Health, Safety & EMS Conference
August 14-18, New York, NY
Residential Fireground Field Experiments
In a landmark study released in April 2010, the National Institute of Standards and Technology (NIST) investigated the effect of varying crew size, first apparatus arrival time and response time on fire fighter safety. Experiments were conducted on a 2,000 square foot house and studied the effectiveness of 2-, 3-, 4- and 5-person crews on identical fireground operations.
Results illustrated the benefits of multiple, larger crews (i.e. 4- and 5-person crews) and their ability to complete essential fireground operations and ultimately extinguish the fire prior to reaching flashover state. The study showed that 4-person fire fighting crews were able to complete 22 essential fire fighting and rescue tasks in a typical 2,000 sq. ft. residential structure 30% faster than 2-person crews and 25% faster than 3-person crews.
The report is the first to quantify the effects of crew sizes and arrival times on the fire service’s life-saving and fire fighting operations for residential fires. Until now, little scientific data have been available.
A Residential Fireground Field Experiments Toolkit, executive summaries, experiment results, study reports and other materials can be found at www.iaff.org/et/deployment.
One of the presenters, Rocky Haynes, President of Tualatin Valley Fire & Rescue, discussed the progress his department and their union made over the past 10 years in securing 4-man engines for all 22 companies. TVFR and Portland are the only two departments in Oregon that have achieved this staffing level. It can be done.
International Association of Fire Chiefs (IAFC) President Jeff Johnson stated that “we call on every fire chief in America to read this report.” Dave Rohr, Fire Chief and Fairfax City Fire Department, pointed out that the NIST report is a scientific report. It is not a union-generated report. It is the result of a true partnership between the IAFF, IAFC, NIST, the Worchester Polytechnic Institute (WPI), and the CFAI (Commission on Fire Accreditation International).
EMS Field Experiments
This report was released by the same coalition that participated in the Residential Fireground Field Experiments, and it shows that the size and configuration of an EMS first responder crew and an ALS crew have a substantial effect on a fire department’s ability to respond to EMS calls. The study looked at a number of factors, including crew size of the assisting engine, and the benefits of having at least one ALS personnel on the engine to begin ALS treatment prior to the ambulance arriving. In the KFD deployment model, our engines are ALS a large majority of the time, and this is a model many larger departments strive to achieve.
Protecting Fire-Based EMS: How They’ll Attack and How to Fight Back
Presentation given by Dean Fletcher, President of Las Vegas Local 1285, and Jeff Hurley, President of North Las Vegas Local 1607. Both Locals and respective fire departments have been battling AMR over the past two years or so over EMS response and patient treatment. In a nutshell, AMR, being a for-profit company, attempts to control costs as much as possible to maximize returns. The result is often slow response times by AMR due to understaffing, and in these cases patient care is often initiated by the local fire departments because of their ability to arrive on scene quickly. Ultimately, though, AMR is the transporting entity and receives the revenue from these transports. AMR has even gone to lengths of falsifying arrival times (hitting MDT “arrival” button minutes before actually arriving on scene) in an attempt to bolster their response data and cover up the problem.
A public relations battle has been playing out in Las Vegas, including investigative stories on the local news stations. The key messages from both Locals are that the private ambulance companies just can’t compete with the fire department in response times or in manpower. Cardiac survival rates are higher with fire-based EMS. And ultimately, the private ambulance companies are for-profit, and they are concerned first and foremost with their bottom-line financial success, which means controlling costs and being as lean as possible. Private ambulance companies are subject to shareholders.
As part of their public relations efforts, both Locals have increased their Community Outreach. Examples include pancake breakfasts, public safety demonstrations and CPR demonstrations.
Behavioral Wellness: Mental Aspects of Performance
Traditionally in the Fire Service, medical and physical fitness have been prioritized above emotional and behavioral wellness. But, in the aftermath of 9/11, Hurricane Katrina, and other disasters, these priorities are now changing. Research shows that fire fighters who balance physical, behavioral and emotional wellness have the best outcomes.
Phoenix Fire had experienced 4 suicides over a two year period. They implemented a Labor/Management program review and developed a three year strategic plan to address this problem. A case study was conducted at Phoenix Fire in an attempt to isolate possible reasons for the high suicide rate.
Among other things, the researcher found that job satisfaction was extremely high and that sworn employees were more satisfied than civilian employees. Phoenix Fire did identify a problem with the use of Oxycontin and Oxycodone among fire fighters, which can have a negative impact on those with suicidal tendencies. The study looked at how calls affect a fire fighter’s mental well-being and identified pediatric calls and calls after midnight as “stressor calls.” As a result, one change that Phoenix Fire has implemented is that any pediatric calls dispatched will notify BCs that they need to follow up, and soon, with participants involved in the call. Phoenix Fire has developed a web-based outreach program at afterdeployment.org.
Staying Competitive in Ambulance Transport
Private ambulance companies, especially in tough economic times, are promoting more than ever their services to government entities and competing with Fire-Based EMS. Fire departments fall into 4 categories regarding EMS: doesn’t tolerate EMS; tolerates EMS; accepts EMS; embraces EMS. According to the presenter, a Memphis FD Deputy Chief who is on the IAFF EMS Standing Committee, if your department falls into one of the first three categories, you’re at risk of a take-over by privatized EMS. At KFD we embrace EMS, and we need to continue to do so. It’s the best service to the citizens of Kennewick and helps fund fire department positions.
AMR has made bids to take over EMS at major cities across the U.S., including Dallas, Los Angeles and Cincinnati. Private ambulance companies, like AMR, focus on the transports, because that’s where they make their money. They count on fire department personnel showing up on scene in a timely manner to begin patient care, so a fast response time from the privates isn’t as critical, so they build their business model around that. They claim to have fast response times, when in reality they don’t a majority of the time.
The population is aging at an alarming rate, so ambulance service will be a huge industry moving forward. For the next 15 years, an average of 10,000 people per day will reach retirement age.
An occupational disease takes years to develop. It’s the result of a career of responding to fires and hazmat incidents, of breathing toxic smoke and fumes. A career of fire fighting takes a toll on fire fighter’s health and well-being. Screening fire fighters for early detection is key, as is early treatment and preventative care.
Heart disease and cancer are two primary causes of death within the fire service. The know hazards to fire fighters fall into the following categories; chemical, physical, biological and psyco-social.
Some early results in studies conducted relating to addressing fire fighter health issues pointed to an increased push for respiratory protection, even during overhaul; an increased emphasis on wellness; and a push for presumptive laws. The IAFF provides a presumptive law resource, detailing what’s covered under presumptive statutes in each state.
The International Agency for Research on Cancer (IARC) is a division of the World Health Organization (WHO). This organization meets every 10 years, and has identified carcinogens found in the fire fighting environment. Group 1 agents (know carcinogens) include arsenic, asbestos, benzene, benzo(a)pyrene, 1,3-butadiene, formaldehyde, dioxin, soot. Group 2 agents (probable carcinogens) include creosote, diesel engine exhaust, combustion products of wood. The principal focus of this group has been on cancer causing chemicals or DNA damaging chemicals in the workplace.
Dr. Travis Kubale of NIOSH presented that sometime next year results will be published updating the prevalence of cancer among U.S. fire fighters. Data has been collected over the past 4 years, and the control groups consists of all fire fighters, hired after 1950, at Chicago, San Francisco and Philadelphia fire departments. This exhaustive study will not only provide hard data to study, but will also help provide a framework for future studies.
According to Dr. Stefanos Kales, the Assistant Professor of Medicine at Harvard School of Medicine, between 1997-2006, 45% of Line of Duty Deaths were the result of Cardiovascular Disease. And, for every 1 fatality, 17 more were non-fatal. It is 50x more likely that a fire fighter will have a heart attack during fire suppression activity vs. non-fire suppression activity.
Another important factor playing into fire fighting and cardiovascular disease is proper hydration. Insufficient hydration can magnify underlying cardiovascular problems and can lead to a cardiac event.
Summary by Brother Dirham:
Physical demands of firefighting:
Fire fighting continues to be one of the most dangerous occupations in North America. Research reveals the need for high levels of physical fitness to safely perform this arduous work with intense physical demands. However, research demonstrates that fire fighting requires greater levels of physical stress than previously expected and may be in excess of current fitness goals. This workshop will reveal the scientific data collected while monitoring fire fighters on the fire ground and discuss strategies for preparing for these acute physiological responses and heat stressors during arduous work as well as needs for emergency scene rehabilitation.
This was the first class I took this as my first class Tues. The scope of the course is to look at Cardiac related events thought to be caused from heat stress and sleep deprivation in FF. Indianapolis fire Dept ran a test for 6 months on the above mentioned topic. In this 6 months 56 FF’s were on 24 hr heart monitoring at work. IFD works the same modified Detroit shift set that we do at Kennewick Fire . The findings of the study can be seen at the link at the end of this post. In short they focused on four different shift types. One on two off, one on three off, one on two off one on four off, and the modified Detroit. Of the four the modified Detroit showed to be by far the worst of the four when it comes to sleep recovery and cardiac output in regards to sleep deprivation. The study also looked at heat stress on the fire ground and cardiac output related to heat and lack of rehab This was an extremely interesting class with lots of good information. Please feel free to contact me to discuss more on the topic or watch the web cast link at the bottom of this page.
Firefighter Environment: Today’s fires are hotter and more dangerous than ever due to the plastics and building construction and the building materials that are fueling them. Learn about the detection and toxic nature of these products of combustion and how to protect yourself from them. The workshop will provide valuable information to interpret fire hazards for both the fire fighters and the medical community and provide the epidemiological effects of fire fighter exposures.
This class was also very informative and had a lot to offer about the toxic particles we absorb and inhale during IDLH activity. The main focus was on overhaul. They did a great study with Tucson, phoenix, and Scottsdale fire departments. The study showed the difference in lung damage when using SCBA, mask canisters, or no mask at all during overhaul. As you would guess the difference is huge when using SCBA compared to not. The interesting part was that cartage style canisters like we use here at KFD were almost no help at all. In short we should be wearing SCBA anytime in the IDLH, even when the for gas says it is safe. The study talks extensively about how bad the air still is even when the four gas says it’s clear. Once again I would be happy to discuss any or all of this in more detail.
HS-6-A: Economics of Fire Fighter Wellness
The current economic crisis increases the chance that administrators will look to cut wellness-fitness programs. Administrators are calling for more rigorous use of economic evaluations to guide resource allocation and spending. A number of studies have shown that a well-designed and implemented program provides a favorable Return on Investment (ROI). This program will highlight the cost justification of the WFI and discuss the seven-year Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME) study health findings and new data on the 10-year study on 600 fire fighters. This workshop will also discuss the necessary cost-effective approach to wellness in today's difficult financial climate.
This was a class that should help our department a lot when it comes time for a funding source. The instructors gave a lot of good data on why the WFI is not only good for FF health, but good for the city financially. The most eye popping figure was that data collected over ten years shows the city will get three to six dollars back in time loss recovery for every dollar it spends towards FF wellness.