Fire Ground Operations For Ems


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Fire Ground Operations For Ems

  1. 1. Fire Ground Operations for EMS Austin-Travis County EMS January 2005
  2. 2. Back Ground <ul><li>There were a total of 104 incidents that took the life of a firefighter in 2004: </li></ul><ul><li>Career firefighters, those who are employed full-time as firefighters, comprised 29 deaths (27%) in 2004. </li></ul><ul><li>Volunteer, seasonal, and part-time firefighters accounted for 78 deaths. </li></ul><ul><li>Half of the firefighters that died in 2004 died from traumatic injuries such as asphyxiation, burns, drowning, vehicle crashes, and other physical injuries. </li></ul>
  3. 3. For every firefighter that is injured and requires rescue from a active fire it…….. <ul><li>takes 6 – 8 firefighters to remove a single firefighter from the building. </li></ul><ul><li>2 firefighters are injured, 1 is seriously injured and the victim is usually a fatality. </li></ul>
  4. 4. Why? <ul><li>The additional weight of gear adds difficulty in moving the victim. </li></ul><ul><li>PPE – Modern Bunker Gear, Helmet, Boots, Gloves, and Hood weigh approximately 50 lbs. </li></ul><ul><li>SCBA – Air pack, bottle, pass device and harness weigh approximately 62 lbs. </li></ul>
  5. 5. Why? <ul><li>Most victims are trapped in a building collapse and wires following a traumatic event. </li></ul><ul><li>Most victims are out of air prior to being found. </li></ul><ul><li>It takes more than one rescue team to remove the victim to safety. </li></ul>
  6. 6. EMS Participation in AFD Multi-Company Drills <ul><li>EMS and AFD both respond to and work together at structure fires. In most cases the roles each agency performs are well defined and separate from each other. EMS is the primary provider of patient care and AFD performs all fire control related duties. There is a potential for overlap that does occur on a regular basis and is not formally addressed, either in policy or through mutual training objectives. A very good example of this overlap occurs when EMS arrives, sometimes minutes before AFD at a structure fire... </li></ul>
  7. 7. EMS Participation in AFD Multi-Company Drills <ul><li>Apparatus positioning, witness interviews to determine fire location and/or possible need for rescues , and initial radio protocols, are very important to a safe and efficient fire attack. With appropriate guidelines, EMS and AFD can better coordinate their actions and ultimately provide better service for the fire victims. </li></ul><ul><li>In addition, EMS provides dedicated medical support for AFD at structure fires. It is important that issues like, “How to treat a fully bunkered, severely injured Firefighter” are practiced, reviewed, and improved upon before it occurs again. </li></ul>
  8. 8. Training Objectives <ul><ul><li>Importance of initial apparatus positioning </li></ul></ul><ul><ul><li>Communicating concise fire size up information </li></ul></ul><ul><ul><li>Conducting Witness interviews to determine </li></ul></ul><ul><ul><ul><li>Need for additional rescue </li></ul></ul></ul><ul><ul><ul><li>Fire location </li></ul></ul></ul><ul><ul><li>Guidelines for communication of concise, pertinent information to responding fire units </li></ul></ul><ul><ul><li>Practice treatment of severely injured, fully bunkered Firefighters </li></ul></ul>
  9. 9. Importance of initial apparatus positioning <ul><li>100’ aerial apparatus are rendered useless if not positioned in close proximity of the scene. </li></ul><ul><li>The front of the structure should be free of all initial apparatus (Ambulances & Fire Engines) </li></ul><ul><li>“ Front” meaning, where the main action will take place. Many times the addressed side. </li></ul><ul><li>Corners of close by side streets should also be avoided if possible. </li></ul>
  10. 10. Importance of initial apparatus positioning <ul><li>Ambulances should consider: </li></ul><ul><ul><li>Stopping close by the front to drop off equipment, personnel. </li></ul></ul><ul><ul><li>Have one person move vehicle away from the front of the structure. </li></ul></ul><ul><ul><li>Many times around the corner will work. </li></ul></ul>
  11. 11. Communicating concise fire size up information <ul><li>The primary fire tactical channel should only be used by EMS when: </li></ul><ul><ul><li>EMS is first on scene with no fire apparatus close by (cannot see or hear responding fire apparatus) </li></ul></ul><ul><ul><li>There is important incident information which needs to be communicated </li></ul></ul><ul><ul><ul><li>Size-up information </li></ul></ul></ul><ul><ul><ul><li>Report of victims still inside </li></ul></ul></ul><ul><ul><li>There is available radio time </li></ul></ul><ul><ul><li>Keep reports brief, if message is longer in nature, ask to meet with an Officer on arrival. </li></ul></ul><ul><ul><li>RETURN TO REGULAR ASSIGNED CHANNEL AFTER AFD IS ON SCENE </li></ul></ul>
  12. 12. Communicating concise fire size information <ul><ul><li>What is important incident (size-up) information? </li></ul></ul><ul><ul><li>Type of structure </li></ul></ul><ul><ul><ul><li>Residence (Small, large) </li></ul></ul></ul><ul><ul><ul><li>Apartments </li></ul></ul></ul><ul><ul><ul><li>Commercial (warehouse, store, business office) </li></ul></ul></ul><ul><ul><ul><li>Hi rise (over 4 floors) </li></ul></ul></ul><ul><ul><li>Number of floors </li></ul></ul><ul><ul><li>Fire conditions </li></ul></ul><ul><ul><ul><li>Fire showing </li></ul></ul></ul><ul><ul><ul><li>Smoke (Heavy,light) </li></ul></ul></ul><ul><ul><ul><li>Nothing Showing </li></ul></ul></ul><ul><ul><li>Access Directions (if needed) </li></ul></ul>
  13. 13. Communicating concise fire size information <ul><ul><li>What is important incident information? </li></ul></ul><ul><ul><li>Locate victims that have exited from the fire building. During treatment ask: </li></ul></ul><ul><ul><ul><li>Is everyone is out? How do you know. </li></ul></ul></ul><ul><ul><ul><li>“How many are still inside. How do you know. </li></ul></ul></ul><ul><ul><ul><li>Where are they located? How do you know. </li></ul></ul></ul><ul><ul><ul><li>EXACTLY where is the fire located? How do you know. </li></ul></ul></ul><ul><ul><li>Asking “How do you know”, is needed to establish the credibility of the witness. I person across the street reporting victims inside does not carry the same weight as the Mother. </li></ul></ul>
  14. 14. Communicating concise fire size up information <ul><li>Radio Report Example: </li></ul><ul><ul><li>Medic 1 on scene, light smoke showing from a small single story residence. OR </li></ul></ul><ul><ul><li>Medic 1 on scene, heavy smoke showing from 2 story office building, people evacuating. </li></ul></ul><ul><li>After interviewing occupants </li></ul><ul><ul><li>Occupant reports no victims inside OR </li></ul></ul><ul><ul><li>Occupant reports child inside, meet me in front of structure for victim and fire location info. </li></ul></ul>
  15. 15. Thing Not to do: <ul><li>Cancel AFD units on a structure fire call. </li></ul><ul><li>Reduce to code one. </li></ul><ul><li>Communicate size-up info when fire units are using the radio. </li></ul><ul><li>Give long radio transmissions. (It is better to meet first on-scene Officer and discuss face-to-face). </li></ul><ul><li>Park in the way of responding fire apparatus. </li></ul><ul><li>Stay on fire tactical channel after first AFD unit on scene. </li></ul>
  16. 16. <ul><li>EMS Paramedics and Commanders become proficient in removing Self-Contained Breathing Apparatus (SCBA) and Personal Protective Equipment (PPE) while maintaining spinal movement restriction in an unconscious fire fighter </li></ul>
  17. 17. Objectives with Practical <ul><li>&quot; Demonstrate the mechanics of removing an air mask and helmet while maintaining spinal movement restriction in an unconscious or critically injured fire fighter </li></ul><ul><li>&quot; Demonstrate the mechanics of removing personal protective equipment while maintaining spinal movement restriction in an unconscious fire fighter </li></ul><ul><li>&quot; Understand the importance of recording the mask fit, tank pressure, and PPE for safety review investigation </li></ul>
  18. 18. SCBA and PPE Removal <ul><li>The following is a recommended step by step process to safely remove an SCBA and PPE from an injured firefighter without causing more injury and supporting spinal motion restriction. </li></ul>
  19. 19. Step 1 <ul><li>Support the firefighter’s head and remove the face piece mounted regulator. </li></ul>
  20. 20. Step 2 <ul><li>Remove the firefighter’s helmet, slide the hood back, and loosen the straps on the face shield. </li></ul>
  21. 21. Step 3 <ul><li>Remove the face shield and open the throat strap on the bunker coat. </li></ul>
  22. 22. Step 4 <ul><li>Loosen the straps on the SCBA (shoulder and waist strap) and prepare to remove the SCBA </li></ul>
  23. 23. Step 5 <ul><li>Remove the strap on the SCBA and the sleeve of the coat on the upward side of the firefighter. </li></ul>
  24. 24. Step 6 <ul><li>Remove the SCBA by guiding the SCBA around the firefighter’s head and off the other arm remove the coat. </li></ul>
  25. 25. Step 7 <ul><li>Remove the boots and pants after logging rolling the firefighter onto a long spine board. The suspender may be cut or unattached </li></ul>
  26. 26. Step 8 <ul><li>Collar, package, and finish assessment of patient and begin transport. </li></ul>
  27. 27. Multi-Company Drills <ul><li>EMS will participate in the scenarios. </li></ul><ul><li>They will: </li></ul><ul><ul><li>Be first on scene </li></ul></ul><ul><ul><li>Communicate a brief size-up report </li></ul></ul><ul><ul><li>Park in appropriate location </li></ul></ul><ul><ul><li>Interview Occupants (if available) to obtain fire location and victim information </li></ul></ul><ul><ul><li>Toward the end of the drill, treat a fully bunkered Firefighter </li></ul></ul>
  28. 28. Question 1 <ul><li>What is the recommend location of parking an ambulance when it arrives simultaneously with the first arriving fire apparatus? </li></ul><ul><li>In front of the burning building </li></ul><ul><li>On the nearest corner </li></ul><ul><li>Approximately 1 block away </li></ul><ul><li>Close so you don’t have to carry equipment very far. </li></ul>
  29. 29. Question 2 <ul><li>Most firefighter fatalities occur on the fire ground, of this fatalities the majority is from either </li></ul><ul><li>Medical Cause </li></ul><ul><li>Traumatic Injury </li></ul><ul><li>50/50 (1/2 Medical and ½ Trauma) </li></ul><ul><li>Unknown </li></ul>
  30. 30. Question 3 <ul><li>When removing protective equipment from a unconscious firefighter, the improper removal of the mask by rapidly pulling the mask without loosening the straps may cause? </li></ul><ul><li>Spinal trauma </li></ul><ul><li>Pull their hair </li></ul><ul><li>Make a strange sucking sound </li></ul><ul><li>Increase intercranial pressure </li></ul>
  31. 31. Question 4 <ul><li>The availability for EMS to rapidly have protection from PPE while at a fire standby is accomplished by: </li></ul><ul><li>Leaving the gear in the side compartment of the truck </li></ul><ul><li>Taking the gear out of the bag and leaving it on the truck </li></ul><ul><li>Don’t worry about it you can have the firemen bring your victims to you </li></ul><ul><li>Put on the PPE (preferred) or have it ready for donning beside you. </li></ul>
  32. 32. Question 5 <ul><li>A firefighter wears @ 100 additional pounds during interior firefighting. This additional weight will _______ his/her heat stress causing a need for more assessment during rehabilitation. </li></ul><ul><li>increase </li></ul><ul><li>decrease </li></ul><ul><li>no change </li></ul>