Photo found on Wikimedia Commons courtesy of Eja2k.
By Michael Morse
Keeping up on emergency medical services (EMS) skills is a great idea for all firefighters, not just those assigned to EMS units. Treating and transporting civilians with trauma and medical emergencies is part of the daily ritual. The nature of the work we do is another reason to have top-notch medics on board every piece of firefighting apparatus on every call.
Firefighting is hazardous and stressful. Firefighters are expected to perform at levels well above what a healthy body can endure. Add to those expectations things like cyanide poisoning (see http://mifdi.8m.com/PFDCyanideReport.pdf), exposure to blood, and risks during response to and from emergency calls (see www.nfpa.org/newsandpublications/nfpa-journal/2014/november-december-2014/features/us-firefighter-injuries-in-2013), heart attacks, and strokes, (www.cardiachealth.org/heart-disease-firefighters) and the million-and-one other ways injuries happen, and ultimately, you have a lot of colleagues with the potential to need emergency medical care.
Somebody (probably a doctor) said that doctors are the worst patients. Another person, likely a nurse, mentioned that nurses are the worst patients. I happen to know for a fact that both of these schools of thought are wrong. Firefighters are by far the worst patients. The less severe the injury, the worse they get. And heaven help the people who have to treat a firefighter who has suffered a minor injury at a fire scene, gets pulled from the fireground by the chief, and is ordered to undergo a medical evaluation!
There was nothing I dreaded more than treating an injured firefighter. Even my friend, Firefighter Baker (who is mentioned in the PFD Cyanide Report) was difficult, and he was dead until the crew from Rescue Co. 2 revived him. When the injury is severe or the medical condition is dire, uncontrollable emotions make even the most hardened medics sweat. We do not have the luxury of deferring duty to treat to someone else with no attachment to the patient. We take what comes our way. Sometimes, the people who come our way are carried from burning buildings, not breathing, broken, and fighting for their lives. They may have suffered a heart attack in the same station you call home for many of your waking hours. The victim could very well have attended your daughter’s christening the week before he became the person struck by an auto at a crash scene. Putting aside your emotions while treating one of your own is impossible.
So, what to do when the victim is one of our own? Try the following:
- Recognize the emotional response your body is enduring.
- Channel your adrenaline into positive action.
- Corral the fear, put it aside, and embrace the idea that the person fighting for life is in the best possible hands: yours.
By staying up to date on your jurisdiction’s protocols, you have the knowledge, ability, and drive to do everything that can be done for your friend who needs you. When one of your own is down, there is no time for wondering what to do. Knowledge truly is power when the worst possible scenario becomes reality.
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Firefighters suffer horrendous injuries doing the job. Firefighters die. Firefighters treat their own, and it is never easy. What makes the outcome—no matter how seemingly unacceptable—bearable is knowing that the person under your care was treated with care, compassion, and expertise. If the unthinkable happens on your watch, sleepless nights, flashbacks, and guilt will be your companions for days and weeks following the incident.
Your best defense against post-traumatic stress disorder is a good offense. Knowing deep down, where it matters most, that you did what any other person with your training, experience, and expectations would have done under the best circumstances will keep you sane and focused; a little therapy probably wouldn’t hurt either.
Making EMS skills another essential ingredient in every good firefighter’s toolbox is not an option. Getting a brother or sister out of a burning building is not enough. Knowing exactly what to do and, equally important, recognizing what is out of your control makes your response automatic. Your trained instinct needs to take over and allows your mind to settle down and absorb everything that is happening. There is time to sort it all out, and that time is never when it is happening.
Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.