Chapter 23

1. Chapter 23 Firefighter Survival

2. Introduction • Survival dependent on: • Prevention through readiness • Training on firefighter emergency procedures • Factors that help prevent emergencies: • PPE; task accountability; fitness for duty • At an incident: deliberate actions (or inaction); attention to hazards • Attention to team continuity, orders, communication, rapid intervention planning, rehabilitation • Must have a planned systematic process for self-rescue or rapid intervention in emergencies

3. Incident Readiness • Incident readiness is a mental process that answers a few questions: • Am I in a position to respond? • Is my personal protective equipment available? • What is my relationship to the response? • Physically can I respond? • Mentally, can I check out my current thoughts and focus on response? • Ensure the “system” is assembled and ready for response

4. Personal Protective Equipment • PPE is the first thing to put on for protection • Last thing to use for protection • In many departments, firefighters check all ensembles at beginning of every shift • Time spent donning gear before arriving at incident is well spent • If seatbelts cannot be worn, better to don PPE at incident • Following an incident, gear may need to be decontaminated

5. Preparing PPE for Readiness • All clothing materials are dry. • All PPE is present and positioned so that it may be donned rapidly. • Essential pocket tools are available and in working order. • Alternative PPE items are appropriately packed and ready for use. • Additionally, firefighters should check protective equipment assigned to their riding position

6. Personal Accountability • Three types of accountability: • Passport • Tag • Company officer • No freelancing • Relationship to response: assignments and personal size-ups • Perform as trained • Know your strengths and weaknesses

7. Figure 23-2 Accountability systems take on many forms—firefighters must know how to check in.

8. Figure 23-3 Firefighters achieve mastery of tasks through repeated training. Mastery reduces the chance of injury.

9. Fitness for Duty • Mental fitness • “Check out” of the environment, “check in” to size-up • Physical fitness and wellness • Cardiovascular conditioning • Core strengthening • Flexibility improvement • Resistance training • Nutritional balance • Hydration maintenance

10. Energy and Rest • Safety directly affected by energy potential and rest a firefighter has stored • Be attentive to energy and rest levels • Communicate rehabilitation needs to an officer

11. Safety at Incidents • Roughly half of all duty-related injuries and deaths happen at incident scene • Individual injured failed to “see” events that lead to injury • Injuries and death occur when firefighters allow urgency to override judgment • Firefighters can prevent injury and death through mental and physical actions • Team continuity • Team must exercise guarded judgment when completing a task

12. Figure 23-6 Team continuity reduces the chance for injuries.

13. Team Procedures for Incidents • Utilize an incident command system (ICS) • Work together and remain intact • Look after each other • Prevent freelancing

14. Figure 23-5 Freelancing is eliminated and incident success is gained when specific tasks are assigned to teams of two or more firefighters operating from a single incident action plan.

15. Orders/Communication • Incident commander responsible for assembling incident action plan (IAP) • Implemented by teams performing tasks • Tasks assigned to organized teams in the form of orders • Team responsible for carrying out the order • Providing updates on a regular basis • Relay information about hazards • First arriving teams perform prescribed tasks • They must know tasks, tools required, and safety considerations

16. Figure 23-8 Practicing good reporting habits enhances communications.

17. Risk/Benefit • Risk/benefit: an evaluation of the potential benefit of a task in relationship to hazards • Basic guidelines: • Take significant risk to save a known life • Take calculated risk, and provide additional safety, to save valuable property or reduce potential for injuries • Take no risk to save what is already lost • Retreat to defensive position when conditions are deteriorating quickly

18. Figure 23-9 Solid risk/benefit analysis means taking no risk for that which is already lost. (Courtesy of Richard W. Davis)

19. Personal Size-Up • Size-up: continuous situational awareness and mental evaluation process • Stay aware of: • Established work areas • Hazardous energy • Smoke conditions • Escape routes • Air management

20. Rehabilitation • Stress and overexertion are leading causes of injury and death • Key concern is controlling heat stress • Rest achieved during crew rotation • Sit down; allow medical personnel to do vital sign check; mentally disengage from the event • Active cooling reduces core body temperature • Water vital to peak operation of body systems • Best nutrition: 30/30/40 balance

21. Figure 23-11 Rehabilitation should start well before a firefighter is thirsty or tired. Failure to rehabilitate “early and often” opens the door to injury.

22. Rapid Intervention Teams • Rapid intervention team (RIT) rescues firefighters in an emergency • Goal is to avoid need for rapid intervention • Two-in/two-out rule provides for immediate intervention if needed • RIT should have no other assignment • Consists of well-trained, experienced firefighters • Other firefighters should not abandon previous assignments until reassigned

23. Table 23-1 RIT Responsibilities Checklist

24. Firefighter Emergencies • When emergency presented, firefighter must rely on instincts and training • Study procedures for rapid escape • For declaring a Mayday for lost and trapped situations • Survival includes processes for rescue of trapped and lost firefighters • Also long-term mental survival

25. Declaring a Mayday • Specific procedures for declaring any mayday developed at local fire department level • Declaring a mayday: • Transmit over radio “Mayday” three times followed by ICS assignment • Wait for an acknowledgement • Once acknowledgement made, report nature of mayday, current location or last known location • Manually activate PASS device

26. Rapid Escape • Evacuation signals: repeated air horn blasts; special radio tone followed by evacuation order • Rapid escape steps: • Preplan the escape • Immediately report need for rapid evacuation • Acknowledge rapid evacuation or escape signals • Rapidly escape • Report successful escape

27. Figure 23-12 Rapid fire spread and partial collapse are likely to trigger the need for rapid escape.

28. Figure 23-13 A PAR is a personnel accountability report organized to check the status of all crews working an incident. PARs should take place every half-hour or after an evacuation or any firefighter emergency.

29. Lost, Trapped, and Injured Firefighters • When firefighting, crews may be placed in environments they have never been in before • Potential to be trapped or lost during assignment • Low-air situations: • Good SCBA air management provides margin of safety • Enter, work, and egress before warning device activates • Low-air warning while in IDLH environment warrants immediate communication

30. Lost, Trapped, and Injured Firefighters (cont’d.) • Entrapment: • First step is to get assistance • Activate PASS device and declare “Mayday” • Follow up with other noise-making activities • Be careful not to use up excess energy • Size up and develop a plan • Attempt self-extrication • Planned and systematic

31. Lost, Trapped, and Injured Firefighters (cont’d.) • Lost/disoriented firefighters: • Firefighter or team must report that they are lost • Mayday should be transmitted over the radio • Manually activate PASS devices • Take deep breaths and calm down • Take inventory of surroundings • Establish direction, door and window locations, potential paths • Maintain radio contact with RIT members

32. Lost, Trapped, and Injured Firefighters (cont’d.) • Injured firefighters: • Firefighters must trust RITs • RIT activated when firefighter found to be trapped or injured • If team in proximity aides firefighter, communicate this • Firefighters not on the RIT or in the vicinity should resist the urge to rush in and help

33. Figure 23-14 A serious firefighter injury or fatality will cause significant incident stress. Focus and use of RITs will minimize unnecessary risk during firefighter rescue and help maintain incident control.

34. Post-Incident Survival • Post-incident thought patterns: firefighter’s mind relaxes as adrenaline fades • Responsible for many injuries and deaths • Critical incident stress (CIS): incidents that lead to long-term mental and health issues

35. Post-Incident Survival (cont’d.) • Post-incident thought patterns • Inattentiveness as soon as order given to “pick up” • Take a time-out and have everyone gather for incident summary and safety reminder • Fatigue and mental drain unavoidable chemical imbalance • Important to stay alert and pick up signs of potential injury • Take steps to “survive” without injury

36. Post-Incident Survival (cont’d.) • Critical incident stress • Firefighters expected to tolerate incident stress • Some events trigger significant emotional response • May not always be external • Many firefighters harbor the reaction internally • CIS exhibited in many ways • “Survive” CIS by critical incident stress management (CISM) • Critical incident stress debriefing (CISD) • “Defusing” in a peer environment

37. Figure 23-16 Signs of critical incident stress are natural following “trigger” incidents.

38. (B) (A) Figure 23-17 Critical incident stress management sessions can be (A) informal such as a “defusing” or (B) formal such as a process that includes peer support and mental health professionals.

39. Lessons Learned • Firefighter survival dependent on: • Incident readiness and safe operations • Appropriate preparation and response to emergencies • Safe operations dependent on team continuity • Emergencies require firefighter to practice clear and concise approach • Survive long term through understanding of post-incident thought patterns and stress