BY WILLIAM SHOULDIS
Each year, fire departments respond to new and different challenges that impact on-scene strategic and safety considerations. Over the past few decades, the emergency services have gradually recognized the importance of ensuring the safety, health, and welfare of all responders. Each department is beginning to fully understand the necessity and rationale for developing and implementing a comprehensive approach to occupational safety and health programs. A command officer’s highest priority will continue to be creating and maintaining a safe place of work, whether it’s in the fire station, en route to a call, or at a rapidly escalating incident.
The incident scene is a dynamic environment and must be closely supervised. Each member is responsible for safety and every aspect of on-scene operations must be carefully evaluated. Tragically, without a steady supervisory influence and a continuous management emphasis on strategic and safe actions, the consequences will be sad and costly.
In general, a safety-based system is firmly rooted in a risk management model based on risk and rewards. Hazard identification and capability assessment actually start before the department is called to respond. Strong operational and administrative controls must be in place and properly communicated to members. The modern safety strategy focuses on modifying an overly aggressive “warrior mentality.” We must change culture by enforcing reasonable safety policies that address the common causes of frequent disabling injuries and line-of-duty deaths. Certainly, practices such as fastening seat belts, stopping apparatus at intersections, maintaining equipment, and wearing all personal protective equipment will produce immediate results.
LINKING TRAINING AND OPERATIONS
Another key to improvement is linking training and operations. A connection between textbook theories and their streetwise applications will provide buy-in. Developing a common thread between the classroom curriculum and coordinated tactics will enhance predictability at the strategic and task levels. However, mixed messages from training officers, incident safety officers, health and safety officers, and field commanders will cause confusion and cannot be tolerated.
|(1) The incident commander must make properly trained, staffed, and equipped rapid intervention crews (RICs) part of his overall incident action plan. The RIC has the most important role on the emergency scene. (Photo by Greg Masi.)|
For all responders, daily decision making is based on the principle of taking only acceptable risk. The rules of engagement require taking a significant risk to save a life; at other times, taking a risk must be evaluated based on conditions, risks, and rewards; yet, at other times, avoiding any human risk is the only prudent approach.
INCIDENT ACTION PLAN
A comprehensive plan for action from the initial assignment to the restoration of equipment is critical. From dispatch to return to readiness, responders need a template to follow. On-scene managers often use Incident Command System Form 201, “Incident Briefing,” and Form 209, “Incident Status Summary.” Extended incidents that may require several operational periods or shift changes should include a formal incident action plan (IAP) with a recommended operational briefing for supervisors.
Every October, the National Fire Academy (NFA) has a weekend of remembrance. It seems that every year, around the same number of firefighters are honored for making the ultimate sacrifice. The ceremony is a solid reminder that an increased commitment to personnel safety is needed. “Never forget” means having the courage to make necessary operational changes before any more names are needlessly added to the national memorial in Emmitsburg, Maryland.
HIGH HAZARD INCIDENTS
In recent years, the fire service has been involved in many major incidents that accurately reflect the high hazards that first responders can encounter anywhere in this nation.
- In Conshohocken, Pennsylvania, a massive apartment complex was under construction. Some of the buildings were completed without sprinkler protection in the huge roof assembly. The partially built structure had no compartmentation and the combustible exterior framing was completely exposed. This “all at once” construction method greatly contributed to a destructive eight-alarm conflagration. Firefighters faced rapid fire spread, limited access, structural collapse, and fatigue; meanwhile, a large portion of the community suffered economic hardship.
- In the aftermath of Hurricanes Gustav and Ike, responders conducted search and rescue operations in dangerous and unhealthy conditions. Swiftwater, power outages, raw sewage, a lack of safe drinking water, debris fields, and insects proved to be formidable obstacles to a “safe workplace.”
- In Massachusetts, a company officer was killed in an apparatus accident. A subsequent investigation cited a lack of proper preventive maintenance as a significant factor in the deadly crash. Nationally, vehicle inspection, licensed mechanics, and replacement parts became safety concerns for all repairs to front line and reserve fire vehicles.
- In California, a collision between a freight train and passenger train created an extended mass casualty incident (MCI). Emergency workers encountered potential exposure to bloodborne and infectious diseases as they performed forcible entry and extrication and administered prehospital medical care.
- In New York, the multiagency response to the US Airways Flight 1549 emergency landing on the Hudson River (the “Miracle on the Hudson”) proved that a seamless preparedness plan can ensure safety in operations.
|(2) NFPA 1584 requires setting up rehab for responders’ safety at training exercises and emergency operations. Every incident commander should ensure the availability of a reliable vehicle capable of carrying the necessary equipment and supplies to provide appropriate relief. (Photo by Greg Masi.)|
The lessons from these and other incidents are simple. Response agencies need clear and concise safety procedures for such operational concerns as facility upkeep, vehicle repairs, pump pressures, water relay, staffing levels, decontamination steps, medical monitoring, and a standardized postincident documentation system. These factors are essential to support field operations and safety initiatives. Continuous risk assessment at the task level, situational awareness at the tactical level, and scene control at the strategic level must be woven into relevant training and all aspects of incident response.
The threat of acute and chronic injury is identical, whether the front line is volunteer, career, or a combination service that serves a small community or a large city. Lately, much has been written on preventing illness and injury. Unfortunately, National Fire Protection Association (NFPA) standards, Occupational Safety and Health Administration regulations, National Institute for Occupational Safety and Health investigations, departmental safety committee recommendations, and written standard operating guidelines are not enough; we need to make significant progress in personal accountability.
The root causes of many injuries and deaths remain constant: human error and poor judgment. These are real-world training issues. Current data show that the warning signals of pending safety failure are tangible. Reliable research supported by the NFA indicates that for every major injury, there are 10 minor injuries, 30 near misses, and 600 unsafe acts.
Firefighting is a physically and mentally demanding task. All members must understand the intent of safety policies such as the current edition of NFPA 1584, Standard On the Rehabilitation Process For Members During Emergency Operations and Training Exercises, which is designed to save lives. Reducing the risk of heat and heart-related injury is based on statistical evidence. Uncomplicated guidelines for working in an immediately dangerous to life and health atmosphere with 45-minute, self-contained breathing apparatus (SCBA) or working 40 minutes without an SCBA require a prescribed work/rest cycle. These are the “trigger points” that call for responder rotation and relief.
|(3) All responders must take precautions to avoid exposure to medical hazards at EMS responses. Don’t act on impulse! (Photo by Jack Wright, Philadelphia Fireman’s Hall.)|
“Talking to the troops” and providing multiagency functional exercises will encourage members to follow established protocols. Realistic training always includes input, idea sharing, and evaluation according to a set of predetermined performance criteria.
Sudden cardiac arrest, live-fire burns, roadway accidents, and disorientation in smoke conditions have resulted in too many fire service fatalities. In response, a coalition of progressive fire service groups formulated the 16 Life Safety Initiatives and their implementation strategies. Indicators strongly point to an ingrained culture of the fire service that frustrates safety endeavors.
Operationally, all available responders—law enforcement, paramedics, public works employees, and firefighters—must be educated in taking precautions to avoid exposure to health hazards at medical emergencies. Providing prehospital emergency care requires strict safety protocols for infectious disease and patient treatment. Bunker gear may not provide sufficient protection against bloodborne and airborne infection. Many responders are injured while lifting patients. Proper training, equipment, and supervision are needed during an EMS call.
Responders should ensure they have regular medical exams and all necessary up-to-date vaccinations. Additionally, first responders must think rationally about the possible medical ramifications before acting impulsively on the front line.
Command officers must focus on the big picture and isolate critical issues. Supervisors must understand the need to deploy to a defensive or evacuation posture when resources are scarce. Individuals should only be permitted to perform tasks that are within their scope of training and endurance level.
Experience is a great teacher; actual case studies reviews often reveal actions, behavior, conditions, and situations to avoid. Preserving tradition and taking appropriate aggressive action are desirable, but no responder should be permitted to cross the line and be reckless. During my career as a command officer, at times, it was not always easy to follow a preprogrammed sequence of risk management steps when companies and crews were overworked and understaffed and the critical mission of protecting the public called for decisive action.
In 2010, take the opportunity to reduce fire service fatalities by learning the lessons of the past. Make the connection between culture, training, and on-scene operations. Safety hinges on the doers, not the dreamers. This year is not the time to back down or slow down; it is the time to “arrive alive” and for “everyone to go home.” Now is the time to reinforce our commitment to meaningful strategic and safety programs. Although industry and organizational culture change may be gradual, risk must be managed every day. Take pride in improving the emergency services’ safety record; it will be your greatest contribution. Safe policies, procedures, and practices will surely save responder lives. This attitude adjustment should be the easiest part of the safety connection.
WILLIAM SHOULDIS retired as deputy chief of the Philadelphia (PA) Fire Department, where he served in line and staff positions for more than 34 years. His assignments included working directly for the chief on labor relations and accountability issues and serving as field commander for one-half of the city, department safety officer, director of training, and hazardous material task force leader. He is an instructor at the Graduate School at St. Joseph’s University in Philadelphia, the National Fire Academy, and the Emergency Management Institute. He has a master’s degree in public safety. Shouldis will present “On-Scene Strategic and Safety Considerations” at FDIC 2010, April 19-24 in Indianapolis, Indiana.