When Rescuers Become Victims

At the beginning of June, the International Association of Fire Chiefs (IAFC) through its Safety, Health and Survival Section and its partnering fire service organizations issued a statement urging all fire chiefs, fire/EMS officers and departments to issue a “stand down.” This request came in response to two separate, but similar, incidents involving response to confined space rescues. In both cases, several firefighters were seriously injured and the civilian victims died.

Critical Safety Training

The purpose of the stand down is to postpone non-essential, non-emergency tasks and activities and focus on related critical safety training. Clearly, training is important to all the things that firefighters do and critical to successful outcomes – that being both a positive rescue and no injuries to the rescuers. Obviously something changes when theory and practice become reality.
Historically there have been many confined space rescues that have not had good endings. Besides civilian victims, rescuers have died trying to “save” someone who could not be saved. The causes have not changed significantly over the years. Either oxygen deficiency, toxic gases or a combination have caused the majority of the fatalities. There have been many attempts to regulate these rescues through federal, state and local laws as well as the development of standards. In spite of clearly defined rules, which intend to minimize, reduce and even eliminate the risk to the rescuers, unfortunate events such as the two recent cases in Ohio and Indiana happen. This is not to diminish the heroic attempts by firefighters to save the victims, but to emphasize the danger to rescuers during these infrequent incidents.

In both of the recent cases, early reports indicate that personal protective equipment was not used. Clearly history tells us that rescuers entering a confined space will need to have their own supply of air because atmospheric contamination is most probably the cause of the emergency. If the victim is not moving and unable to respond, rescuers must assume that the air is contaminated. SCBA or a supplied air system must be used or the rescuers are at great risk of becoming victims. Unless sophisticated monitoring equipment is available and indicates an adequate oxygen supply, rescuers need to maintain their discipline and follow sound practices.
 
SCBA Not Always Feasible

Self-contained breathing apparatus may not always be feasible due to space limitations. If this is the case then a supplied air system must be used. But if SCBA is the choice, precautions must be taken and redundancies must be in place in case things go bad. Remember that oftentimes the atmospheric makeup is so toxic that injury and/or death can occur in a very short period of time. SCBA has limitations on time and maneuverability. Firefighters expected to attempt these types of rescues must not only be trained, but must also practice.
 
One of the points that must be made is that it is very difficult to “regulate” or “legislate” safety regardless of the type of call. As with all aspects of firefighting there are inherent dangers, proper safety procedures and necessary safety equipment. A big part of any safe operation is personal and team accountability. The individuals and groups working at an emergency scene must maintain their discipline and function within their capabilities and limitations. These are based upon skills, knowledge and abilities honed through study, training and practice. This ability is balanced with the available equipment and apparatus. The right people with the right tools and proper training will produce better outcomes.
 
While this seems like a simple concept, there are human (and firefighter) factors that come into play. First and foremost firefighters join the service to help others – fight fires, perform rescues, save lives. They are action oriented and are not used to standing around waiting for something to happen. They want to make something happen. When fires happen, firefighters get off the apparatus and almost instantly attack the fire. For most fires, especially those known to be what might be considered “bread and butter,” experience and training create instant decision-making capabilities so that action can begin immediately. Hose gets stretched, water begins to flow, and ventilation takes place and so on. This action model has been the basis for handling emergencies since Ben Franklin’s time.

Infrequent Events

Unfortunately this model does not always work and, as history has shown, can create very dangerous situations for firefighters. Infrequent events, such as confined space rescues, by their nature do not create a bank of experiences that rescuers can call upon during the incident. Very few firefighters have been to enough of these types of incidents to establish the experience needed to become an expert. Since there are few experts, the lessons learned are harder to pass to the next generation. It would be interesting to know if any of the rescuers in the two events listed above had ever been in a similar incident.

Without regular response to confined space rescues, the next best thing is training and repetition. This may be easier said than done. The training requirements for firefighters have grown significantly – to the point that there may not be enough time for many to master the various skills that are now required. Further, even though training and awareness may increase, the time needed for practice and repetition may not be sufficient to create habits that are second nature. This is not intended to say that what is needed can’t be done, but only to point out the challenges that exist.

Another contributing factor to the dangers is emotions. Firefighters believe they respond to calls to offer help. Upon arrival, they find a victim and believe they need to do something quickly. Firefighters are taught that seconds count. A person down requires instant action in their minds. When there is inadequate experience or training, the emotion of the situation can take over. Bystanders expect the “professional” rescuers to do something, anything. And while a rational discussion during training can produce all the right answers, the real world incident produces pressures that cannot be created during training or discussions. Without sound fundamentals deeply ingrained into the rescuers, shortcuts, bad practices and poor decisions can take over.

Unfortunately, infrequent events such as confined space rescues often present the most dangers to firefighters. During times of stress, firefighters, like others, rely upon their instincts to jump right into action. Unfortunately, this is not always the best choice. The natural tendencies need to be reprogrammed so that the proper action is taken while under tremendous duress. History can predict what can happen if certain things are done or not done. Laws and standards are developed to prevent disasters. However, if the rescuers are not “programmed” right, they will resort to what they naturally do.

In both of the recent cases, I would venture to guess that none of the rescuers thought they were going to critically injure themselves. No matter what job firefighters are asked to do, they need the appropriate equipment, quality training, sound procedures and enough practice to compensate for insufficient experience.

Editor’s Note: Richard Marinucci is chief of the Northville Township (Mich.) Fire Department. He retired as chief of the Farmington Hills (Mich.) Fire Department in 2008, a position he had held since 1984. He is a past president of the International Association of Fire Chiefs (IAFC) and past chairman of the Commission on Chief Fire Officer Designation. In 1999 he served as acting chief operating officer of the U.S. Fire Administration for seven months. He holds three bachelor’s degrees in fire science and administration and has taught extensively.

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