The National Wildfire Coordinating Group has issued a new document titled Minimum Standards for Medical Units Managed by NWCG Member Agencies. Your first thought might be that this is a response to the death of firefighter Andrew Palmer who, three hours and 20 minutes after being struck by a falling tree, bled to death while he was being transported in a Coast Guard helicopter (which responded staffed by a rescue swimmer) to the Redding, California airport. But the document states that it is being published “after years of hard work”, and does not say it is because horrendous errors were exposed during the Andrew Palmer tragedy.
I am no medical expert…I used to teach Advanced First Aid and my EMT expired a long time ago. The new standards are only a very small step in the right direction. It covers credentials, scope of practice, and some very basic principles of communication and patient transportation. But it does not cover to what degree Emergency Medical Services will be provided to fire line personnel, minimum EMS staffing for fires, or minimum time standards for treating and transporting patients.
Nor does it cover many of the principles that Andrew Palmer’s brother, Rob, outlined in his “2009 National Wildland Fire Reform: The Palmer Perspective”, such as transporting a severely injured firefighter to an appropriate medical facility during the “golden hour”.
There is a statement on page 14:
Following the adoption of the Minimum Standards for Medical Units Managed by NWCG Member Agencies, the IEMTG will develop NWCG Wildland Fire EMS Protocols.
Maybe that Protocol document, if and when it is developed, will be the meaningful one.
The NWCG needs to take the final step and address the issues that affect the treatment of firefighters during the “Golden Hour”. I used to tell my firefighters, “If we can’t do it safely, we won’t do it”.
Wildland firefighters face safety issues that have never been considered by urban firefighters. If a firefighter working on a structure fire is injured, a ground ambulance can access the patient 99.9% of the time. Almost by definition, where there is a structure, there is a road to it, so transporting an injured structural firefighter to a hospital within the Golden Hour is rarely a problem. And a landing zone for an EMS helicopter is usually within five minutes from the site of the accident by ground ambulance.
The NWCG agencies must develop an Emergency Medical System for firefighters that is unprecedented for civilian agencies. To ignore this issue, or delay it for years, would be negligent.
It may be difficult for executives in the federal land management agencies, whose expertise may be as a biologist or forester, to wrap their thoughts around how to adequately treat a firefighter who is seriously injured in the middle of a wilderness area. A person has to wonder if this issue would have been already addressed if wildland firefighters were part of their own fire management agency, rather than being farmed out to an assortment of land management agencies run by -ologists.
The military has been successfully and rapidly treating their injured warriors since the 1960’s. The NWCG needs to borrow their ideas and provide a safer working environment for wildland firefighters. Immediately.
The NWCG, including the National Park Service, US Fish and Wildlife Service, Bureau of Land Management, Bureau of Indian Affairs, and the US Forest Service, needs to immediately create a task force that will work full-time to create a policy that will address these issues.