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Medical evacuations of firefighters and the Golden Hour

Andrew Palmer
Andrew Palmer
Andrew Palmer

In 2008 firefighter Andrew Palmer was struck by debris during a tree felling operation on the Iron Complex fire in northern California. According to the coroner he died of “blood loss due to blunt force trauma to the left leg”. He bled to death

Andrew was pronounced dead after he arrived via Coast Guard helicopter at the Redding airport. It took three hours and 20 minutes to get him to the airport due to inadequate planning and many screw-ups and poor decisions.

We previously covered the accident and its effects, here and here, including a paper written by Andrew’s brother, Robert, who recommended that injured wildland firefighters be transported to an appropriate medical facility within the first “Golden Hour”.

The federal land management agencies have done little to adopt a “Golden Hour” policy, but the issue, rightfully, refuses to disappear, as evidenced by this excerpt from an October 17, 2011 article in High Country News:

…Rob Palmer’s suggestions are facing resistance from many in the wildfire establishment. Tom Harbour, the U.S. Forest Service’s director of fire and aviation, says, “Implementing a Golden Hour response as Robert Palmer has framed it would require fundamental changes,” and the benefits might not outweigh “the additional risks or the unintended consequences.”

Harbour contends that a Golden Hour mandate would require greater use of aircraft. Because aircraft accidents are responsible for so many wildland firefighter deaths — 50 percent since 2000 — aircraft fatalities would likely increase. And millions of new homes have been built in recent years within wildfire-prone forests; if crews were prohibited from battling some wildfires around homes, that would put more lives at risk.

But Palmer also has allies. Chad Fisher, a National Park Service safety officer at the National Interagency Fire Center in Boise, Idaho, acknowledges that “implementing the Golden Hour proper (a strict policy) is very difficult. Risk management comes into play.” Sometimes fires that threaten valuable resources — such as habitat for rare native trout or historic buildings — must be attacked even where evacuations can’t be done in an hour. Yet Fisher has encouraged the multi-agency National Wildfire Coordinating Group to learn from the Dutch Creek tragedy and make its recommendations for improving the framework for emergency medical care. For instance, all morning briefings for every large fire now include specific evacuation routes and procedures.

Fisher is also pushing what he calls — “for lack of a better term” — the Golden Hour Engagement Strategy. The “comprehensive strategy” recommends providing more appropriate medical gear on firelines, and urges that the distance to medical facilities be taken into account when fire-management decisions are made. The strategy is taking hold, he says, noting that in the last year or so, many crews have bought backboards and litters. He believes that, in the future, fire managers will be more likely to deploy EMTs with fire crews going into especially risky situations.

Fisher created a webinar presentation partly based on Palmer’s talk at the Safety Summit, and he’s showed it to influential agency groups. He’s also working with other Park Service leaders to find a national park where the Golden Hour strategy could best be fully tested.

A list of Wildfire Today articles that mention Andrew Palmer.

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