Firefighter short-hand: what does it mean?

I realized this morning as I was captioning a photograph on my morning update ("2nd alarm, Newark, NJ, heavy fire conditions in a single-story, commercial taxpayer. All hands working.") and I realized, unless you are a firefighter, you probably didn't understand what I was talking about. Using the photo at left, I will give you the short-hand description - that we would transmit over the radio - and then explain it in plain language.

Short-hand version:

W/F on a two story commercial structure with apartments above. Advancing 1.75" hand lines to the front door on the alpha side. Have the second due engine establish positive water supply. DWH. All hands working.

Plain language explanation

Crews arrived at the two story building that has a business (commercial) occupancy on the first floor and residential (apartment) occupancies on the second floor. The first engine on the scene is going to advance multiple one and three quarter inch hand lines to the front door. The officer on that engine is requesting that the next engine to arrive connect to the nearest fire hydrant (and then to the first engine) to establish a positive water supply. Based on the conditions observed on arrival, the officer suspect that it is doubtful that he will be able to hold (contain) the fire with the units currently on the scene. This indicates to the 911 center / alarm center / radio room to be prepared to dispatch multiple units ("alarms") to assist with the containment operation.

Firefighter deaths from cardiovascular events (Part 2 of 2)

In part one of "Firefighter deaths from cardiovascular events" I discussed the effect smoke - especially particulate matter - has on the cardiovascular system and what places us at higher risk than the general population. Today, I will look at what can be done to prevent us (I was a volunteer firefighter for 25 years) from becoming a statistic.

V. What can be done to make us healthier

Get a yearly physical

Ask your physician to conduct a complete blood panel (also known as a complete blood count or CBC). In addition, ask him/her to include the following:

C-Reactive Protein (CRP) is elevated in the blood when there is widespread inflammation somewhere in the body. Evidence now shows that inflammation and molecules such as CRP (see table below) associated with the inflammation might be just as important as cholesterol in determining the development of atherosclerosis (hardening of the arteries) and heart disease.

CRP level	Risk level
I	Patients are at a low-risk of cardiovascular disease if their high sensitivity CRP (HS-CRP) is lower than 1.0 mg/L.
II	Patients are at an average risk of cardiovascular disease if their HS-CRP is between 1.0 - 3.0 mg/L.
III	Patients are at a high risk of cardiovascular disease if their HS-CRP is higher than 3.0 mg/L.

Low Testosterone levels have been proven to be an independent risk factor for worse outcomes in BOTH man and women suffering from heart failure. It has also been associated with decreased survival for men with coronary artery disease (CAD).

 Eat healthy

Forget about diets and low fat and engage in healthier eating habits. It is important to remember there is not magic pill when it comes to healthy eating. Although there are some benefits associated with taking Omega-3 (usually taken in the form of a fish oil supplement), there are published studies that say otherwise. In analyzing past studies, there is no difference in the number of heart attacks, strokes, or deaths among people with heart disease who took a fish oil supplement.

Include more fruits and vegetables in your diet. These are high in antioxidants and continued good health is dependent on open, flexible arteries that are able to deliver blood efficiently throughout the body. The key to this is to combat cell damage caused by free radicals which cause fatty plaque to build up on artery walls.

Exercise and control those emotions

Exercise and exercise some more. Thirty minutes of aerobic exercise has been shown to reduce the risk of myocardial infarction (MI) by seventy percent (70%) over a one (1) year period. Researchers at the Mayo Clinic found that walking briskly for 10-minute a day reduces the risk of an MI by fifty percent (50%).

To quote a song popular in the 80's "Don't worry, be happy". A study conducted by Duke University of 255 doctors showed that fourteen percent (14%) of them rated themselves above average for hostility based on a personality test given as part of the study. Within 25 years following the study most of them had died from an MI compared with two percent (2%) who had tested below average for hostility.



Additional information:  Firefighter deaths from cardiovascular events, Heart disease and firefighters

Firefighter deaths from cardiovascular events (Part 1 of 2)

I. Introduction

Coronary artery disease (CAD) in firefighters is due to a combination of workplace factors and personal factors such Diabetes mellitus, hypertension, smoking, elevated blood cholesterol (HDL-C), obesity, and a lack of exercise (AHA, 2007). Although not as widely known, firefighters are also exposed to factors in the workplace which are also associated with adverse cardiac outcomes.

II. Cardiovascular effects associated with smoke

Think back to your first fire academy class. You learned that smoke is a combination of heated gases, vapors, and particulate matter. It is also important to remember that the composition of smoke is determined not only by its fuel source, but also by fire conditions such as oxygen availability and temperature (Kulig, 1991). While hundreds of decomposition products can be found, two gases with known cardiovascular effects are carbon monoxide and hydrogen cyanide.

Carbon monoxide (CO)

Carbon monoxide - a product of incomplete combustion - is present in virtually all fire environments. One thing I think many of us are guilty of overlooking is the fact that high CO levels are usually still present during the overhaul phase of an operation and, to make that situation worse, it is during this phase of the operation that many firefighter's remove their self-contained breathing apparatus (SCBA). When CO is inhaled, it disrupts the transport of (and intracellular use of) oxygen which can result in a myocardial injury.

Hydrogen cyanide (HCN)

Hydrogen cyanide is formed due to the incomplete combustion of substances which contain both carbon and nitrogen (e.g. paper, cotton, and wool). It has frequently been detected in residential structure fires in levels that exceed established exposure limits. Like CO, hydrogen cyanide disrupts the intracellular use of oxygen resulting in intracellular hypoxia with cardiac manifestations.

Particulate matter

It's a well-known fact that firefighters are exposed to particulate matter contained in the smoke from a structure fire. (For those who might be reading this blog and not be associated with the fire service, particulate matter is the "sum of all solid and liquid particles in air many of which are hazardous". Studies conducted in the general population have indicated that particulate matter, as a component of air pollution, has adverse cardiovascular effect. For example, short-term exposure to particulate matter has been shown to trigger heart attacks particularly in persons with pre-existing heart disease.

III. Why are we at higher risk

It is a well-known fact that sleep plays a vital role in helping our body recover from fatigue, illness, and stress. Without it, our metabolic rate begins to decrease resulting in weight gain. A firefighter's "internal biological clock"is often disrupted numerous times during a shift making it difficult to regulate the sleep-wake system.  In addition, researcher's at Boston Hospital and Medical Center have determined that prolonged sleep restriction combined with circadian rhythm disruption can be a contributing factor to an increased risk for diabetes.

Electrocardiogram (ECG) tracing shows coronary
heart disease

As if that wasn't bad enough, the University of Chicago conducted research that shows a direct link between sleeping (or the lack of it) and a increased risk of cerebrovascular accident (stroke), myocardial infarction (MI), and congestive heart failure (CHF). According to their findings, an individual who sleeps more than eight (8) hours a night or less than six (6) hours a night has a significantly higher chance of experiencing chest pain or angina and developing Coronary heart disease.

As a firefighter, we are exposed to traumatic stress almost every shift. If we work thirty (30) years that stress will take a toll on our body both physically and mentally. Researchers at the University of California - San Francisco  (UC San Francisco) have found that these exposures over the course of a lifetime will experience an increase in inflammation in their body even if they don't develop Post-Traumatic Stress Disorder (PTSD). These increased levels of inflammation also tend to put the person at a greater risk of having an MI. Intervention strategies to combat this stress, such as exercise, yoga, and other health-related activities should be integrated at the start of a firefighter's career.

IV. Conclusion

Chicago Engine 29 operates at an early morning
warehouse fire.

Firefighting in and of itself is a physically demanding job and will eventually break even the healthiest body down. According to a study performed at the Illinois Fire Service Institute (IFSI), just three (3) hours of prolonged firefighting stiffens arteries and impairs function of the heart in young, healthy male firefighters. This same phenomena is seen in both heavy powerlifters and marathon runners. This means firefighters who do not value the importance of physical fitness are at a greater risk of exhibiting several factors of cardiovascular disease including being overweight and becoming hypertensive.

Additional information: Firefighter deaths from cardiovascular events, Heart disease and firefighters

References

American Heart Association (AHA) [2007]. Risk factors and coronary artery disease. Retrieved on September 19, 2017 from http://www.americanheart.org/presenter. jhtml?identifier=4726

Hofman, John (September, 2012). Heart disease and firefighters: how and why? Retrieved on September 28, 2017 from http://www.fireengineering.com/articles/2012/09/heart-disease-and-firefighters-how-and-why.html

Kulig, K. [1991]. Cyanide antidotes and fire technology. New Eng J Med 325:1801-1802

September is National Preparedness Month

It wasn't until earlier this morning when I was on Facebook that I remembered that September is also National Preparedness Month. I thought on how I could do my part to raise awareness of preparedness and I thought the best avenue would be to address preparedness and the disabled. That being said, "Lets do this".

The first step in preparing for an emergency is to consider how it will affect you as an individual (emphasis added). The first step in doing this is to realize that you might have to fend for yourself for up to three (3) days without access to disaster assistance, a medical facility, or even a drug store. With that in mind, you (and your family) need to consider what resources you utilize on a daily basis and what you would do if there is a limited supply or none at all

I. Prepare an emergency kit

Example of a room modified for
sheltering-in-place

Think first about the basics -- food, water, and clean air and any other life-saving supplies needed to maintain health, safety, and independence. Disaster preparedness experts - such as the American Red Cross - recommend having two versions of these basics: 1) A kit that contains the basics you would need to "shelter in place" (preferably in a interior room of your house or apartment with few or no windows) for up to 72 hours; 2) A light weight, smaller version of the kit (referred to as a "go kit") that you can take with you if it becomes necessary to evacuate your home.

II. Make a plan

The reality of a disaster is that it will likely prevent your from having access to the everyday conveniences to which we have become accustomed. If you have a "support network" that helps you on a daily basis, make a list of their names and how you can contact them during an emergency. It's also important to consider the mode of transportation that you use on a daily basis; what alternative modes will be available if there is a weather-related emergency (such as an snow storm) or a disaster. When planning for a disaster, it is imperative to take into consideration specialized equipment (such as mobility aids) that you are dependent on day-to-day. What would you do if these were not available? In the nutshell, for every aspect of your day-to-day life, you should have an alternate way to accomplish this.


For additional information: Preparing makes sense (PDF)

Do they not understand sometimes?

Link to newspaper story: Fire Chief arrested as PD officer allows structure to burn

We often joke about a our colleagues in the police department not understanding what we do, but the article above points out there might be more truth to the statement than we are willing to admit. Earlier this week in Cannelton, Indianna, Fire Chief Christopher Herzog was arrested by a CIPD officer who felt that his authority was "being threatened".  According to Indianna media outlets, Ryan Foertsch was on the scene (dressed in plain clothes) and attempting to smash open a window. Chief Herzog stopped him and was promptly arrested for "interfering with an officer" or some such manufactured charge. It didn't stop there, however, as Foertsch (and other CIPD officers) stated "We are in charge of this scene now" and ordered fire personnel to leave the scene. Perhaps those officers should be reminded that the National Incident Management System says unequivocably that the first-arriving fire personnel on a scene are the ones in command of the incident -- not the police. Because of their actions, the home was for all purposes destroyed.

As one newspaper article on the incident stated . . .

 "It seems that officer Foertsch was more concerned with his own ego and perceived authority than he was with saving lives, which is a dangerous consequence of giving some people unlimited power"

Following the northern Arizona wildfires

Being a college sophomore studying both Fire science and Emergency Management, I have spent the last few days monitoring the northern Arizona wildfire. The human-caused fire has been burning since last Tuesday (May 20) and currently covers 21 square-miles (Associated Press, 2014). Containment is currently estimated at 25% although a spokesman stated "It will still be a lot of work to be done before those numbers will increase significantly".

I first heard about the fire from a long-time friend who lives in Sedona and started searching on Broadcastify to see if I could hear scanner traffic about the fire. Since then - at least during the daytime - I've listened to the Northern Arizona Wildland Agencies feed as they work to control the fire that is burning around Oak Creek Canyon between Sedona and Flagstaff. The fire has necessitated the closing of Slide Rock State Park.

Fire Managers said their primary goals are to protect an estimated 300 structures threatened by the flames in Oak Creek Canyon, preventing the flames from pushing into the communities of Forest Highlands and Kachina Village located east of the fire, and minimize potential flooding that could occur. Thus far, no homes have been destroyed by the fire.

Bibliography

Associated Press. (2014, May 26). Officials say northern Arizona wildfire 25 percent contained. Retrieved from Fox News: http://www.foxnews.com/us/2014/05/26/northern-arizona-wildfire-grows-but-officials-say-firefighters-making-progress/

Cross-training firefighters as code inspectors

Last night I was working on the discussion board for my Principles of Emergency Services class and I decided to try something new: I enlisted the "voices of experience" by posting the question on Facebook and asking my friends to respond. I want to thank Jerry Michael Allen (Deputy Chief, Brunswick Fire Department), David J. Bullard (Lieutenant,  Columbia County Fire/Rescue Department), Robert J. Duncan (Firefighter, Bradley County Fire/Rescue Department), David Harris (Chief, Mountain Park Fire Department (Ret.)), and Jeff Williamson (Captain, Johns Creek Fire Department for their invaluable input. Here is my discussion board:

Since I know in the past cross-training has been something of a “hot button” topic, I decided to post this question on Facebook to get the thoughts of both current and retired firefighters on my friend’s list. As I suspected I got mixed reviews with some coming out in favor and some opposed. Honestly, I think I have to agree with the mindset of being opposed because, from my experience, department’s that utilize cross-trained personnel tend to have problems with both areas of duty not receiving equal attention. Consider the responsibilities that are already placed on the plate of Firefighter/Medic’s and then add the following duties if they are also responsible for inspection/code enforcement: 1) the design of fire safe assemblies and systems; 2) Review of plans; 3) Inspection of fire safety equipment; and 4) Public education in fire prevention just to name a few responsibilities (Klinoff, 2012). Surprisingly, the strongest opposition did not come from line personnel, but from chief officers – one active and one retired. Explained Deputy Chief Michael Allen of the Brunswick, Georgia Fire Department: “a firefighter doing code enforcement is a bad idea. If a firefighter does all the things expected along with EMS First Responder and all the special ops they shouldn't have time to do other peoples jobs,” (Allen, 2013).

In the interest of fairness, I did some on-line research and found a blog entitled “The Pros and Cons of Cross-Training” written by Mr. Hoyt Mann. In the blog he presented both the pros and cons associated with cross-training (Mann, 2009):

 

Pro	Con
Possible to transfer ideas from one area of responsibility to another	Jack of all Trades is master of none. A limit of two (2) areas to support is probably best.
Keeps you fresh	Burn-out can occur if you are asked to switch back and forth too often or too quickly.
May keep you from being laid off	No time to catch up on reports or other paperwork.
If management is in your future, knowing more than one could be useful	Tends to be more stressful

 

In conclusion, I will leave you with the opinion of retired Mountain Park (GA) Fire Chief David Harris: “If you are at a station which has hardly any calls it would be OK. They had us doing that for a while at FCFD #2's and we were never able to complete the task in our first alarm territory. We were also out of position and or late responding many times because of it,”  

Reference

Allen, M. (2013, September 22). Would you support the idea of cross-training your local firefighters to perform inspection/code enforcement roles? What are the “pros” and “cons” to this idea? [Online forum comment]. Retrieved from https://www.facebook.com/wtlittle Retrieved: September 22, 2013

Harris, D. (2013, September 22). Would you support the idea of cross-training your local firefighters to perform inspection/code enforcement roles? What are the “pros” and “cons” to this idea? [Online forum comment]. Retrieved from https://www.facebook.com/wtlittle  Retrieved: September 22, 2013

Klinoff, R. (2012). Introduction to fire protection. (4th ed., p. 322). Clifton Park, NY: Cengage Learning. DOI: www.cengage.com/ Retrieved: September 22, 2013

Mann, H. (2009, January 12). [Web log message]. Retrieved from http://www.phaseware.com/PhaseWare-Files-blog/bid/12379/The-Pros-and-Cons-of-Cross-Training-in-the-support-center-not-the-gym  Retrieved: September 22, 2013