Stress Studied, Measured on Course For Safe Use of Breathing Apparatus

Stress Studied, Measured on Course For Safe Use of Breathing Apparatus

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A few years ago, several fire fighters in our area were killed or injured in unusual incidents involving breathing apparatus. Several officers felt that a special course was needed to focus on the problems they encountered.

The result was a course entitled, “Survival Technology and Rescue Team Training.” This title was quickly shortened to the acronym, STAR team.

There were four basic objectives to the STAR team course. They were:

1. To give the students information on the physiological and psychological effects of using self-contained breathing apparatus during fire combat or high stress conditions.
2. To provide fire service personnel with an opportunity to collect empirical data on the physiolpgical effects of fire fighting on individual fire fighters.
3. To give students information, techniques, technology and materials to use in training other fire fighters in the proper use of breathing apparatus.
4. To give students an opportunity to participate in exercises that simulate the physical and mental stress of fire fighting.

Study of stress

On the surface, this course may appear to be similar to a smoke diver’s course. However, there are some crucial differences in the STAR team project. The project organizers researched numerous other specialized breathing apparatus courses. Most smoke diver’s courses emphasize action taken by the fire Fighter and focus on the technique of donning, operation of regulators, etc. The primary difference in the STAR team project is that much of the course was directed at studying and measuring the effects of stress on the fire fighter.

Not enough time and attention has been given to examining such things as the effects of change in a fire fighter’s blood pressure, heart rate, blood gas, etc. This area is missing in the curriculum of most breathing apparatus classes.

The STAR team course was designed to rectify this information gap. Initially, course participation was limited to training officers or those who had a responsibility for training fire fighters in recruit academies, during in-service programs or in specialized courses that they ran locally. All participants were required to be well versed in the donning, care and maintenance of their own brand of self-contained breathing apparatus. In addition, they were required to be in good physical condition and capable of strenuous activity.

The first STAR team course was conducted as a joint effort of the San Clemente Fire Department, the Orange County Fire Chiefs Association— Training Officer’s Section, and the California State Fire Training Program of the State Fire Marshal’s Office.

Subsequent to the first course, variations of the course have been held in six other communities in two other states.

Training program

The course outline consists of the following:

1. Completion of a class profile (2 hours). This was the collection of all base line data on the physical and mental condition of the STAR team participants. This data was recorded on a special form designed for the class. It included the vital lung capacity tests and at-rest heart rates and blood pressure.
2. The fire fighter’s hostile environment (4 hours). This included a class on fire behavior and the products of combustion, as well as a discussion of the effects of fire-attack practices on fire behavior.
3. The history and development of self-contained breathing apparatus from wet beards to the new bio-paks.
4. Trends and developments in studying the death, injury and disability rates of fire fighters.
5. Laws, legislation and organizations that impact fire fighter safety.
6. The human body under stress. This included examination of the cardiopulmonary system, including the vital lung capacity, and the psychological factors of panic.
7. Criteria for a physical conditioning program for fire fighters.
8. References, resources and materials on fire fighter safety.
9. Burns and burn treatment of fire fighters.
10. Model curriculum for recruit fire fighters on safety.
11. The SCBA Olympics. This section included a 30-minute stress test consisting of an obstacle course and medical data collection.
12. Basic survival techniques.
13. Fire attack exercises with and without breathing apparatus.
14. Tests were completed on EKG monitoring, blood gas sampling, vital lung capacities, heart rates, and blood pressure changes.

Systems approach used

The design of the STAR team course used a systems approach to the problem. The model we developed consists of essentially four elements: the problem (the existence of fire fighter deaths and injuries resulting from stress and burns), the existence of a wide variety of standards (some were institutionalized, such as NFPA 10001, OSHA regulations on breathing apparatus and minimum training requirements, such as in fire fighter certification programs), physical testing of fire fighters (the results of which were documented on a set of standardized forms), and evaluation of the test results to formulate conclusions and recommendations to help eliminate the problem.

Probably the most important element of the model is the data base profile. This is a record of a man’s physiological norms when he enters the fire service that can be compared to his responses to stress as he continues through his career. This data base consists of a series of data elements that most likely will change as a man grows older, undergoes changes in his physical conditioning, or suffers a deterioration of one or more of his bodily functions. This profile also establishes a base line for comparison of a man’s changes while fighting a fire with or without breathing apparatus.

Each candidate in the program was asked to fill our a fairly comprehensive profile. This form, theoretically, could be started when a man enters the fire service and continued as part of his training record throughout his career.

It should be admitted at the outset that there are a lot of fire fighters who don’t want this information collected. The STAR team organizers realized this. However, they chose to pursue it nonetheless. One of the reasons fire fighters don’t want the data collected is that they are afraid it will be used against them as they grow older. In some respects, this fear is real.

Preventive median goal

The STAR team recognizes this and hopes to utilize this data as a form of preventive medicine to increase the longevity of fire fighters—not to deny them an opportunity to continue their career.

The form was completed by each candidate before any training began or any exercises were completed. Among other things, the profile considered respiration rate, both blood pressure and heart rate at rest and under stress, and air cylinder use rate under stress.

One of the focuses in the STAR team project was to orient the student to the idea that the level of training in fire behavior survival techniques and in physical conditioning is more of a protection against injury than his protective clothing. This philosophy could best be summarized in one statement made to the candidates that their protective clothing is the final line of defense against injury. The first line of defense is training and making proper decisions under fire fighting conditions.

Few fire fighters are aware that their blood gases change and that carbon dioxide builds up in their blood even while wearing breathing apparatus. Many fire fighters are totally unaware of the differences in blood pressure, heart rates, EKGs, etc. They know only that they are tired after a fire. Some of these phenomena can and do result in improper use of breathing apparatus under certain conditions. At the very minimum, they can result in fatigue and errors in judgment. They may, in fact, be a contributing factor to situations where fire fighters are injured or killed.

Two levels of exercises

In conducting the STAR team training, there were two levels of exercises. The first, called the SCBA Olympics, consisted of a series of physical exercises taken from an article in the November 1976 issue of Fire Engineering, page 68. Medical data on each candidate was obtained before he went through the 30-minute exercise test, upon completion of the test and after a 10-minute recovery period.

The second test was a live fire test. This consisted of a series of controlled burns where the fire officers fought fires both with and without breathing apparatus. Once again, the medical staff collected vital signs before and after the test. In an additional exam with live fires, blood gases were drawn and each candidate wore special devices to measure the heat level.

The 24 participants in the school fought over two dozen fires to complete this portion of the test. Some of the fires were in the incipient stage, some had heavy smoke and others had flashed over. Many involved heavy manual labor.

Equipment not enough

Upon completion of the 36-hour course, almost all the participants agreed that the experience had been revealing to them. Many expressed concern that they had been overlooking many vital elements in the training of their personnel. Most importantly, they began to recognize that even the most advanced equipment does not make a fire fighter’s job safe. It’s a fire fighter’s knowledge, training and sense of perspective on his own strengths and weaknesses that make him an effective, aggressive fire fighter.

The lab results drawn from our experiments were not conclusive, but we were able to identify some serious problems that all fire fighters should be aware of. To paraphrase one of the medical staff, “If I had of seen this man in an E.R. and he had exhibited these vital signs, I would have hospitalized him immediately.” This quote was made after testing a fire fighter who had completed 20 minutes of intense fire fighting and who had used up one air cylinder. Ten minutes later, this same fighter was rolling hose tired but unaware of what he had just done to his body.

Poor heat judgment

Another phenomenon noted in the course was that fire fighters are notoriously wrong when it comes to judging heat levels. Temperature ratings were recorded by some instrumentation on helmets. After each exercise, candidates were asked to evaluate the levels they experienced. Almost 100 percent of the men were 200 to 300 degrees off in their estimates.

One thing we discussed was the belief that ears are good indicators of heat levels. It was pointed out to the students that a study conducted by Factory Mutual Research Corporation in 1971 refuted the idea that skin is a good measurement of heat levels. The study, “Pain Time Versus Fabric Ignition for Exposure to Flame,” states that “ignition (of the test samples) occurred well before the skin could register intense pain.” What this points out is that the ears can be used as thermometers as long as we are willing to burn them.

The conclusion we drew from our course and experiments is that we need to give fire fighters more specific information on how to protect themselves against the negative effects of wearing breathing apparatus in a hostile environment. They need to be much more aware of the effects of stress on their cardiopulmonary system and how to control that stress.

Rung and Hesktead, technical memorandum, Factory Mutual Research Corporation, FMRC Serial No. 19967, December 1971

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