Myth about the Golden Hour

EMT iconA myth is developing at Redding, California’s Record Searchlight that the new protocols developed by the National Wildfire Coordinating Group about managing medical emergencies on incidents recommend or even mandate that accident victims on a fire arrive at an appropriate medical facility within the “Golden Hour”. We pointed out on July 4 that even though the myth is fueled by Jim Milestone, superintendent of the Whiskeytown National Recreation Area, who was on the investigation team for Andrew Palmer’s fatal accident, the new protocols fall short of establishing target time frames for transporting a seriously injured patient.

Here is an excerpt from an editorial in the July 11 edition of the Record Searchlight that repeats their myth:

…Federal firefighters have taken the lesson from Palmer’s death and are drafting more detailed evacuation plans so they know not just how to get crews to a fire, but how to get injured colleagues out promptly. The goal is to reach a hospital within “the Golden Hour,” when experience shows emergency physicians have the best chance to save trauma victims’ lives.

Recommendations from the National Wildfire Coordinating Group also focus on creating a clear chain of command and communications so conflicting orders and information don’t make a bad situation even worse.

Bringing those lessons into the various fire agencies’ standard procedures would go a long way toward saving firefighters’ lives, but the diverse ecosystem of local, state and federal fire teams, along with private contractors, means even lifesaving changes can take time to filter through the ranks.

Delay carries a heavy cost. Over the past decade, an average of 22 firefighters have died each year battling wildland blazes in the United States. And with long-term trends seeming to bring worse fire seasons with ever-larger acreages burning, the hazards for the men and women who keep our homes safe are only likely to grow.

For the fire commanders and agency bosses who can push for progress toward greater safety, it’s hard to see a better motivation than those nearly two dozen deaths that happen in a typical year. The lives that tighter evacuation procedures might save could easily be those of the firefighters on your crew. Those heroes deserve every chance we can provide to make it home.

I wish it were true that the NWCG protocols established patient transport time frames, but until they do, the Record Searchlight needs to get their facts straight.

Thanks Dick

Medevac on wildfires: can we do it in one hour?

EMTOn June 2 Wildfire Today covered the release of some new protocols developed by the National Wildfire Coordinating Group about managing medical emergencies on incidents. Redding, California’s Record Searchlight, which frequently covers wildfire issues, has an article published yesterday about the new policy, including quotes from several recognizable names in the wildland fire community. Read the article — but here is an excerpt:

“They are really going to set up plans to get firefighters out within an hour,” said Jim Milestone, superintendent of the Whiskeytown National Recreation Area. “The idea is to get that person out of there.”

Like generals planning for battle, managers of major forest fires meet early each morning to devise the day’s strategies.

As part of the planning in the past they’ve outlined basic plans for treating fire-line injuries, discussing only generally how fire crews will respond to a severe injury on the fire line, Milestone said.

This fire season the plans will be more detailed and focused on how to retrieve injured firefighters as quickly as possible.

On the Shasta-Trinity National Forest this year there will be an emphasis on continually creating fire plans that include “solid and effective” medical evacuation plans, said Jim Peña, the U.S. Forest Service’s deputy regional forester for California.

“The idea is to assess where we work in the forest,” he said. “This isn’t just focused on fire.”

The goal is to avoid another death like that of Andrew “Andy” Palmer.

Palmer, 18, of Port Townsend, Wash., died after an 8-foot section of pine tree fell on him while he fought a fire near Junction City in 2008. Palmer’s family and fire officials who reviewed a federal investigation of his death say it could have been prevented by a quicker medical response. The tree broke Palmer’s left leg and severed his femoral artery, but Palmer lay on the ground for more than 2½ hours as firefighters tried to figure out how to get him to a hospital.

A better rescue plan could have saved Palmer’s life, said Milestone, who was a member of the federal team that investigated the death.

I wish what Superintendent Milestone said were true:

They are really going to set up plans to get firefighters out within an hour.

Unfortunately, the new NWCG protocols fell short of establishing target time frames for getting a seriously injured patient to an appropriate medical facility. During the development of the strategy and tactics for a fire, the feasibility of timely medevac must be considered. If, for example, the location of a remote work assignment during a night shift would require 30 minutes of on-scene treatment, then a 90-minute carry-out followed by a one-hour ground ambulance ride, then the Medical Unit Leader, the Safety Officer, the Operations Section Chief, and the Incident Commander need to discuss ways to mitigate that problem.

While the new NWCG protocols are a step in the right direction, they should have also recommended transport time frames and the number of EMTs to be assigned to an incident.

Thanks Dick

Cheap air tankers cost lives

air tanker contract 2010Awarding air tanker contracts to the lowest bidders may at first sound like good fiscal management, but it means that the only aircraft private operators can afford to supply at those low prices are 40 to 60 year old military aircraft that were determined by one government agency to be no longer practical to operate. And then another agency, The U. S. Forest Service, without thinking, operates them through a contractor, using them on missions for which they were not designed, flying low and slow, into, and usually out of canyons.

A “Blue Ribbon Panel”, chaired by former NTSB Chairman James E. Hall, evaluated the air tanker program following the two crashes in 2002 in which the wings fell off very old military surplus aircraft, killing their crews. The panel issued a report in December, 2002, which said in part:

Continue reading “Cheap air tankers cost lives”

Six Minutes for safety calendar

This calendar was created and maintained by Kathy Komatz of the National Park Service and the Six Minutes for Safety Work Group. Kathy recently won the Paul Gleason Award for developing an informational safety series of vignettes titled “This Day in Wildland Fire History.

Bookmark this page: https://wildfiretoday.com/2010/05/20/six-minutes-for-safety-calendar/

 

The concept of Six Minutes for Safety is that each day firefighters will hold a daily six-minute safety meeting based on the topic from this calendar.

Stupid people are confident, while the intelligent are doubtful

That is how an introduction to a transcript from a radio program begins on the Australian network, ABC. On the program The Science Show, they explored the conclusions reached by David Dunning and Justin Kruger when they studied people’s perceptions of their own talents. Now known as the Dunning-Kruger effect, it helps explain why moderately skilled people act as experts, and inept politicians get our votes.

We’ll touch on how this relates to wildland fire in a moment, but first here are some excerpts from the radio show transcript.

…And here’s the kicker; across every test, the students at the bottom end of the bell curve held inflated opinions of their own talents, hugely inflated. In one test of logical reasoning, the lowest quartile of students estimated that their skills would put them above more than 60% of their peers when in fact they had beaten out just 12%. To put that misjudgement in perspective, it’s like guessing that this piece of music [music for 5 seconds] lasted nearly half a minute.

Even more surprisingly, the Dunning-Kruger effect leads high achievers to doubt themselves, because on the other end of the bell curve the talented students consistently underestimated their performance. Again to the test of logic; those topping the class felt that they were only just beating out three-quarters of their classmates, whereas in reality they had out-performed almost 90% of them.

The verdict was in; idiots get confident while the smart get modest, an idea that was around long before Dunning and Kruger’s day. Bertrand Russell once said, ‘In the modern world the stupid are cocksure while the intelligent are full of doubt.’ From his essay ‘The Triumph of Stupidity’, published in 1933.

Charles Darwin once said, ‘Ignorance more frequently begets confidence than knowledge,’ and Dunning and Kruger seem to have proven this point. In light of this, it suddenly becomes clear why public debate can be so excruciating. Debates on climate change, the age of the Earth or intelligent design are perfect real-life examples of the Dunning-Kruger effect. It beautifully explains the utter confidence of those who, with no expertise, remain stubborn in their views regardless of overwhelming evidence. It makes you want to shake them by the collar and scream about how stupid they are. But evidence shows that’s not the best strategy.

Have you ever been on a fire and met a Squad Boss, Crew Boss, or Division Supervisor who you knew was not the sharpest tool in the cache, but who was supremely confident in their abilities? They might be the person who just can’t understand why their supervisors have not recognized their huge potential and wonder why they have not been promoted every year.

In some cases, this person may be ineffective but benign. Their screw-ups may be inconvenient or costly but not life-threatening. But if someone on a fire, with power and authority, over-estimates their skill and ability, the consequences can be disastrous.

Some people don’t know what they don’t know. They have no idea or self-awareness about the holes in their knowledge and experience. You may know of a politician or two that can be described this way coughsarahpalincough.

I can think of several fatality and near-miss incidents on wildfires where this was, in my humble opinion, the primary cause of the accident. But it is not politically correct for the writers of the accident reports to spell it out so clearly. One report that came close is the one about last August’s escaped prescribed fire in Yosemite National Park where the the writers used the term “hubris”.

How do we avoid the trap of over-confident people making poor decisions on fires?

  • The first step is to be sure that firefighters can proficiently perform the jobs that appear on their red cards.
  • Next, be sure that everyone receives an honest performance rating on every fire, at least a verbal one, and preferably a written one for significant fires or assignments.
  • Conduct After Action Reviews at the end of shifts or fires.
  • And, if you are given an assignment that does not make sense, or causes the hair on the back of your neck to stand up, say something.
  • If an individual does this to you repeatedly, have a chat with their supervisor or the Safety Officer. Filing a SAFENET form that does not list names may not be effective.