Types of institutions
‣ First-generation confinement
‣ Second-generation confinement
‣ Third-generation confinement

47. Penal Institutions (3 of 7)
‣ Emergency operating plan
‣ Fire department preplans
‣ Delayed alarms
‣ Fires
‣ Riots
‣ Evacuation

48. Penal Institutions (4 of 7)
‣ Unified Command
‣ Handling of EMS calls
‣ Critical incident stress debriefing

49. Penal Institutions (5 of 7)
‣ Size-up factors for penal institutions
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather
‣ Auxiliary appliances

50. Penal Institutions (6 of 7)
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

51. Penal Institutions (7 of 7)
‣ Considerations for fires in penal institutions
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system
considerations/solutions for an offensive attack
‣ Strategic goals and tactical priorities for a
defensive attack
‣ Incident management system
considerations/solutions for a defensive attack

52. Public Assembly Buildings (1 of 5)
‣ Question to ask students:
‣ What would be the strategic goals for an
offensive attack at a fire in a public assembly
building?

53. Public Assembly Buildings (2 of 5)
‣ Occupancy
‣ Combustible furnishing
‣ Construction and design
‣ Exits and evacuation
‣ Evacuation
‣ Strategic considerations

54. Public Assembly Buildings (3 of 5)
‣ Size-up factors for public assembly buildings
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather
‣ Auxiliary appliances

55. Public Assembly Buildings (4 of 5)
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

56. Public Assembly Buildings (5 of 5)
‣ Considerations for fires in public assembly
buildings
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system
considerations/solutions for an offensive attack
‣ Strategic goals and tactical priorities for a
defensive attack
‣ Incident management system
considerations/solutions for a defensive attack

57. Schools (1 of 6)
‣ Question to ask students:
‣ What can be learned from the fire that
occurred at Our Lady of Angels in Chicago in
1958? How did this fire change school fire
safety?

58. Schools (2 of 6)
‣ Evacuation plan
‣ Evacuation problems
‣ Building design
‣ Exits and fire doors

59. Schools (3 of 6)
‣ Firefighting
‣ Laddering
‣ Preplanning
‣ Causes of school fires

60. Schools (4 of 6)
‣ Size-up factors for schools
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse

61. Schools (5 of 6)
‣ Exposures
‣ Weather
‣ Auxiliary appliances
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

62. Schools (6 of 6)
‣ Considerations for fires in schools
‣ Strategic goals and tactical priorities for an
offensive attack
‣ Incident management system
considerations/solutions for an offensive attack
‣ Strategic goals and tactical priorities for a
defensive attack
‣ Incident management system
considerations/solutions for a defensive attack

63. School Violence (1 of 7)
‣ Question to ask students:
‣ What can be learned from case study reviews
to help optimize response in future incidents?

64. School Violence (2 of 7)
‣ School violence is on the rise.
‣ Violence is imposed by one student upon another,
gang activity, and random attacks.
‣ Responders must now be fully prepared to
confront violence in a school setting.

65. School Violence (3 of 7)
‣ Developing an emergency operating plan
‣ Active shooter incidents occurring at locations
other than schools
‣ Interaction of firefighters
‣ Police procedures
‣ Interior of the school building
‣ Active shooter on school grounds

66. School Violence (4 of 7)
‣ Police front-line supervisors
‣ Fire department and EMS responsibilities
‣ Deployment of fire department personnel
‣ School personnel responsibilities
‣ Lessons learned and reinforced at Northern
Illinois University
‣ Incident command system

67. School Violence (5 of 7)
‣ Size-up factors for school violence
‣ Water
‣ Area
‣ Life hazard
‣ Location, extent
‣ Apparatus, personnel
‣ Construction/collapse
‣ Exposures
‣ Weather
‣ Auxiliary appliances

68. School Violence (6 of 7)
‣ Special matters
‣ Height
‣ Occupancy
‣ Time

69. School Violence (7 of 7)
‣ Considerations for violence in schools
‣ Strategic goals for an offensive attack
‣ Incident management system
considerations/solutions for an offensive attack
‣ Strategic goals for a defensive attack
‣ Incident management system
considerations/solutions for a defensive attack