By AARON DEAN
When you arrive at the firehouse, are you ready to perform your duties as assigned? Or, do you scramble to get your gear and get on the rig when the bells ring? Most of us are physically prepared to perform our duties when we arrive to work. We inspect our apparatus and check our equipment. We ensure our personal protective equipment is close to the rig. We ready ourselves for whatever the day has in store for us. Yet, are we ready to perform our duties?
Did you get into an argument with a loved one just before you left the house for work? Were you running late, rushing to get to the firehouse on time? Did you get enough sleep on your off days? Are you feeling fatigued, tired, run down, or ill, but you can’t take a sick day because you used all of your leave? In other words, are you truly ready to protect life, property, and your community today?
It could be argued that one’s mental game is THE most important aspect of performing our sworn duty. Knowing how to do something, when to do it, and being able to do it under pressure is what our job is all about. Being mentally prepared can be the difference between successfully performing your duties and experiencing a new learning opportunity.
|(1) Calmly handling the pressure, a seasoned battalion chief establishes command. (Photo by author.)|
Fire service duties posted in job descriptions include fire suppression, hazmat, EMS, service calls, rescue, and more. At the very end of most job descriptions, there is a typical catch-all phrase: “other duties as assigned.” Such a broad term could mean anything. Most of us think this means performing duties not generally associated with the actual tasks of fireground operations. However, it could mean that and so much more.
For instance, we all know incident command positions are filled by need and availability of personnel on each incident. At a bread-and-butter residential structure fire, the first-in engine company will do a size-up, relay its intended actions for fire attack, secure or request a water supply, and take or pass command to the next-due company or battalion chief. What about fire service tasks that you, by rank, don’t generally do because they are “not your job”? Tasks generally performed by a captain or battalion chief are usually not done by a rank firefighter unless absolutely necessary.
As a firefighter, do you think about doing size-ups or other low-frequency, high-impact job tasks that you may not expect to perform? A little mental preplanning can go a long way. I learned this lesson at a mass casualty incident (MCI) on a remote stretch of highway near the edge of my department’s response area. My mind was still back at home, thinking about inconsequential things; I was not mentally prepared to deal with what I saw and was overwhelmed by the scene. All of my training and all the time that I spent learning what to do for such a situation was suddenly not in my recollection. My mental game was absent.
The original dispatch was for a single vehicle in a ditch. I was assigned to a medic unit (ambulance). My partner had arrived at the firehouse about 20 minutes before the bells rang. We had relieved the off-going crew a half hour before official shift change. We scrambled to get our gear on the rig, grab coffee, and get en route. The call seemed like a possible cancellation en route, as it was first reported by a cell phone caller. It had every indication that someone crashed the car into a ditch; fled the scene; and left the vehicle to be retrieved later, if ever … or so we assumed. We never considered what we might find.
En route, the assignment was balanced to an extrication assignment; a truck company and a battalion chief were added to support the engine and the medic already responding. This should have clued me in that this was not going to be a “cancelled en route” call. My partner and I were still oblivious to the obvious. Around the time when we would normally receive a cancel from dispatch because another company was in the area and unable to locate, we realized we had driven a long way past the dispatched location of the accident. Fortunately, soon after, we arrived at the scene.
We were both aghast at what we encountered. My partner later called it a “garage sale.” Chaos mixed with the fog on both northbound lanes. Debris, car parts, and numerous injured people were scattered across two lanes of highway. Northbound traffic could not pass. The roadway looked like a scene from a movie. Uninjured people were frantically waving their arms for us to stop and immediately help the injured. Fear and pain were in their eyes. Their faces told a story I was not ready to hear. I was in a fog, mentally and physically; I was not ready to do my job, the job I took an oath to perform and spent 11 years working to get.
A full-sized SUV speeding at an estimated 80 miles per hour (mph) in a 65-mph zone under very foggy conditions had struck a small commuter sedan. The SUV had five nonEnglish-speaking occupants; the vehicle it hit had an adult female occupant. The SUV had run a red light, swerving just prior to impact and hitting the rear quarter panel of the sedan, which was making a left-hand turn from a side road onto the highway, crossing the SUV’s path. The SUV rolled multiple times, ejecting four of its five unbelted occupants. The driver, who was wearing a seat belt, remained in the overturned SUV. The sedan’s driver also was seat belted and sustained only minor physical injuries but was emotionally distraught.
We slowly realized we were not only first on scene but the only unit on scene, and we were overwhelmed by what we saw; it was a MCI from the start. Good Samaritans assisting a 10-year-old girl with obvious injuries frantically flagged us down. We saw three other patients on our initial survey of the scene; I was consumed by the incident immediately. My partner and I did not communicate. As soon as he parked the medic unit, we each took off in opposite directions with good intent but no incident action plan. We only added to the chaos. After a more careful look at the girl, I saw a pool of blood on the asphalt around her head. Brain matter was showing. I was shocked that she was actually conscious!
Regardless of what textbooks teach or how many times you tabletop an MCI, all of our very limited resources were immediately put in play to try to save this girl’s life; this was in lieu of establishing command, performing a size-up, or requesting additional resources. No triage happened. By protocol, this child should have been tagged as a Priority Zero (a deceased patient) and left where she lay. Yet, I attempted to help her.
The rest of the scene produced a total of six patients; all were transported. Because of mechanism, five of the six were considered critical trauma. Two patients sustained life-threatening injuries requiring surgery: one a pelvis/abdomen and the other a head injury. There were also three minor injuries. One critical patient—the 10-year-old girl—died en route to the trauma center. Air transport was not available because of the fog.
For this incident, as it is with any incident, good command and control set the tone. When more resources arrived, a command structure was established. The call eventually stabilized, as all incidents do; it could have run much more smoothly much earlier. It was obvious from my exasperation that I was ill prepared. My lack of mental focus and inability to recall and follow our EMS protocols and department’s standard operating procedures resulted from my duress. Inexperience in a command position and my gut-wrenching feeling of being overwhelmed added to the mayhem on the highway.
Smooth calls are a result of training and experience and, occasionally, a little bit of luck. For me, this was not one of those calls. Instead, it was a bad time for me to learn a valuable lesson—the same lesson that drill instructors had attempted to teach me in the fire academy, the same lesson my parents tried to instill into me as a child. This is a lesson I will never forget.
When it is your time to “sit in the seat” and perform the duties of the rank above you, you are usually prepared and very aware of your expected role. But when it is the first call of the shift coming back from your days off and you have not quite mentally arrived at work, it just may be the time you are required to exercise your mental game and perform “other duties as assigned.”
AARON DEAN has been a firefighter/paramedic for the Sacramento (CA) Fire Department (SFD) since 2001. He began his career as a volunteer firefighter in 1990. Dean has a master of science degree in emergency services administration from California State University—Long Beach and received his paramedic training from the Stanford Prehospital Care Program in 1994. Dean is the coordinator for the Every 15 Minutes program at SFD, which teaches high school students the consequences of drinking and driving.
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