2020
Guide
2020
Guide
A good HEART and TRAINING are not the only things firefighters need to get their job done. This is where Carolina Fire Rescue EMS Journal’s eBook Buyers Guide comes in. Within these pages you will find an array of solutions for the challenges you face on the fireground. Take a few minutes to peruse the offerings from top of the line fire industry providers. Unlike print-only publications, this eBook contains offerings with direct links that will connect you to the manufacturers pages for further information. Chances are that within these pages you will find something that will help you and your department save lives and protect property. These companies want your business. 2
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Dealing With Gases Mark J. Schmitt
The Department of Transportation’s Hazard Class Two contains all of the gases. There are many definitions of what exactly a gas is, but one of the easiest to understand is that used by Merriam Webster that states that a gas is “a fluid (such as air) that has neither independent shape nor volume but tends to expand indefinitely.” A gas will expand to fill the size of any container that it occupies and will continue to expand until acted upon by an outside force. Think of an expanding gas like a rising column of smoke. In a structure fire, smoke will expand and fill the room until visibility is reduced to zero. In an outside fire, the column of smoke will rise into the atmosphere until it is dissipated by the wind. Gases will act in much the same manner. All gases can be divided into four basic categories: flammable, non-flammable, oxidizers and poisonous. As with all hazardous materials shipments, they are only required to be placarded to the highest hazard. Therefore a poisonous gas can also be flammable or vice-versa. Gases are always stored and shipped in some sort of pressurized container. It may be as small as a cylinder to power a pellet gun or as large as a railroad tank car or fixed facility tank containing hundreds of thousands gallons.
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All gases can be divided into four basic categories: flammable, nonflammable, oxidizers and poisonous. As with all hazardous materials shipments, they are only required to be placarded to the highest hazard. Regardless of the size or contents of the container, the fact that the contents are under pressure must always be respected. To do anything less invites disaster. In responding to hazardous materials emergencies, we must understand a few terms that pertain to gases. You do not need to be a Hazardous Materials Technician to understand these terms. In fact, we are just reviewing terms that you learned about when you took your Hazardous Materials Operations course. The first term relates to flammable gases and that is the Flammable Range. The Flammable Range is the area between the Lower Flammable Limit (LFL)
and the Upper Flammable Limit (UFL). If the concentration of the flammable gas in air is less than the Lower Flammable Limit, the mixture is “fuel lean” and will not burn. There is too much oxygen and too little fuel for the mixture to burn. Conversely, if the concentration of the flammable gas in air is more that the Upper Flammable Limit, the mixture is “fuel rich” and also will not burn. There is too much fuel and too little oxygen for the mixture to burn. This situation is by no means to be considered safe. A sudden influx of fresh air from a ventilating system or open window could introduce enough oxygen to drop the mixture directly into the Flammable Range. This could have
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catastrophic consequences. While the Flammable Range is associated with flammable gases, do not be lulled into a false sense of security if a material is placarded as a non-flammable gas. As hard as it may be to understand, some non-flammable gases CAN AND WILL burn! According to CFR49 173.115, in order for a gas to be placarded as flammable, one of the following two conditions must be met: (1) The gas must be ignitable at 101.3 kPa (14.7 psi) when in a mixture of 13 percent or less by volume with air; or (2) The gas must have a flammable range at 101.3 kPa (14.7 psi) with air of at least 12 percent regardless of the lower limit. A gas such as ammonia will burn, but it is not placarded as flammable because it has a relatively narrow Flammable Range of 16 to 25 percent. The Vapor Density of the gas must also be known. The Vapor Density of regular air at sea level is one. Any gas with a Vapor Density greater than one will be heavier than air and will sink to low lying areas such as basements, sewers or storm drains. Any gas with a Vapor Density less than one will be lighter than air and will rise into the atmosphere. Depending on the product in question, this could create an extremely hazardous area of concern downwind. At best, the wind will dissipate the product until it is no longer a concern. Most gases are heavier than air with only a few being lighter than air. If you can remember the simple acronym 4H MEDIC ANNA, you can remember the gases that are lighter than air. These lighter than air gases
Most gases are heavier than air with only a few being lighter than air. If you can remember the simple acronym 4H MEDIC ANNA, you can remember the gases that are lighter than air. are Hydrogen, Helium, Hydrogen Cyanide, Hydrogen Fluoride, Methane, Ethylene, Diborane, Illuminating Gases, Carbon Monoxide, Acetylene, Neon, Nitrogen and Ammonia. The Vapor Density and Flammable Range can easily be found on the Safety Data Sheet (SDS). The SDS can be found in fixed facilities or with hazardous materials shipments. In the era of smart phones, this information can easily be located by searching for the product name or United Nations Identification Number on any Internet search engine or a wide variety of hazardous materials related smart phone applications. The primary hazard in dealing with any gas is a BLEVE (Boiling Liquid Expanding Vapor Explosion). Gases are pressurized to change them from a gaseous state to a liquid state for ease of storage and transportation. Any pressurized container that is exposed to excess heat will cause the liquid product to boil producing vapor. This vapor production will increase the pressure inside the container. If the pressure exceeds the rating of the pressure relief valve or design pressure of the container, a BLEVE will occur.
A BLEVE will cause the container, or the remains of the container, to rocket in any manner of directions. It is impossible to predict in which direction the container will travel, so don’t even try. Even the smallest container — think an aerosol can — will become a lethal missile traveling at high rates of speed. Make no mistake; being struck by one of these containers, or parts thereof, will kill you. Don’t become a statistic! Poisonous gases present a great difficulty for first responders. They vaporize easily and very dangerous to life, even in small amounts. They are also known to be so toxic to humans as to pose a hazard to health during transportation. Poison gases are also presumed to be toxic because of laboratory testing. When reviewing an SDS for a poisonous gas, you will see that the material was more than likely tested on laboratory animals such as mice or rats as it is illegal and unethical to test these materials on human beings. Even SCBA may not provide enough protection for the First Responder as these materials can easily be absorbed through the skin. Poisonous gases will always require the response of a Hazardous Materials Team with Level A Chemical Protective Equipment. The last gases we will discuss are oxidizers. Oxidizers will not burn like a flammable gas but they will support combustion. Oxygen is a common oxidizer and can be found in many residential occupancies. A patient on home oxygen that suffers a structure fire in their residence will see the oxygen they depend on intensify the fire. It is impossible to tell you how to respond to every gas emergency you may encounter during your career in the fire service. In order to keep your skills sharp, you must maintain proficiency with both Safety Data Sheets and the Department of Transportation’s Emergency Response Guidebook. Reading a placard and being able to interpret the SDS or the ERG could mean the difference between a successful incident and a lawsuit. It could literally be the difference between life and death.
Until next time, stay safe!
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Steve Marks
When I began my career in the fire service in 1982, I aspired to one day become a chief. I believe that many young firefighters share that dream of one day serving in a leadership position in the fire service. I am not sure, however, that we always properly prepare our rising leaders for such a position. Nor do I believe that we equip them to sustain themselves once they reach their destination. Climbing the career ladder can be very fulfilling. But it can also be dangerously overwhelming at times. To be as inclusive as possible, I define a fire service career as simply one of serving. You may be serving as a paid firefighter or as a volunteer firefighter, or in some cases both. Regardless of the classification, you are still called to serve in a professional capacity that I define as a career. So this message applies equally to my peers in both the paid as well as the volunteer fire service. And while leading a paid staff does differ from leading volunteers, the skills needed to become and remain a leader apply to everyone. There are steps — or in our case rungs — that we climb throughout our career as we move from the position of rookie firefighter to fire service leader. There are generally some proficiency requirements that we must master as we move up the ladder. In theory, we should be well versed on the basic skills necessary to do the job. Then we should receive additional training to effectively manage and lead our organization before we are actually assigned that responsibility. I have found that the promotional process
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up the career ladder is often based more on technical capability than leadership capacity. We all know that one firefighter who was an outstanding nozzle man or an extraordinary fire equipment operator, and was subsequently promoted to a company officer because of their strong technical proficiency. Yet once promoted, we see that same fire officer struggle to manage his/her people. This occurs because we have not prepared our folks for leadership positions. I have also seen how the concept of promotion based on popularity can elevate folks who are quite likeable into positions that they are simply not equipped to undertake. Many volunteer fire departments still elect their leadership positions. I’m sure that in some cases the outcomes have been favorable. But as a rule, voting someone into a leadership position is more about departmental politics than it is about leadership ability. And such a system can have disastrous consequences for everyone involved. So, if you are a fire chief — or someone in a senior leadership role — or if you are aspiring to serve in that capacity, do you want to be leading an organization that is not actively developing the leadership potential of the future fire department officers? Interestingly, there are chief officers who do not want to provide their folks with such training. Some of the comments I have noted include: “If my people know more or can perform better than me, I will surely be replaced.” “I learned about leadership the hard way. They should too.” “Leadership training is that touchfeely crap. Our folks don’t want any of that.” “I am the fire chief. My people don’t need to know about leading the department because they will begin to second guess me. My job is hard enough already.” Knowledge is power. We have all heard that before. And no doubt it is true. But more powerful than knowledge is well intended empowerment and delegation. I have never met a chief who has the answer to everything. I have met some very intelli-
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gent chiefs who knew that their effectiveness was in their ability to prepare, train, equip and empower a leadership team to successfully carry out the mission. A good motto to work by is simply, “teamwork makes the dream work!” I think we all agree that the fire service cannot survive without men and women who learn the basics of fire fighting and are able to carry out the organizational mission. That is what we do. I would now ask you to consider taking that one step further. The fire service cannot flourish without equipping our folks to serve as leaders in addition to training them on the necessary technical skills. As chief officers, are we committed to that process? If the leadership of the organization is not 100 percent committed to a process, then that process will inevitably fail. If the chief is not on board, there is little chance that the governing body — Board of Directors, Council, Commissioners, etc. — will even know about the initiative, let alone support it. And rest assured that those folks reporting to the chief certainly would not feel compelled to run with the program without the necessary support. So what happens when there is no support for organizational leadership development, empowerment and delegation of responsibility? In most cases the fire Department does not cease to operate. Most firefighters will continue to work or volunteer because it is in our DNA. However, the safe and efficient operation of fire protection may be diminished because personnel lack motivation due to low morale or personnel have chosen to leave the department thereby reducing staffing to potentially unsafe levels. Furthermore, when morale is low, departmental tensions normally run high. Who wants to come to work or hang out at the fire station when there is always some drama to contend with? No one wants this type of atmosphere nor does the leadership ever strive for such a negative environment. It just seems to happen over time. And this is what leads to a separation between the leadership
and the membership of the department. Once separation occurs, it becomes increasing difficult to reunite. Separation inevitably leads to isolation. If we consider that the strengths of our organization come from teamwork, empowerment and delegation, the effective fire service leader must remain engaged, not isolated. Engagement requires effort. Effort requires commitment. Commitment requires passion — that same passion we all embraced when we began our careers in the fire service. Serving as a chief officer is more than simply sitting behind a desk or commanding incidents. It’s all about the leadership. Effective chief officers harness their passion for the good of the department. They prepare themselves for leading the organization by attending professional development programs, by learning from other fire service leaders, and by immersing themselves in a culture of continual improvement. Effective chief officers understand the importance of preparing future generations to lead the department one day. They serve as positive role models and mentors. They encourage leadership development. Climbing up the ladder requires a number of positive attributes. For example, important qualities include confidence, determination, dedication, proficiency, commitment, and resilience just to name a few. The ladder may be an extension ladder on the fire ground or a career ladder within the fire department. These characteristics are appropriate for personal development in either case. Climbing up the ladder means that we never stop learning and we never stop leading. Serving in a leadership capacity as a chief officer will be very fulfilling and rewarding as you develop your leadership skills as well as those skills of others. Equipping yourself for success is paramount. Delegating responsibility and empowering others for success will bring you great satisfaction in your career. While climbing any ladder can be challenging, reaching the top and helping others climb with you makes the effort all the more worthwhile.
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Firefighters often find mealtime at the station a challenge to good eating. Instead look at it as a opportunity for the firehouse kitchen to become healthy. Work as a unit just like you do on all your tasks so you will have support to make these changes. Try this as a 30 Day Challenge for everyone on your shift.
The Refrigerator
Let’s start with the fridge, the heart of your kitchen. If you find something in your fridge that is on the “Dump This” list, then you know what you have to do. Get that garbage bag ready.
Dump This:
Karen Leatherman
Beverages with high fructose corn syrup or sugar. Drinking calories is one of the quickest ways to gain weight, so quickly rid your fridge of any beverage that lists HFCS or sugar on the ingredient list.
Replace With:
Water. It is a well known fact that most people are partially dehydrated, a condition that is harmful to your health and wreaks havoc on your weight loss efforts. Keep plenty of cold water on hand for proper hydration.
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Dump This:
Rich dairy products. I know that cream cheese tastes amazing, but fat-filled dairy products are extremely high in calories and should not reside in your fridge. Eliminate high-fat cheese, milk and yogurt from your kitchen.
Replace With:
Fresh Vegetables. The produce drawer in your fridge should be overflowing with colorful nutrient-rich veggies. In fact, your fridge should hold more veggies than the drawer can hold. Veggies are filled with fiber, vitamins and nutrients and are a vital part of a healthy well-rounded diet.
Dump This:
Fatty meats. It is important that you be selective about the meats that you eat. I may tell you that chicken is a great source of protein, but if you take that as a license to eat fried chicken everyday then the benefit of the protein will be lost in all the extra fat calories.
Replace With:
Lean meats. Skinless chicken breast, lean ground turkey, white fish - there are numerous choices when it comes to lean meats.
Dump This:
Fruit-flavored yogurt. I hate to break this to you, but that cute individually packaged yogurt is going to do more harm to your waistline than you think. More than 50 percent of the calories in fruit-flavored yogurt come from sugar. Check out the ingredient list and you likely find both high fructose corn syrup AND sugar.
Replace With:
Plain low-fat yogurt, Greek yogurt, or low-fat cottage cheese. If you love yogurt, then get the low-fat plain version. You can even chop up some fresh fruit and stir it in. Another option is to have a scoop of low-fat cottage cheese with chopped fruit on top.
The Freezer
Next let’s take a look into your freezer. Anyone who has walked the freezer aisles at the store knows how plentiful frozen temptations are. How does your freezer measure up?
Dump This:
Ice cream. We may as well get this one over with. Hiding a gallon or two (or even a pint) of your favorite ice cream “for a rainy day” is NOT a good idea. Save yourself from that temptation and don’t buy ice cream.
Replace With:
Frozen fruit. When your sweet tooth
starts acting up, throw an assortment of frozen fruit into the blender and whip up a healthy fiber-filled smoothie.
Dump This:
Frozen Pizza. This is another one of those items that is just too tempting to keep around. Why would you bother to make a healthy dinner when a frozen pizza is calling your name? Ban frozen pizza from your home and watch as your waist starts to shrink.
Replace With:
Turkey or Veggie Patties. For quick dinners keep your freezer filled with lean turkey patties and veggie patties. Serve on a bed of brown rice or on a whole grain bun.
Dump This:
TV Dinners. I doubt that you need me to go into too much detail on this one. The next time that you are tempted to buy a pre-packaged frozen meal, please turn the package over and read the nutritional facts. You will be shocked by the staggering number of calories and less-than-healthy ingredients in these.
Replace With:
Home-made Portioned Meals. Spend some time on the weekends to cook up healthy meals, and then freeze them in portioned containers. Then throughout the week you simply need to reheat and enjoy.
Dump This:
Frozen Breakfast Food. French toast, waffles and pancakes are popular items in the freezer aisle. Don’t fall for the pretty photos and tasty-sounding names. These items are highly processed and contain loads of unnecessary sugar.
Replace With:
Sprouted Whole Grain Bread & Muffins. It is just as easy to throw a slice of sprouted, whole grain bread into the toaster as it is a frozen waffle. Spread it with some natural peanut butter and pair it with a piece of fruit.
The Pantry
Last, but not least, we come to your pantry. This may be the most painful part of your kitchen raid, since most junk food ends up here. So take a moment to give yourself a pep talk before grabbing that garbage bag and opening your pantry.
Dump This:
Sugar-filled cereal. If sugar or high fructose corn syrup are listed as ingredients on your cereal box, it’s got to go. Sugarfilled cereal is basically another form of junk food, and will only add inches to your waist.
Replace With:
Whole Grain Oatmeal. There is a huge difference between instant, sugar-filled oatmeal and whole grain oatmeal.
Dump This:
Refined/White Bread/Rice/Pasta. These highly processed products promote weight gain and a plethora of other health problems. Do not buy “white” bread, rice or pasta - especially if you want to lose weight.
Replace With:
Whole Grain Bread/Rice/Pasta. Whole grain is the best choice you can make. It is filled with healthy fiber, and is less likely to contain harmful, waist-expanding ingredients.
Dump This:
Chips/Crackers. While refined chips and crackers are fun to munch on, the extra calories will quickly add up. Do yourself a favor by not allowing these into your pantry.
Replace With:
Almonds. The key to making this snack a winner is to practice portion control. Place a handful of almonds into individual bags for pre-portioned snacks.
Dump This:
Packaged Sweets. I don’t really have to explain this one, do I? Cookies and cakes and candies shouldn’t be a regular part of your diet, so keep them out of your house. It’s one thing to enjoy a dessert once in a while, it is quite another to routinely eat processed sweets at home.
Replace With:
Dried Fruit. When you want to munch on something sweet, turn to a bag of dried fruit. Make sure that you purchase dried fruit that does not contained added sugars. That completes your self-guided kitchen raid. I encourage you to raid your kitchen every couple of months as a way of keeping your station on track. Karen Leatherman is president/owner of Fitness Forum Occupational Testing Services. She started the first hospitalbased fitness center in South Carolina where she started cardiac and pulmonary rehab programs. She has over 30 years performing exercise stress testing and has been testing firefighters for over 20 years. In addition, she was on the American College of Sports Medicine (ACSM), Health and Fitness Certification Committee where she travelled with a team from the U.S. to India and Hong Kong to teach and administer ACSM exams.
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e h t t n f e o d e i r c a n r’ I w e d e r d B oa an b m y e ‘K Com Bill Suthard
Beware of the ‘Keyboard Incident Commander’ In our last article we discussed how my agency’s use of Social Media made an amazing impact for our community during the holidays. Over the last year or so we’ve also touched slightly on negative aspects that can accompany the use of Social Media. In this article we’ll dive into two of these potentially negative aspects — the “Keyboard Incident Commander” (KIC for short) and the “Internet Troll” (Troll for short).
The KIC
The KIC can be found, primarily, within the fire service and comments on fire related pictures, videos and incident summaries. Within our profession there is no shortage of firefighters that are confident in their abilities, skillsets and knowledge and many feel the need to share this with the rest of us — in the form of opinions and comments on our social media posts. Essentially the KIC is another term for an Arm Chair Quarterback or Monday Morning Quarterback. We’re all guilty of being a KIC — even myself. However, as a Public Information Officer, it is important that you identify and minimize opportunities that a KIC could take over your well intentioned social media post. Their posts could bring into question your agency’s
ability to respond to and or mitigate an incident; unfortunately, your customer could be the one questioning after they read what the KIC has to say. As many have experienced first-hand with our personal social media accounts; people can be rather bold and opinionated in what they post/comment on others’ accounts. Social Media portals give us a vehicle to comment and respond relatively anonymously, bolder and more aggressive than we would in person. Arguments often follow some of these comments which can lead to an increase in anxiety. So much so that the Pew Research Center performed a study on social media arguments. According to the Pew study, 60 percent of those interviewed found social media arguments to be extremely stressful. Pew also discovered that only one in five people (20 percent) changed their mind or opinion following a social media argument. Although this is not a very good success rate, nothing positive seems to result from a social media argument.
The Troll
➢ insert picture “The Troll” here An “Internet Troll” is someone whose sole purpose is to create discord on your page with your followers; he or she may make inflammatory com-
ments, start arguments, or offer wild opinions in the hopes of provoking an emotional response from you or your followers. They’re instigators and their main modus operandi is to cause distress and frustration. Many use nontraceable social media accounts — often with a generic picture and bio. Experts believe that a troll’s actions can be a form of cyber harassment, often using verbal, social and emotional abuse as tools of their trade. The best way to reduce the impact of a troll is to ignore them and not engage them. Engagement is what they want, with emotional engagement their ultimate goal. Don’t feed the troll is the best advice. However, if you feel you must respond to a troll, it’s best to quiet them with kindness, respond gracefully and respectfully, even if they don’t reciprocate (fyi…they won’t). According to a YouGov poll, millennial men are the most likely to engage in online trolling.
KIC versus TROLL
A KIC is very different than that of an Internet Troll. While the troll’s sole purpose is to hurt and bully, the KIC means well in their posts. Although many may perceive a KIC’s post to be an arrogant comment – if the shoe was on the other foot, there is almost certainty that something could be identified on that
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alternate fire scene as well. Why? Because NO fire scene is perfect; after all we are talking about an emergency incident, fire scenes are fast paced and dynamic environments. So, why am I discussing this topic? As a PIO, I have experienced KIC’S and trolls on my agency’s social media accounts. The trolls are fairly easy to manage, as mentioned previously — don’t engage them. I have engaged trolls in the past, as we all have, and I learned the hard way. Many of my customers’ instantly discredit the troll — mainly due to what and how the troll is posting. It’s the KICs that you should be on the lookout for. Their comments come in various forms. From individuals offering tactical response opinions on how the fire department could have responded differently to the incident depicted to ar-
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guing with each other on who has more experience. While we all appreciate constructive criticism; what do our customers’ think when they read these KIC posts? Never lose sight of who our customers are: They’re our residents, visitors, sister agencies, fellow employees and even our community leaders. As a PIO, we cannot afford to let these posts distract or ruin our reputation. A well intentioned social media post can be derailed quickly by a KIC questioning your agency’s ability to mitigate an incident. Imagine what your town manager, mayor or council members would think reading these posts. Protecting Against the KIC So how do you protect yourself from becoming the target of KICs? The solution is simple — don’t give them the material. Our success as PIOs relies on our ability to post material frequently on our social media accounts. Our customers love content, especially content with media attached (photos, videos etc.). So, this is where you have to get crafty and earn your money as the PIO. You need to find a balance, one that satisfies your customers with content, but also doesn’t draw the attention of Trolls or KICs. It’s taken some time to perfect our approach, but it has worked for the majority of the time. Here’s my approach: • Keep content to a minimum. When discussing an incident, stick with the facts, keep it brief and relevant. Don’t offer up any extraneous information. There is a saying in the PIO world: Be brief. Be brilliant. Be gone. • Share Media from the scene tape. I learned this long ago from a veteran PIO. Share media (photos, video) from the ordinary witness perspective (the fire scene tape). Always use some sort of apparatus in the foreground, with the active incident in the background. It allows your customer to see their capital purchase in action, while also sharing the emergency incident you are informing about. • Stay out of the weeds. Do not get too deep into fire scene tactics as this almost always invites critique, which is quickly followed by the trolls and the KICs. Besides, your main customers won’t understand what you’re talking about anyway and if the trolls and KICs show up they may undermine you. • Be very careful using live, scene video. You can’t control everything you film live. What if the firefighter in the background decides to not wear an SCBA on the roof during ventilation or while extinguishing a car fire. What if you
accidentally film someone in violation of Department or OSHA policy? Remember, you’re filming a dynamic scene. I like to film video on scene and then review the video BEFORE I release it. I save Facebook LIVE and Periscope for the softer side of the business, like training, fire prevention, scene briefings and or presentations. • Use extreme caution posting helmet cam videos. I’ve always avoided these videos on our department accounts, they are ripe targets for trolls and KICs. If you do decide to use video like this, I recommend a thorough review of the content prior to releasing. Released video that depicts violations of policy, SOGs could result in liability, troll and KIC activity. They peruse the Internet for material like this.
Coach Your Employees
Last, but certainly not least, make sure you take the time to coach your fellow employees. The fire service is a brotherhood and there exists a tremendous amount of pride and ownership and members can be easily offended when they see a troll or KIC post on the department’s social media accounts, especially if they were part of the incident. The best approach for them is to not comment or participate. Now this can be extremely difficult — but the less engagement the better. Remember: Do Not Feed the Troll! Bill Suthard is a Firefighter/EMT and Public Information Officer (PIO) for the Huntersville Fire Department. The Huntersville Fire Department is a four-station, combination, fire department covering 62 square miles in northern Mecklenburg County. The department, just north of Charlotte, includes two lakes (Lake Norman and Mountain Island Lake) and serves a population of just over 60,000 residents. The department has over 100 part-time employees and approximately 28 volunteer firefighters. Suthard also works for the Charlotte Fire Department where he is currently assigned as a supervisor within their communications division and helps to manage the division’s public information and Social Media accounts. He is also a member of and the PIO for the Carolina Brotherhood Ride. #CBH18 Web: http://huntersvillefd.com Twitter: @huntersville_fd Twitter: @BPSuthard Twitter: @CarolinaBhood Twitter: @CFD_Alarm Facebook: https://www.facebook.com/ HuntersvilleFireDepartment
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Revisiting Radiologicals:
The Basics of Radioactive Hazardous Materials Glenn C. Clapp Many Hazmat Technicians and Specialists make the comment that “I do not do radioactives� — sometimes even with a few unprintable words thrown in. Radiological hazardous materials seem to elicit such a response due to the infrequent nature of responses to incidents involving
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such materials and the erroneous belief that radioactive materials are a mysterious realm of the hazmat discipline. Personally, I would rather respond to a radiological incident rather than one involving an unknown hazardous material or multiple unknown hazardous materials because
radiologicals are a known entity in that we know how to monitor for their presence, their relative level of harm, and we know how to protect ourselves from them. Due to the above, it was felt that we should revisit the topic of radiologicals. Additionally, as of late we have been concentrating
on management and leadership topics in our discussions so it was deemed that a return to the more technical side of things was warranted.
Different Types of Radioactivity
Alpha and beta radiation is of a particulate nature (e.g. like dust particles). Alpha particles are heavy particles that travel only four to seven inches and can be blocked by clothing, paper or skin. Beta particles are lighter than alpha particles and hence travel a farther distance than alpha particles. Beta particles can be blocked by several millimeters of aluminum. Our structural firefighting ensemble (including SCBA) will actually protect us from alpha and low-level beta radiation. Since both alpha and beta radiation are particulate in nature, they can leave contamination behind. Due to this fact, alpha and beta radiation pose some of the greatest threats to emergency responders of any of the types of radiation. Gamma radiation, on the other hand, is not particulate in nature but rather travels as a wave much like x-rays. Due to this fact, gamma radiation does not leave contamination behind and can be blocked by lead. Emergency responders do not usually have to be concerned about the fourth type of radiation — neutron radiation — as it is normally only present inside the containment structure of a nuclear power plant during operation. Neutron radiation is blocked by a thick mass of concrete. As emergency responders, we should all be familiar with the principles of radiation protection that we have been taught since the beginning of our hazmat careers. The first principle is time, meaning we should spend as little time as possible in the area of exposure or possible exposure. Distance is the second radiation protection principle in that we should put as great a distance as is possible between ourselves and the radiological source. The third principle is shielding, as we should put whatever we can in between ourselves and the radiological source to block the radiation as much as possible such as fire apparatus, a masonry wall, or other appropriate objects. This combination of time, distance, and shielding should be ingrained into our hazmat response memories. We are likely to encounter radiologicals in one of two settings, namely either in transportation or in nuclear power plant response and operations. We will first focus on the realm of transportation. The packaging that radiologicals are transported in is categorized by the Department of Transportation (DOT) into three
categories: Industrial, Type A, and Type B packaging. Industrial packaging — also known as strong, tight packaging — is utilized for low-level radiologicals and is designed to withstand normal transportation handling. Type A packaging is designed to withstand normal transportation handling and minor accidents, while Type B packaging is designed to survive severe accidents. Type A and B packaging must meet specified performance-based standards set forth by the DOT. As we all know, individual packages in transportation carrying hazardous materials are required to have labels affixed to them. Packages carrying radioactives are no exception. Radioactive labels exist in three main categories entitled Radioactive I, Radioactive II, or Radioactive III. These labels not only have distinctive colors — all white for Radioactive I; and yellow over white for Radioactive II and III — but also display the trefoil or “propeller” radiological symbol. The maximum allowable level of activity allowed in each category increases as the Roman numeral designator increases. The contents of the container and the activity level are listed on the label, and for Radioactive II and III labels the Transport Index (TI) is also indicated. The TI equals the radiation level at one meter from the package measured in units of millirems per hour. Any highway or rail mode of conveyance carrying any amount of a Radioactive III substance must be placarded on all four sides with yellow over white placards displaying the word “Radioactive” and the DOT hazard class numeral “7.” Prior to transitioning to the setting of nuclear power plant response and operations, let us discuss the measures that we use to quantify radiologicals. Exposure to radiation is measured in Roentgens (R). The biological damage caused to human body tissue is measured in units of Roentgen Equivalent Man (rem). For beta and gamma radiation, one Roentgen equals one rem. Units of time can also be combined with the above units to indicate the dose rate, such as rem/hr or R/hr. Just as in the metric system of length measurement, the prefixes of milli (one one-thousandth) and micro (one one-millionth) may be utilized. For example, in length measurement there are 1000 millimeters in one meter. Likewise, there are 1000 millirems in one rem (or alternatively one millirem equals one one-thousandth of a rem). The level of alpha and beta contamination is measured in units of counts per minute (cpm). In the State of North Carolina, 300 cpm is considered the threshold for contamination. We must next state that the likelihood
of a radiological release from a nuclear power plant is highly unlikely due to the highly regulated nature of nuclear power plants and the redundant safety measures that are in place. Nuclear power plants simply utilize a nuclear reaction to heat water into steam to turn a turbine that is attached to a generator. If responders ever were required to conduct operations at or near a nuclear power plant, however, they should be trained in the use of radiological detection and protection equipment and principles. Personnel entering into an area of possible exposure or contamination would wear a device called a pocket dosimeter on their person that provides a direct reading of exposure levels and is read at regularly specified intervals. Personnel also would wear a thermoluminescent dosimeter (TLD) which is now also known as a personal record dosimeter (PRD) that is returned following the possible exposure and is read after the fact to determine exposure levels, serving as a second source of information regarding exposure levels. Personnel and vehicles exiting the area of possible exposure would also be monitored for contamination, with the aforementioned threshold of 300 cpm existing in the State of North Carolina to denote contamination. The first level of concern for responders to nuclear power plant incidents is the administrative limit of one R or rem. When that exposure level is obtained, the responder must notify their supervisor. One major topic of note is that in the State of North Carolina, the remaining levels of concern for exposure in nuclear power plant response have recently been reduced by half. The turn back value or working limit of two and one-half R or rem is the exposure level at which the responder must exit the area of exposure or possible exposure. Responders may protect critical facilities up to an exposure level of five R or rem. Lifesaving activities can be conducted at up to 12 and one-half R or rem, and voluntary lifesaving activities can be conducted in excess of 12 and one-half R or rem. As can be witnessed in our discussion above, the supposed mysterious nature of the subject of radiological hazardous materials can be de-mystified through the attainment of knowledge in the topical area regarding radiation detection and protection principles; as well as the recognition and identification of radioactive hazardous materials in the transportation setting. As always, stay safe out there and be sure to visit the North Carolina Association of Hazardous Materials Responders website at www.nchazmat.com
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Hardening Your Station Against the Storm
Ken Newell Each year Rescue stations across the nation are damaged or destroyed as a result of serious storms. Most stations that are impacted suffer from storm damage such as high winds and/or flood waters. This leads many in the fire services industry, to reconsider how their current or planned facility would fair in a similar storm. Major storm damage in the Southeastern United States usually comes in the form of hurricanes or tornados. It is important, though, to understand that the immediate, intense structural stresses caused by strong tornados are typically more catastrophic than those caused by extended hurricane loads. Many of the issues we will consider in this article will apply to both types of storms, but we will discuss these issues as they usually relate to hurricanes. While the following issues should wisely be addressed in fire station design where storm events are anticipated, everyone
understands that only underground bunkers are capable of withstanding the worst possible storms. And an underground bunker typically doesn’t perform that well when floods accompany the storm. Not to mention that you probably can’t afford an underground bunker the size of a fire station.
Site Considerations Most coastal areas affected by hurricanes have very flat topography. That is the major reason that flooding is so prevalent before, during and after the storm. Proper location for ISO purposes cannot be the only consideration for the hurricane-prone station site selection. If you can identify the property that satisfies your response time and is at an elevation above the desired flood level then you have likely solved the majority of your future station flooding problems. Just because the property is free, inexpensive,
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The site building pad for the recently completed Town of Hilton Head Island Station No. 6 was built up, in order to be above anticipated flood levels.
or available doesn’t mean it is the best location. If the best available property is only a few feet below the high flood elevation, you should seriously consider the option of building up the site with structural fill. You will simply have to weigh the cost benefit of making sure you are above the “high water mark.” Also to consider are any onsite or nearby elements that could become missiles during high wind conditions. A poorly constructed, four-story hotel is not what you want to be next to when 150 mph winds come through. You may end up with building materials from the adjacent structure penetrating portions of your facility. While no one would advocate clear-cutting all significant trees from a site, you must understand what damage a tree falling onto your building or blocking the apparatus driveway can do.
Building Structure
The applicable building code will certainly outline the minimum design loads that the building must withstand. As an essential facility most codes will require a fire station to meet a higher level of structural stability than a normal commercial building. Often times, the department desires to have the structure designed to withstand greater storm loads than the minimum required by code. For each 10
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mph or so increment in wind resistance added to the structure, substantial costs of construction can be expected. The costs of such structural upgrades have to be balanced against the received benefits.
Exterior Building Skin This issue relates mostly to two issues: walls and roofs. It is advisable to use exterior wall materials that are capable of withstanding considerable wind and impact loads. Masonry walls, even if only veneer, when properly designed can serve as an extremely durable and impact resistant surface. Cracked masonry joints caused by substantial wind loads are easy to tolerate compared to wall systems that have been penetrated by flying objects. Historically, roof panels or materials are often the first items to “fly away” during a storm’s strong winds. Extreme care must be taken when specifying and constructing the roof system. There are several roof systems that can be specified to withstand wind loads in excess of 130 mph. Careful observation and verification of the construction methods should accompany the design of these systems. In the past, the problem with wall or roof sections coming off during the storm has been the pressurization of the building
envelope. Once the first section comes off, the difference in inside versus outside pressure causes the entire envelope to weaken and quickly disintegrate. One remedy to this problem is to design the entire structure as a partially enclosed structure instead of an enclosed structure. It does add to the cost of construction, but will result in the building withstanding the adverse pressures even if the envelope is violated.
Doors and Windows The most obvious building elements that you probably have seen “storm-protected” are the doors and windows. There are more products or systems made to protect these openings than can be individually mentioned here. You will want your overhead doors to be of such material and design that it can withstand impacts and wind loads. Most overhead door companies can upfit many of their doors with wind bracing packages that greatly enhances wind load capability. The bi-fold, apparatus doors are generally designed to withstand far greater wind loads than the normal overhead door. But the bi-fold door comes with a much higher price tag. One of our coastal clients use glass overhead doors to show off the apparatus — typically thought a no-no when considering hurricane winds. But they also put a
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steel-coiling door on the outside of the glass door to be used only in the event of a storm. This is very nice, but very expensive. You really do have a huge selection of choices when it comes to wind protection for windows. From channel-held steel panel shutters manually installed, to heavy steelmesh screens that look like darker insect screens, to accordionstyle metal covers, all the way to impact resistant glass with no shutters. Your budget and ease of deployment are all that limits you on your choice of storm window protection.
Hardened Rooms
Several storm-prone clients have taken advantage of small rooms that are hardened for the worstcase storm. You may not be able to afford building the entire station as a concrete bunker, but you can probably afford to make one of the interior rooms capable of protecting life in a category 5. The theory is that by making a support room, such as the shop, gear room, or decontamination room with concrete walls and ceilings, the entire building could
come down around it while it still stands. Obviously, this does nothing to protect the apparatus, but apparatus can be replaced.
Emergency Back-up Power
Most essential facilities will want full-building or partial-building emergency back-up power even if they’re not in a storm prone area. Since most large generators are outside, keep in mind several of the previously discussed means of protection against wind and water. This includes making sure that the generator, like the building elevation, is above the flood line. By the way, it doesn’t make a lot of sense to provide back-up power for HVAC if your mechanical yards or condenser units are not above the flood line as well. Each department has their own preference for diesel versus natural gas/LP generators. Each has its pros and cons. You need to consider which fuel source will most likely be uninterrupted following a storm. Often the deciding factor is the rule of thumb that natural gas/LP generators are usually twice the price of diesel generators.
Temporary Residents
If you’ve designed well, constructed well — or maybe you’re just lucky — and your station survives the big one, you may very well be housing occupants that you don’t house on a normal basis. Many departments or municipalities think ahead to be able to use the station training room as a temporary EOC. Careful consideration to electrical outlet, data-box and TV cable boxes will provide the EOC occupants with the ease of use they need. Before, during, and after the storm, a higher number of people than usual may find themselves living in the station. Having the ability to set up cots in small or large rooms will prove beneficial. You may be able to separate citizen sleepers from public safety sleepers if you plan ahead.
Conclusion
It is impossible to plan, design, and construct for every devastating storm. But if you can do just a few things to modify your existing station or plan your new facility considering the occasional storm, it only makes sense to do so.
The recently completed Public Safety Facility for Wrightsville Beach featured “occupant spaces” that are raised above anticipated flood elevations. After a flooding storm, the apparatus bays are hosed out and the vehicles are returned. Notice the elevated generator to the right.
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T h e Pre h o s p i ta l
Trauma System F r o m 2 0 ,0 0 0 Fe e t .
Andrew Rowley While the title takes a metaphorical stance on the viewpoint below, it is safe to say that pre-hospital providers should have an understanding of how everything works. The adage that “trauma is easy” is long overdue for removal from our vocabulary. According to the CDC accidents (unintentional injuries) are the fourth cause of death in the United States (CDC, 2016). In 2015, 146,571 deaths occurred due to trauma. This statistic is a pretty staggering number from any viewpoint. With that, we have seen little in the ways we manage trauma from a prehospital perspective. I will say there have been some massive changes, mostly for the better. Now these changes such as shifts in assessment models and newer treatment strategies, have had an impact on outcomes and survivability. So, let’s look at what we’re doing and then understand why, as well as take the blinders off and look at the whole picture. It wouldn’t make sense to look at what we’re doing now, or what the future holds without looking a little at the past.
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Historically, trauma has been a series of algorithms and understatements that honestly undermine what effect we have on someone’s life. Referring to the statement above “trauma is easy” and adding “load and go” or “it’ll buff out,” it’s safe to say that these terms have been used synonymously with the response to and management of trauma patients. These statements in my earlier personal practice have to lead to a sense of complacency that could have ultimately lead to apathy towards continuing my education to serve patients better. It is safe to say there were a fair amount of assumptions made in trauma management past. Everyone was placed on a long backboard, large bore IVs, rapid transport with attempts to resuscitate patients to “normal blood pressure” of 120/80 with no real information dictating these treatment modalities. What we have learned from this, that probably seems common sense now; not everyone needs a backboard, IV fluids do not replace blood, there is no such thing as over-resuscitating patients and 120/80 is not “normal” for everyone. We were getting patients to the trauma center, and then they were passing two to three weeks later, and the understanding of why has not been well understood until recently.
What Has Changed?
That brings us to the now, what’s changed? One of the most evident changes that are present across all first responder disciplines is the ever decreasing uses of long backboards for trauma patients. While this change may be occurring slower some places than others, it is still progress! Another shift has been the integration of tourniquets earlier rather than later. This once voodoo practice has become initial treatment in extremity hemorrhage. This shift is primarily based on the overwhelming amount of data that has been analyzed from our past 16 years at war. The data has been instrumental in genuinely pushing pre-hospital trauma management to evidence-based practice. Our ability to now look at information and definitively say if treatments are or are not working is a huge milestone in our field. However, the translation of this information to actionable changes in protocol has taken some time. So what can we do to shorten the timeline of better patient care? I most certainly do not have that answer, but do have some thoughts on the matter. Proactivity and advocating to crush complacency is a good starting point.
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Medicine is known as a practice because it is precisely that, application of the scientific method to care for humans that are sick or injured. If we as providers continue to do the same thing to patients given changes that would improve outcomes, we are causing a detriment to our society. One of the most frustrating statements to hear is “I’m only an EMT or first-responder.” The continued use of this statement is one of the worst psychological weapons against the growth and progression of our discipline. There is no member of the team that is less or more valuable. Arguably, the first responder has the most significant impact on the survivability of trauma patients. If you look at the raw numbers (there are variations), it can take only three to five minutes for an individual to bleed out from a major vessel interruption. Plainly said, the first person to make contact with that patient, is the one that has the most impact on their survival. This is not in the medic’s hands, nor should it be in anyone’s minds that it is the case. The three most preventable causes of death from trauma are extremity hemorrhage, tension pneumothorax and airway obstruction. This is from combat data but also applies domestically. Each of those components also has a basic skill set that can be implemented by an EMT or even a trained layperson. Tourniquets, chest seals, and airway positioning are all basic skills that greatly increase survivability. There is a caveat, however, and it needs to be very clear. Regardless of the provider skill level. Nothing we do in the field “fixes” the injuries sustained in a traumatic event. We merely slow the clock, but the importance of our care should not be underemphasized. Our interventions are an attempt to minimize the worsening of whatever injury has occurred, as well as get them to a surgeon quickly.
Training Programs
Looking at care provided in the field for trauma can be pretty closely related to that of the AHA’s tiered training programs. There is something everyone can do. You go to any public place these days, and there is a good chance that you find an AED (automated external defibrillator) on a wall. This is due to a push as well as legislation supporting the need for access to equipment and training for sudden cardiac arrest. It has been proven that this program is saving lives. Is it not fair to say though that the same could
be assumed for trauma? More trained people and access to equipment could be directly tied to a decrease in mortality from traumatic events. The evidence supports this, but it also must be said that there has been a direct correlation between bleeding control training, etc. as it is associated only with active shooter events or mass casualty incidents. This belief is an unfortunate misconception. Trauma is trauma regardless of the means in which it occurred. It is nonselective to only acts of violence, which leads us to the national shift occurring.
Standardizing Improvements
All of this new-found insight into mortality related to trauma, and the availability of data has to lead to an increasing interest in the topic. There has also been an increase in standardizing and improving care outside of the hospital. This starts with the citizen or layperson. The Bleeding Control (B-Con) program through the American College of Surgeons is a testament to this interest. Again, relating to the AHA model loosely, it has been found that the first person trained to intervene has the most impact. So, as responders we must increase awareness within our communities, as well as direct organizations and individuals to vetted and accurate training that could help them save lives. From a first responder role, we also need to equip ourselves mentally as well as with the correct tools to intervene appropriately. Mentally means to step outside of our comfort zone and be a proactive member of the prehospital community to educate yourself and advocate for the departments to do the same. Then we must be more comfortable in interacting with trauma centers and build the relationships when working together to create a truly seamless transition of care from the citizen first responder all the way to the trauma surgeon. While this is a very generalized overview, there is so much more that could be said on this topic. I challenge you to investigate more into the recognition and treatment of traumatic injuries, as well as understand it is not isolated to the “tactical environment.” For more information visit: www.bleedingcontrol.org www.naemt.org www.soarescue.com wwww.jsomonline.com www.c-tecc.org www.deployedmedicine.com
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