The following questions were submitted for the “All Hell Breaks Loose… And Now You’re Out of Air” Webcast for Fire Engineering. The Seattle Guys–Mike Gagliano, Casey Phillips, Phil Jose, and Steve Bernocco–want to thank everyone for the great participation and interest in air management. Where possible, similar questions have been combined. Feel free to send e-mail regarding your questions or concerns to email@example.com, firstname.lastname@example.org, email@example.com or firstname.lastname@example.org
Q. What do you consider a hot zone, or how far out would you consider the hot zone, for wearing the SCBA and go on air?
Q. What about the toxicity of wildland smoke vs. structural smoke? What are your thoughts on using SCBA at wildland or brush fire assignments? Does wildland fire cause/contain the same poisonous gases?
A. Thanks for the question. I wish we had a solid answer for you. This is outside of the area we studied and there are probably others within that field of fire protection who could answer these questions better. Here are a few a thoughts from what we do know.
There is no question that large amounts of CO are being generated in wildland fires. Depending on what else is burning, there are going to be any number of other gases present as well. In the recent Station (CA) fire, we read reports of firefighters testing positive for cyanide because of their proximity to a burning “dump” fire. You can imagine all the stuff that was off-gassing in that situation. The fact that you are outside and don’t have all the products contained within a “box,” and that you have a steady supply of oxygen, makes it a different environment from that on which we have focused our efforts. This would be a great area of study, and maybe you are the one to take it on for the rest of us.
I hope you are not among those advocating this “rule.” For those still advocating this type of approach, our prayers are with you and your families, as you are headed for disaster.
There is always going to be some resistance to change, especially from older firefighters, but that is all part of the job. Most positive innovations in the fire service were resisted at first. Make the case very clearly about how dangerous the smoke is. Show them the elevated risks for cancer and the very real likelihood that they will have limited medical coverage when it occurs. Demonstrate the positive aspects of enhanced fireground operations when teamwork is used as opposed to staying as long as you possibly can and continually putting yourself at a greater risk exposure to the immediately dangerous to life and health environment. Drill extensively with the ROAM concept, and you’ll soon find that you can be as aggressive as ever and will have enhanced situational awareness as a bonus.
These are a few thoughts. There are many more in the materials mentioned above.
Anyone wanting our policy can e-mail me at email@example.com, and I’ll send some of the policies we’ve come across.
Q. With today’s economy and all the cutbacks, how would you help us sell our upper management or city on keeping air management a top priority?
A. There are a few things we recommend when tackling the sticky issue of dollars and cents with the powers that be. The first would be that implementing air management, as we teach it, is not an expensive venture. It requires no addition of personnel, no addition of new equipment or technology, and no extensive/expensive training program to implement. You simply begin drilling your people on the ROAM and incorporating the air management philosophy into all of your training. You can buy a book or two or have a class, if training dollars allow. But that is not essential to getting things moving.
On the flip side, you ARE going to be held accountable should one of your members suffer death or injury because of an “out of air” event. The regulatory requirements are clear, and no department can make a reasonable argument that it is not aware of the dangers associated with the modern smoke environment. This is a no-brainer from a financial standpoint.
Here’s what you should be concerned about, however. You are not going to know at any given time the concentrations with which you are dealing an emergency. The only time judging the concentrations are going to matter is in postfire, overhaul type situations during which everything can slow down. There is a movement to add things like cyanide monitors to the firefighters’ gear. That’s an interesting approach, but it begs the question about where we are going to fit monitors for all the other stuff in smoke. Where will the benzene, phosgene, gas monitor fit?
The point should be to wear your SCBA and manage your air. That takes the deadly effects of the smoke off the radar as far as impact. Everything else is half measure that may or may not work depending on the circumstances.
The following is a reply from Dr. Alan Hall, who partners with the Cyanide Poisoning Treatment Coalition:
As far as off-gassing of HCN (or H+ CN-) from various nitrogen and carbon containing materials (natural and synthetic), this indeed will very much depend on the specific material(s) involved, the situation (if combustion or pyrolysis without flaming is involved), and what very local/specific oxygen concentrations and partial pressures are involved. There is no easy answer.
As a general rule, whenever any material (natural or synthetic) that contains both nitrogen and carbon is either burning or smoldering (pyrolysis without flaming), some amount of HCN will be released. There are literally hundreds of studies on this subject that go far beyond my expertise as a medical toxicologist.
In the field, the issue is to suspect that HCN MAY be there and to take proper precautions to protect firefighters and victims, including absolute adherence to respiratory protection/air supplies guidelines/regulations, rapid extrication of victims from the fireground, airway management as indicated, and provision of the highest concentration of oxygen possible in individual circumstances, standard advanced life support care as soon as possible, and consideration of administering the safest currently available cyanide antidote, hydroxocobalamin, as soon as possible for those with altered mental status; soot in the nose, mouth, throat, or in expectorations; and particularly to those with hypotension (=/< 90 mmHg systolic in adults and similar age-appropriate values in children). If rapid screening for lactic acidosis can be done (plasma lactate =/>10 mmol/L), this is an additional indication for administration of hydroxocobalamin as soon as possible–preferably by paramedics in the field, but at least as soon as possible on emergency department arrival.
I realize this does not completely answer the question, but perhaps it cannot be directly answered with currently available data. For example, in some fireground studies done in the 1980s, in the same room of a smoke-filled burning building, air cyanide concentrations varied by three to four or more orders of magnitude (an order of magnitude is 10 times – 1 to 10 to 100 to 1,000 to 10,000, 100,000, etc.) in different areas of the same smoke-filled room and about the same from standing height to lying on the floor in the same location in the room. Even with direct-reading cyanide air monitors, it’s so far just not practical in the field to decide who HAS a cyanide poisoning component in smoke inhalation victims and who does NOT based on rapidly obtained objective environmental or biological monitoring data. There’s still a place for prehospital and emergency department clinical judgment, which is really all we have as of the present time.
This is the best I can do for now. Who knows in 20 years?
If all you want to know is when hydrocyanic acid will become hydrogen cyanide vapor, all you need to do is consult any MSDS sheet or the HCN document in the HSDB (Hazardous Substances Data Bank) from the National Library of Medicine. Just go to www.nlm.nih.gov, select anything that says “environmental” from the menu on the left, select HSDB, and type in Hydrogen Cyanide and look at physical-chemical properties for the vapor pressure (NOT vapor density). But I don’t think that was the question (you can find similar data in the Coast Guard CHRIS manual and any number of references a hazmat team likely keeps on hand).
We appreciate your support and kind words. We are working with many other committed folks like you to see that firefighter asphyxiation in structures becomes a rarity.
We recommend using the ROAM so that you can tailor your time-to-exit decision to the actual incident, not some predetermined exit time that does not fit the majority of incidents you will go to. In our current system, we have found the following to work very well:
• If you use one cylinder (30- or 45-minute) and leave before your bell hits, you can change cylinders and work another acceptable work cycle before going to rehab.
• If you use one cylinder and violate the ROAM by going past your low air alarm, you’ve worked an extended work cycle and must go to rehab after only one cylinder.
This works great because it puts the onus on the firefighter to act professionally and stay within the recommended work cycle time. If you violate it, you go to rehab earlier than those who operate correctly.
A. First off, it is an honor to have such a great contributor to the fire service as you watch and comment on our program. Dr. Svensson is a brilliant tactician and cares very deeply about firefighter safety and survival.
Now that the easy answer is available, you can get much more information about overhaul and the SCBA in our book, or you can go to www.firesmoke.org and look for the pamphlet “Smoke: Perceptions, Myths, and Misunderstandings.” There is no detector that will ensure the safety of your people. A detector that identifies, tests for, and notifies the user for each and every one of hundreds of gases produced at a fire does not exist. CO detectors and cyanide detectors, at their best, provide only a localized identification of the toxicity of one toxic gas for a short time period. Why accept an unknown exposure to toxic gases when no exposure is so easy to ensure?
It may be advisable to use a 60-minute cylinder for RIT as long as the RIT team is going to be sent to rehab after only one cylinder. That does not change the requirement that firefighters exit the hazard area BEFORE the low-air alarm activates. The RIT team’s job is to increase the survivability of the firefighter in trouble. Running low on air does not increase that survivability.
Q. How do you view the new ‘slim packs’ impacting the departments across the board in regard to ability to get into ‘smaller’ areas … tighter quarters… and buddy breathing situations?
A. We are excited about technology increasing the safety and effectiveness of firefighters. New materials that are lighter weight have no downside that we can identify. Lower profiles could prove useful, although we would hesitate to recommend going into tighter spaces on the fireground. The use of low-profile maneuvers should be limited to exiting under duress or the “rare and unusual circumstance” for firefighting, and additional time should be set aside to exit. We recommend making a big hole for entry into a firefighting environment. Lower profiles would decrease the dynamic load on the firefighter’s frame and, therefore, decrease the workload and the heat generated. Decreasing the load on the chest and back is always a good thing.
Last, but not least, buddy breathing is a Mayday, every time, as soon as possible. We think the ROAM would decrease the probability of buddy-breathing situations, but we support providing firefighters the tools and training necessary to handle the worst when it arrives.