Fire EMS, Tech Zone

Technological Flashover

Several fire departments in Oregon are piloting this baseball-sized “metal fireball” created by Intel Labs. When thrown into a burning building, its sensors can detect temperature, noxious gases, or dangerous chemicals before firefighters enter. (Photo by Intel Free Press.)

By D. Bradey Rogers

Computers and technology, so prominent in science fiction, make us hunger for a time when reality would catch-up with fiction. The National Aeronautics and Space Administration’s Voyager One space probe, launched in 1977 (and which left the solar system in 2013), has 68 kilobytes of memory. The lower priced iPhone has 16,000,000 kilobytes. Today, computers are now as much a part of a firefighter’s job as is establishing a water supply.

Computers run our apparatus. E-One features V-Mux, a computer system that integrates systems and components. A touch screen provides on-board diagnostics, service information, easy access dimming controls, and highly visible “Door Ajar” warnings. Pierce Manufacturing has Command Zone, diagnostic software that allows technicians to troubleshoot vehicles in the field by modem, pinpointing problem areas within minutes. Pump panels have pressure governors, flow meters, and electronic digital foam proportioning.

Fire whistles that at one time sounded—calling firefighters to duty—became silent when members began carrying Motorola’s minitor radio/pager. When departments started issuing 400- or 800-band portable radios, pagers became obsolete. Departments now use cellphones and text messages for incident notification, traffic alerts or severe weather warnings. Departments can dispatch and plan accordingly with firefighters who have the ability to electronically acknowledge that they are responding.

Computer aided dispatch is becoming a standard, not a luxury. Software and access to the Wireless Information System for First Responders (WISER), the Emergency Response Guidebook (ERG), or Cameo help identify hazardous materials, incident actions, and plot evacuation zones. If you don’t have a computer in the right front seat, the firefighter next to you probably has an app on his phone that will do the same, or perhaps even more.

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With dependency comes complacency. Now, there’s no need to learn phone numbers; they’re in our contact lists. Without MapQuest or global positioning systems (GPS), we get lost easier; many roads have similar names. Being dependent on the computer keeps us from physically getting out and on the street, and learning response areas becomes less of a priority There’s now a fire flow/pump pressure calculator app. Firefighters are no longer as proficient in hydraulics or the National Fire Academy’s basic fire flow formula, which follows:

Needed Fire Flow (NFF) = Length × Width:  X% of fire involvement.

Dispatchers don’t need to know the running assignments; the computer prompts them. They can quickly pull up and replay the recorded 911 and incident radio transmissions. Sometimes, you can hear call takers entering the information—sometimes frustratingly slow—before dispatching the call, creating time lost. Listen to radio dispatch and response information from the dispatcher and the responder when the system crashes.

With dependency comes distraction. Overhead, drones give the incident commander (IC) a different perspective to help make tactical decisions. Like drivers dependent on GPS, it’s easy for the IC to focus on tablets and iPhones with a variety of incident management applications, losing situational awareness of the ever-changing incident scene. There’s no time for lost signals or “recalculating” gadgets. Devices don’t know the incident; they can’t tell us when to go from offensive to defensive.  Like past chiefs, ICs need an aide or help from an incident management team. Heat is still heat, smoke is still smoke, fire is still fire, and water is still water. The basics are the same, but the technology isn’t, providing endless possibilities and information overload.

Another problem now developing is senior officers or shift commanders who use personal phones for department business. The department has no idea what’s on those phones, the possibility of them being hacked, or their difficulty of use for others. Departments need to issue phones based on positions; the need with standard contact information; standardized apps; and the ability for people to contact those officers, not having to think who’s on duty today. Departments should offer members department business-only phones and create standard operating guidelines for their use.

Thermal imaging cameras (TICs) allow companies to penetrate buildings faster and deeper. With dependency on the TIC, firefighters’ focus could be on the images, thus making them lose situational awareness of their surroundings. TIC failure could result in disorientation, a leading cause in firefighter line-of-duty deaths. Self-contained breathing apparatus come with heads-up displays. Multigas meters help determine if atmospheres are toxic. Mayday calls are made on multichannel portable radios and by activating a personal alert safety system device (and which will sound itself under certain conditions).

Dr. Lloyd Bremer, an emergency room physician, was among a group who founded the Cape & Islands Emergency Medical Services System paramedic program. Working with others, he brought advanced prehospital care to Cape Cod, Massachusetts, in the 1970s, a time when the television show Emergency!, with pioneer TV paramedics Johnny and Roy, were still on the air. Bremer, an advocate for technology, was equally alarmed by it, reminding medics to “Treat the patient, not the monitor.”

With dependency comes concerns about proficiency. With electrocardiogram (EKG) monitors reading and interpreting arrhythmias, the need to be skilled in the ability to read them diminishes. Advanced cardiac life support classes are finding that some paramedics struggle to read EKGs. Automated external defibrillators, an offshoot of cardia monitors, are in public places, easy for a layman to use them.

Capnography measures exhaled carbon dioxide, providing a diagnostic tool on how well the patient is exchanging air. Pulse oximetry is routine, measuring blood oxygen saturation and taking the patient’s pulse. Blood pressures are taken electronically. Vital signs can be sent through the EKG monitor and Bluetooth technology as well as to a tablet as a part of the electronic patient care report.

Technology makes it easier, pre- and in-hospital, to treat the machine, not the patient. Patients in respiratory distress may not be given oxygen because “their pulse ox is okay.” If the pulse ox is okay, we may not be as aggressive as we should in auscultation of lung fields. Depending on the situation, with patient exposure, the pulse ox may be inaccurate, resulting in a false positive such as in carbon monoxide saturation. And it may be broken.  So, why bother learning protocols? There’s an “app for that”!

Online training has invaded education. To compete financially, colleges and universities offer online degrees. It’s easy to use slide presentations, online videos, and online scenarios while providing a forum to expose first responders to many subjects, incidents, or latest challenges. They’re excellent as a supplement, but they can never replace physical training.

The impact of the National Fire Academy’s Executive Fire Officer Program (EFO) would be lessened if it, too, became an online program. The success of EFO includes interaction with national and international professionals.  Graduates know that networking in and out of the classroom is a valuable part of the program. Technology through texting, e-mail, and Skype allows that networking to continue long after graduation. Successful leadership and management depend on interaction in the firehouse, in training or on the incident scene.

The panic that sets in when one forgets his cell or smartphone is called “nomophobia,” short for no-mobile-phone phobia. In 2012, TIME magazine, in partnership with Qualcomm, polled 5,000 people worldwide to gather information on how we use our phones and how it connects to our lifestyles. Notably, 84 percent of respondents said they could not go a single day without a mobile device.

Technology, used properly, can help make the difference in strategy and tactics, keeping people safer. Firefighters can “see” the best response routes, hydrant locations, and building preplans. We can “see” in the smoke better. We can “see” when we’re low on air. We can quickly “interpret” EKGs. We can treat patients to a higher level of care. To paraphrase Dr. Bremer, “Run the incident, manage the technology.”

 

D. Brady Rogers retired as a captain/shift commander for the Centerville-Osterville-Marstons Mills (MA) Department of Fire-Rescue & Emergency Services after 37 years of service. He has an MPA from Anna Maria College, and is an EFO graduate and an accredited Chief Fire Officer by the Commission on Professional Credentialing through the Center for Public Safety Excellence. Rogers is also an adjunct instructor at both the Massachusetts and National Fire Academies.