Having medical personnel on a fire with the ability to administer IVs may have prevented a death on the Halstead Fire near Stanley, Idaho in September.
The firefighters at the incident base were sleeping in cold, damp, conditions. At times the temperature was as low as 12 degrees at night and inversions caused the area to be smoked in.
The firefighter was diagnosed with septic shock which has a death rate of over 60 percent. The initial treatment by a medic may have saved his life. Congratulations to the medic for the treatment provided, and to the Incident Management Team for having a Medical Unit on scene with the ability to administer IVs.
Here are some excerpts from the Facilitated Learning Analysis:
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On September 13, 2012, “Jim”, a firefighter from the Halstead fire, near Stanley, Idaho, was transported via ambulance to a hospital in Ketchum, Idaho. The next morning he was transported by life flight to Twin Falls, Idaho. He was diagnosed with pneumonia and sepsis [blood poisoning], and was suffering from septic shock. He stayed in the ICU for two days and remained in the hospital for three additional days.
[…]
In the days leading up to the incident, the Medical Unit on the fire reported having 30 to 40 cough and cold symptom related cases a day; roughly 10 to 15 percent of the people in camp.
[…after being treated at the fire and while being transported to the hospital…]
The next morning the attending physician elected to transport Jim via life flight to a larger medical facility in Twin Falls. Jim had been diagnosed with pneumonia and sepsis, and was suffering from septic shock. In layman’s terms that means he had fluid in his lungs and was suffering from blood poisoning, and the blood poisoning sent his body into shock. The doctor’s assessment was that the blood poisoning was caused by the pneumonia.
The next morning CRWB(t) saw Jim just after he had a “central line” put in his neck. A centralline is used to administer medication or fluids, obtain blood tests (specifically the “mixed venous oxygen saturation”), and directly obtain cardiovascular measurements such as the central venous pressure. CRWB(t) saw quite a bit of blood on Jim and saw his demeanor and became very concerned. He asked one of the hospital staff how Jim was doing and the person replied by asking CRWB(t) how old he was. CRWB(t) said “27” and the person said, “If this had happened to you, you would be dead right now.” CRWB(t) did not leave Jim’s side from that moment until Jim’s mom came to look after him.
According to WebMD (www.webmd.com), permanent organ damage can occur in people who survive sepsis, the death rate for sepsis is 20%, and the death rate from septic shock is over 60%.
You know in retrospect i’ve looked back on this incident as an oppurtunity for the fire community to make a few small changes. For me that is taking the time to learn the correct protocol for injuries on and off the fireline. The incident personel are usually very plugged in on these factors, but knowing them for myself could help in the aftermath of a medical incident. Paramedics on the line? Usefull, but ulitmately the medical training needs to be practiced at a FFT1 level and up to at least DIVS. The recognition of illness is tricky even for doctors with virtually unlimited equipment. The ER doctor in this case gave that as partial reason to fly “Jim” to Twin Falls. I know that i would greatly appreciate some advanced training to be able to recognize warning signs of many different ailments that plague our fire community. The WFF offers assistance that the Federal Govt can’t, and the involvement of them should never be brought into question, other than involvment with the organazation earlier in cases like this. I know i will involve them earlier in my future.
Bret
CRWB (t) from this incident
To donate to and support WFF or not was decided for me by this video, BURN TREATMENT PROTOCOLS (2008) – HUMAN FACTORS
Two burn victims discuss the unorganized and inefficient complete process of dealing with recent burns, pain, recovery and paperwork nightmares.
Available at this link:
http://www.nifc.gov/wfstar/toolbox_medical.html
HERE is a direct link to the 27-second video on YouTube in which a firefighter describes her problems in obtaining appropriate treatment for a burn.
Smokejumpers use the “Bone Gun” for rapid IV insertion. From the You Tube Videos I have seen it is a fairly easy piece of equipment to use and the learning curve doesnt appear to be steep.
Sounds scary.
CRWB(t) Totally Rocked!! Favorite Quote: “People kept saying over the phone, ‘You’re doing a great job.’ And I kept wondering ‘Of what?’” = Being a leader: taking charge, seeing it thoroughly through to a safe and sane conclusion! I follow Lessons Learned Center on Twitter & keep a link on my desktop – signed up for First Responder training before reading this FLA — now all the more interested.
I’d encourage people to read that whole FLA document — it’s incredibly well done and well written. High fives to Joe Harris and an even bigger high fives to the CRWB(t) on the incident.
Bill and others,
This FLA is not only a prime reason for having Advanced Life Support personnel (Paramedics) on Wildland fires but also provides a critical need of training more fire line personnel to understand more then just old standard “little first aid book” that so often we subject firefighters to very two years.
Not only can each member of any resource crew type be prepared to handle situations, but we as fire personnel are the type of individuals who always feel a need to help our co-workers.
Having said that, it at times seems to me, that sometimes we certainly seem to learn about a topic after a critical situation has arisen.
So my simple message here is, be pro-active in medical and trauma training and care.
Again, good save on the parts of all involved in recongizing a critical situation.
Bill Arsenault
Wildland Firefighter/Paramedic
Neat too was the admonition to get the Wildland Firefighter Foundation involved soonest. Cash direct to “Jim’s” Mom to help with the travel expenses she was paying herself. Time for another donation.
I find it rather pathetic that in an official USFS document, that they recommend calling a private non profit organization to help the family of an individual who was injured in the line of duty. You know….. Instead of taking care of it themselves.
I guess it really is time for another donation.
DRD, it ain’t pathetic at all. The agency is recommending the best thing for the firefighter and the families. The agency can do only so much, and they’re legally bound by federal laws and regulations. After the South Canyon Fire, the Chief publicly said he was thankful to the National Forest Foundation for stepping up and helping with expenses, because the FS legally could not do certain things that were “the right thing to do” after that tragedy. Don’t knock the FS for doing the right thing in this case, which is to contact the Foundation!
http://wffoundation.org