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To Keep Safe, Wear Your PPE

Issue 4 and Volume 12.

There has been a lot said in the last five years regarding firefighter deaths and injury, and that’s great. It seems that firefighters, officers and chiefs are all re-focusing on minimizing firefighter injury and, of course, death.

The elimination of firefighter injury and death seems, at the onset, to be complicated. But, when time is taken to look at the ways firefighters are getting hurt and killed, it gets very clear. In fact, it’s very simple.

In the United States each year approximately 100 firefighters are killed while on duty and tens of thousands are injured, according to the U.S. Fire Administration.

Although the number of firefighter fatalities has steadily decreased over the past 20 years, the incidence of firefighter fatalities per 100,000 incidents has actually risen.

Despite a downward dip in the early 1990s, the level of firefighter fatalities is back up to the same levels experienced in the 1980s.

Ultimately, some forces and circumstances that lead to firefighter death and injury are simply beyond our control. In other words, sometimes firefighters, while performing valid, heroic life saving (or attempting to save) actions with everything being done right, lose their lives.

It is, however, possible to significantly lower the number of firefighters killed each year through research, training, improved operations, new technologies and the appropriate use of adequate staffing.

Using All Available PPE

Using all available personal protective equipment (PPE) is one of the biggest factors in saving firefighters. This article discusses how to wear personal protective clothing properly.

The leading cause of fatal injuries to firefighters is heart attack at nearly 50 percent.  Trauma, including internal and head injuries, is the second leading type of fatal injury at nearly 30 percent and asphyxia and burns combined account for 20 percent of fatalities. It’s interesting to note more firefighters die from trauma than from asphyxiation and burns combined.

Firefighters under the age of 35 are more likely to be killed by traumatic injuries than they are to die of medical causes, such as heart attacks and stroke. After age 35, the proportion of deaths due to traumatic injuries decreases and the proportion of deaths due to medical causes rise.

In many fire departments, emergency medical service (EMS) calls account for between 50 and 80 percent of emergency call volume. These incidents result in only three percent of firefighter fatalities.

Traumatic internal and head injuries account for the deaths of 50 percent of firefighters who were involved in EMS operations at the time of their fatal injury, while another 38 percent involved in EMS operations died from heart attacks.

Many firefighters have been killed while responding to or returning from calls, while operating at fires, during roadway incidents and during training. Essentially wherever firefighters are deployed they can die.

Minimizing Injuries

This fact is important because the equipment firefighters wear can contribute directly to they whether or not they live or die. Unfortunately, we know some of them will die. The issue is to minimize those who must die. The ones who do die are usually the ones performing heroic life saving actions – and even they may not have to die.

As hard as it is to believe, saving ourselves is as simple as wearing protective clothing. We certainly understand that not every firefighter injury and death can be prevented by properly wearing bunker gear and other items of PPE.

Properly wearing is the operative clause and that means; no exposed skin in hazardous environments such as fires; being visible on roadways and seen by those not looking for you; protecting one’s self against infectious disease and hazardous non-fire environments, like EMS runs.

If it seems simple that’s because it is. Firefighters must understand what their PPE can and cannot do and how it can save their lives.

Severe Burns Resulting

Recently a firefighter was severely burned while fighting a wildland fire. The victim was spraying water from the bed of a pickup truck that was equipped with a portable water tank and pump when he fell out of the truck bed into the fire. The victim ran trying to escape the fire, but during his escape attempt, he was severely burned. He died 5 days later from his burn injuries. He was not wearing proper protective clothing.

Who knows whether bunker gear or wildland gear would have saved the firefighter, but his odds would have improved. Naturally, if he was belted and secure on the vehicle, the incident could have been avoided.

As uncomfortable as the thought may be, put yourself in the place of that firefighter. What would you do knowing the outcome of that situation? Recall the firefighter literally burned to death. Isn’t wearing protective clothing worth it?

In another example, a firefighter died after he ran out of air, became disoriented, and then collapsed at a dwelling fire. The victim and another firefighter made entry into the structure with a hand line to search for and extinguish the fire.

While searching in the basement, the victim removed his SCBA mask for one to two minutes to see if he could find the location and cause of the fire by smell.

While searching on the main floor of the structure, the firefighter’s low air alarm sounded, and the victim directed the firefighter to exit and have another firefighter working outside take his place.

The victim and the second firefighter went to the second floor without the hand line to continue searching for the fire. Within a couple of minutes, the victim’s low air alarm started sounding. The victim and the second firefighter became disoriented and could not find their way out of the structure. The second firefighter “buddy breathed” with the victim until the victim became unresponsive. The second firefighter was low on air and exited. The fire intensified and had to be knocked down before the victim could be recovered.

In this incident, an interior attack was initiated with only two firefighters with bunker gear on the scene. If other fully geared up firefighters were available and ready, could it have lead to a positive outcome? There were other firefighters on the scene, but they didn’t have their gear ready.

Wear Gear Properly

Research reveals there are not many firefighter deaths directly related to the failure of bunker gear when worn properly. The key is to wear the gear and, yes, wear it properly.

And while some claim that the “protective envelope” actually creates more of a hazard for firefighters because they are too protected, the proof is in the numbers.

Simply put, firefighters who are properly protected have a greater chance of survival than those who are not.

Not properly protected means, not wearing gloves, not using the helmet strap, and not donning your hood because you want to use your ears to sense heat. It also means not ensuring the lining of your coat and pants are properly in place and secured, not having your collar up and deployed with your helmet ear covers down, not completely closing your gear so there’s no exposed skin and finally, not wearing and using your self contained breathing apparatus (SCBA).

There are several reasons why firefighters don’t wear their gear, and none of them are justifiable. The reasons can be traced back to lack of training, lack of policy and procedures, lack of enforcement by fire officers, lack of example by fire officers and over confidence.

Training Required

Like anything firefighters do, using PPE requires initial and on going training to be experts. While it seems simple enough, proper training in the care and use of protective clothing is vital.

Firefighters must understand how fit is critical. After all, if the gear is too loose, it can interfere with a firefighter’s ability to function. If the gear is too tight, it can lead to greater heat conduction and burn injuries. Your gear should be fitted to you during the acquisition process.

Training is available from all firefighter protective clothing manufacturers as well as any entry-level fire training center. As part of training, don’t forget to read the user guide supplied with your gear.

Standard firefighter training manuals all cover the basics of protective clothing.

Training in the use and care of your bunker gear is critical. After all, that is what comes between you and the fire.

Going hand in hand with training is the need for policy and procedures for use of PPE. Departments must have clearly written, trainable and enforceable protective gear policies.

The policies must define what protective clothing is and should cover the following: helmets with face shields or goggles; protective hoods tucked into collars; protective bunker coat with a collar turned up; protective bunker pants; boots; gloves; personal alert safety systems (PASS) devices; SCBAs; and passport systems.

The policy could be modeled after this sample document: Full protective clothing shall be worn when responding to and working inside the incident perimeter as defined for emergency incidents. Exceptions are drivers or firefighters operating equipment in an area where their safety will not be affected. This exception is left to the discretion of the incident commander.

Protective hoods must be utilized (protecting head, neck, and ears) when a SCBA face piece is in place, using air. The tail of the hood must be placed inside the neck of the coat. Protective hoods must be readily available (on person) when SCBA is being worn and ready for use.

Face shields and goggles must be utilized any time the need for eye protection seems apparent and when SCBA is not being utilized, such as during overhaul, while operating hand or power tools and related gear and equipment.

Gloves must be worn when engaged in training/working with hose and ladders, when using hand or power tools, and other situations where injuries to the hand are likely to occur.

In specific situations for which no guidelines have been provided, the proper protective clothing, to protect against all foreseeable hazards, must be worn.

The use of protective coat, hood, and SCBA during lengthy overhaul operations, with a safe atmosphere, will be at the discretion of a safety officer or each company officer if a safety officer is not on the scene based upon measurable air and structural/scene conditions.

The following protective clothing shall be worn by firefighters while responding to all fire calls: protective bunker coat and pants; helmet (if riding in an unenclosed position) and drivers and command personnel should dress so that they can safely control their apparatus/vehicle.

Take The Time To Use Gear

There may be times when members feel they do not have time to put on personal protective equipment. When this situation arises, take the time. If you don’t you could be signing your own death warrant.

It is presumptuous to think you can determine when not to take proper precautions. Besides, you will be violating policy, which will be enforced.

High-visibility vests shall be worn by all members wearing and not wearing turn out coats when working in or around streets, roads, intersections, or highways, and/or any other time the possibility exists of being struck by a vehicle.

Drivers and operators shall wear turn out coats and high visibility vests at all times when operating the pump, except when the scene is totally free of moving vehicles.

Hearing Protection

Personnel working with power tools or equipment shall use hearing protection.

Hearing protection shall not be utilized when such protective equipment would create an additional hazard to the user.

A policy like this will clearly spell out what’s expected of firefighters and give officers something to lean on should firefighters choose to be dumb and not use PPE correctly to protect themselves and others around them.

Great chiefs develop great policies but they are only effective when fire officers buy into them. It is the responsibility of the chief to make sure the policy is very clear and understood. As in most cases, a fire officer can either make, or break (specifically) the effectiveness of the department’s PPE policy.

To insure effectiveness, a zero tolerance policy must be enforced. The challenge is to make sure fire officers have the courage to enforce the policies. After all, that is their job.

Almost all fire officers have worked hard for many years to achieve their rank. That is a demonstration of their dedication and commitment.

Once promoted, officers “are in the spotlight” and have to make a concerted effort to always set the example. In most cases, fire officers have worked for that front piece or coat title. Fire officers should be proud to wear all their gear and set that example.

Fire officers who don’t set the example self destroy their ability to enforce the policies when put in a position to do so. If it the gear is issued to you – wear it. It’s as simple as that. And, to the officers, if firefighters must wear it – enforce the rule. Fire officers are required to enforce the policies.

When uneducated firefighters fail to wear proper gear, over time they become overconfident. A level of invincibility sets in, and firefighters begin to think, “I haven’t been hurt yet, so why waste my time gearing up for these nonsense calls.”

Making a statement like that virtually guarantees that something will go wrong. Remember, firefighting is a risky and dangerous business. No one wants to get hurt. The yahoos who believe they can get away without properly using all PPE available have never been hurt. If they had, they’d be singing a different tune. Those who have been hurt never want to be hurt again.

Overconfidence provides a false sense of security that can, and has, ended in tragedy.

Constant training and education related to policies as well as current events related to firefighter injury and death can minimize the negative outcomes precipitated by stupidity.

When it comes to your safety, it may be as simple as properly wearing your PPE.

Editor’s Note: Will Grilliot has been active in the fire service since 2002 and is a member of the West Milton (Ohio) Fire Department. He is a certified Level II Firefighter/Hazmat Operations Technican. He oversees inventory and distribution operations with Total Fire Group/Morning Pride. He represents the fourth generation of his family managing  the company.

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