National Fire Fighter Near-Miss Reporting System: It’s One of Our Own!

There is no more chilling radio transmission than a civilian on a department radio that a member is down. Providing care to one of our own is something that we hope we will never have to do. We train to take care of the public giving little thought that our CPR, AED and ALS skill training may have to be used on another firefighter/EMT. We understand that immediate recognition of cardiac arrest, early CPR, rapid defibrillation, effective ALS, and integrated post cardiac care will save the citizen, but this featured firefighter near-miss report reinforces that this training will also save US! As you read this report, think about what proactive steps you implemented in your organization regarding your approach to firefighter/EMT health and wellness. Have discussions that reinforce the value of National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.

“Our units were toned out to a respiratory distress call. The medic unit, engine, and volunteer stations were dispatched. We arrived on scene to find the patient unresponsive with agonal respirations. The cardiac monitor was applied and we found the patient was in V-fib. CPR was initiated and ALS treatment started. The patient was moved onto a long spine board, placed on the medic unit’s stretcher, and transferred to the medic unit for transport to the ER.

After loading of the patient was complete, a driver/operator from one of the volunteer stations returned to where the patient had been found and started to clean up the area. He was accompanied by a family member who was on scene with the initial patient. As the medic unit was leaving the scene, they heard a female voice on the radio calling for help stating, “One of your firefighters has fallen to the ground behind the house and is not moving at this time.” An EMT ran to the back of the house and found the driver/operator lying supine on the ground, pulseless and apneic. The EMT called for ALS backup. The medic unit stopped on the road and traded out personnel with the engine. They kept one medic and two EMT’s on the medic unit and left one medic and one EMT on scene with the unresponsive driver/operator.

All ACLS interventions were initiated and the driver/operator was defibrillated by the engine crew. An IV was established by the engine’s medic and CPR continued with O2 administered via a BVM. The driver/operator was then defibrillated a second time and regained a pulse. Shortly after an additional medic unit arrived on scene, they continued care with the engine crew and transported the driver/operator to the hospital. The driver/operator’s pulse rate and B/P improved while enroute to the ER. Patient care was turned over to the ER staff upon arrival and resuscitative efforts continued. The driver/operator is recovering and ready to get back home to his own surroundings.”

By all accounts, the crews in this situation reacted with an admirable level of professionalism, calm, and conviction to save another firefighter. What about you and your crew? Look around at the members sitting at the table as you review this month’s report and picture one of them “…pulseless and apneic…” Consider the following:

  1. Would your department’s current response assignment to a similar incident (the initial respiratory distress call) provide enough members to take care of one of your own if needed?
  2. How far away would the next arriving ALS service and/or transport unit have to come from to care for the member down?
  3. Would you have considered bringing the ALS unit that was transporting the first patient back to the scene to also transport the member down?
  4. When was your last physical exam?
  5. Did the exam follow the requirements outlined in NFPA 1582?  

Submit your report to www.firefighternearmiss.com today on a similar call you have run. For more on the value of firefighter near-miss reporting, CLICK HERE.

Note: The questions posed by the reviewers are designed to generate discussion and thought in the name of promoting firefighter safety. They are not intended to pass judgment on the actions and performance of individuals in the reports.

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