Importance of Active and Passive Recovery for Firefighters

Importance of Active & Passive Recovery for Firefighters

by Nick Higgins

Firefighters are athletes. Taking care of ourselves means not just getting evaluated by our primary care or department physician but truly embracing a healthy lifestyle. Being able understand your body and prepare your body is equally, if not more, important to ensure our personal protective equipment is in check, self-contained breathing apparatus bottles are topped off, and the apparatus is in working order. The rigors and demands of the job place a toll on our physical and mental well-being, and it is vital we prepare our body and mind for the work potentially ahead of us, not just for one shift or call but for an entire career.

Active Recovery

Active recovery is beneficial to the body and may help us recover faster after difficult workouts or strenuous activity. I recommend that this type of recovery be on shift day or the day before or after to allow the body to recuperate from any physical activity performed on off days and to provide your body with some type of active, low-intensity recovery during shift so your body does not go into complete relaxation mode while on call. Limit active recovery exertion to no more than 75% of your typical workout level. The 75% level is just enough to keep the muscles warm and not enough to induce muscle fatigue.

Before we outline a few methods to perform active recovery, here are some of the benefits it provides.

• Reduction of lactic acid buildup in muscles.

• Elimination of toxins.

• Helps keep muscles flexible.

• Reduction of soreness.

• Increase in blood flow.

• Helps keep an exercise routine.

• Release of endorphins usually associated with regular exercise.

Here are a few methods of active recovery that are simple, yet highly effective:

• Walking

• Swimming

• Cycling

• Stretching

Passive Recovery

Passive recovery is a type of recovery that entails resting for considerable periods of time after strenuous activity. Unlike active recovery, with this type of recovery, your body is allowed total undisturbed rest to repair muscle damage and recuperate.

Proper passive recuperation is necessary for firefighters who are sick, are injured, or need physical and mental relaxation. For firefighters, rest is highly important and needed to perform at an optimal level. Rest has physiological and psychological benefits.

A healthy and optimal life is all about finding the right balance. From a 24-hour shift to 48 hours off in most cases, it is critical to take a day in between every now and then to relax and balance out the body.

By allowing the body to rest and avoid weariness of the muscles, it is allowing the body’s glycogen stores to refill, therefore attributing to the enhancement in muscle recovery. While exercise depletes your body’s energy stores or muscle glycogen, leading to muscular tissue breakdown, adequate rest helps your body correct this problem by restoring muscle glycogen, balancing blood flow, and rebuilding damaged tissue.

Here are a few methods of passive recovery that are simple, yet highly effective:

• Sleep

• Rest

• Hydration

• Massage Therapy

How to Use Recovery in Your Regimen

Adding active recovery into your training sessions can be done in two methods, and both are greatly beneficial to your recovery. The first is to add it into your current training session as soon as it has been completed, as a cool-down approach. This is where you will allow your body to ease itself out of your workout, allowing your heart rate and breathing to return to their normal states and reducing the amount of lactate in your blood. The lactate in your blood is an organic acid made by tissue and red blood cells in your muscles, which is what causes the muscle burn felt during exercise. This is the same approach as if you were driving your car and approaching a red light. Instead of slamming on the brakes to make the stop, you gently ease on the brakes for a gradual stop at the light. This same method applies to cooling down after a workout with respect to your heart rate and breathing, by going for a light walk or jog or adding in some dynamic and static stretches and yoga poses. The other option for active recovery is to incorporate this as a full active recovery day and implement the methods listed above as active recovery for the day, through swimming, walking, or yoga to name a few.

Both forms of recovery are crucial within your training cycle regimen to allow your body to find its balance repeatedly as you progress in your training. I highly recommend incorporating cool-down recovery, especially after high-intensity workouts and after fireground training sessions, for optimal recovery of the heart and body with at least one recovery day (active and passive) each week for maximum recovery and performance. In the end, listen to your body and what it is telling you. After all, it is the only place we truly have to live.

Nicholas J. Higgins is a firefighter and district training officer for Piscataway Fire District #2 in Piscataway, New Jersey. He is a New Jersey State Level 2 Fire Instructor, a National Fallen Firefighters Foundation state advocate, and a member of the Board of Directors for the 5-Alarm Task Force—a 501 (c) (3), non-profit organization. Nick is also the founder and a contributor of The Firehouse Tribune website and has spoken at various fire departments and fire conferences nationwide. He is the author of both “The 5-Tool Firefighter,” a book that helps firefighters perform at their highest level and the companion book, “The 5-Tool Firefighter Tactical Workbook” along with being the host of “The 5-Tool Firefighter Podcast”.

The Five C’s of Radio Communications

The Five C’s of Radio Communications

by Mark van der Feyst

The essential elements of effective incident scene communications fall into five categories. Understanding these attributes of successful communication and engaging in the suggested strategies will enhance your communication effectiveness, as well as that of the overall communications on the emergency incident scene. These are known as the Five C’s of Radio Communications: Conciseness, Clarity, Confidence, Control and Capability.

Conciseness

·      Keep the messages short and concise. This will help in reducing radio traffic.

·      Keep the messages specific. Think about what you want to say before you speak and then say it.

·      Condense the message as much as you can while still keeping it complete. This will help in eliminating any confusion by the receiver.  

Clarity

·      Use standard terms as defined in your department’s procedures. This will avoid any confusion on the incident scene.

·      Use plain-text language in all radio communications. Avoid using ten-codes, acronyms, or technical jargon.

·      Avoid multitasking. Describe and assign one task at a time to company members. Do not overload a company with multiple tasks to be completed at one time.

Confidence

·      Communicate on the radio in a calm manner. This helps to maintain calmness on the incident scene and does not create or add to hysteria.

·      Be audibly received. Speak in a voice loud enough to be heard by the receiver. Do not speak in soft tones or yell into the radio. Yelling will distort the message, whereas speaking too softly will require repeating of messages.

·      Use a good vocal pitch to communicate. This will help to be audibly received. Having a high pitch or a low pitch will have the same impacts as in the previous point. 

Control

·      Take control of the radio communications on the incident scene. Follow established departmental procedures and protocols.

·      Minimize unnecessary radio chatter. Prioritize messages to be sent and received.

·      Keep your emotions in check. This will help with establishing confidence and allow for more sensible direction to be given.

Capability

·      Use active listening skills. Be sure to hear all the messages that are being transmitted to you. This may require being in a quiet place versus being outside near a working engine.

·      Know how to use the communications equipment. Know where to hold the radio or microphone in relation to your mouth, SCBA face piece, or other radios nearby that may produce feedback.

about the author: Mark van der Feyst has been in the fire service since 1999 working in both Canada and the USA. Currently he works for the Fort Gratiot Fire Department in Michigan after taking early retirement from his career department at the end of 2020. He is an international instructor teaching in Canada, USA, India and many large and regional conferences such as FDIC, Firehouse World & Expo. He holds an MS in Safety, Security & Emergency Management from Eastern Kentucky University and has been providing virtual training sessions for Africa Fire Mission for two years.

Successes of 2023 and Opportunities for growth in 2024

December 2023 -

 WOW!  It’s been a busy year for Africa Fire Mission and every week we get requests to serve in new places!

 Here are some highlights of the work you’ve supported this year -

·       Team mission trips to Kenya & Malawi with more than 40 instructors!

·       Tochi and Jose Fire Safety Show airing daily on TV in Kenya with new episodes planned for early 2024!

·       Replication of Community Fire Prevention efforts with more than 30 African volunteers providing fire safety training to their communities.

·       Weekly firefighter refresher training for 150 people online each week!

·       500 sets of firefighter PPE donated to fire departments in Africa (Kenya, Malawi and Nigeria).

 We need your help to continue to grow our impact - Would you consider making a year-end gift support our work in 2024? Your ongoing support allows us to continue to serve firefighters across Africa!  By volunteering with us, praying for us and supporting our work financially, you are part of our team and our success!

Thank you for saving lives through fire departments and communities in Africa. We appreciate your generous support and partnership!

Wishing you a blessed Christmas and Holiday Season,

Nancy L. Moore,

Co-Founder & Executive Director

Africa Fire Mission Receives Major Grant from Motorola Solutions Foundation

October 17, 2023

Africa Fire Mission Receives Major Grant from Motorola Solutions Foundation

Africa Fire Mission (AFM) is a Cincinnati-based non-profit organization with team members of firefighters, chief fire officers and other first responders from across the United States, Canada and Europe. For eleven years, AFM has provided fire training and equipment in various parts of Africa.  AFM has announced they have received a $25,000 grant from the Motorola Solutions Foundation, the charitable arm of Motorola Foundation, to help continue its training programs and to provide a national Fire and EMS Training Symposium and Competition in Kenya in November 2023.

This grant will support hands-on Fire Training and distribution of firefighter personal protective equipment (PPE).  In November, a team of thirty-five firefighters, EMT’s paramedics and other professionals from the United States will train over 500 Kenyan firefighters and EMT’s at the Jomo-Kenyatta International Airport in Nairobi, Kenya.

AFM’s training team members volunteer their time and pay their own expenses to travel to Africa to teach their fellow firefighters the latest techniques in firefighting, rescue and emergency medical services.

“Africa Fire Mission is grateful to Motorola Solutions Foundations for its continued support of our programs through this grant. It is because of dedicated volunteers and partners like Motorola Solutions Foundation that we are able to continue to impact communities and support firefighters in Africa as they strive to save lives and property” says Nancy Moore, Executive Director for Africa Fire Mission.

The Motorola Solutions Foundation, which has donated $100 million over the past 10 years, focuses its giving on three key areas: First responder programming, technology and engineering education, and programs that blend the two. The Foundation has a long-standing commitment to supporting programs that benefit underrepresented populations and aims to partner with organizations that align to its values of accountability, innovation, impact, diversity and inclusion.

"The Motorola Solutions Foundation is honored to partner with organizations like Africa Fire Mission that are actively driving positive change within the community," said Karem Pérez, vice president of Diversity, Equity and Inclusion and executive director of the Motorola Solutions Foundation. "We are immensely proud of the work that Africa Fire Mission is doing, and we look forward to seeing their continued impact."

For additional information on the Motorola Solutions Foundation grants program, visit: motorolasolutions.com/foundation-grant-partner.

For additional information regarding Africa Fire Mission visit: www.africafiremission.org  - Contact Nancy Moore at 513-620-4236 or nancy@africafiremission.org

About Africa Fire Mission

Africa Fire Mission is a nonprofit organization committed to increasing the sustainable capacity of Fire Departments in developing communities. We accomplish this through training, empowerment, support and encouragement.

• Train – We partner with governments, NGO’s, missionaries, schools and corporations to provide education and training to firefighters and local communities. We use Community Health Education to teach firefighters and community members in Africa to protect themselves from the dangers of fire. We provide fire prevention training and fire safety assessments to schools ensuring the students are able to learn in an environment safe from fires.

• Empower – We work to increase the ability of communities in Africa to respond to disasters and provide relief when disasters occur.

• Support – We provide personal protective equipment and communication tools to fire services throughout Africa to allow fire departments to operate in a safer and more coordinator manner.

• Encourage – We build the capacity of African fire services so that local communities are able to provide sustainable public safety and disaster management services.

Where does AFM work?

Africa Fire Mission currently works throughout Africa including: Nigeria, Kenya, Malawi, and Zambia.

About the Motorola Solutions Foundation

As the charitable and philanthropic arm of Motorola Solutions, the Motorola Solutions Foundation partners with organizations around the globe to create safer cities and equitable, thriving communities. We focus on giving back through strategic grants, employee volunteerism and other community investment initiatives. Our strategic grants program supports organizations that offer first responder programming and technology and engineering education, and align to our values of accountability, innovation, impact, diversity and inclusion. The Foundation is one of the many ways in which the company lives out its purpose of helping people be their best in the moments that matter. For more information on the Foundation, visit: www.motorolasolutions.com/foundation

Why should fire trucks and ambulances always show up for a medical emergency?

Why should fire trucks and ambulances always show up for a medical emergency?

By Kelvin from Swift Emergencies Response Unit - Kenya

When a call comes in at the call center, dispatchers often are not given precise or complete information. As such, units are dispatched on a worst-case scenario. To ensure the highest level of care, the closest fire engine station is dispatched and EMS sends an ambulance (staffed with two paramedics and/or EMT's).

No medical call is “routine.” Most require assessing the patient, obtaining their vital signs, providing oxygen therapy, and moving them, at a minimum. EMS may also need to place an advanced airway, administer drugs intravenously, or monitor cardiac conditions. All of these procedures are completed more efficiently when the appropriate amount of help is on scene. Efficient care is our goal, and efficient care often is the difference between life and death.

Unfortunately, units have no way of knowing what they will encounter on a call until they arrive. They work in a “what if” and “all risk” business. Responding to the unknown is public safety. The public can help by calling emergency numbers quickly when there is an emergency and providing details of the emergency. Emergency hotlines are your instant go-to when the need arises. It is important that you know the numbers to call to get assistance and keep a copy with you.

Celebrating our Volunteers!

On October 14, 2023 during our Annual Fundraiser, the Chama, Africa Fire Mission will honor volunteers Chief Bradley Banz and Chief Michael Kull.

Volunteer of the Year

Africa Fire Mission thrives on volunteers. Volunteers are at the heart of our organization. We have dozens and dozens of volunteers. We have volunteers from all across the North America, Africa and Europe that help allow AFM to serve on a daily basis.  These men, women, firefighters, civilians and children are all a vital part of Africa Fire Mission being able to achieve its goals and objectives. 

Chief Michael Kull – Volunteer of the Year

Chief Mike first joined Africa Fire Mission team in 2021 and has been all in with us ever since. Mike has participated in missions to Kenya and Malawi and facilitates AFM’s weekly virtual trainings. This past year, Mike stepped further into leadership co-leading our Malawi training trip! Mike just get’s it. He understands that the fire service in Africa is limited in physical resources and rich in people resources! Mike uses his creativity to help solve problems and helps the fire service advocate for what they need. This week we learned that the Zomba, Malawi fire brigade received its first uniforms from their local government as a result of the advocacy that their team learned from Mike. Mike’s dedication to facilitating our online trainings and lead to steady growth of our trainings from 60 participants a week at the beginning of 2023 to more than 100 participants a week now.

Mike fully embodies our mission to train, empower, support and encourage firefighters in Africa and his leadership has allowed us to continue to grow!

Thank you Mike for all that you have done for Africa Fire Mission! We are looking forward to serving with you for year’s to come!!

More about Chief Michael Kull: Chief Michael Kull is from Pennsylvania where he recently retired as the Fire Chief for the Valley Township Fire Department, Forest Fire Warden for Weiser State Forest and as a Township Supervisor for Valley Township. As a volunteer firefighter with over 25 years of experience, Michael has learned creative strategies for meeting his community’s needs for fire and rescue services.

Instructor of the Year

When Africa Fire Mission travels with a team to provide training in Africa or other parts of the world, our team members volunteer their time, talents and treasures to provide world class training to our partners.  Our instructors undergo training in advance of the trip to prepare of the mission and prepare the lessons that they will teach in our week long fire training events. We are fortunate to have many instructors return year after year who continue to build each year on the training that they have been providing as well as to build strong relationships with firefighers and our overseas partners. 

Chief Bradley Banz, Instructor of the Year

Chief Banz heard about AFM from our partner at Missions Of Hope International after providing CPR and first aid training there. Brad’s been involved with AFM since 2015. Brad has traveled with AFM on missions to Kenya, Zambia, and Malawi. Brad has been instrumental in the development of our Community Health Evangelism curriculum on Fire Prevention and Safety which has impacted millions of lives across Africa. Brad notices needs and responds making sure that curriculum developed for classes he teaches meet the needs of the fire service. This past year, he developed a Hazardous Materials class for firefighters in Africa after seeing the dangers firefighters were exposing themselves to attempting to respond to some Haz Mat incidents.

Brad encourages our team members and advocates for the firefighters. He takes time to get to know the firefighters we are serving and what their needs are. His heart for Africa is abundantly clear!

Thank you Brad for serving with heart and passion! We are grateful to have you on our team!

More about Chief Bradley Banz: Chief Banz is a firefighter with over 38 years of experience. Brad retired as a Captain for the Wichita, Kansas Fire Department and retired as Fire Chief from Colwich Kansas. Brad continues to serve his community as a volunteer firefighter in addition to training firefighters in Africa.

Interested in volunteering with AFM in administrative roles or as one of our international instructors?

Ambulance Services and Its Importance in Society

Ambulance Services and Its Importance in Society

 By: Kelvin from Swift Emergencies Response Unit - Kenya

Increase in medical ailments has led to the rise in hospitals and emergency medical services assisting patients who require emergency medical assistance at critical moments, helping them to reach the hospital on time thus saving their life.

Private and public ambulance transport services are operating in more numbers today as an inevitable service providing care to critical patients at crucial moments. In Kenya, ambulance operating centers are set up at every hospital and private EMS organization. These Ambulance operating centers function with adequate ambulance transport services to offer immediate medical care for patients. Private ambulance transport services depict a consistent rise in the growth curve each year offering non-emergency services unlike hospital ambulance transport services which primarily function for emergency needs. Some of the non-emergency services include shifting patients from one hospital to another, transporting patients for any scanning or laboratory services to the relevant facilities, or patients with any travelling disabilities in normal vehicles to hospitals for treatments.

Emergency ambulance services are usually equipped with adequate medical equipment and paramedical professionals. Sometimes, non-emergency ambulance transport services are also equipped with some basic medical aids and a para medical staff to cater the needs of immediate medical care to patients.

Let us discuss a few points about the pre-hospital medical professions - paramedics and emergency medical technicians (EMTs) who are the spine of ambulance transport services:

• Paramedics or EMTs are first treating patients even before doctors (pre-hospital care) thus saving patients through immediate medical procedures ensuring the vitals stable before reaching hospitals for further treatments.

• Paramedics and EMTs are trained healthcare professionals, authorized to attend patients with required medications and procedures based on their training level.

• Education level, standards, functions and skills of paramedics and EMTs vary with countries. However. certain standard functionalities remain common such as being trained to practice CPR procedures for cardiac arrest patients, usage of defibrillators, certain analgesic, paralytics and sedative medications for pain control, first aid to treat burns, fractures, childbirth complications, spine injury, airway management, blood control etc.

• One should respect the noble service of prehospital providers who form an integral part of ambulance services.

• The youth of our nation should involve themselves in such noble service, joining community life saving teams and can considering a career as a paramedic or EMT.

• The government could benefit from taking initiatives to support volunteer community first responders at the community level and to empower them to continue saving lives at the scene before qualified personnel arrives.

Kenya Stairclimb 2023

Kenya Stairclimb 2023

On September 16, 2023, firefighters gathered for a day of remembrance of fallen firefighters and a day of camaraderie and awareness of the fire service in Kenya.

Heels on Mountains collaborated with Africa Fire Mission for this year’s Annual Firefighter Stairclimb event in Kenya, which had a had a total of 65 participants! We are grateful to all the participants and sponsors of this event.

Heels on Mountains has continuously supported firefighters in Kenya since 2019, supporting 4 stairclimb events for firefighters at the Kenya International Conference Center . Thank you to everyone that participated: Mombasa County, Kenya Airports Authority, ICT Fire and Rescue, West Pokot County. We are grateful to individual Firefighters and EMT’s as well as supporters of First Responders.

Asanti sana. You helped Kenya be on the map as the only African country that commemorated the Twin Tower bombings with a stair climb activity.

Check out photos from the Kenya Stairclimb event here:

The EXIT Project: Using U-STEP OUT Principles in Vehicle Accidents

Many patients will require extrication following a motor vehicle collision (MVC) however, little information exists on the time taken for the various stages of extrication. Dr. Tim Nutbeam, Rob Fenwick and their research team conducted research on the time it takes to extricate a patient and the positive results reducing time for extrication may have on their health. 

The EXIT Project - Using U-STEP OUT Principles in Vehicle Accidents

 by : Dr Tim Nutbeam and Rob Fenwick

In this article we will be taking a look at the USTEP Out protocol, which is a self-extrication practice. If you are unfamiliar with the EXIT Project watch this video and then continue reading here. Before discussing the USTEP Out protocol, we will look the supporting research. Recent research shows that rescuers should reduce extrication times. This can be done by recognizing that the old protocol (the absolute spinal movement minimization approach) was evolved due to a concern that excess movement may lead to avoidable secondary spinal injury, was never justified.

Further that this approach should instead be replaced – where it is in accordance with your rescue organization’s clinical governance – with:

1.     an emphasis on rapid self or assisted extrication

 2.     and where this is not initially possible, the timely creation of minimum safe space through which the trapped person can subsequently self-extricate (or be extricated by rescuers focussing on the minimization of time rather than movement)

Process

With regard to rapid self or assisted extrication, the EXIT Project’s U STEP OUT protocol is detailed below, with example photos and commentary to follow:

1.       U – Understand   

While rescuer protection is paramount, if it is safe to do so a rescuer should raise their visor and lower any mask, thus facilitating effective communication with the patient. This is allow verification that the patient is fully responsive and that they understand their circumstance.

It is important that from the outset the rescuer allocated to support the patient explains to them what is going on and their method of extrication. The rescuer should listen to and manage the patients concerns and offer verbal guidance, as well as emotional and physical support as they leave the vehicle.

2.     S - Support 

Many patients who are capable of self-extrication will do so immediately after the collision. If they are capable but have chosen not to do this, then they will likely require a rescuer’s reassurance that they will be safe if they do so. The patient should agree to the plan, but the rescuers must be aware that they may change this preference and if so, be able to manage this.

       3.     T – Try moving 

Ask the patient to move both their legs, if they cant they wont be able to self extricate

        4.     E – Egress

The door must be fully opened - consider the need to force it away from the patient if doing so will assist safe movement. Both the exit space and the identified egress path must be clear of all trip hazards and obstructions.

             5.     P – Plan 

Determine where will the patient go on exit and ensure that a suitable means of support is available and nearby.

    6.     OUT  

Offering an arm, with the patient using it to support their own movement is very low risk, compared to actively pulling the patient out of the vehicle.

Conclusion

The use of self or minimally assisted extrication will depend on the decision of the lead rescuers as to whether this option best suits their patient’s medical circumstances and needs.

The simple U STEP OUT protocol can be easily understood and used by all rescuers and will minimize patient entrapment time which will help ensure their earliest arrival to a medical care facility.

Learn more > The EXIT PROJECT

Supporting AFM's Programs

Thank you for being a part of AFM! - maybe you are regular donor and friend of ours, maybe you supported a team member that has trained firefighters in Africa, or maybe you have been part of an AFM event. Whatever your involvement - you are part of the work that is helping to develop fire services in Africa.   Thank you! I’m writing to ask you to continue to be part of the impact that AFM is making in Africa by giving financially to AFM.

Nearly every day I hear stories of firefighters that feel empowered to do their jobs in Africa.   I hear stories of community members who have started coming alongside the fire service in Africa and I learn about communities where lives have been saved due to the fire prevention work that is ongoing.   Your support to AFM makes all of this possible!

This is just SOME of what’s happened already this year:

• The Tochi and José Fire Safety Show is making a huge impact in Kenya with the Kenya Burn Society reporting that they have seen a 60% reduction in burns requiring hospital care compared to this time in 2022. We have 7 new episodes coming out by the end of 2023 to further expand our impact.

• 400 sets of firefighter personal protective equipment are being sent to Nigeria as part of a public-private partnership with FCT Fire Service, AFM & the Institute of Human Virology.

• AFM’s weekly online trainings are averaging over 65 training participants each week!

• AFM’s mission trip to Malawi in June resulted in training at all of the fire stations in Malawi and over 80% of the municipal firefighters in Malawi receiving training!   Our team members were encouraged to see the growth of the firefighters over the past year.   In addition to training we were also able to begin a mentoring program for the fire chief’s that we plan to grow in the coming year!

Every person needs to be safe from harmful fires. Africa Fire Mission is working to empower people with knowledge of how to harness fire for good: light, heat, cooking, so that they can be safe and secure in their homes. We are partnering with firefighters to ensure that they have the knowledge, training and equipment to effectively protect those they serve from unwanted fires and other disasters.  Will you help us continue to provide life-saving trainings and equipment in Africa?

Here are some ways your donations will be put to work:

• $25,000 provides funding for a Fire Safety Advocate in Africa.

• $5,000 allows us to produce an episode of the Tochi and José Fire Safety Show

• $200 allows to provide one hour of online training & certificates to 80 firefighters in Africa

• $50 helps us provide one set of firefighter PPE to firefighters in Africa

• $25 allows us to print one copy of our training of trainer’s curriculum so that firefighters and community members can train their community in fire prevention.  

• $10 provides one firefighter with safety gloves and eye protection

Our goal for this campaign is $50,400 – which will allow us finish our year strong and enables us to continue to expand our reach (requests are coming from Ghana, Nigeria and Zambia to expand our work). Will you help us continue to Train, Empower, Support and Encourage firefighters and communities in Africa with a gift to support the growth in our ongoing work?  

Here are some ways to contribute:

• Become a monthly donor or make a one-time donation - DONATE HERE >

• Mail a check to us:   P.O. Box 53242, Cincinnati, OH 45253

• Double your impact with matching funds from your employer

• Donate stock:   email me and I’ll send you the details

• Designate a gift to Africa Fire Mission in your estate

• Introduce us to individuals or businesses that might be interested in partnering with us financially

Thank you for providing firefighters and other first responders in Africa with the training and equipment they need to thrive and flourish and provides community members with life-saving fire prevention trainings.                                                                             

Please contact me directly if you have any questions about our programs and how you could get involved in our work!

With Gratitude, Nancy

Nancy L. Moore, LISW-S; Co-Founder & Executive Director

nancy@africafiremission.org

(513) 620-4236

SAVE THE DATE!

AFM’s annual event – The “Chama” -  Saturday, October 14, 2023

Cincinnati Fire Museum.

Using EXIT Principles in Motor Vehicle Accidents

Many patients will require extrication following a motor vehicle collision (MVC) however, little information exists on the time taken for the various stages of extrication. Dr. Tim Nutbeam, Rob Fenwick and their research team conducted research on the time it takes to extricate a patient and the positive results that reducing time for extrication may have on their health. 

The EXIT Project - Using EXIT Principles

 by : Dr Tim Nutbeam and Rob Fenwick

In this article, we are going to take a brief look at the main EXIT Principles – identified during Evidence Based Research in the UK – and from two different perspectives. We’ll also see how these principles can be put in Practice. Find out more here.

The Rescuer’s Perspective

The main principle identified in the research study was that rescuers should reduce extrication times by recognizing that the patient movement minimization approach (MMA), which focuses on potential damage to the patient’s spinal cord, was never justified.

The research findings point to the idea that MMA should be replaced with a primary emphasis on rapid patient self or assisted extrication, if medically appropriate and where they can follow instructions and also move their legs.

Where this is not the case, they should be extricated by rescuers focussing on the minimization of time rather than movement, with the creation of the minimum necessary safe extrication space.

In terms of clinical care, this latter practice is facilitated by :

-        medical and fire rescuers working together to develop and manage a patient centred extrication plan

-        medical and fire rescuers being aware that frequent stops for medical observations will extend the extrication time, thereby delaying arrival at hospital and so should be kept to a minimum

-        limiting care to only the clinical interventions necessary to allow safe extrication.

-        medical and fire rescuers being aware of the signs of patient deterioration and notifying the senior clinician if these signs are seen.

The Patient’s Perspective

The principle here is to meet both the physical and emotional needs of the patient. The EXIT researchers consulted with past trauma patients and found that this often tends to be poor or gets missed, because the main rescuers focus is on (extensive) space creation activities.

In response to these findings, EXIT is a patient-centred practice and allocates a dedicated ‘extrication buddy’ to the patient. Pivotal to the buddy’s role is communication; establishing a connection with that vulnerable person, including being in the car with them, using their name, explaining what’s happening and advocating on their behalf with the rescue team.

The ‘buddy’ should also use clear language, give assurance that any co-occupants and pets are safe and allow patients to call family or other close contacts.

Patient privacy is also important and so limiting the ability of the public to record events (and subsequently post them on social media), perhaps via the Police attendance, may be necessary. Note that this restriction also applies to the rescuers and their respective organizations.

Conclusion

The EXIT Principles identify that while we must care for the patient’s needs, where they present with any evidence of injury, that they should be considered as time-dependent and efforts must be made to minimise their extrication time. The quickest way to enable this is assisted self - extrication, as rescuer-extrications can be complex and take longer to perform, and so should only be employed where self-extrication is not feasible.

Learn More > The EXIT PROJECT

Confined Space Rescue: Reasons for Technical Rescue Operations Failures

Conducting a confined space rescue is a risky endeavor that requires great skill and patience.

Many times we have seen numerous rescue attempts fail due to the lack of patience and skill

being exercised by rescue personnel. In training of technical rescue operations, we instruct

upon how we want to avoid a failed rescue attempt by recognizing certain attributes that are

lending to the overall situation. The acronym FAILURE is used to describe these certain

attributes that can be present at each confined space rescue operation. The acronym FAILURE

stands for:

F – Failure to understand the environment

A – Additional medical implications not considered – dust, crush syndrome

I – Inadequate preparation

L – Lack of team work, training

U – Underestimating the logistical needs

R – Rescue vs. Recovery

E – Equipment not mastered

The first important consideration of the environment is the atmosphere inside and around the

confined space. Monitoring the atmosphere is sometimes overlooked by responding personnel

and thus leads them to become victims as atmospheric conditions overtake. The basic four gas

monitor will be a benefit as it will detect for percentage of oxygen, carbon monoxide, hydrogen

sulfide gas and lower explosive limits. Ideally, conditions should be 0 % for hydrogen sulfide, 0%

for carbon monoxide, 0% for LEL and 21% for oxygen. An increase/decrease of 1% in any

category is equivalent to 10,000 ppm of a contaminant in the ambient air. Even though there is

just a 1% difference between normal and acceptable limits, doesn’t mean that it is safe to

enter. Using hydrogen sulfide as an example, it only takes between 1000 to 2000 ppm to cause

death in a few minutes which is less than 1%.

The letter “A” represents a lack of consideration for additional medical implications that are not

being considered. The majority of confined space rescues involve a person who is overcome by

a toxic environment or a lack of oxygen within the space. Very few incidents involve medical

reasons as the catalyst for the rescue operation. When we think of medical reasons we are

considering falls, traumas, and cardiac arrest. These types of incidents represent a very low

number of why we have a confined space rescue. However, when there is a confined space

rescue operation initiated, these factors must be considered and answered.

The letter “I” is in reference to inadequate preparation. What makes a confined space rescue

incident worse is the lack of preparation for the worse to happen. Many workers will enter into

a confined space thinking that it is only another routine day. There has been no time taken to

prepare for the actual rescue of that worker. Gaining entry into a confined space is the easy

part, getting the entrant out of the confined space when something goes wrong is the hard

part. Adequate preparation must be taken to ensure that the question of “How do we get the

entrant out” can be answered before the entrant goes in.

The letter “L” is for a lack of team work. During a confined space rescue incident, there needs to

be one person one charge who will be your Incident Commander. This person will be the one

who will make the final decisions on how to affect the rescue, which person will do what tasks

and oversee the whole operation from start to finish. When you have emotions taking over

certain members of the team, they seem to want to control the operation and start to ignore

the Incident Commander and start to implement what they think is best and should be done. At

this point communications starts to break down, and mistakes start to occur.

The letter “U” is for understanding the logistical needs. It is wise to expect the worse and be

prepared for it rather than being unprepared and expecting the least. Many times rescue crews

are responding to a call not prepared for what they are going to be faced with. For a confined

space rescue incident, the crews responding need to expect the worse. This way they will be

prepared when arriving and ready to act without hesitation.

The letter “R” is for rescue vs. recovery. Establishing the mode of operation at the onset of the

effort is vital to the success of it. The Incident Commander needs to determine right away

whether they are going to be conducting a rescue or a recovery. This determination will set the

pace of the operation and it needs to be communicated to everyone on site very clearly..

Would be rescuers soon become the victim as they are overcome by toxic atmospheres found

within the space. According to statistics from NIOSH, 60% of confined space fatalities are would

be rescuers.

The letter “E” is for equipment not mastered. Confined space rescue teams use lots of different

equipment to aid them with their operations. The equipment used needs to be mastered by all

those who are expected to use it. This only occurs through training and practicing with the

equipment on a regular basis. The time to learn how to use a certain piece of equipment is on

the training grounds and not at the confined space incident.

About the Author:

Mark van der Feyst is a 25 year veteran of the fire service and is currently the Senior Battalion Chief at the Six Nations Fire & Emergency Services in Canada and a part time firefighter with the Fort Gratiot Fire Department in Michigan. He has worked in both the USA and Canada for various fire departments and holds a Masters of Science degree in Safety, Security & Emergency Management from Eastern Kentucky University.

Malawi: How the Future of Their Fire Service is Bright

By: Brad Banz

I was blessed to be a part of the recent AFM team that travelled to Malawi in June. During our trip, our team split up to visit all four fire brigades in the country. We shared our knowledge and provided equipment to better allow them to execute their jobs.

I have been working with AFM, almost since their beginning, making my first trip to Kenya with Dave and Nancy Moore in 2015. I have been travelling to Kenya since 2009, working in the Mathare Valley with church mission groups. My interest in the Kenyan fire service was boosted after a trip to Kenya was cancelled in 2013, due to a victim of a fire in the airports arrival hall the day before we were to arrive. What does this have to do with Malawi, you might be asking? In terms of resources, the Malawi fire service is where Kenya’s was 10 years ago.

As I alluded to earlier, Malawi has four fire brigades for a country of 18 million people. The firefighters have no uniforms, their apparatus and PPE are donated from other countries. From what I could see, less than half of the apparatus’ were in working condition. The fire brigades do not have their own stations, but are instead collocated within public works facility, using whatever leftover space is afforded to them. While the state of the fire brigades are saddening, they are not surprising. Malawi has the 12th poorest household income in the world.

Something that also stuck with me was an interaction I had with one of the firefighters. While firefighters were building a wood fire to heat the cooking oil for our fire prevention demonstration, one of them shared with me that his wife woke up every morning at 5, built such a fire, heated water, and put in a basin so he could bathe and got to work. This is an example of how little their firefighters are getting paid in this country. Living in homes without hot water is a struggle very few of us can relate to- and it reminds me of how blessed I am to have the resources I have. Despite these limitations, like most firefighters, they get the most they can out of the resources at hand.

Zomba firefighters stopped a fire in a small attached building from spreading to a much larger one. The Lilongwe Chief was summoned to city hall to answer for a fire that burned the top floor of a six story building. His firefighters couldn’t get to the sixth floor because they didn’t have the hose. Using what they had, they confined it to the top. What Malawi does have is firefighters who are eager to do the job. This is the best resource any fire brigade can have.

After visiting both, Malawi and Kenya are very different countries with different challenges. Our team all talked about how we could fix the problems, but it is a complex issue that will require that both us as westerners and the Malawians both quit creating a mindset of dependency and start helping them to develop. The changes that we have seen in Kenya are what the Malawi fire service can use as a benchmark to learn from.

Serving Firefighters in Malawi

June 5, 2023 a team of eight instructors for Africa Fire Mission set off from their homes in the United States, Germany, and Kenya. Our team members come from diverse experiences in the fire service.

We set off, with most team members having more than 30 hours of travel, to serve the firefighters in Malawi. There are 4 fire brigades in Malawi - Mzuzu, Lilongwe, Zomba and Blantyre and we were able to provide training at each station. After arriving in Malawi - our team divided into 2 smaller teams and traveled to each city.

Training topics and practical application was customized for each department and included: hazmat, rope rescue, hose management, ladders, interior search and rescue, CPR, first aid, and community fire prevention. While they were in Malawi the team went with the Fire Brigade to nearby schools and practiced showing the children fire safety!

Our team found it encouraging to see how the firefighters had furthered their trainings form our work in 2022 and improved their skills. Firefighters in Malawi work so hard and deserve the respect that they are gaining from their communities! Chief Mike Kull said, "It is such a pleasure working and training with these firefighters who are so dedicated to their profession and so willing to learn and train." Additionally, we were able to donate 15 sets of PPE to the firefighters this year and are making arrangements with the help of Malawi Goodlife to send more equipment to the fire service from Germany.

Chief Mike Kull trained in Blantyre and Zomba and blogged about his experience. If you’d like to read more about AFM’s mission to Malawi, check out Chief Kull’s blog: Far Off Chief.

Electric Vehicle Fires

By: Chief Hank Clemmensen, AFM Board Chair

With adoption of electric vehicles (EVs) increasing around the world, firefighters need to be aware of the dangers they present and the unique challenges associated with extinguishing an electric vehicle fire.  Training and preparation is critical to prepare for advancements like the introduction of electric buses in Kenya.  Is your fire brigade prepared to respond to incidents for electric vehicles? Start training specifically for EVs, now reading this detailed article on EV fire attack and extrication basics by Patrick Durham.

https://www.firerescue1.com/electric-fire/articles/electric-vehicle-response-fire-attack-and-extrication-basics-PwPBmx8uuMuMOR2G/

Keeping Firefighters Safe through PPE Donations

If you are a firefighter you probably know that gear expires. Maybe reading this, you are learning about the fire service and this might be new information to you. Either way, in the United States, NFPA codes dictate how long firefighter equipment can be used and when it needs to be replaced. For good equipment, the reason equipment expires is largely with the thought that within 10 years there are very likely new equipment safety technologies to keep firefighters safe.

Many firefighters in the world don’t have the luxury of new gear every 10 years. Additionally, much of the 10 year old gear is still effective in keeping firefighters safe from fire even if it is not the newest technology. As a result, Africa Fire Mission has partnered with fire departments across the US (and in Germany) to get quality used personal protective equipment to Africa.

In September 2022, AFM had a team visit FCT Fire Service in Abuja, Nigeria. While there, I asked one of the firefighters to allow me to inspect the label of his Turnout Coat. Bold of me, but important to the work that we do to understand the needs of the firefighters. When he a allowed me to look - I was expecting to see a label dated 30 years old based on the PPE I was looking at - instead there was no date and the label said that the garment was actually a “Firefighter Costume” with NO international approvals or rating. Our team educated the firefighters about their current equipment limitations and have been helping to advocate for a public private partnership with the Institute of Human Virology- Nigeria to support training and equipment for the fire service in Nigeria.

We are excited to have the opportunity to send over 300 sets of PPE to the Institute of Human Virology, Nigeria. We will load a 20 foot container on August 5, 2023.

We need your help! We have most of the equipment we need for this shipment, but still need about 160 fire helmets! If you know a fire department that has decommissioned fire helmets that are still serviceable, please contact us and we will determine the best way to get the equipment to us in Cincinnati, Ohio.

We also need volunteers to help us load the equipment on August 5th! You can sign up to help by clicking this link:

Trauma: Who, What, Where, When and Why?

Trauma is a word that seems to get used more and more these days; heal your trauma, childhood trauma, vicarious trauma... What to do with trauma?

 Eleven years ago, I started my career as a full-time firefighter. Out training around trauma consisted of looking at horrible pictures and hearing a few stories of bad calls.  At that time, the only experience I had with dead people was at the few funerals I had attended. I had never placed my hands on a dead body before becoming a firefighter, and there was no preparation for the psychological aftermath of some of the events that would happen in my life.

 Fast forward to now, and that surely is not the case. There have been hundreds of dead bodies, and I can't even count the number of times I have done CPR.  However, up until just a few years ago, I still didn’t fully grasp what Trauma was, let alone how it shows up, where one might find it and why it tends to linger around. 

 Through a long journey of healing, research and life experience, I have understood what my trauma means for me in this life.  The thing about exceptional experiences, like trauma, is that once they have occurred, there is no erasing them.  Now, this doesn't mean it has to remain the same forever and ever.  The beauty of the human mind is that we can create perspective.  Take politics, for example. The same people and the same problems have different perspectives on how to solve the issues.  A lesson I have learned through my trauma experience is that this approach can take one out of dark times and into brighter days.

 In December 2020, I was a part of a crew that extracted a woman from a house fire.  The scene was a known homicide, the victim was beaten and burned to death.  The image of her body and her children standing on her lawn stayed with me for a long time; they were hard to shake.  At the same time in my life, I owned a Gym, and the closures from the pandemic were wreaking havoc on my finances, my stress and my relationship; this traumatic experience put me over the edge.

The shift that happened through various therapies was very subtle yet extremely powerful.

 It was this:

  Why is this happening FOR me? vs. Why is this happening TO me?

For vs To:

 The understanding of this came from experiencing trauma's impact on my life.  Let's break down the who, what, where, when, and why of trauma.

 Who is Trauma? 

 Weird question, right? Too often, we become our trauma; it victimizes us, and we fall into the trap of continually asking ourselves, why did this happen to me?  We create an entire identity around our trauma and allow that story to infiltrate our lives.  Unfortunately, most of the time, this takes on a negative narrative that can lead to dark places of unhappiness, anxiety and depression; that is what happened to me.  Once I learned that I am not my trauma, it enabled me to separate from it.  From this place of separation, I could now view it as something different.

Our Trauma comes from an experience; it sticks around and hunts us because of the narratives our mind places on the traumatic experience. By learning to change this narrative, we can change how we perceive the experience of trauma in our life.

 What is Trauma?

 Is the Trauma the event that occurred? Perhaps and if that is true that trauma is the event, then why do we continue to suffer from the trauma after the event takes place?  I sat down for dinner three days after extracting a dead, burnt person from a house fire. My wife had made roasted chicken for dinner.  The traumatic experience was now over; however, my entire body was shaking, my heart was pounding, and I could not bring myself to eat as I was on the verge of vomiting, just from the look of the chicken on the table. My children were trying to talk to me as I stared blankly at the food before me, not hearing a single word.  I was having physical, emotional and psychological responses to the event that had occurred three days prior.  The trauma was alive and thriving within me.

 Trauma is the emotional, psychological and sometimes physical response to a traumatic event. After the event has taken place, it now remains an experience in our lives.  We do, as humans, have the ability to change how we respond to this event.  Knowing that our response is adaptable is the first step in helping heal from any horrible event.

 Where is Trauma?

 If trauma isn’t the event but how we respond to the circumstance that has already happened, then where is it? Where is the trauma?

There is no correct answer here because how trauma shows up is different for everyone.  My experience showed up in several ways, constant anxiety, insomnia, outbursts of uncontrollable crying in the middle of the night, depression, yelling and swearing at my children (they were 3 and 6 at the time), negative self-talk, negativity towards others, and playing the victim card.  There were moments when I was playing with my kids, laughing and rolling around when out of nowhere, the thought of that night would enter my mind and rob my children of their father.  One of the most potent therapies I did was Neuro-Linguistic Programming or NLP.  It worked by changing my image of the dead body to a pair of jeans and a wreath of roses.  I know it sounds weird, but it worked.  Every time that thought enters my mind, I think of a pair of jeans and a wreath of roses. 

 When looking to talk to a professional, find one who practices NLP.  It worked wonders for me.

 Why?

 This question was probably asked ten thousand times, “Why is this happening to me.”  One evening in bed, I broke down and asked this question to my wife, and her response changed my life.  She said, “Maybe it's not happening to you; maybe it's happening for you.”  As I explored this perspective shift, I kept finding positive reinforcement.  “Maybe this happened to show me that even when horrible things happen, love still exists,”  the proof being the person's children crying on the front lawn. 

 When?

 We never know when or how our past experiences will show up in our lives.  Lots of the time, it happens unexpectedly.  As a first responder, finding tools to help manage our stress and anxiety helps to mitigate our trauma when it shows up.  We train to prepare for the unexpected; our mental health and trauma are no different.  By consistently working on healing and discovering new tools that work for us, we can shift our mindset around what trauma is, how it shows up, and where to find it.   We can begin to shift our perspectives about why our trauma has happened for us, not to us.

 Trauma is no joke. As a firefighter, I don’t believe we have enough education or tools to help us deal with and manage our trauma.  My best advice is to start exercising your relationship with trauma before it happens.  Learn how to breathe, talk to a professional early, and know that there is always another way to view what has happened. 

The entire city would burn down if we waited for the fire to start to learn how to put out the fire.  Learn the tools before the trauma occurs; if it already has, there is no time like the present to start.

 About the Author

Brandon Evans is a professional firefighter, father, and Founder of Fire to Light, a research and development organization specializing in preventative mental health of firefighters.

Brandon works to raise awareness around trauma in firefighters, helping to identify what it is, where it shows up and what we can do about it, before and after.

Through sharing stories, experiences and tools, Brandon hopes to help reduce the rates of suicide and PTSD amongst firefighters globally.

Fire Dynamics

By: Mark van der Feyst

Rapid fire developments (RFD) are when we have a sudden and immediate change in the fire environment. At one moment we have thick, dark, black smoke with intense heat and the next second, we have a ball of fire from floor to ceiling – this is an RFD.

Every fire department will face RFD’s no matter what type of structure they are dealing with – if it has four walls and a roof, then there is the space and environment for an RFD. The different types of RFD’s are going to be flashover, back draft, and smoke explosions. The three are different in how they develop and react but are the same with the outcomes – deadly outcomes. RFD’s produce RIP’s (Rest In Peace) for the fire service.

Of the three RFD’s, flashover is going to be the one that will occur the majority of time at any and every structure fire. So, what is a flashover? A flashover is the simultaneous ignition of unburned fire gases within a room. It occurs when hot gases rise to the ceiling and spread out across the walls. These hot gases are what we call black smoke – unburned particles of combustion. As it spreads out across the ceiling and the walls, it starts to heat up the items found within the room such as the paint on the walls, the furnishings, clothing, mattress, flooring material, etc. – until they all reach their ignition temperature. Once they are all at their ignition temperature, an RFD occurs.

Before a flashover occurs, there are warning signs that are presented or given off by the fire to indicate that flashover is impending. These warning signs are presented to us both visibly and tactically – our eyes can see and our bodies can feel them.

·       Heat buildup – based upon the temperature range of flashover, there will be a period of time when excessive heat buildup will occur. This heat buildup will descend down towards the lower levels of the room pushing the firefighter down to the floor. This will be the result of radiant heat being produced by the unburnt particles of combustion spreading out from ceiling to walls and then down to the floor area. When this quick increase in heat occurs, and it is an intensive heat; flashover is impending. 

·       Roll over – this is a visible indicator as it reveals itself in the smoke. A roll over or flame over is when small gaps open up in the smoke layer allowing air to mix with the unburned particles of combustion and ignite. Small flames can be seen in the midst of the smoke for momentary periods of time and then disappear. When this occurs, this is a warning sign that flashover is coming.  

·       Thick dark smoke – this is also a visible indicator as it will present itself outside the building as well as inside the building. On the inside, you will not see anything except total blackness: but on the outside, you will notice this. Whenever you have thick dark, acrid black smoke pushing out from a structure under high pressure and with high velocity, flashover is impending. This is an outside warning of what is waiting for us on the inside.

What has been described above are the common signs that we will see and feel at every fire – it is important for the firefighter to learn and understand the basic concept of what a flashover is before being able to learn the actions that can be used to aggressively cool the fire or escape the situation if warranted.

About the Author:

Mark van der Feyst is a 25 year veteran of the fire service and is currently the Senior Battalion Chief at the Six Nations Fire & Emergency Services in Canada and a part time firefighter with the Fort Gratiot Fire Department in Michigan. He has worked in both the USA and Canada for various fire departments and holds a Masters of Science degree in Safety, Security & Emergency Management from Eastern Kentucky University.

From Ideal to Real

By: Rabbi Howard A Cohen (Deputy Chief, ret.) AFM Virtual Training Coordinator

As first responders we are required to absorb an overwhelming quantity of data.  As good as our intentions are to remember all that we are taught, the reality is that we forget details.  This is why constant reviewing, drilling and periodic recertification is so important.  Even with doing our best to keep our skills sharp and our knowledge base current, the reality is that we cannot possibly be experts in every situation we might encounter in the course of work.  For example, though we may have a solid understanding of basic first aid principles, we are not doctors and therefore are limited to the extent that we can help a patient in the field.  Even if we were trained to the level of a medical doctor, in the field far removed from a hospital facility, we would still be limited with what can do.  We do not work in controlled environments or under ideal conditions.  No matter what the situation or our skill level, our response is always on a spectrum that moves from the ideal to the real.

Every three years I re-certify as a wilderness first responder.  Every three years I’m embarrassed to admit how much I’ve forgotten.  Although I wish my memory was such that I was better at calling up a lot of details and data that I rarely ever use, I don’t worry about it.  Why? Early on in my first responder career I was taught two important lessons.  The first lesson is that an emergency response in the field will always be somewhere on the spectrum from the ideal to the real.  As emergency responders we do the best that we can with the tools and knowledge that we have on the scene. This is what it means to move from the ideal to the real.  Remember, as first responders, our objective is keep the patient alive long enough to get to advanced medical care.  It is not our job, nor do we have the skills, to fix or heal patients.  Our job is to stabilize, comfort, and transport our patients.

To do our job well as first responders we do not need a medical education. This brings me to the second important lesson I have learned in my career as a first responder:  Pay special attention to the three big systems: circulatory, neurological and respiratory and do whatever you can do to keep them functioning.  The vast majority of injuries to people are not life threatening.  However, any significant trauma to one or more the three big systems has a high probability of being life threatening.  If a person is bleeding, stop the bleeding.  You do not need to know how to suture.  You do not need to know how long to keep pressure on an open wound.  You only need to know that you have to “plug” the hole where the bleeding is coming from.  If your patient is not breathing you don’t need to know how to do a tracheotomy.  You just need to know what to do to open her airway because if you can’t get your patient breathing she will die.  Ideal to the real.  Remember, it is not our job, nor do we have the skills, to fix or heal patients.  Our job is to keep them alive and as comfortable as possible as we get them to advanced medical care.

As first responders we will always strive to respond with the very best of our abilities.  That’s what we do.  However, the reality is that we are generalists trained to respond to a mind boggling variety of emergency situations that always happen under less than ideal conditions.  Ideally, we might want to respond in a certain way, in reality, the situation and our knowledge level will determine our response.  Therefore, it is important to remember that emergency medical responses in the field always fall somewhere on the ideal to real spectrum. Our goal is to do the best that we can with the tools and knowledge we have on the scene.

About the author:

Howard joined the fire service in 2001 to serve as chaplain of his local fire department. Twenty years later he retired as his department's deputy chief.  Howard planned to join Africa Fire Mission on a trip to Zambia but Covid interrupted those plans. He has since traveled twice to Kenya with AFM. He is regular AFM blog contributor and webinar instructor. Outside of the fire service, Howard serves as rabbi to Congregation Shirat Hayam in Duxbury MA. He also has a leadership and mental fitness coaching practice called code3leadershipcoaching.

Got L.C.E.S.?

By: F. R. Montes de Oca, EFO, MESH, CPM 

Previously published in The Pennsylvania Fireman

In a former life I wore many hats – firefighter, paramedic, chief training officer and fire chief, to name a few.  Now, I spend time researching and sharing information I hope in some small way assists those now holding the line in the trenches.

  A few years back as the fire chief of a department whose 1,500 square mile response area included sixty miles of the Florida Turnpike, I listened intently when units responded to motor vehicle accidents (MVAs) on this limited-access, high speed roadway.  Every day, typical traffic on this motorway consisted of semi-tractor trailer rigs speeding well over the posted limit. And to make the situation even more challenging, there was never a shortage of families travelling up and down the spine of Florida with visions of Mickey Mouse in their sights. Mix a collection of church and retiree vans filled with Mickey fans rocketing to the world-famous vacation destination just south of Orlando, and you’ve got a recipe for disaster.

  Shortly after receiving a delivery of several engines and ambulances decked out with the latest DOT and NFPA lighting packages and exterior high-visibility markings I received the call every fire chief dreads. “Comm to Chief 1, Engine 6-2 has been struck on the turnpike by a van.  Significant damage. No injuries reported. Standing by for follow-up report and will update you.” 

  Prior to this report from Comm, Engine 6-2 arrived on the scene of a minor MVA. During initial size-up, Engine 6-2 and Medic 6-2 was sideswiped by a church van.  Damage occurred to both engine and medic unit, but fortunately no responder injuries.  A few van occupants were slightly injured.

  Now to keep the incident a bit more interesting, this event occurred a few weeks following the catastrophic damage of another recently-delivered engine.  On the morning of this event the turnpike was enveloped in a thick blanket of smog;  the result of smoke from a weeks-long underground peat bog fire combining with early morning fog.  Following the closure of the turnpike twice and receiving pressure from the Governor’s office, state highway patrol ordered the thoroughfare reopened. Shortly after this, a car struck a slowed semi hauling lumber at a high rate of speed.  All four occupants of the car died on impact. While Engine 5-7 was sizing up the scene the officer sensed an eerie quiet combined with a faint, low frequency rumble and ordered all crew members off the road.  Within seconds another lumber hauler struck Engine 5-7 severely damaging the unit, but no responder injuries. Immediately, the officer requested an additional engine and medic unit to assist.

  Within one week of the event, I convened a meeting of senior officers along with training staff to discuss and develop an enhanced limited access highway operational policy.  The result was the beginning of a policy based on the LCES practice utilized by wildland firefighters.

To paint a better picture of the department, its response area includes a large rural setting of approximately 1,500 square miles resulting in a very active annual fire season. In addition to the typical structural, medical and special services training regimen, members were well-versed in wildland firefighting procedures and tactics included in the National Wildland Coordinating Group (NWCG) S-130 and S-190 curriculum. During one of the highway policy discussions a young training officer whose focus and experience was wildland operations suggested we look at LCES.  Several of us collectively stared at him in puzzlement. Quickly an “aha moment” look appeared when the group realized the suggestion had legs.  Below is a summary of the outcome that assists firefighters operating at limited access, highspeed thoroughfares.

  As a result of researching and transforming the LCES concept into a traffic safety policy, we discovered the teachings of Paul Gleason, an avid wildland safety proponent and veteran wildland firefighter who defined common WUI hazards and solutions. This is the abbreviated version of the new LCES strategy for MVAs, which can be applied to essentially all fire service emergency scenes.

  Upon arrival at an MVA the size-up includes applying the LCES policy. This includes the company officer and crew members quickly surveying and establishing an immediate refuge point.  The most common and readily-available refuge point is over the guardrail considering elevation and not compromising patient care. All engines whose first-due areas included high-speed, limited access routes would be assigned an extra member to play the role of lookout.

Lookout at all turnpike and similar responses is posted to the rear of the unit closest to oncoming traffic. The Lookout’s sole assignment is focusing on approaching traffic. At any sign that oncoming traffic poses a direct threat to the scene the Lookout would utilize a handheld, portable airhorn. Upon hearing the airhorn signal, all members immediately begin moving to the designated refuge site. In the department’s command system, Lookouts are considered Assistant Safety Officers whose sole function is spotting approaching traffic threats.

Communication(s) at the commencement of operations and throughout the operation the company officer communicates to on scene members keeping them abreast of possible threats. Active communications is a conduit to deliver safety and operational messages throughout the event. Safety Officers (assigned to multi-alarm incidents) would work in tandem with Command and the Lookout to maintain a high degree of safety and threat awareness.

Escape Routes in almost all cases were the closest, most direct access to a refuge point using the guardrail as a striking buffer.  Integral to the safety plan was reconning the area focusing on safety threat potentials along the highways. Another, more succinct definition by Paul Gleason, “Escape routes are the path the firefighter takes from their current locations, exposed to the danger, to an area free of danger.”

Safety Zones during this time were locations where responders threatened by oncoming traffic or similar threats could find refuge. During highway operations this was often “over the rail”.

What evolved as a concept, quickly terminated into a policy aimed at saving lives during often chaotic times. As the department began exploring other on scene protective techniques, vehicle positioning was incorporated into the practice.  And as Traffic Incident Management (TIM) continues to gain traction across the country, I suggest any and all objectives and strategies included in that extremely successful campaign be incorporated.

In a recent publication, I stated that Fire and EMS departments are living, breathing organisms whose members wish to serve their communities and feel proud of their accomplishments.  This is a constant that I have found throughout my travels and discussions with peers and colleagues.  As is said among campers; “Leave it better than you found it.”

Go forth and be safe.

About the Author: Frank Montes de Oca served as a firefighter/paramedic for over 38 years and appointed fire chief in Springfield, Ohio and Osceola County, Florida. His last appointment was as Emergency Services Director in Orange County, North Carolina.  Throughout his career he has been deeply engaged in developing firefighter safety training, leadership development and organizational change. Chief Montes de Oca is an adjunct instructor for the National Fire Academy and qualified to present training programs for Occupational Safety and Health Administration and the Environmental Protection Agency. He can be reached at frm1@me.com or www.responder1.org.