From Burn Survivor to Prevention Advocate: Together We Can Prevent Burns

by José Njuki-Imwe Ngunjiri, Fire Safety Officer

Burn prevention is not the responsibility of one profession or organization. It requires the combined efforts of survivors, firefighters, medical professionals, schools, government agencies and communities.

Prevention Is Better Than Treatment

Burn care professionals see the extraordinary work required to help someone recover after a serious injury. Treatment may involve prolonged hospitalization, painful procedures, surgery, rehabilitation and lasting physical and emotional scars.

Burn injuries can also result in missed school, lost income and significant financial strain for individuals and families. Their effects can continue long after the physical wounds have healed.

Prevention offers another path.

When people understand common fire and burn hazards, they can make their homes and kitchens safer. When children learn how to respond during a fire, schools become better prepared. When communities organize around fire safety, lives can be protected before an emergency occurs.

Treating burn injuries is essential, but preventing burns whenever possible must be a shared priority.

Together We Prevent Burns

No single organization can create a burn-free world alone. Different contributions are needed from across the community:

• Burn survivors bring essential lived experience and a powerful voice for change.

• Plastic surgeons and other medical professionals treat injuries, restore lives and provide hope.

• Firefighters respond to emergencies while also helping communities understand and reduce risks.

• Schools equip children with knowledge that can protect them and their families.

• Youth champions can influence behaviors and become leaders in their communities.

• Community groups identify local risks and help ensure that prevention efforts reflect local realities.

• Government agencies establish policies, provide leadership and invest in prevention.

• The media expands the reach of lifesaving safety messages.

• NGOs connect partners, support communities and help turn ideas into sustained action.

• Regulatory agencies promote the safe use of LPG and other household energy sources.

Each partner brings a different form of knowledge, influence or experience. Together, we can build safer homes, stronger communities and a culture in which fire and burn prevention becomes everyone’s responsibility.

Turning Prevention into Community Action

There are many practical ways that collaboration can become action.

Gas cylinder safety education can help families learn to check for leaks, use cylinders in well-ventilated spaces, keep them upright and store them away from heat. Home safety visits can identify electrical hazards, unsafe cooking practices, improperly stored flammable materials and homes without a clear escape plan.

School fire prevention programs can teach children how to recognize hazards, respond to an alarm and evacuate safely. Youth training can equip young people with practical skills while preparing them to become fire safety leaders.

Community resilience groups can organize residents, identify neighborhood risks and strengthen local emergency preparedness. Public awareness campaigns can then carry these lessons to a much wider audience.

These approaches reflect Africa Fire Mission’s broader model: equip local people with knowledge and skills, support them as they teach others and build lasting prevention capacity within the community.

Survivor Voices Must Be Part of the Solution

Survivors understand the consequences of fire in ways that statistics alone cannot communicate. Their experiences can identify gaps in existing prevention efforts, shape more relevant solutions and inspire others to take safety seriously.

Supporting survivors means helping them heal and rebuild their lives. It also means recognizing them as leaders, educators and advocates whose voices can help prevent future injuries.

What Can We Do Together?

A challenge to everyone involved in burn care and fire safety:

Strengthen prevention education. Support burn survivors. Promote safer homes and kitchens. Improve gas safety awareness. Build partnerships. Listen to survivor voices.

Every organization and every community has a role.

Learn More:

To learn more about Africa Fire Mission’s fire prevention programs and opportunities to partner with us, visit www.AfricaFireMission.org.

To learn more about José’s personal story, watch this video.

Africa Fire Mission’s José Njuki-Imwe Ngunjiri brought a deeply personal message to the annual conference of the Kenya Society of Plastic, Reconstructive and Aesthetic Surgeons in Mombasa, Kenya in August 2026. This article is a summary of the presentation.

About the Author

José Njuki-Imwe Ngunjiri serves as a fire safety officer and prevention advocate, but his commitment to this work began with his own experience as a burn survivor. During his presentation, “From Burn Survivor to Prevention Advocate,” he shared how that experience shaped his life and inspired him to turn pain into purpose, scars into action and personal experience into prevention.

Image note: Images in this article were created with the assistance of artificial intelligence to illustrate fire and burn-prevention concepts. They are illustrative and do not depict actual people, incidents or locations.

Fueling the Frontline: Why Nutrition Is a Strategic Priority for Africa’s Firefighters

Firefighting is among the most physically and mentally demanding professions. Across Africa, firefighters routinely operate in extreme heat, resource constrained settings, and prolonged emergency conditions. In this context, nutrition should not be viewed as a personal lifestyle choice, but as a strategic component of operational readiness, safety, and workforce resilience.

Nutrition as a Performance Enabler

Firefighters depend on sustained strength, endurance, and mental clarity to perform critical tasks, including equipment handling, rescue operations, and rapid decision‑making under pressure. Diets that provide adequate energy, protein, and micronutrients are essential to maintaining physical capacity and reducing fatigue during long or repeated deployments.

Poor nutrition, by contrast, contributes to reduced stamina, slower reaction times, and impaired judgment factors that directly increase operational risk. Ensuring access to balanced meals is therefore a matter of performance management, not convenience.

Cognitive Readiness and Decision‑Making.

Emergency response environments demand precision, focus, and sound judgment. Nutritional deficiencies are known to affect concentration, mood stability, and stress tolerance. For firefighters working in high‑risk scenarios, even minor lapses in attention can have dire consequences.

Consistent access to nutrient‑dense foods supports cognitive function, helping firefighters remain alert, decisive, and emotionally regulated throughout extended operations.

Health Protection in High‑Exposure Environments

Firefighters are routinely exposed to smoke, toxins, extreme heat, and infectious agents. Nutrition plays a critical role in supporting immune function, reducing susceptibility to illness, and accelerating recovery after exposure.

Hydration and electrolyte balance are particularly vital in hot climates, where dehydration and heat stress pose ongoing threats to health and performance. Integrating hydration strategies into daily routines is a practical and cost‑effective risk‑reduction measure.

Long‑Term Workforce Sustainability

Beyond immediate operational demands, nutrition contributes to long‑term health outcomes. Balanced diets help manage body weight, support bone strength, and reduce the risk of chronic conditions such as hypertension and diabetes ailments that disproportionately affect emergency responders over time.

By prioritizing nutrition, fire services can reduce injury rates, improve career longevity, and limit the long‑term health costs associated with the profession.

Team Cohesion and Operational Safety

Well-nourished teams are safer and more effective. Fatigue‑related errors decline, coordination improves, and morale is strengthened. In many fire stations, shared meals also serve as a mechanism for reinforcing teamwork, communication, and mutual accountability critical elements during high‑pressure emergency responses.

Conclusion

Nutrition is one of the most underutilized yet impactful tools available to fire services. For African firefighters operating under demanding conditions, investing in balanced meals, hydration, and nutritional education is not a luxury, it is an operational necessity.

Fueling the frontline begins with recognizing that firefighter performance, safety, and resilience are inseparable from what fuels the body.

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James Nyadwe is a Water Survival/Safety Expert and Trainer, Open Water Scuba Diver, and a Fire Advocate. James is passionate about sharing knowledge on safety issues on land and water that impact first responders. Additionally, James has served as an instructor for AFM’s virtual firefighter training.

Safe Schools Save Lives: Africa Fire Mission Calls for Stronger School Fire Safety and Preparedness Across Kenya

FOR IMMEDIATE RELEASE

Monday, June 8, 2026

Nairobi, Kenya – June 2026

Africa Fire Mission (AFM) is calling on schools, communities, government leaders, and fire brigades across Kenya to strengthen fire safety education and emergency preparedness following recent school fire incidents that have resulted in the loss of young lives and impacted communities across the country.

Recent tragedies serve as a reminder that fire prevention, preparedness, and effective emergency response must remain priorities for every educational institution. While firefighters play a critical role in responding to emergencies, the greatest opportunity to save lives comes before a fire ever starts.

“Every child deserves to learn in a safe environment,” said Nancy Moore, Co-Founder and Executive Director of Africa Fire Mission. “Schools, fire brigades, government agencies, parents, and community leaders each contribute to creating safer environments for children. By combining strong building safety practices, fire prevention education, and regular preparedness exercises, we can reduce risk and help prevent future tragedies.”

For more than a decade, Africa Fire Mission has partnered with firefighters, educators, community organizations, and emergency responders throughout Kenya to promote fire prevention education and improve community safety. Through school outreach initiatives, firefighter training programs, and community fire safety education, AFM has helped thousands of students, teachers, and community members gain practical skills to prevent fires and respond safely during emergencies.

The Role of Fire Brigades in School Preparedness

Local fire brigades offer valuable expertise that extends far beyond emergency response. Firefighters can assist schools by:

• Conducting fire safety inspections and identifying hazards

• Reviewing evacuation plans and emergency procedures

• Participating in fire drills and evacuation exercises

• Training teachers, staff, and student leaders

• Providing fire prevention education and demonstrations

• Recommending improvements to building safety and emergency access

Strong partnerships between schools and local fire brigades help create a culture of preparedness and ensure that schools are better equipped to respond effectively during emergencies.

Safe Buildings Save Lives

Fire safety begins long before an emergency occurs. AFM encourages school administrators, education officials, and facility managers to regularly evaluate school buildings to ensure critical life safety features are functioning properly and accessible when needed.

Key considerations include:

• Dormitory and classroom doors that can be easily opened during an emergency and swing outward in the direction of evacuation

• Emergency exits that remain unlocked and unobstructed whenever buildings are occupied

• Windows that can be opened or used as emergency escape points where appropriate

• Clearly marked exit routes and assembly areas

• Functional fire extinguishers and fire detection systems

• Safe electrical installations and routine inspections to identify potential hazards

• Adequate supervision and emergency procedures for boarding facilities, especially during nighttime hours

Many school fire tragedies around the world have demonstrated that blocked exits, locked doors, overcrowding, and delayed evacuation can significantly increase the risk of injury and loss of life. Creating safe buildings and regularly practicing evacuation procedures helps ensure that students and staff can respond quickly and safely when emergencies occur.

Fire Prevention Education Matters

“When a fire occurs in a school, seconds matter,” said Jose Ngunjiri, Fire Safety Officer for Africa Fire Mission. “Every student should know at least two ways out of a building, every teacher should know the evacuation plan, and every school should regularly practice emergency drills. Firefighters can respond quickly, but preparation before an emergency is what saves the most lives.”

Ngunjiri added, “Simple measures such as regular fire drills, clear evacuation routes, accessible emergency exits, and strong partnerships with local fire brigades can make a significant difference when an emergency occurs.”

AFM encourages schools throughout Kenya to establish or strengthen fire safety programs that include regular fire drills, staff training, student education, emergency planning, and ongoing collaboration with local emergency responders.

As Kenya continues to grow and develop, investments in fire prevention education and preparedness represent one of the most effective ways to protect students, educators, and communities. Through collaboration between schools, fire brigades, government agencies, and community organizations, meaningful progress can be made toward preventing future tragedies.

About Africa Fire Mission

Africa Fire Mission is committed to building and increasing the sustainable capacity of the fire services across Africa through training, empowerment, support, and encouragement. Since 2012, AFM has partnered with firefighters, emergency responders, educators, and community organizations to strengthen fire prevention, preparedness, and emergency response capacity across Africa.

Through its Fire Safety Officer program, school fire prevention initiatives, firefighter training programs, and community outreach activities, Africa Fire Mission works alongside local partners to create safer communities and reduce the impact of fire-related emergencies.

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Media Contact: Africa Fire Mission

José Njuki-Imwe Ngunjiri

Fire Safety Officer

Jose@africafiremission.org

+1 513 620 4236

Nancy L. Moore

Co-Founder and Executive Director

Africa Fire Mission

nancy@africafiremission.org

www.africafiremission.org

Building a Mental Health System of Care: Supporting the Resilience and Sustainability of Fire Brigades and Emergency Services

Written by Nancy L. Moore, MSW, LISW-S, CPCC

Executive Summary

First responders routinely respond to situations involving trauma, loss, and extreme stress. These experiences accumulate over time and can have profound impacts on physical health, emotional wellbeing, decision-making, and the long-term sustainability of fire brigades. Despite the critical role first responders play in protecting communities, first responder mental health is often overlooked, particularly in low- and middle-income countries.

Across Africa, many fire brigades operate with limited resources and minimal access to formal mental health support systems. First responders frequently experience repeated exposure to traumatic incidents such as fatal fires, road traffic accidents, disasters, and community violence. Without appropriate support structures, these experiences can lead to burnout, substance misuse, depression, family strain, and early departure from the profession.

This white paper outlines the importance of implementing a First Responder System of Care, a structured approach that supports first responder wellbeing before, during, and after traumatic incidents. The system includes prevention strategies, Stress First Aid (also referred to as Psychological First Aid), peer support programs, Critical Incident Stress Management (CISM), access to professional mental health services, and departmental policies that promote resilience.

By implementing a systematic approach to first responder mental health, fire brigades can protect their most valuable resource—their people—while strengthening operational readiness and long-term sustainability.

Introductory Ladder Skills and Knowledge for Firefighters

by retired Deputy Chief Howard Cohen

Ground ladders are one of the most basic and essential tools we use in the fire service. This is why it is important to master ladder skills early in your fire training and to continue practicing them throughout. Ladders are essential for many firefighting situations, including rescues, access to elevated areas, ventilation of structures, and establishing secondary means of egress. They are also often used in non-emergency situations. This is why every firefighter needs to develop a strong foundation in ladder knowledge, safety, and basic operations early in their training.

There are numerous ladder types. There are straight, extension, roof, and folding ladders (see Appendix 2 below for a detailed look at different types). There are ladders made out of aluminum, fiberglass, and wood. It is important that you are very familiar with the ladders your department uses. All ladders have some or all of the following components: beams, rungs, halyard, dogs, or pawls. For definitions of these terms, see Appendix 1. These parts might have different names in your fire district. In addition, it is important to know your ladder lengths. When you need to rescue someone from a second floor or higher, time is critical; you don’t want to pull a ladder that's too short.

It is not enough to know how to use a ladder; you need to know how to use it safely. Ladders are cumbersome, heavy objects to lift, carry, and raise into position. Therefore, to reduce the risk of injury when deploying a ladder, you need to know proper lifting techniques. Make sure you are familiar with basic shoulder carries, suitcase carries, and flat carries. Just as important, you need to be proficient at different types of ladder raises, such as the beam raise, flat raise, and basic extension ladder raise. Follow your department’s SOPs for the preferred ladder carrying and raising methods.

Effective ladder placement will keep you safe while allowing you access to difficult areas.

Another important ladder skill is placement: knowing how and where to place a ladder. Your department should establish SOPs for ladder placement based on the task at hand. For example, ladder placement for rescue purposes might differ from that for accessing the interior of a building. Other concerns with ladder placement include ground conditions, overhead obstructions, electrical hazards, and building stability. Make sure the ground is level and firm enough to support a loaded ladder. A general rule for the proper climbing angle for extension ladders is about 75 degrees. Alternatively, you can use the 4-to-1 rule. Leaning ladders should be placed 1 unit out for every 4 units up. However, ladder positioning may differ for other tasks, such as patient rescue, firefighter quick escape, ventilation, or roof access.

Finally, everyone needs to know how to clean ladders after use, inspect them, and report any damage. Review your department’s SOPs on ladder maintenance. Ladder skills and knowledge are vital to firefighter safety and operational effectiveness. A strong foundation in ladder types, safety, carries, raises, placement, and maintenance prepares you to perform essential tasks confidently and efficiently on the fireground.

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Appendix 1: Ladder Parts

1: Beams (Rails)

The long side pieces that run the length of the ladder. They support the load and give the ladder its overall strength. On some ladders, the beams taper toward the tip to reduce weight.

2: Rungs (Steps)
The horizontal steps firefighters climb. They’re spaced evenly and designed with slip-resistant surfaces for boots and wet conditions.

3: Tip (Top)
The very top end of the ladder. It’s shaped to rest against a building or window sill and often includes ladder shoes or caps for grip.

4: Butt (Base)
The bottom end of the ladder that rests on the ground. Proper footing here is critical for ladder stability.

5: Butt Spurs / Ladder Shoes
Metal spikes or rubber pads at the butt that prevent the ladder from slipping. Spurs are used on soft ground; shoes are used on hard surfaces.

6: Halyard (Extension ladders only)
The rope used to raise and lower the fly section of an extension ladder.

7: Fly Section (Extension ladders only)
The movable upper section that extends to reach higher elevations.

8: Locks / Dogs / Pawls (Extension ladders only)
Mechanical hooks that engage the rungs to hold the fly section in place once raised. 

9: Guides / Slides
Tracks that allow the fly section to move smoothly along the bed section.

Appendix 2: Types of Ladders

1: Straight Ladder

Single section, fixed length; Used for quick access to windows, roofs, and rescues. Often placed for secondary egress.

2: Extension Ladder

Two or more sections that extend using halyards and pawls. Provides greater reach than straight ladders. Common for upper floors, roofs, and ventilation.

3: Roof Ladder

Straight ladder with folding hooks at the top. Hooks secure over the roof peak. Designed for working on pitched roofs during ventilation.

4: Attic (Folding) Ladder

Short, collapsible ladder. Used in tight spaces like attics, closets, or scuttle holes. Easy to store and deploy indoors.

5: Aerial Ladders

These are permanently mounted on ladder trucks or quints. The ladder that extends hydraulically or mechanically. Provides high-angle access, rescue, and ventilation. Can support firefighters and victims.

6: Aerial Platform (Tower Ladder)

Features a bucket or platform at the tip. Allows safer rescue, master stream operations, and elevated work. Excellent for commercial or high-rise incidents.

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Want to learn more about safe and effective ladder usage? Check out a Weekly Virtual Training by instructor and volunteer fire safety advocate Richard Gichina.

The Need for Quality Peer-Based Mental Health and Spiritual Wellness Program for First Responders

by Retired Deputy Chief Howard Cohen

Firefighters, emergency medical technicians (EMTs) and other first responders routinely confront some of the most devastating scenes imaginable. Overtime, the accumulative impact of providing care and support to victims of these traumatic events takes a huge toll on the first responders emotional, psychological and spiritual well being. Repeated exposure to gruesome accident scenes and wrecked lives has been documented through numerous studies throughout the world to contribute to the deterioration of first responders mental health, as well as inflicting a moral injury on them. Moreover, trauma induced stress not only harms first responders, but it also negatively impacts job performance, undermines team cohesiveness and damages family relationships.  

While it is impossible for first responders to avoid encountering horrendous accident scenes, there are proven peer-based intervention strategies that improves resilience and helps restore mental well being.

Critical Incident Stress Management (CISM) is a comprehensive, integrated, systematic and multicomponent strategy widely used in many places throughout the world. It was developed by Dr. Jeffrey T. Mitchell in the early 1980s, and promotes pre-event stress and crisis management education, planning and policy development, as well as training for the management of traumatic stress.

Stress First Aid (sometimes referred to as Psychological First Aid) is another important peer-based intervention program. Unlike CISM, Stress First Aid requires very little training. Stress First Aid is built upon three primary objectives:  (1) recreate a sense of safety, (2) establish meaningful social connections, (3) reestablish a sense of efficacy. Whereas CISM is orientated toward first responders, Stress First Aid is effective with civilians as well.  Stress First Aid immediately address physical needs, e.g. food, water, sleep, bathroom breaks and determines if additional help, formal or informal, is necessary. CISM typically occurs one or two days later and assumes these basic physical needs have been addressed.  Both programs address symptoms of stress and include education on how to mitigate unhealthy behaviors. The biggest difference is that CISM is a comprehensive program that includes Stress First Aid as a component. Another difference is that it takes several days to become trained in CISM, whereas Stress First Aid, as a stand alone peer-based intervention, requires little training.

CISM and Stress First Aid are both peer-based programs. This means that the program is presented peer to peer. This is important because first responders tend to be reluctant to open up to outsiders, or those who are not or were not first responders. Although there are many different reasons for this, what is important is that the best way to provide critical early intervention to intercept post traumatic problems from developing later is through a peer to peer program.

Peer to Peer Based Mental Health Programs for First Responders

Peer to peer communication is key to many support systems.

It is often said that those who provide care for others cannot do their job if they do not take care of themselves. While the availability of supporting data varies from country to country, the reality is that first responders everywhere are more likely to suffer from psychological distress due to job stress, repeated exposure to trauma, lack of sleep, the physical demands of the job, lack of resources and working long hours or multiple jobs. Increasingly world wide, we are beginning to see the consequences of the stressors of the job. Unfortunately, first responders are often reluctant to seek out professional therapy primarily because of cultural stigmas, both within the first responder world and/or the wider society, because of mistaken belief that dangerously equates seeking help with weakness. First responders are often more open to participating in peer to peer to programs.  Moreover, numerous studies throughout the world found that peer to peer program are the most effective way to mitigate long term negative consequences of secondary trauma.  

The physical, emotional, mental and spiritual health of first responders is critical to their being able to safely and efficiently perform their duties to protect citizens and property. Therefore, it is important for first responders to have access to peer to peer-based programs with properly trained peer leaders.

Training

Fortunately, training first responders to serve as peers for others is neither complicated nor expensive. The first step to provide Stress First Aid training for every first responder. These trainings typically take several hours and can be done in person or online. The First Responder Center for Excellence Offers several relevant training: https://firstrespondercenter.org/

Once concepts of Stress First Aid have been put into place for first responders, the next step is training peers in Crisis Incident Stress Management. This involves several days of training by a trained trainer. You can reach out to Africa Fire Mission if you are interested in receiving this training.

Conclusion

Eddy Kimani, a celebrated Kenyan media personality who battled bouts of mental illness, said Kenyan men were more prone to bouts of depression that lead to suicide due to stereotypes about what it means to be a man. As Kimani so aptly describes it, “Men are generally taking their lives in Kenya because of the warped understanding of what it is to be a man. An African man guards up his feelings because he fears the repercussions in a society that has taught men that they do not cry, that they are not supposed to show their emotions or be vulnerable.” You can read more about Kimani’s perspective here >

Kimani’s description is often also true of first responders who are often required to stuff their emotions while responding to traumatic events and then afterwards because of social pressure.

The good news is that introducing easy to learn and inexpensive peer-based interventions can save lives and improve the mental health and spiritual wellness of first responders, leading to them better serving their communities and caring for their families.

What Every Firefighter Should Know About the 2025 AHA CPR & ECC Updates

by Africa Fire Mission Training Team, Utilizing AI Technology

Firefighters are often the first to respond to life-threatening emergencies, whether it’s a cardiac arrest, choking incident, trauma, or another sudden crisis. In 2025, the American Heart Association (AHA) released its latest comprehensive update to the Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Guidelines, and these changes matter for every member of the African firefighter community.

In a recent Weekly Virtual Firefighter Training, AFM instructor and EMS expert Eric Saunders focused on translating these guideline updates into practical, lifesaving actions that you can apply in the field. Watch the training for strategies you can apply, wherever you’re training or responding.

Watch this Weekly Virtual Firefighter Training for updates on CPR/BLS Guidelines

What’s New in the 2025 AHA Guidelines

Every five years, the AHA reviews the latest science to update its guidance for CPR and emergency use. One update unifies the chain of survival for adults and children into one streamlined model. Another clearly recommends 5 back blows followed by 5 abdominal thrusts if a conscious adult or child is choking, while rescuers should alternate between 5 back blows and 5 heel of hand chest thrusts for infants. Read more about the updates here.

 Why These Updates Matter for Firefighters

Whether you are stationed at an urban firehouse or volunteering in a rural brigade, cardiac emergencies, choking incidents, and sudden collapses are not uncommon. Updated global science means:

·      Faster, more effective responses

·      Increased survival chances for victims

·      More confidence in training and real-world performance

Firefighters are not just fire suppressors, they are lifesavers in every sense. Staying up-to-date with global standards ensures that the care you provide is backed by the best available evidence.

Want to deepen your lifesaving skills and stay current with international resuscitation science? Use these opportunities from AFM to strengthen your skills:

·      Join our Weekly Virtual Trainings for African Firefighters

·      Subscribe to AFM’s YouTube Channel

·      Access our Resources and Training Materials

Stay safe, stay prepared, and keep training!

Shallow Water Blackouts: A Hidden Risk for Firefighters

by James Nyadwe

Shallow water blackouts (SWB) pose a challenging risk to firefighters and first responders in aquatic emergencies. A SWB is a sudden loss of consciousness underwater due to oxygen deprivation, often after hyperventilation or prolonged breath-holding. Hyperventilation lowers carbon dioxide, delaying the urge to breathe and increasing risk. Consider the following risk factors, warning signs, and prevention strategies to ensure a safe response to aquatic emergencies.

Risk Factors

SWBs occur during competitive swimming, underwater training drills, and rescue simulations. Firefighters are at risk during aquatic training, even in shallow pools or tanks. They can happen silently and quickly, with no struggle or warning. Drowning occurs within minutes if not rescued. SWB-related incidents can endanger rescuers who respond unprepared.

Warning Signs

The following warning signs can alert you to a potential SWB:

• Unusual breath-holding, like those in a competition

• Dizziness or confusion during underwater drills

• Sudden stillness underwater

Prevention Strategies

It is possible to prevent SWBs. You should never train or respond alone in water. Avoid hyperventilation before breath-holding, and enforce strict safety protocols during aquatic drills. Educate crews about SWBs and rehearse rescue responses.

Real-World Incident Example: Training Incident

Underwater training or exercise can be a valuable way to strengthen your body and skills, but it’s important to stay safe and be vigilant for SWBs.

During a firefighter training session, a strong swimmer participated in an underwater endurance drill. After hyperventilating to extend breath-hold time, the individual lost consciousness without warning and began to drown silently. The absence of immediate supervision delayed rescue, resulting in a critical incident. This case led the fire department to implement strict “no solo underwater training” rules and mandatory spotters, which significantly reduced future shallow water blackout incidents among trainees.

Examples like this illustrate the caution that should be used during aquatic rescue, even if it is simply a training drill. Utilize the prevention strategies, consider the risk factors, and be vigilant for warning signs to avoid shallow water blackouts.

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James Nyadwe is a Water Survival/Safety Expert and Trainer, Open Water Scuba Diver, and a Fire Advocate. James is passionate about sharing knowledge on safety issues on land and water that impact first responders. Additionally, James has served as an instructor for AFM’s virtual firefighter training.

Burn Care Resources

Resources from Kristina Stiles

Saving Lives is Not Enough Report - A casualty-centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.

The Family Oops and Burns First Aid Book - A children's book created to support children and their families learning about burns prevention and first aid principles together. The book describes an accident prone family who are not burns aware, who have to go to school to learn about burn safety and first aid within the home. This book is a recommended reading for all nursery school teachers.

20 Minutes of Cool Running Water - Information on how and why to treat burns with cool running water for 20 minutes.

Burn Scar - Burn scars often form when deep skin layers are damaged and healing takes over three weeks. Discover why scarring is common, what treatments can reduce it, and why complete removal isn't possible.

Gas Cylinder Care

Gas cylinder care is a vital topic in communities that rely on these devices for cooking or other purposes. AFM’s staff team in Kenya, including Fire Safety Officer José Ngunjiri and Fire Safety Advocate Errol Sianga, regularly perform gas cylinder safety lessons in local communities. Now, you can access an official, professional recording of this training on our YouTube page! Whether you are a community member that relies on gas cylinders or you are a fire prevention instructor looking to further your understanding on the topic, please access the video below and watch the full lesson to help prevent deadly fires or explosions from gas cylinders.

Watch this training on Gas Cylinder Care and subscribe to our YouTube channel for more updates and resources.

Gas Cylinder Care Tips

Before using a gas cylinder, there are two steps you should always keep in mind:

1. Check the quality of your regulator. It needs to as clean as possible.

2. Take time connecting the regulator. Check to see if it is leaking or if there is any visible damage.

If a gas cylinder catches fire and starts to get out of control, remember to never throw your gas cylinder under any circumstances. If there is a fire that is starting to get out of control, take a solid, empty bucket and place it on top of the cylinder to create a vacuum, cutting off the air to the fire. Count slowly to five, then carefully remove the bucket away from you and turn off the cylinder. You can also drape a wet blanket and wrap the fire and cylinder completely. Again, count to five, then open it away from you and turn off the cylinder.

Kindly share this post and the video training with your communities to spread awareness on gas cylinder care.

Firefighter Wellness

by Michael Anderson

Firefighter Wellness can be thought of as the firefighter encompassing their state of health including physical, mental, emotional and spiritual fitness. Firefighters should strive to improve their wellness and work to take steps in each of these areas to improve their lives and serve a very long career.

Fire service organizations have long been investing in the development of resources for fitness and items such as medical screenings. In recent years, more resources have been dedicated to behavioral health to highlight the needs of firefighters to address their mental and emotional fitness. This article will discuss a few of these topics and provide some small steps for individuals to work on their wellness.

Physical fitness:

Firefighting activities require a level of functional performance during response activities. Maintaining a level of fitness is necessary for firefighters and other emergency responders. The physical demands of firefighting along with the working environments require that members develop muscular strength and endurance. This functional fitness should include movements and activities that mimic situations that the firefighter will encounter in their duties.

Stretches, running, and other exercises are very important to a regular and beneficial fitness routine.

Maintaining a level of fitness through cardiovascular and strength training exercises has many benefits. Fitness activities will help firefighters develop muscular strength and endurance, allowing effective use of their equipment and more efficiency on incidents. Fitness helps with fatigue and recovery from strenuous work. The improved range of motion, strength, balance, and coordination also helps prevent injuries of firefighters. Additionally, fitness improves cardiovascular and respiratory system performance. Improvements in these areas both improve performance and overall health.

Medical Evaluations:

Routine medical evaluations are another component of firefighter wellness. Cardiovascular disease and occupational cancers continue to be leading causes of firefighter deaths in the United States. Several medical risk factors have been linked to line of duty death and injuries. The recently revised NFPA 1580 standards provide guidance on the areas to be evaluated during your medical exam.

The benefits of routine medical evaluations can be summed up in one word: detection. Early detection of medical conditions such as high blood pressure, high cholesterol, obesity, diabetes, and others will allow for treatment that can positively impact the risks of firefighters suffering a medical related emergency. Firefighters should take action when faced with increased risk factors from these medical conditions. Treatment for these conditions can reduce the impacts on a firefighter health event.

The increased risk of firefighters to cancer has been identified, recognized, and promoted throughout the fire service. Research has been able to link these increases risks to the exposures that firefighters face during their duties. Cancer screenings are encouraged to be included in your medical evaluation. Early detection and treatment have been shown to improve survival while allowing for reduced costs and less invasive procedures.

Behavioral Health:

The impact of the emotional stress that firefighters face is nothing new to those who serve. Many of us have seen our fellow firefighters experience emotional trauma with various impacts to their lives and careers. Suicides amongst first responders have been increasing at an alarming rate now that reporting mechanisms are in place. Research continues to show that ourselves and our colleagues are plagued by post-traumatic stress and the effects of self-coping activities that many choose to use to deal with these stresses.

A critical step in improving behavioral health is the understanding at the individual level and the organizational level that stress reactions to our job duties are normal. Developing a positive culture around the job stress and supporting members that need assistance can help ensure that mental and emotional fitness can be improved. As an organization, developing programs that look to support firefighters who are suffering from stress can be beneficial on the mental well-being of employees.  Programs should look to ensure that members have access to specialized services that understand PTSD, firefighter stressors, alcohol and substance treatment, along with the ability to assist members with other areas of their lives that can impact their mental wellness.

Simple steps towards general wellness:

• Maintain levels of functional fitness. Stay active, move often, and work to improve strength and endurance. Push yourself a few days a week and get your heart rate up towards your max heart rate.

• Find fun activities with your exercise routine. Adding enjoyable activities to your routine will help you stay motivated in your fitness journey and will help your emotional fitness along the way.

• Get an annual medical evaluation. Find a doctor or make an appointment with your physician. Tell them about the dangers firefighter face and ask them to include cancer screenings on a regular basis.

• If your examination finds something, take action! Early detection leads to early intervention and vastly improves your ability to reduce your risks of injury or death.

• Work hard to sleep well. Evaluate your sleep and find ways to sleep and rest better. Improved sleep can reduce stress and reduce risks.

• Understand your stress and attack your stressors. Evaluate the stressors in your life and find ways to reduce how much they impact you. Managing your stress will make you a happier and healthier firefighter.

• Find resources for your personal medical and mental health. Resources are available to help you overcome almost anything. Find some and use them when needed.

Physical wellness is key to improving your general wellness!

Taking small and simple steps can have big impacts on your personal and professional life. Begin the journey now and start becoming the best version of you.

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Michael Anderson started in the fire service in 1998 as a volunteer in his rural hometown. He has served at Pflugerville Fire Dept. since 2000, currently holding the rank of Deputy Assistant Chief in Administration. With a passion for firefighter health and safety, Michael spent 14 years involved with the NFFF Everyone Goes Home Advocate Program. He has worked with firefighters and organizations across the United States working to improve the health and safety of firefighters. Chief Anderson also serves as an At-Large Director for the IAFC Safety, Health, and Survival Section.

Chief Anderson completed his undergraduate studies in Applied Arts and Sciences from Texas A&M University-Commerce and earned a master’s degree in Public Affairs from the University of Texas- Rio Grande Valley. Michael holds Fire Officer IV, Instructor III, Incident Safety Officer and Health & Safety Officer Certifications. In 2019, he Graduated the NFA Managing Officer program and achieved designation as a Chief Fire Officer from the CPSE Commission for Professional Credentialing in 2023.

Situational Awareness

As firefighters, we face numerous visible and hidden threats both on our way to the fireground and after we arrive. It is important for us to develop our situational awareness skills to help us identify the hazards and minimize risks to ourselves and the public. Furthermore, maintaining situational awareness enhances decision-making under pressure and fosters more effective responses in various situations, such as fighting a fire, rescuing a victim, or driving to a fire scene.

The OODA Loop

The OODA Loop, created by Air Force fighter pilot and military strategist John Boyd, is an excellent decision-making framework that consists of four steps: Observe, Orient, Decide, and Act.

- Observe: This step focuses on what is commonly called situational awareness. It involves making and recording observations.

- Orient: Observations are placed in context to understand the overall situation.

- Decide: Take the results of the orientation and observation steps and formulate the optimal course of action.

- Act: Execute on your decision without delay

The OODA loop helps us remain calm and relaxed during stressful situations, reducing tension and stress and improving everyone's ability to perform their tasks. It is also very helpful for preventing tunnel vision, one of the most dangerous pitfalls on the foreground. Tunnel vision occurs when stress and nerves narrow our focus, causing us to concentrate only on what is immediately in front of us. This lack of peripheral awareness can be deadly.

It is important to develop the habit of instinctively using the OODA loop. Practice it around the firehouse and even at minor calls. As you develop your observation skills, learn to use more than your sight. Paying attention to sounds and smells can teach us crucial fire information.

A firefighter checks his surroundings while training with a firehose.

Communication

Another important situational tool is communication. It is critical that we maintain constant communication with our team on the fireground. We need to inform our commanders and officers of our planned actions. For instance, if a window needs to be broken for ventilation, we must communicate this so that team members below can be aware of any falling glass.

Situational awareness is critical for first responders.  We often must make quick decisions in high-pressure, high-stakes environments. By enhancing our situational awareness, we can make more informed decisions that help us stay alert and safe on the fireground.

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Howard A. Cohen was a volunteer firefighter for 20 years. He began his firefighting career as a chaplain and retired as the deputy chief. He is currently AFM’s online program content director. He frequently presents for the Wednesday Webinars and contributes to the AFM blog.

An Introduction to the Principles of Emergency First Aid for Firefighters

by Howard Cohen

Not all firefighters are emergency medical technicians or paramedics, but we often serve as the first responders at scenes requiring life-saving first aid. Therefore, it is vital for all firefighters to possess at least a basic understanding of first aid. This short article aims to outline foundational principles for addressing trauma in situations where immediate life-saving medical assistance is needed. This article should not be seen as comprehensive first aid training. Nevertheless, with the basic and limited information provided here, and without any formal training, you may still have the opportunity to save someone’s life.

Scene Survey: The First Task

Size up: Regardless of your level of technical first aid training or medical knowledge, your first task when responding to an incident involving injuries is to gather as much information as possible about the situation. This is achieved through a thorough size up. It is crucial to assess the risks and dangers before rushing in to provide aid. Ask yourself, “What is trying to kill or harm me?” Is it traffic, wildlife, fire, an unstable building, falling objects, or floodwaters? You do not want to become another casualty or cause further harm to the patient.

Number of patients: Once you’ve ensured the scene is safe and stable, it’s time to determine how many individuals are involved in the incident. It’s easy to focus on patients who are crying out in pain and overlook those who are unconscious or not visible. Additionally, it can be tempting to rush to assist a person whose injuries seem more life-threatening than they actually are, such as someone bleeding from a superficial head injury, while another individual nearby has stopped breathing.

Primary Survey:  The Second Task

The primary survey is an assessment of the three essential life-supporting functions: the respiratory, circulatory, and nervous systems, often called the ABCDs. Any problems related to these systems present an immediate risk to the patient's life and must be addressed without delay.   

ABCDs: Once the size-up is completed, the scene is safe (or as safe as you can make it), and you have a sense of the number of patients needing aid, initiate a primary survey of the patients by checking the status of the three conditions that represent an immediate threat to life.

Airway: Check to make sure that the mouth and airway are cleared and that air is actually going in and out.

Blood is circulating: Ensure that blood is not spilling out and that it is actively circulating.

Disabled: Check whether the spine is stable and the central nervous system is functioning normally. Due to the limited scope of this article, I will not discuss further injuries related to the head, neck, or spine.

Active Bleeding Control Instructor checks the pulse and applies bandages to a patient.

Basic Life Support (BLS)

Basic life support (BLS) is the immediate treatment of one of the three life-threatening emergencies found during your primary survey.  Its purpose is to provide temporary support to keep the patient alive while a secondary survey is conducted and/or until advanced treatment is available.

The simplest way to begin a primary survey is to ask the patient, “How are you?” If he answers, you know that his airway is not obstructed (A), his heart is beating (B & C), and his brain is functioning (D). If the patient does not respond or responds in an unusual way, you will need to look more closely.  

Airway:

Airway problems result from an obstruction to the pharynx or larynx, which can be complete or partial. A complete obstruction is rapidly fatal, but it can be effectively and dramatically treated by clearing the airway. There are various ways an airway can become obstructed, such as vomit, a foreign object, swelling caused by trauma, an irritant, or an allergic reaction. It is imperative that you clear the airway, but you must do so without causing any additional harm to the patient.

Breathing:

A person can have an open airway yet still experience difficulty breathing. This may result from an injury to the brain, spinal cord, or diaphragm. The method for assisting a patient with breathing when more advanced medical care is unavailable is known as positive pressure ventilation or artificial respiration (mouth-to-mouth). The inflation rate should be around 12 breaths per minute or one every 5 seconds, with each breath lasting about 1 to 1.5 seconds. Rapid breaths can push air into the stomach, potentially leading to vomiting.

Bleeding & Circulation:

Uninterrupted blood circulation is essential for survival. There are two primary types of disruptions to blood circulation that a first responder can address: cardiac arrest and bleeding. Cardiac arrest occurs when the heart stops beating. During your primary survey, if you discover that the patient has no pulse, it indicates that her heart has stopped beating, and she is in cardiac arrest. It's important to note that in adverse situations, or if the patient is in shock, finding a pulse can be challenging. The carotid pulse is the strongest and easiest to access; it is located on either side of the larynx in the neck. If there is no carotid pulse, the heart is not beating. CPR (cardiopulmonary resuscitation) is the only treatment for cardiac arrest. Even with hands-on training, it has limited potential to restore and sustain life.

The second type of disruption to circulation results from significant blood loss. Controlling blood loss is essential as part of BLS. Bleeding can be internal, which is often difficult to identify and stop, or external, though it may not always be obvious. Addressing internal bleeding goes beyond the scope of this article and the capabilities of most first responders in the field. External bleeding is managed by applying direct pressure to the bleeding site with your hand, ideally using a cloth or bandage. This application is not intended to absorb the blood; instead, it provides uniform pressure across the wound. Prepare to maintain direct pressure for ten minutes or more. If the bleeding does not stop, remove the bandage to locate the source of the blood and then reposition your hand.  

There is no easy rule for determining when bleeding is severe. A rule of thumb is that if it looks like a lot of blood, it probably is. However, severe bleeding can be missed if the patient is wearing a lot of clothing or the blood is absorbed into the ground around the patient.

Conclusion:

Firefighters practice safely transporting an injured person.

When developing first aid skills, like all skills a firefighter must master, training and practice are essential. Additionally, reading about the principles and theories that support these skills is important. However, there is no substitute for training and practice.

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For more information, visit the following references:

Africa Fire Mission Active Bleeding Control Resources

The Outward Bound Wilderness First-Aid Handbook; Jeff Isaac & Peter Goth.

The Field Guide of Wilderness & Rescue Medicine; Jim Morrissey & David Johnson.

Opening an Unconscious Patient’s Airway with a Manual Manipulation

Red Cross CPR

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Howard A. Cohen was a volunteer firefighter for 20 years. He began his firefighting career as a chaplain and retired as the deputy chief. He is currently AFM’s online program content director. He frequently presents for the Weekly Virtual Firefighter Trainings and contributes to the AFM blog.

Fireground Tactics

by F. R. Montes de Oca

Initial arrival at a fire often poses several simultaneous challenges for the officer to address rapidly. Utilizing the Rule of 3 can help the incident commander to develop a tactical posture. They are:

1.   What do I have?

2.   Where is it going?

3.   What do I need?

The first question (What do I have?) addresses:

The terrain of an incident location or layout of a building can impact the tactics you should use.

• What is the building used for?  Living? Storage? Manufacturing?

• Is it a single or multiple-family dwelling?

• Are there victims? If so, how many? Are they exiting on their own?

• What is the square footage and how many stories?

• Are additional occupants still in the structure who need help to exit?

Similar questions can be asked for a vehicle fire: size (single, multi-vehicle or public transit vehicle. Victims out or entrapped?

The second question (Where is it going?) forces you to think about the possibility of spread:

• Do I have exposures? Is high heat or high winds affecting fire spread?

• Can I ignore the exposures and focus on the primary body of fire?

• Will I need additional resources for fire progression AND exposures?

• Must I focus all resources to rescue occupants?

Focusing on egress pathways for building occupants is imperative. Often-times with limited resources tactics must be focused solely on rescuing or assisting occupants exit the structure.

The third question (What do I need?) is based on what is discovered or decided upon by answering the first two questions. What resources needed implies deciding whether hoselines are applied directly initially or are supply lines needed – or must victim rescue be my first tactic?  

The situation is often complicated by the fire rapidly spreading due to high winds or multiple victims needing rescue. When this occurs, tactics will change quickly from suppression to rescue.

While the tactics may address the initial and additional  challenges, it is important to remain cognizant of additional aspects to ensure an effective fireground operation:

Communications, which is the critical conduit of incident management. All on-scene and responding members must be apprised of the current situation and have a clear understanding of their assignments.

Rehabbing responders operating on scene is one of the most important actions the Incident Commander can ensure occurs. Ensuring that  members take a short break every 15 minutes or so will allow crew viability and increased scene effectiveness.

Incident Safety should be the overarching effort all scene commanders should undertake. Whether on scene at a structure fire, complex vehicular accident or hazardous materials incidents maintaining the safety and well-being of responders is imperative.

If formally assigned Safety Officers are not part of the department, it is advisable to appoint someone on scene whose only function is observing operations to ensure the safety and welfare of all firefighters. Whenever possible, the individual assigned the task should possess a mix of experience and formalized safety training.

At your next emergency incident pose the three questions to assist you in developing effective tactical decisions.

In closing, Incident command truisms that help officers maintain a sharper eye on effective tactical decision-making:

• When a tactic is not working, change the tactic.

• No matter how good your plan is, have a backup plan.

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Frank Montes de Oca served as a firefighter/paramedic for over 38 years attaining positions as Chief of EMS, Training Bureau Commander, and Chief of Department. He remains engaged in managing and developing firefighter safety programs and mentoring leaders.