EMTs Can Avoid Becoming Part of Rescue Problem
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Arkansas Fire Training Academy, Southern Arkansas University, Camden, Ark.
“EMS Unit 14 responding to structure fire at 1040 North 14th Street.”
“Ten-Four Unit 14; time-out 0232.”
An ambulance cuts through the deserted streets with well-equipped and well-trained personnel.
Thinking of the lives in the burning building, the two EMTs find an open door and enter the house as fire companies begin their operations. The EMTs at first choke and gasp in the light smoke. As they search for victims farther inside the room, the temperature rises rapidly, but the heat is not as intolerable as those gases! Respiration rates increase, demanding more oxygen. One EMT calls to his partner to retreat. As they inhale one deep breath to get them outside, they stand to run outside to fresh cool air and safety.
Problem increases
“Engine 24, to headquarters. Dispatch second ambulance to this location. Reporting three victims, one family member, two EMTs from Unit 14.”
“Ten-Four Engine 24, ETA 6 minutes.”
“Engine 24: All three in bad shape. Tell them to hurry.”
To those of us who provide emergency services (whether fire, police or medical care), the risk of our own lives so that others may live comes with our job. But when we risk our lives foolishly without considering that we may not be able to help our victims once we reach them, we need to reassess our responsibilities and capabilities.
Rescue hazards
The two EMTs in the beginning scenes had only one thought in mind: save lives in danger. Commendable, to be sure, but at what costs?
The atmosphere in a serious fire is certainly not conducive to an easy rescue. The ambient temperature may rise rapidly (as much as 1000 degrees in the first five to six minutes). The smoke is no more than toxic gases made visible by soot, ashes, tar, and water vapor. The toxic gases themselves are invisible— many of them odorless and tasteless— and they may be present independent of the visible smoke.
Oxygen content decreases to dangerous levels as the fire replaces the atmosphere with carbon monoxide -(as a result of incomplete combustion), carbon dioxide (from normal combustion), hydrogen cyanide and hydrogen sulfide (from burning rubber, plastics, wools, silks), oxides and byproducts of nitrogen (such as ammonia), and sulfur dioxide (from materials containing sulfur).
Oxygen deficiency
As oxygen is depleted, the body compensates by faster and deeper breathing efforts and instead of oxygen-fresh air, the body doses itself with toxic gases.
Muscular coordination is affected as oxygen levels decrease from the normal 21 percent to 15 percent. As oxygen levels drop to 10 percent, faulty judgment and fatigue occur. Collapse with possible revival occurs in atmospheres with oxygen levels of 10 to 6 percent. Below 6 percent, death can be expected within six minutes.
The fire fighters, wearing protective clothing and self-contained breathing apparatus, made a good rescue and all three victims have better-than-average chances of recovery.
Basic safety rules
The story, of course, is fictional, but somehow much too possible for most of us in emergency services. The alternatives to Unit 14’s operation are evident:
- Perform only those tasks you have been trained to do. Don’t try to second guess someone else’s job.
- Assist other emergency personnel only as needed. Help, but don’t get in the way.
- Perform rescue only to the extent that you are equipped to do it. Don’t risk yourself or victims needlessly with makeshift tools or methods.
- Coordinate your actions with other rescue efforts. Don’t work against fire or police personnel in a race to get to the victim.
- Communicate with those in charge at the scene. Don’t leave the dispatchers or officers in the dark as to your location, actions or needs. Ask for assistance when you need it.
- Plan for a coordinated rescue before the incident occurs. Don’t wait until the last minute to decide you need to know how to use protective breathing equipment or how to contact other authorities for assistance.
Anyone who works in hazardous environments, who is duty bound to risk his life, who serves other human beings in trouble should prepare with these suggestions in mind to provide the quality of service expected by citizens. Self-contained breathing apparatus, protective clothing and effective coordination of personnel are essential to our protection when attempting to rescue victims at many emergency scenes.
Will you provide the next rescue or will you need rescue? It is up to you.
