Chapter 23 Firefighter Survival

Introduction Survival dependent on: Prevention through readiness Training on firefighter emergency procedures Factors that help prevent emergencies: PPE; task accountability; fitness for duty At an incident: deliberate actions (or inaction); attention to hazards Attention to team continuity, orders, communication, rapid intervention planning, rehabilitation Must have a planned systematic process for self-rescue or rapid intervention in emergencies

Incident Readiness Incident readiness is a mental process that answers a few questions: Am I in a position to respond? Is my personal protective equipment available? What is my relationship to the response? Physically can I respond? Mentally, can I check out my current thoughts and focus on response? Ensure the “system” is assembled and ready for response

Personal Protective Equipment PPE is the first thing to put on for protection Last thing to use for protection In many departments, firefighters check all ensembles at beginning of every shift Time spent donning gear before arriving at incident is well spent If seatbelts cannot be worn, better to don PPE at incident Following an incident, gear may need to be decontaminated

Preparing PPE for Readiness All clothing materials are dry. All PPE is present and positioned so that it may be donned rapidly. Essential pocket tools are available and in working order. Alternative PPE items are appropriately packed and ready for use. Additionally, firefighters should check protective equipment assigned to their riding position

Personal Accountability Three types of accountability: Passport Tag Company officer No freelancing Relationship to response: assignments and personal size-ups Perform as trained Know your strengths and weaknesses

Figure 23-2 Accountability systems take on many forms—firefighters must know how to check in.

Figure 23-3 Firefighters achieve mastery of tasks through repeated training. Mastery reduces the chance of injury.

Fitness for Duty Mental fitness Physical fitness and wellness “Check out” of the environment, “check in” to size-up Physical fitness and wellness Cardiovascular conditioning Core strengthening Flexibility improvement Resistance training Nutritional balance Hydration maintenance

Energy and Rest Safety directly affected by energy potential and rest a firefighter has stored Be attentive to energy and rest levels Communicate rehabilitation needs to an officer

Safety at Incidents Roughly half of all duty-related injuries and deaths happen at incident scene Individual injured failed to “see” events that lead to injury Injuries and death occur when firefighters allow urgency to override judgment Firefighters can prevent injury and death through mental and physical actions Team continuity Team must exercise guarded judgment when completing a task

Figure 23-6 Team continuity reduces the chance for injuries.

Team Procedures for Incidents Utilize an incident command system (ICS) Work together and remain intact Look after each other Prevent freelancing

Figure 23-5 Freelancing is eliminated and incident success is gained when specific tasks are assigned to teams of two or more firefighters operating from a single incident action plan.

Orders/Communication Incident commander responsible for assembling incident action plan (IAP) Implemented by teams performing tasks Tasks assigned to organized teams in the form of orders Team responsible for carrying out the order Providing updates on a regular basis Relay information about hazards First arriving teams perform prescribed tasks They must know tasks, tools required, and safety considerations

Figure 23-8 Practicing good reporting habits enhances communications.

Risk/Benefit Risk/benefit: an evaluation of the potential benefit of a task in relationship to hazards Basic guidelines: Take significant risk to save a known life Take calculated risk, and provide additional safety, to save valuable property or reduce potential for injuries Take no risk to save what is already lost Retreat to defensive position when conditions are deteriorating quickly

Figure 23-9 Solid risk/benefit analysis means taking no risk for that which is already lost. (Courtesy of Richard W. Davis)

Personal Size-Up Size-up: continuous situational awareness and mental evaluation process Stay aware of: Established work areas Hazardous energy Smoke conditions Escape routes Air management

Rehabilitation Stress and overexertion are leading causes of injury and death Key concern is controlling heat stress Rest achieved during crew rotation Sit down; allow medical personnel to do vital sign check; mentally disengage from the event Active cooling reduces core body temperature Water vital to peak operation of body systems Best nutrition: 30/30/40 balance

Figure 23-11 Rehabilitation should start well before a firefighter is thirsty or tired. Failure to rehabilitate “early and often” opens the door to injury.

Rapid Intervention Teams Rapid intervention team (RIT) rescues firefighters in an emergency Goal is to avoid need for rapid intervention Two-in/two-out rule provides for immediate intervention if needed RIT should have no other assignment Consists of well-trained, experienced firefighters Other firefighters should not abandon previous assignments until reassigned

Table 23-1 RIT Responsibilities Checklist

Firefighter Emergencies When emergency presented, firefighter must rely on instincts and training Study procedures for rapid escape For declaring a Mayday for lost and trapped situations Survival includes processes for rescue of trapped and lost firefighters Also long-term mental survival

Declaring a Mayday Specific procedures for declaring any mayday developed at local fire department level Declaring a mayday: Transmit over radio “Mayday” three times followed by ICS assignment Wait for an acknowledgement Once acknowledgement made, report nature of mayday, current location or last known location Manually activate PASS device

Rapid Escape Evacuation signals: repeated air horn blasts; special radio tone followed by evacuation order Rapid escape steps: Preplan the escape Immediately report need for rapid evacuation Acknowledge rapid evacuation or escape signals Rapidly escape Report successful escape

Figure 23-12 Rapid fire spread and partial collapse are likely to trigger the need for rapid escape.

Figure 23-13 A PAR is a personnel accountability report organized to check the status of all crews working an incident. PARs should take place every half-hour or after an evacuation or any firefighter emergency.

Lost, Trapped, and Injured Firefighters When firefighting, crews may be placed in environments they have never been in before Potential to be trapped or lost during assignment Low-air situations: Good SCBA air management provides margin of safety Enter, work, and egress before warning device activates Low-air warning while in IDLH environment warrants immediate communication

Lost, Trapped, and Injured Firefighters (cont’d.) Entrapment: First step is to get assistance Activate PASS device and declare “Mayday” Follow up with other noise-making activities Be careful not to use up excess energy Size up and develop a plan Attempt self-extrication Planned and systematic

Lost, Trapped, and Injured Firefighters (cont’d.) Lost/disoriented firefighters: Firefighter or team must report that they are lost Mayday should be transmitted over the radio Manually activate PASS devices Take deep breaths and calm down Take inventory of surroundings Establish direction, door and window locations, potential paths Maintain radio contact with RIT members

Lost, Trapped, and Injured Firefighters (cont’d.) Firefighters must trust RITs RIT activated when firefighter found to be trapped or injured If team in proximity aides firefighter, communicate this Firefighters not on the RIT or in the vicinity should resist the urge to rush in and help

Figure 23-14 A serious firefighter injury or fatality will cause significant incident stress. Focus and use of RITs will minimize unnecessary risk during firefighter rescue and help maintain incident control.

Post-Incident Survival Post-incident thought patterns: firefighter’s mind relaxes as adrenaline fades Responsible for many injuries and deaths Critical incident stress (CIS): incidents that lead to long-term mental and health issues

Post-Incident Survival (cont’d.) Post-incident thought patterns Inattentiveness as soon as order given to “pick up” Take a time-out and have everyone gather for incident summary and safety reminder Fatigue and mental drain unavoidable chemical imbalance Important to stay alert and pick up signs of potential injury Take steps to “survive” without injury

Post-Incident Survival (cont’d.) Critical incident stress Firefighters expected to tolerate incident stress Some events trigger significant emotional response May not always be external Many firefighters harbor the reaction internally CIS exhibited in many ways “Survive” CIS by critical incident stress management (CISM) Critical incident stress debriefing (CISD) “Defusing” in a peer environment

Figure 23-16 Signs of critical incident stress are natural following “trigger” incidents.

(A) (B) Figure 23-17 Critical incident stress management sessions can be (A) informal such as a “defusing” or (B) formal such as a process that includes peer support and mental health professionals.

Lessons Learned Firefighter survival dependent on: Incident readiness and safe operations Appropriate preparation and response to emergencies Safe operations dependent on team continuity Emergencies require firefighter to practice clear and concise approach Survive long term through understanding of post-incident thought patterns and stress