6742 Ch 9 PowerPoint

1. Fire Department Incident Safety
Officer
Third Edition
Chapter 9 — Reading Firefighters

2. Knowledge Objectives (1 of 2)
‣ List the three factors that influence the chance of
overexertion.
‣ List the three ergonomic stressors that can produce injury
and the three strategies to mitigate them.
‣ Describe the criteria used for heat and cold assessment of
personnel at an incident.
‣ State the signs and symptoms of cardiac, heat, and cold
stress.

3. Knowledge Objectives (2 of 2)
‣ List the essential ingredients that help human cells perform.
‣ Explain the role of hydration in preventing injuries.
‣ Define the conditions or activities that determine the need
for rehabilitation strategies at an incident.
‣ Define the five elements that make up firefighter REHAB.

4. Introduction: Is It Possible to Read
Firefighters?
‣ Predicting firefighter behavior is not easy
‣ Many factors affect firefighter judgment
‣ Most working firefighter judgment mistakes can be explained
‣ Human performance (including mental processing) is
dependent on many factors
‣ Overexertion is the leading cause of injuries (and deaths) at
incidents

5. The Overexertion Setup (1 of 4)
‣ Need to achieve peak
performance without
warming up
‣ Hostile, working-fire
environments
‣ Anywhere and at a
moment’s notice
© Kim Fitzsimmons. Used with permission.

6. ‣ Essence of fire service professionalism
‣ Ability to function safely at all times
‣ Stay alert, strong, and clear-headed
‣ An understanding of the proactive and real-time
overexertion influences
The Overexertion Setup (2 of 4)

7. ‣ Overexertion resistance
‣ Firefighting requires people who are physically fit
‣ Work hardening
‣ “Workouts” in full personal protective equipment (PPE)
‣ Efficient fueling (feeding) that supports metabolism
‣ Proactive prevention
‣ Helps in the overall firefighting effort
The Overexertion Setup (3 of 4)

8. ‣ Overexertion realities
‣ “Here-and-now” overexertion threats
‣ Solid understanding of overexertion influences
‣ ISOs need to quickly identify
‣ Three stressors that influence overexertion are related to
the following:
‣ Environment
‣ Human physiology
‣ Quality of rehabilitation (rehab) efforts
The Overexertion Setup (4 of 4)

9. Environmental Stressors (1 of 9)
‣ Ergonomic stressors
‣ Firefighters don’t have the luxury of having an
“ergonomically friendly workplace”
‣ Physical setting
‣ Surface conditions of the work area
‣ Temperature variations
‣ Space size or geometry of work location
‣ Distractions (noise, lights, weather)

10. ‣ Ergonomic stressors
‣ Worker relationship to the setting
‣ Body mechanics
‣ Bending down, standing, crawling, or stooping
‣ Pulling, twisting, and pushing
‣ Task requirements
‣ Task priority or immediacy can create additional stress
‣ Limited staffing can be a factor
‣ Types of tools and equipment necessary
Environmental Stressors (2 of 9)

11. ‣ Ergonomic abatement strategies
‣ Awareness
‣ Most used abatement strategy
‣ Most simple
‣ Accommodation
‣ Altering or adjusting the environment
‣ Acclimation
‣ Most difficult strategy to implement
‣ Done proactively and is typically gradual
Environmental Stressors (3 of 9)

12. ‣ Thermal stressors
‣ Several environmental factors, including:
‣ Ambient air temperature
‣ Humidity
‣ Wind speed
‣ Thermal radiation (flames and reflected heat energy
from surfaces)
‣ Direct sun exposure
‣ Wetness (rain, snow, fire streams)
Environmental Stressors (4 of 9)

13. ‣ Thermal stressors
‣ Heat stress
‣ Transient heat fatigue (THF): physical exhaustion
caused by elevated core temperature
‣ Heat rash: blotches of red skin or red bumps
‣ Heat cramps: painful muscle spasms
‣ Heat exhaustion: cool, clammy skin that may be ashen
or gray; dizziness; nausea; and/or headaches
‣ Heatstroke: decreased mental alertness; hot, dry,
flushed skin
Environmental Stressors (5 of 9)

14. ‣ Thermal stressors
‣ Heat stress
Environmental Stressors (6 of 9)

15. ‣ Thermal stressors
‣ Cold stress injuries and warnings
‣ Shivering
‣ Frostnip: pale skin and loss of sensation; not painful
‣ Frostbite: cold, hardened skin that may appear whitish
or bluish
‣ Hypothermia: uncontrolled shivering and loss of
concentration leading to loss of coordination, confusion,
lethargy, and cardiac arrhythmias
Environmental Stressors (7 of 9)

16. ‣ Thermal stressors
‣ Cold stress
injuries and
warnings
Courtesy of National Oceanic and Atmospheric Administration/Department of Commerce.
Environmental Stressors (8 of 9)

17. ‣ Fighting thermal stress
‣ Accommodation: starts with efforts to remove the
firefighters from the environment that is creating the
thermal stress
‣ Rotation: the planned action to rotate crews through rehab,
heavy tasks, and light tasks to minimize the stress caused
by working in extreme environments
‣ Hydration: cannot be overemphasized in heat-stress
environments, but it is also effective, and often forgotten,
in cold-stress environments
Environmental Stressors (9 of 9)

18. Physiological Stressors (1 of 6)
‣ Physiological performance depends on the metabolic
processing (cell chemistry) of the firefighter
‣ Understanding optimal cell performance
‣ Three essential ingredients
‣ Oxygen
‣ Water
‣ Fuel

19. ‣ Oxygen
‣ Oxygen and fuel combine in the cell to create energy
‣ The higher the demand, the more oxygen/fuel is
needed
‣ Work hardening improves the body’s ability to meet
demands
‣ The fire ground
‣ Stresses oxygen intake
‣ Can impact the heart
‣ SCBA during firefighting and overhaul makes this risk a
nonissue
Physiological Stressors (2 of 6)

20. ‣ Hydration
‣ When the body becomes dehydrated, cells become stressed
‣ Fatigue
‣ Reduced mental ability
‣ Hyper- or hypothermia
‣ In extreme cases, renal (kidney) failure, shock, cardiac
irritation (inadequate stroke volume), and death
Physiological Stressors (3 of 6)

21. ‣ Hydration
‣ Hydration of all firefighters should
be paramount
‣ Firefighters need to
prehydrate, hydrate, and
rehydrate
‣ Firefighters should strive to
drink a quart of water an hour
during periods of work
‣ Essential electrolytes need to
be added for prolonged work
periods (sport drinks vs. energy
drinks)
Courtesy of David Dodson
Physiological Stressors (4 of 6)

22. ‣ Fuel replacement
‣ Cell-fueling theory
‣ Fuel for the human machine is glucose (sugar from
food) balanced and made usable by insulin
‣ Firefighters should be fueled with low-glycemic-index
food so that the blood sugar levels and insulin are
stable, gradual, and consistent
Physiological Stressors (5 of 6)

23. ‣ Fuel replacement
‣ Cell-fueling strategy
‣ Consume a balance of foods from the three food groups
of low-glycemic carbohydrates, protein, and fat
‣ 40% carbohydrates, 30% protein, and 30% fat
‣ Balanced approach achieves the following benefits:
‣ Low-glycemic carbs stabilize insulin release into the
bloodstream, stabilizing blood sugar levels
‣ Protein rejuvenates and facilitates building of new
cells
‣ Dietary fat helps essential hormones form and
stabilizes the carbohydrate entry rate
Physiological Stressors (6 of 6)

24. Rehabilitation Efforts (1 of 8)
‣ NFPA rehabilitation requirements
‣ NPFA 1584, Standard on the Rehabilitation Process for
Members During Emergency Operations and Training
Exercises (2015)
‣ Responsibility of a fire department to develop an
effective rehab program
‣ Specific rehab standard operating
procedures/guidelines that should be developed
‣ Rehab site characteristics
‣ Specific procedures and guidelines for rest, hydration,
nourishment, EMS, cooling/warming, and so on

25. ‣ NFPA rehabilitation requirements (cont.)
‣ NFPA 1561, Standard on Emergency Service Incident
Management System and Command Safety (2014)
‣ “Ensure that the incident scene rehabilitation area has
been established”
‣ Rest
‣ Hydration
‣ Basic life support monitoring and care
‣ Energy nutrition (food and electrolyte replacement)
‣ Accommodation for weather conditions
Rehabilitation Efforts (2 of 8)

26. ‣ NFPA rehabilitation requirements (cont.)
‣ NFPA 1521, Standard on Fire Department Safety Officer
(2015)
‣ Objectives: rehabilitation
‣ Monitor conditions, including weather, firefighter
activities, and work cycle durations, given an
incident or planned event, so that the need for
rehabilitation can be determined, communicated to
the IC, and implemented to ensure firefighter
health and safety
Rehabilitation Efforts (3 of 8)

27. ‣ Evaluating rehabilitation
‣ ISO needs to front-load some logistical considerations
‣ ISO should stay up-to-date with best rehab practices
‣ NFPA 1584 provides reasonable criteria to help the ISO
perform an evaluation
‣ Further education and evaluation criteria:
‣ Rehabilitation and Medical Monitoring: A Guide for Best
Practices by the International Association of Fire Chiefs
‣ Emergency Incident Rehabilitation by the U.S. Fire
Administration
Rehabilitation Efforts (4 of 8)

28. ‣ Five components of rehabilitation
‣ R = Rest
‣ Pulse rate, blood pressure, breathing rate, and core
temperature should return to normal
‣ E = Energy nutrition
‣ H = Hydration
‣ A = Accommodation for weather
‣ B = BLS monitoring and care
Rehabilitation Efforts (5 of 8)

29. ‣ Scaling the rehabilitation effort
‣ Self-rehabilitation
‣ Relies on pre-
established SOPs/SOGs
‣ Should take place after
each bottle of SCBA
used
‣ 10/20 rule
‣ Remind the IC of the
need for medical
monitoring
Courtesy of Frisco (TX) Fire Department
Rehabilitation Efforts (6 of 8)

30. ‣ Scaling the rehabilitation effort
‣ Formal rehabilitation
‣ Required when:
‣ Incidents require physical labor longer than 2 hours
‣ High-rise fires or wildland fire are not controlled by
a single company
‣ Hazardous materials require technician-level
response
‣ Confined spaces are involved
‣ Incidents expose responders to weather extremes
‣ Incidents require excessive physical labor
‣ Incidents involve defined hourly work periods
Rehabilitation Efforts (7 of 8)

31. ‣ Scaling the rehabilitation effort
‣ Formal rehabilitation
‣ Clearly address the
five REHAB
components
‣ Rehab area should be
divided into segments
‣ It is not the duty of the
ISO to help rehab
attendants accomplish
their tasks
Rehabilitation Efforts (8 of 8)