All rights reserved to respective authors or parties. This is a compilation of various materials from various sources.

1. EMeRG Charge Curriculum
Module I: Advanced Operations

2. Outline
• Fire Scene Operations
• Water Rescue Awareness
• Diesel Operations and Vehicle Troubleshooting

3. Fire Scene Operations: DCFEMS
• 33 Engine Companies
• 16 Truck Companies
• 3 Heavy Duty Rescue
• 2 Twinned Agent Units
• Hazmat Unit
• Metro Support
• 2 Air Units
• 2 Foam Units
• MCI Unit
• 3 Fireboats

4. A What?
• Engine Companies: Carries H2O, Hoses, Pump
• Job is to extinguish fire
• Truck Companies: Specialized
Equipment, Ladder
• Job is to gain access, ventilate
• Rescue Truck: Specialized Training, Equipment
• Gain access, entrapments
• Battalion Chiefs: Supervisor of Operations
• Usually found in SUV

5. Fire Scene Operations: DCFEMS
• 21 BLS Units
• 13 ALS Units
• 2 Rapid Response Units

6. DCFEMS: Tiered Response
You called for ALS, who might they send?
-Medic Unit (1: M St., 2: Georgetown, 5, 7)
-BLS Unit + Paramedic Engine (oops)
-Paramedic Engine (16)
-EMS Supervisor (EMS 4,6)

7. DCFEMS Alarms
LOCAL ALARM: This can be for an electrical
short, smoke in the area, alarm bells, car
fire, trash/wood fire, in/out side gas leak, etc.
One to three engine companies, one or two
truck companies, a battalion chief (It is up to
communications what is dispatched on these
types of calls)

8. DCFEMS Alarms
BOX ALARM: This alarm is for smoke or fire in
a row-house, school, commercial store or
office building, detached
dwelling, hospital, apartment
house, church, etc. A box alarm receives five
engines, two trucks, two battalion chiefs and
a rescue squad.

9. DCFEMS Alarms
WORKING FIRE DISPATCH: This alarm is
transmitted when a fire is confirmed as
“working”, and receives one engine
company, one truck company, one air
unit, the fire investigation unit and the safety
officer.

10. EMS Fire Scene Operations
5862 Southern Ave., SE

11. EMS Fire Scene Operations:
Objectives
• Explain how to ID who is in charge and what the
FD priorities are.
• Explain fire department operations at the scene
of a structure fire.
• Identify the role of EMeRG Responding Units
• Explain how EMS is incorporated into the incident
command structure.
• Know where to stage/park.
• Explain anticipated medical problems from
firefighters and occupants.

12. EMS Fire Operation
In reality, DCFEMS is probably going to kick
you off scene, but you never know, and it’s
best to be prepared.

13. Fire Department Structure
• Based on military command structure.
• Units operate as companies, teamwork is
stressed.
• Each company has a pre-determined
assignment.
• Engines, trucks, rescues, chiefs.

14. The Work
• VERY Demanding
• Hot and Humid
• Physical exertion for
extended periods of
time
• Diesel guys prone to
over-extending
themselves

15. Who’s in charge?
White – Chief
Red- Company Officer
Black – Firefighter
Yellow – Rookie
Blue – Medical
Green - Safety

16. What Happens at a Structure Fire?
• Fires are pre-planned, everyone knows what
to do and when to do it.
• Units arrive piecemeal.
• Offensive versus defensive attack.
• What is a 2nd & 3rd alarm?
• Key word – ACCOUNTABILITY!

17. Flashover
• When the overall temperature reaches the
ignition point of everything in the
room, everything ignites very rapidly.
• The survival time of a FF in full PPE is
estimated to be between 10 and 15 seconds.

18. Ambulance GW-1 1st On-Scene
• Yikes, not a tummy ache…Now What?
• Make sure OUC knows of
location, Smoke?, Visible Fire?, Occupants?, A-
GW 1 On-scene
– Primarily UPD responsibility
• Locate fire hydrants.
• Locate occupants if outside
• Keep area clear of vehicles.
• Establish Incident Command- who is IC?
• DO NOT ENTER BUILDING!!
• Give report to first arriving officer.

19. Terminology: Building Sides
C
B D
A

20. Staging Ambulances
• Back ambulance into scene and leave plenty
of room for rapid egress.
• Make sure your escape route stays clear!
• Do not block access to scene.
• Be proactive, not reactive.

21. Watch Where You Park!

22. What To Wear
I better see you with the following:
– Helmets
– Vests
– ID Badges
– Gloves (if needed)

23. Anticipate Injuries - FF
• Firefighting is hard work. It includes heavy
equipment and PPE, falls from heights, falling
objects, burns, heat stress, toxic inhalation
injuries, etc.
• Top reasons for injuries/fatalities are:
1. Heart attacks
2. Falls
3. Inhalation of toxic gases

24. Anticipate Injuries - Civilian
• Smoke and toxic gas inhalation.
• Burns are rare but do occur. Be aware of the
following signs of respiratory involvement:
– Burns around face
– Singed eyebrows
– Hoarse voice (80% airway closure)
– Carbonaceous sputum
– Hx of burn in an enclosed space

25. Inhalation Injury
• Watch for increasing voice from swelling.
• Administer high-flow humidified oxygen.
• Call ALS for advanced airway control.

26. CO Poisoning
• Carbon Monoxide bonds to hemoglobin
instead of oxygen
• Can give false pulse oximetry reading
• Treatment
– High Flow O2
– Rapid Transport: Hyperbaric Chamber

27. Hyperbaric Medicine
• Specialty unto itself
• Chamber that increases the partial pressure In
the tissues dislodging CO from Hemoglobin
• Also used in diving emergencies for nitrogen
• GW has chamber, hospital notify

30. Fire on 3rd floor of Kappa Kappa Gamma House
(left) Onlookers are visibly upset as firefighters extinguish the fire that
broke out on the third floor of the Kappa Kappa Gamma house Saturday
afternoon. (right) Firefighters knocked out a third floor window at the
Kappa Kappa Gamma house to expel burning notebooks and papers
Saturday afternoon. –GW Hatchet

31. Questions?

32. Water Rescue Awareness

33. We don’t have water! Why Bother?
• False!
– The Potomac is one block past our jurisdiction
– Our Mutual Aid agreements covers the river
– Many GW-sponsored events
• GW Crew
• GW Sailing
• GU Crew
– Smith Center, HelWel, Vern Pools

34. Water Rescue Awareness
• 2nd most powerful force on earth
• Kills more people than any other natural
phenomenon
• Causes more rescues than anything else
natural
• Average 7 rescuer fatalities a year since ‘83

35. Swift Water Recue (Potomac)
• While it may not seem it, Currents are un-
relenting, powerful, and appear out of
nowhere.
• Under NO!! Circumstance should any EMeRG
member enter the water.

36. What’s The Plan?
• Identify threat
• Locate victim, where are they headed?
• Initiate Resources
– Immediate Notification of GWPD and OUC
• Establish ICS

37. Swift Water Rescue Efforts
• Remember: No EMeRG Members get wet!
• Throw anything that floats down river of the
victim
– Don’t hit the victim
– If victim is close to shore, lay flat on ground and
reach out to grab victim
• What could you use?
• Never tie any rope to the person or vehicle
• Sit Tight!

38. DCFEMS Water Apparatus

39. So that’s a little out there but how
about this…
Dispatch: A GW-1 respond to the Smith Center
pool for a 20 yo possible drowning, ALS
Priority (I hope)

41. The Conscious Victim
• ALL injuries in a pool should indicate a VERY
HIGH suspicion of spinal injury
• If victim is flailing and panicked, DO NOT enter
the water
• High Risk of rescuer being dragged under or injured
• Throw life ring or tube to victim
– What else floats?
• Lifeguard Staff will bring victim to side of pool

42. Things That Float at a Pool

43. The Unconscious Victim
• Efforts should be focused on rapid extrication
from water
– Harder to provide care in water
• Assist, but pt is lifeguards until side of pool

45. Remember
• We are not a Lifeguard service and provider
safety is top priority
• Getting in the water is a LAST resort

46. Ambulance Operations and
Troubleshooting

47. Overview
The goal of this section is not to make you a
mechanic but to give you a better
understanding of the systems at work in an
ambulance and recognize the need to place
the unit OOS or continue your shift.
When in doubt, Place OOS and call ops-on-
demand.

48. Basic Diesel Operations
A diesel Vehicle is different from a car:
– Operates on compression, not combustion
– No spark plugs, Glow Plugs
– Intake air is compressed, diesel injected, Ignites
Advantages:
– Higher MPG
– More torque
– Lasts longer than gas vehicle

49. Wait to Start? Why?
• The end of glow plug heats up to provide
initial temperature to ignite diesel-air mixture
• Need to give time to heat up

50. Disadvantages
If started too early the driver will experience:
– Poorer fuel economy
– Sluggish acceleration
– Increased engine wear
– Difficulty starting

51. Final Note on Diesel Engines
Diesel Engines are not designed to be started
and stopped continuously, they are designed
for the long haul, therefore, it is imperative to
treat it gently. Allow at least 30 seconds in the
summer, 1 minute in the winter before
starting. If possible allow to warm-up
fully, temperature gauge comes off
zero, before moving.

52. Troubleshooting

53. Electrical
1. Ambulance won’t start
• Wait longer before starting
• Still no go? Calls ops, place OOS
• Click, Click, Click? Battery dead, place OOS, call ops
2. High Idle is very high
• Continue if transporting pt, calls ops ASAP
3. Ambulance isn’t charging
• Check breaker, shore power connection (next slide)
4. Emergency lights won’t go on
• Check battery switch, on? Batter level low, allow to
high idle, call ops

55. Other
HVAC Malfunction
– Call ops, place OOS if ambient temp is
unacceptable
Large puddle of fluid under engine
– Place OOS, call ops

56. Questions? Thanks!