First Aid For The Fireman
FIRST AID training is a must for every fireman, whether he be a member of a large city unit or a volunteer company located in a community of five hundred. However, the type of training has always been debated and challenged by various doctors and instructors of fire departments.
Granted that large cities have their training schools which embody the study of emergency measures in case of accident or sudden illness, many small communities lack these facilities and generally leave the training to the chief or appointed drill master.
Therefore, as director of First Aid of one of the largest cities in the State of New Jersey, I took it upon myself to investigate this problem of “What Kind of First Aid Should Be Taught to a Fireman,” which has often been tossed into my lap.
The American Red Cross First Aid Instructor’s Manual, under the Advanced Course, covers the main essentials which have often been used in training volunteer groups. Nevertheless, this course seemed to lack that extra something which was needed to fully satisfy the embryonic firefighter.
Research proved that basically a general course in first aid would suffice, but special emphasis should be placed upon various emergencies which only confront the fireman.
My investigations were readily solved when I found in one of my Red Cross Standard First Aid courses, a Battalion Chief of the Paterson, N. J., Fire Department, who, on his own time, had enrolled in the course to further his knowledge of this vital subject.
I shall never forget Battalion Chief W. L. Titus’ words, after he finished the course, when he said, “I am more convinced than ever that there can be no short, quick course in First Aid for firemen. Our Chief James J. Troy has for many years advocated full Red Cross First Aid courses for his men.” Many training schools expose the new “smoke-eater” to ten hours of basic training, whereas he should attend a course which should consist, if an hourly basis be construed as a means of accomplishment, of at least 80 hours duration. This should provide the fireman with a basic knowledge of first aid.
There are many people who don’t understand the dangers and perils which confront the fireman. Most people associate injuries to firemen with large, spectacular fires. This is utterly untrue. Other than falling walls, hose lines out of control, or falls due to slippery conditions. injuries are seldom sustained. The real hazardous fire is the dense, smoky, choking one wherein firemen must enter strange, congested structures and seek out the location of the fire. Here, men are exposed to possible falls into unguarded openings and the presence of flammable and explosive stocks. Since this is the more common fire encountered, it is surprising that injuries are held to such a low number.
Battalion Chief Titus is of the opinion that firemen should be concerned with two classes of first aid: that which they give to their fellow firemen to cope with injuries received at the scene of the fire, and secondly, the type that all firemen at some time or another are called upon to render to residents in neighborhoods surrounding fire houses.
Therefore, it seems logical to list the injuries and conditions prevalent in fire fighting and then build a course around these problems. Here, in the opinion of the writer and Chief Titus, are the dangers:
ASPHYXIATION—From lack of oxygen. Encountered in varying degrees that may require either complete artificial respiration or, in some cases not quite so severe, inhalation of oxygen. This condition is considerably aggravated by the presence of toxic fumes generated by burning plastics, nitro-cellulose products, or other chemicals. I mention this because of several instances in the past where inhalation of these toxic fumes has resulted in death, (refer to the Cleveland Clinic Disaster caused by burning nitro-cellulose X-ray films.)
CUTS FROM HEAVY PLATE GLASS—Quite common in mercantile areas, generally caused by use of forcible-entry tools. For example, the use of door opener places unequal stress and strain on door frame, causing shattering of heavy plate glass. This drops on the operator of the door opener, causing severe cuts and, due to weight and height from which this glass drops, sometimes breaks a limb.
Carelessness while working about ordinary windows. Glass already cracked from intense heat may fall out and strike the opener’s arm or feet.
CUTS FROM Tools—Firemen are also exposed to cuts from axes or pike poles, plaster hooks, or sharp-edged tools which they are called upon to use. However, this represents carelessness on the part of the user.
Burns—Strange as it may seem, firemen are seldom burned by actual flame contact. Probably the most common burn received is caused by firemen coming in contact with heated metal objects, such as metal bedsteads, door knobs and stoves. Another burn hazard and the one most feared by firemen is the back draft or smoke explosion often caused by improper ventilation of a burning building. There is a particular hazard when this condition is encountered in mercantile areas, for back drafts generally blow out large plate glass show windows. This exposes firemen to the double hazard of burns and cuts front broken glass. The next burn hazard arises from careless handling of containers of volatile fluids. Containers of unknown fluids may give off fumes that can travel until they reach a hidden
ember, causing a flashback and severely injuring men in this area. This hazard is greatly aggravated when such containers are spilled.
PUNCTURED Wounds—This injury is also quite common to firemen and is usually received about the feet. It is
generally caused bv nails protruding from partially-burned boards removed in the process of overhauling. Treatment is required immediately. This wound can oftimes be prevented by placing leather or metal inserts into boots.
OBJECTS IN Eyes—Also quite common; caused by pieces of plaster, while removing ceilings, being struck in face by high-pressure hose stream when same is operated in smoky area by coworkers. This stream many times carries bits of charred wood and other debris into the face and eyes of firemen.
FALLS (AND IMPROPER HANDLING)Added to the above injuries are the many conditions aggravated by improper handling. Some examples are: Firemen falling from ladders, removal of the men is started before any effort is made to ascertain the extent of injuries. Then, there is also the condition where firemen may enter smoke-filled structures, falling into unprotected floor openings, particularly true of cellars. Fire in this area is slow burning and smoky. Firemen entering this area may stumble into furnace pits and possibly incur three injuries: 1. injury to the limb in the fall, 2. striking the head against the projecting part, 3. burns from coming in contact with heated surfaces. If rendered unconscious in such a fall, and absence is unnoticed, additional hazard of drowning is set up should pit be filled with water.
GENERAL—Injuries are also received from high pressure hose out of control.
I believe it is also well to note that many times firemen are called upon to give artificial respiration under hazardous conditions; this may be to firemen trapped by falling beams or wails, or to civilians trapped in coal pockets, or holes in earth. Due to the possibility of firemen receiving severe cuts, I believe it is important that they be familiar with the proper method of controlling hemorrhage, since it has been my observation that treatment of most injuries received by firemen are held in abeyance until the arrival of an ambulance or doctor, or the injured person is removed to the hospital in a vehicle.
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Note:—I have purposely omitted the hazard from hanging electric wires, for it is the duty of the officer in charge of severe fires to immediately have the service disconnected. We also make it a point to shut off the flow of illuminating gas at the meter or street valve to prevent explosion or asphyxiation.
Only a complete course, one which includes the Standard and Advanced courses of the American Red Cross, would seem adequate. However, many training departments minimize the necessity of such complete education. Chief Titus best described the importance of this training when he said, “It is a pleasant thought to know that the men of my company know how to take care of each other if anything should happen while they are engaged in fire-fighting. This confidence they have in each other enables us to do a better job for the citizens whom we protect from one of the nation’s chief destroyers of property and lives.”