New rhabdomyolysis resources for firefighters

If left untreated, severe rhabdo may be fatal or result in permanent disability.

Too many wildland firefighters have suffered from rhabdomyolysis (often referred to as rhabdo) in recent years. In some cases they could have been treated much earlier if the victims and those around them had recognized the symptoms.

Rhabdo informationFirefighting, both structural and wildland, involves tasks in environments that place fire fighters at increased risk for this condition. Rhabdo is a breakdown of muscle tissue that releases proteins and electrolytes into the blood stream and can cause heart and kidney damage. If left untreated, severe rhabdo may be fatal or result in permanent disability. Heat exposure and intense physical effort are just two of many known risk factors for rhabdo.

NIOSH has developed two sets of factsheets and wallet cards—one for structural firefighters and their healthcare providers and another for wildland firefighters and their healthcare providers—to increase awareness about the signs and symptoms of rhabdomyolysis and help fire fighters get early treatment to prevent more serious medical problems.

Factsheets for wildland firefighters and their healthcare providers:

What Wildland Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Wildland Fire Fighters: A Patient Population at Risk

Wallet cards for wildland fire fighters

 

Factsheets for structural firefighters and their healthcare providers:

What Structural Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Structural Fire Fighters: A Patient Population at Risk

Wallet cards for structural fire fighters

Thanks and a tip of the hat go out to Bryan.
Typos or errors, report them HERE.

A new slide for your file

When firefighters use their past experiences to affect how they make present day decisions at a fire, sometimes the process is compared to having photos, or slides, in a file or slide tray (for those of us who remember when a photograph could be developed on transparent film, to produce a slide which could be shown on a large screen using an analog projector). Having years of experience with each emergency incident represented by an image or slide in your memory, guides a person on what to expect when a similar scenario is presented. “I have seen this situation before, so I have a good sense of how to deal with it, safely and efficiently”.

Big Sur Kate’s photo above is a situation that not every firefighter has encountered. You’re on a bridge 50 to 75 feet above a fire. The fire can burn under you. What do you consider about how to be in that situation safely? What are your trigger points when your safety begins to be compromised and you move to a different location? I’m not criticizing the tactics of the firefighters in the photo. It just makes me think, since I’ve never been in a similar situation. I have no similar slide.

Kate’s photo is of the Front Fire that was reported around 1:30 p.m. PDT Sunday. As of mid-morning on Monday it has burned approximately 1,000 acres and is being fought by 700 personnel. It is 20 air miles northeast of Santa Maria, California on Highway 166.

Not every part of the country, like Southern California, has the luxury of having 700 firefighters on a fire 18 hours after it starts. The 7,835-acre Howe Ridge Fire north of West Glacier, Montana that has been burning for 10 days has destroyed 27 structures and is causing evacuations. The Incident Management Team can only muster 191 personnel. Part of that fire is in “less than full suppression” mode, with the probable exception of the areas that are being evacuated and where structures burned.

Examples of catastrophic events on wildland fires that led to changes

Interviews with 13 people

Above: Heather Heward, one of 13 people interviewed, describes a catastrophic event on a wildland fire that led to a positive change.

Chief John Hawkins (@JhawkFire) of CAL FIRE/Riverside County wrote a tweet recently that mentioned the “Law of Catastrophic Reform”, meaning a positive change following a catastrophe on a fire. He gave examples including positive pressure breathing apparatus, fire shelters, keeping personal protective equipment clean, enclosed vehicle cabs, and moving sirens farther away from occupants in a vehicle.

While attending the Fire Continuum Conference in Missoula this week, I asked some of the attendees if they would describe a catastrophic event on a wildland fire that led to a significant change. The video has short (in most cases less than two minute) interviews with 13 people from several countries:

  • Tom Harbour
  • Dave Calkin
  • Tom Zimmerman
  • Tim Sexton
  • Domingos Viegas
  • Heather Heward
  • Marta Miralles
  • Mike Beasley
  • Russel Parsons
  • Chris Dicus
  • Shelia Murphy
  • Mike Norton, and
  • Colin Hardy

I really appreciate the 13 folks that contributed to this, who in some cases told a story of how they were personally affected.

Legislation would provide “Holy Grail” for wildland firefighters

Senate Bill 2209 would enhance situational awareness for firefighters

Smoky conditions on the Legion Lake Fire
Smoky conditions on the Legion Lake Fire in Custer State Park in South Dakota, December 12, 2017. Photo by Bill Gabbert.

Two U.S. Senators are co-sponsoring a bill that would enhance the safety and situational awareness of wildland firefighters. Senate Bill 2290 would be an important step toward what we have called the “Holy Grail of Firefighter Safety”. This concept would provide the real time location of a wildfire and the resources working on the incident. Too often fatalities have occurred when firefighters did not know where the fire was or overhead personnel were not aware of the position of firefighters who were endangered by the quickly spreading fire. Or both at the same time.

The legislation would require the Departments of Interior and Agriculture to jointly develop and operate “a tracking system to remotely locate the positions of fire resources assigned to Federal Type 1 Wildland Fire Incident Management Teams”.

A complimentary requirement in the bill is “unmanned aircraft systems to [supply] real-time maps, detect spot fires, assess fire behavior, develop tactical and strategic firefighting plans, position fire resources, and enhance firefighter safety”.

The sponsoring Senators are a Democrat and a Republican, Maria Cantwell (D-WA) and Cory Gardner (R-CO). Since the bill was introduced January 10, 2018 no further action has taken place and no additional Senators have signed on, so it appears there is not much momentum pushing it through the process.

Here are the first two paragraphs in a press release issued by Senator Gardner’s office:

Washington D.C. —U.S. Senators Cory Gardner (R-CO) and Maria Cantwell (D-WA) introduced the Wildfire Management Technology Advancement Act of 2017, a bill designed to bring firefighting agencies into the 21st century.

This bill will increase firefighter safety by requiring the Forest Service and the Department of the Interior to begin providing GPS locations for crews on wildfires and to begin using Unmanned Aircraft Systems to scout out and map wildfires in real-time. Wildfire Today refers to the simultaneous use of mapping aircraft and GPS locators as the ‘Holy Grail’ of firefighter safety.

It is nice to see that at least two Senators are thinking about firefighter safety.

Thanks and a tip of the hat go out to Bean.
Typos or errors, report them HERE.

Victoria’s new fire engines have rollover and tree protection

Above: Mercedes Benz G-wagon fire engine. Photo by Victoria Department of Environment, Land, Water and Planning 

In the last week two reports have been released about serious accidents involving U.S. Forest Service fire engines. One was a rollover and the other was an engine that was hit by a falling tree. Rollovers of wildland engines are common. We have assigned the “rollover” tag to 48 articles on Wildfire Today. There were two fairly minor injuries in the most recent rollover and none in the tree strike incident. Other rollovers have been much more serious.

Engine 492 crash Wyoming
The crash of USFS Engine 492 in Wyoming August 8, 2013. USFS photo.

Some of the newer USFS engines have what the manufacturer calls a “Rear Cab Protection Rack (headache rack)”, a roll bar behind the cab, but in spite of this, the cab of the recent rollover was partially crushed, making it a challenge for the three occupants to climb out of the damaged side window.

The Australians have been more forward-thinking than their US counterparts when it comes to providing for the safety of the firefighters that work with engines. Many of the trucks have spray bars that provide a water curtain around the cab which can be activated if the crew is entrapped in a fire. Some of them also have substantial rollover protection systems that prevent the passenger compartment from being crushed in a rollover.

Internal roll bar Country Fire Authority engine
Internal roll bar in a Country Fire Authority engine in Victoria..

Three years ago in Victoria, Australia two firefighters were killed at Harrietville when their fire engine was struck by a falling tree. The next year the Department of Environment, Land, Water and Planning began acquiring the first of dozens of new Mercedes-Benz G-wagon fire engines.

Mercedes Benz G-wagon fire engine
Mercedes Benz G-wagon engine. Screen grab from the Tweet below.

The new trucks have a superstructure suspended horizontally over the cab that should minimize injuries to the crew in case of a falling tree. It appears that it would also offer rollover protection for the occupants.

We have often suggested that the wildland fire agencies in the United States fund research conducted by engineers to determine how to prevent the passenger compartments in their fire engines from collapsing in accidents. The Aussies have it covered, so to speak.

Early diagnosis of firefighter mental and physical health issues

It can extend or improve the quality of life.

The leading cause of fatalities on wildland fires is medical issues, according to data for 1990 through 2014 supplied by the National Interagency Fire Center. The numbers would probably be significantly higher if deaths that occurred away from the fireline but caused by the job were figured in, such as leukemia, testicular cancer, lung cancer, brain cancer, bladder cancer, ureter cancer, colorectal cancer, and non-Hodgkins’s lymphoma. Many jurisdictions list these as “presumptive cancers” and will automatically cover the medical bills of firefighters diagnosed with the conditions.

Another medical issue affecting firefighters, the elephant in the room, is mental health, something that is rarely talked about in a job where physical prowess and endurance is often used as a measuring stick. We are reminded of a firefighter who earlier in his career was highly regarded and respected, but has changed to the point where he is causing serious problems on and off the job. Some of his colleagues think he might benefit from professional psychiatric help.

Early diagnosis and treatment of physical and mental conditions can extend or improve the quality of life. We often hear, “If you see something, say something”. Usually that is used in the context of possibly dangerous conditions or crew resource management, but it can also apply to our co-workers who might need treatment for a dangerous physical or mental issue.

All firefighters and their families need to see the excellent nine-minute video covering the physical and mental health of firefighters  produced by Edmonton Fire Rescue. It was made possible by the family of deceased firefighter Edward James Paul (1954-2015).

Watch the video.

And, be careful out there.