Rurally Speaking: Are You Bulletproof?

By Carl J. Haddon

The number of near-miss, and nonfire-related line-of-duty deaths (LODDs) reported in the last six months is nothing but astounding and gut-wrenching. What’s also truly frightening to me is the number of near misses that I’ve witnessed and heard about from the “medical” side while on duty that most of us do not pay attention to. These are NOT exclusively rural or urban issues. They affect us, one and all.

Although I understand that this magazine is traditionally about equipment and apparatus used in our profession, I would be remiss if I didn’t address these troubling statistics from a couple of common-sense vantage points. The apparatus and equipment needed to help minimize on-duty exposure to communicable and noncommunicable diseases, as well as traffic- or highway-related accidents and deaths, will reveal themselves to the reader, as I hope and pray that they are readily available to all of you. If for some reason they don’t reveal themselves, you might want to consider another line of work.

I‘ve just returned from an overseas assignment where I worked in tandem with and for United States Centers for Disease Control and Prevention (CDC) and Department of Homeland Security (DHS). Part of my duties involved Ebola/bio hazmat response preparedness. During a breakout training session involving a group of career firefighters from the islands, a hair-raising question was asked of me that has haunted me ever since. We were discussing Ebola and other pandemic issues and scenarios when the concerned group asked, “Chief, how do we know who has or who doesn’t have these diseases if they’re not showing obvious signs or symptoms?” This question about tipped me over backward. My answer, which was another question, was how do we ever know what someone has or doesn’t have when we respond to calls? Whether Ebola, HIV, Hepatitis, Influenza, or the common cold, given the right time and circumstances, we are prime candidates for exposure and should always be vigilant toward exposure mitigation and prevention. My purpose for this article is not about bio hazmat response stuff but situational awareness and personal protection on a daily basis.

During extrication and vehicle accident operations, we use, or should use, apparatus as blocker vehicles against oncoming traffic to protect our crew and the patients. We have a number of things in our jump bags, trucks, or engines that we can use as blockers against oncoming disease threats, don’t we? Ahhh, but do we use them like we should? Albeit inconvenient (like safety vests) we have simple things like gloves, N95 masks, gowns, eye shields, and sanitizers that should be part of our everyday blood-borne pathogen (BBP) protection supplies. Advances in even these products are nothing short of amazing—in an attempt to help keep us safe and be as comfortable and user friendly as possible for us to don and doff. With that said, perhaps we need to reexamine some of our professional behavior as well.

On my flight from Tokyo to the United States, a fellow passenger a few rows behind me tipped over in the aisle with some sort of medical condition. The flight crew asked for help from any EMS or medical personnel on board. I stood and cautiously walked back. I noticed a young adult male, maybe late 20s, breathing, and semiconscious laying in the aisle. He was a bit pale and sweating. I asked his family a couple of questions before making real patient contact. I ascertained that he had been exhibiting “flu-like symptoms.” Hmmm, flu-like symptoms on a flight from Japan. I asked the flight attendants for their jump kit and a pair of gloves. Suddenly, a middle aged man comes flying down the aisle proclaiming that he’s a “firefighter/EMT from Georgia.” He smokes past me, straddles the patient, and gets down into the patient’s face to try to communicate with him—no gloves; no mask; no personal protection, other than being seemingly bullet proof; and no questions or history asked whatsoever. Call me old school, but I likened that behavior to removing the apparatus blockers from a vehicle accident scene and placing a giant “Hit Me” sign on this well-meaning responder’s bright green safety vest.

All of the newest, best, and brightest apparatus, equipment, and personal protective gear is only as good as the person or persons using or operating it. If we don’t use it or don’t use it correctly, it never works. We have to take care of ourselves and our crewmembers. For the sake of what I’m discussing with you here, that may be as simple as making sure you wash your hands more often and being a little more discerning in how you make patient contact. Just be mindful and remind your crewmembers of these hazards, especially around cold and flu seasons or if you serve in an area frequented by tourists or foreign visitors. Hotels, motels, schools, cruise ships, concert venues, and tourist attractions are just a few examples of places that many of us respond to on a regular basis where many people from out of the area gather or vacation. We never know who is infected with what and when or where we might encounter them. The old adage holds true that we are no good to anyone we serve if we become part of the problem as opposed to part of the solution.

There is a lot of good precautionary information out about carcinogens that we get on our turnout gear and the need to keep our gear clean and not transfer those carcinogens into our homes or firehouses—especially for those of us volunteers that bring our gear home. But, shouldn’t the same precautions be true regarding biological or disease hazards? After all, don’t the vast majority of us see more medical aid runs than we do actual structure fires? A patient doesn’t have to bleed or vomit all over you to contaminate you or your gear, and I have to believe that none of us wants to bring anything bad like that home to our families. Remember that keeping your head on a swivel doesn’t just apply to traffic accidents, fires, or shooters. These diseases are very real, and many of them are very deadly. Be smart and wash your hands. We just never know.

CARL J. HADDON is a member of the Fire Apparatus & Emergency Equipment editorial advisory board and the director of Five Star Fire Training LLC, which is sponsored, in part, by Volvo North America. He served as assistant chief and fire commissioner for the North Fork (ID) Fire Department and is a career veteran of more than 25 years in the fire and EMS services in southern California. He is a certified Level 2 fire instructor and an ISFSI member and teaches Five Star Auto Extrication and NFPA 610 classes across the country.

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