To the Rescue: Where Do We Go from Here? Lessons Learned and SOPs Changing

BY CARL J. HADDON

Carl j. Haddon
In my April 2020 column, I wrote about some of the things found in today’s new cars that many first responders, extrication gurus, and keyboard warriors don’t know about and extrication instructors don’t teach about but should.

The point to the article was that many of the things discussed have every potential to injure or kill an unaware or unknowing rescuer. This article will be of the same ilk but MUCH, MUCH closer to home and in a different vein.


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My, oh my, how our world has changed in the past six months! As a fellow firefighter, instructor, and officer, I hope and pray that as you read this, you and your families are healthy and safe and that we are past this COVID-19 pandemic nightmare.

In my previous column, I wrote about how those things found in new vehicle extrication that we didn’t know about can kill us. Here I sit writing about the relevance, complications, and hopefully lessons learned in the shadows of a “never before seen type” of pandemic to hit our American shores in modern time. But, how does that apply to “To the Rescue,” you ask? The simple and direct answer to that question is: It should have applied long, long ago. Not only that, but looking back through my decades in the fire and EMS business, it seems as if it did apply, but we may have allowed our “profession” to become complacent. I remember years and years of watching gowns, face shields, and other related personal protective equipment in the back of our paramedic units dry rot from nonuse. We stopped training and drilling on their use. We were never going to need those things! Get where I’m going?

So, what about those of us charged with responding to technical rescue and extrication calls in the wake of COVID-19? Is there anything to be learned? Is it time for a few departmental standard operating procedure (SOP) changes? I really hope that everyone can answer that with a “Yes.” I also hope you get a chance to review those current SOPs and see if perhaps they included some personal protection things that were overlooked. Or, maybe it’s time to step up and help with updating them.

BEYOND COVID-19

Let’s forget about COVID-19 or at least put it off to the side for just a moment. This issue really has NOTHING to do with COVID-19 specifically. I’m guessing that none of us want to catch the flu or any one of the myriad diseases or ailments that can be transmitted from human to human as a result of trying to do our job. That said, I’m so old that I remember being a medic before we even wore gloves to do patient care! Without going overboard or suggesting that all fire, EMS, and rescue personnel should wear a Tyvek® level B hazmat suit to every call, there are some commonsense things that we can and should do to better protect ourselves, our crews, and our patients. Some or most of these things we knew, or know, but may have just forgotten.

Let’s look at a few things we routinely do when arriving on scene at a crash that may or may not require extrication. Someone on your rig is assigned to “make patient contact.” This has traditionally involved opening one of the vehicle’s doors or sticking your head into one of the windows to try to make verbal contact with the patient or patients. Might there be a safer or better way (for everyone’s safety and well-being) to make verbal contact with our patients? Remember, this virus is just that: a virus. The seasonal flu is viral. There are lots of bad ailments out there that result from contracting viruses. Why wouldn’t we want to adopt reasonable self-protection measures that help to ensure that we can continue to do the job without having to blow it off and simply invoke that “we took an oath”? In the case of making patient contact, instead of sticking your head in the window of the vehicle, simply figure out another reasonable way to make contact. Remember, too, that sticking your head into the front driver or passenger side window prior to disabling the 12-volt supplemental restraint system can cause you brain damage should a live air bag deploy. I’ve gotta believe that will kill you faster than a virus!

I’m certainly not going to tell you what “the” reasonable alternative to this practice might be, because each and every wreck is different, and the circumstances surrounding them are also different. What CAN be the same is the departmentwide personnel reeducation and reevaluation of departmental SOPs that reflect your willingness to modify certain behaviors that result in everyone’s well-being. With all of that said, maybe one of the answers can be found by employing our helmet shields more often. This is not virus-related, but rest assured that it won’t be too long before we will be wearing self-contained breathing apparatus (SCBA) at vehicle wrecks until we can definitively determine that there is no smoke or off-gassing coming from the vehicles’ lithium ion batteries. I will leave the recently discovered bombshell of that toxicity for another article. It may sound crazy, but we could certainly make patient contact while wearing SCBA, right?

We all wear gloves when doing patient care as part of our bloodborne pathogen protection. How much consideration do we give to our extrication or fire gloves? I don’t know about you, but I routinely take them off and stuff them back into the bunker coat pocket they came out of until I need them again. Frankly, (until now) if those extrication or fire gloves kept me from getting cut or burned, I figured they did their job. But, have I ever considered just what I’ve touched or how contaminated those gloves get or how permeable they are to liquid? It’s not going to keep me from doing my job, but I’ve also had to consider and research just how permeable my rescue or bunker gear might be to the same toxic lithium ion battery smoke and gases that I don’t want to breathe. If we are truly “students of our craft,” we will think about these very same types of things and come up with different, sometimes new, and hopefully innovative solutions.

At the end of the day, I believe that lots of “good” will come out of this very bad event that we’ve all had to endure. The hardest part is that it will involve changes to the way we do lots of things in the fire service, and we all know that change doesn’t go down easily and certainly not quickly. Changing SOPs is a painstaking job, but it seems to me that we will all be better, be healthier, and live longer as a result of those changes. Stay safe, and be a part of the solution.


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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