Avenue of Egress

Whenever you receive a call for an “unconscious” person, numerous scenarios run through your mind; you’re never quite sure what you’re going to encounter. Your mind will go through a litany of “have done before” incidents-from a shooting victim to an overdose to an elderly senior in a nursing home to a drunk sleeping one off. Emergency medical services (EMS) calls account for a good portion of our workload and run the gamut from minor injury to major trauma incident.

Working the eve of any holiday always means a busy tour, and the types of runs will vary, especially when you’re working outside your own company. An EMS run for an unconscious person on the fifth floor was our first one of the tour. As we pulled into the block, the police department was already on scene. Entering the building, we chocked the entrance doors so the arriving medics wouldn’t be delayed in gaining access. After walking the five floors, we noticed a patrolman standing outside the apartment talking on his radio; another patrolman was walking out of the apartment. We passed him as we entered the apartment, and he said, “All the way toward the front, in the bedroom.” Then he blurted out, “He’s on the bed, hooked up to a tank and wire.” Immediately, we put the brakes on and began to exit the apartment. If this person was hooked up to a tank and wire, the police had better call the bomb squad. We called for help to evacuate the rest of the building.

The second officer was now off his radio and asked why we were apprehensive about going into the apartment. We explained our fear of a radio transmission, a trip cord, or a booby trap going off if the victim was hooked up to this tank and wire. He chuckled and said, “It’s a barbecue tank and hose-not a wire.” He assured us that it was okay to enter the apartment and see if the victim was still alive.

After a size-up, we detailed one member to attempt to gain entry to the apartment on the floor below to check for a buildup of propane (it’s heavier than air and could seep down through the steam pipe riser, floorboards, or baseboard). Next, only two of us would enter the apartment to do a quick recon of the situation and formulate a plan. We turned off radios and were reminded not to touch anything and to move cautiously.

Slowly entering the apartment and spreading out, giving verbal signals to each other, we finally made it to the bedroom. Just our luck, a huge dresser was blocking the view of the bed, so we had to enter the room. Proceeding around opposite ends of the dresser, we finally laid eyes on the victim.

He was ash gray and blue in color, with plastic bags affixed over his head with duct tape and rubber bands. Rigor mortis had set in. The member at the end of the bed toward the window had a complete view of the tank and hose. It was definitely not a wire, and the hose ran up into the bag, filling it with propane, asphyxiating the victim. To make the scene safe, he turned off the cylinder with a quarter turn to make sure any leftover propane would not leak out and cause a hazard. We then exited the apartment. Because of the severity of the situation and hazardous material cylinder in the apartment, we requested that the chief respond.

While awaiting his arrival, we searched the apartments on the floor below and found no odors of propane. The entry team then compared notes on their scene size-up: The victim’s hand was holding a butane lighter, and a plate of burning cigarettes was on the bed. Because of those factors and the fear that the bag might contain some residual propane, the decision was made to quickly reenter the apartment to ensure the cigarettes were not still burning. Again, only two members entered, stopping in the kitchen to fill a small pot of water before heading toward the bedroom. The plate of cigarettes was nothing but ash, so no water was required.

As the members exited the room, they both were startled when the victim’s cell phone, which was lying on the bed, suddenly rang.

When members reached the public hallway, the chief had arrived on scene and was briefed on the situation. He spoke with higher-ranking police personnel who arrived on the scene as well. The police declared that this was a crime scene and took over operations.

Once we got down to the street, we began an informal critique and reviewed the following:

  • Make all attempts to maintain situational awareness when entering any apartment on a call; size up the area and rooms leading to the victim for any signs that could endanger firefighters.
  • If you find an unknown odor or strong odor of gas, it may be necessary to don proper personal protective equipment and self-contained breathing apparatus for protection.
  • The victim had a secondary plan if the propane didn’t work; he hoped that the lit cigarettes would cause an explosion or a fire to assist in his suicide.
  • Notifying the proper authorities and calling for assistance and the appropriate resources may be necessary when dealing with these new-age suicides, such as exit bags and chemical suicides in cars. A few breaths of escaping chemicals could cause severe injury or death to first responders.

Thankfully, no emergency service workers or other building tenants were harmed at this scene.

MICHAEL N. CIAMPO is a 30-year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC Truck Essentials H.O.T. program. He wrote the Ladder chapter and co-authored the Ventilation chapter for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and is featured in “Training Minutes” truck company videos on www.FireEngineering.com.

For related video go to http://bcove.me/81drmi9w

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