R U Rhabdo Ready?

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Background:

In the profession of wildland firefighting, there has been a rise in the occurrence and awareness of exertional rhabdomyolysis (rhabdo), a serious medical condition. Rhabdomyolysis is the breakdown of muscle fibers in the human body. In wildland firefighters, we typically see cases of rhabdo during initial crew training periods. Below are some key points to remember, topics to discuss with your crew, and links to educational materials on rhabdo.

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Rhabdomyolysis in Wildland Firefighters

Key Points:

Exercise, particularly when strenuous and unaccustomed, is a common factor in wildland firefighter rhabdo cases.

Each case of rhabdo is unique in its causes, signs and symptoms, health consequences, and recovery.

The prognosis depends on the extent and severity of rhabdomyolysis, as well as response time – early and prompt medical intervention is crucial.

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Risk, Signs, and Complications

Discussion Topics:

Has your crew been training in the offseason under conditions that prepare them for how the crew will be training/performing once they come on? An individual may be a great runner and physically fit, but if he or she has not been carrying weight during training, the individual will be unaccustomed to this exercise.

Have you talked to your crew about rhabdo? Do they feel comfortable telling you they have a problem?

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Prevention Steps

Educational Materials:

NDTP Summary Report on Rhabdo in Wildland Fire

Video on Rhabdo in Wildland Firefighters

PT Rhabdo FLA


 

Please share your Rhabdo stories and lessons with us.

It’s Here (and it’s purple)

By Travis Dotson

Yep. The new IRPG is out, and I guarantee you will not mistake it for an old one.

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2018 Incident Response Pocket Guides

Good call NWCG – this cover will do exactly what it’s intended to do – set this version apart.

But why are we even talking about the window dressing? Let’s get to the meat.

Check out the list of parts with significant changes:

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List of Significant Changes

That’s a lot of big deal stuff. You should go through this list item by item to get familiar with it.

See that last item on the list? You might want to pay special attention to that one.

Yeah, the Medical Incident Report changed. You know, that super critical communication tool we use when our sisters and brothers get hurt.

Look close:

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New Medical Incident Report

How many lines do you see? That’s right: 8 not 9.

Yeah, it’s different – that’s OK.

This is an improvement.

This is the one we have.

Uniformity matters.

Now do these two things:

  • Make sure you have this one (we all need to play off the same sheet of music).
  • Practice using this one. Drill Drill Drill – it really helps.

Eyes forward folks – let’s get to work on getting better.

Complaining is not work.


Download the new version here: IRPG Download

Ordering information for the new IRPG here: NWCG Ordering

Download new Medical Incident Report here: Medical Incident Report

Calm is Contagious

By Travis Dotson

Chances are you have had this very assignment.

Just putting some indirect dozer line in a couple miles away and downhill from the fire…no big deal.

Then s#!t got real.

Division does what Divisons do – cleared everyone off the line then went to check on those that didn’t have time.

Dozer operator played salty to a tee – working until the very last moment.

Heavy Equipment Boss Trainee is crazy calm while death comes walking by.

These are the situations we face and this is how we act.

Chances are you have had this assignment before. Chances are you took on the assignment, got it done and didn’t end up digging in the dirt for air to breathe.

These folks took the assignment. They were getting it done.

Then s#!t got real.

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So what’s the difference between your outcome and theirs?

Did they wander into a bad luck day or are they just bad firefighters?

Are those the only choices?


Tell us your answers in the comments.

Maybe think before you type.

The Monster Inside

DRAWN BY FIRE

•-Combs-Social

From the time we are children, we are told to be afraid of monsters. Monsters under the bed. Monsters in the closet. The monster in that dark and treacherous basement that our parents never wanted us to explore alone. As we grew older, our teenage monsters changed to be the bully in second-period literature or our ever-present self-doubting reflection in the mirror. Adults? Yeah, we have our monsters, too, but the faces have morphed into opposing politicians, rogue foreign leaders, pedophiles, and the new reality of school shooters who kill indiscriminately and without remorse. Monsters are everywhere.

First Responders are not without their own monsters, who, in addition to the monsters of every day society, multiply silently in the dark corners and cellars of our minds. They are ghouls of our own creation and can grow in their ferocity if neglected … or, worse, fed a constant diet of fear…

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One Ash Pit Ate Two Firefighters

This blog post was compiled using several excerpts from two separate documents on the Laguna Fire Burn Injuries.


At approximately 1010 a crew member from the Type 2 crew fell into an ash pit, after ground gave way on a mechanically constructed berm the crewmember was mopping up with a branch line. The crewmember advanced a hose line up the berm and upon reaching the top the employee stepped toward the downhill side facing the Colorado River and berm gave way.

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The berm that gave way.

The employee went down to approximately the knee level in a void space created by burning material being consumed under the crust of the berm. The employee fell forward towards the downhill side adjacent the Colorado River. The employee had forward inertia and momentum which continued him downhill with a section of ash and dirt. The section was approximately 38 inches wide and 18 inches long. The employee extended their hands and arms to provide protection while falling forward. The employee sunk into the hot ash pit up to approximately the armpit and shoulder, additional hot rolling material followed the employee downslope encompassing lower extremities and upper torso.

As the employee was falling an adjacent crewmember heard the employee’s screaming. The witness employee was approximately 6 feet to the south on the same berm. The witness employee observed the employee who fell sinking up to the armpits and shoulders and then rolling forward. The employee also recounted seeing the employee who fell struggling to get out of the ash pit, and then once self-extricated beginning to walk/run around trying to get hot material off the employee’s body and personal protective equipment.

At approximately 1012 a witness employee began yelling for assistance and a radio to notify the crew overhead of an injury/incident. The witness employee generated a radio call as well as a physical call for additional assistance. At approximately 1013 several members of the crew including the crew boss, the foreman, and the squad bosses started toward the scene.

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Overview of fire area and injury location.

At approximately 1024 Fish and Wildlife Engine 2162 with two emergency medical technicians arrived on scene to continue patient care. The emergency medical technicians continued to expose and evaluate the nature of the injuries. At approximately 1027 an update on the employee’s medical condition was given via radio to the incident commander.

The incident commander notified Arizona dispatch, requesting an ambulance to transport the employee and start the notification process to the fire staff. The crewmember was ambulatory and communicating. The decision was made to walk the injured employee to a waiting crew agency vehicle to be driven and rendezvous with the ambulance at the ICP.


It continues…


At approximately 1045 the DFFM Safety Officer called the IC to receive an update on the incident within an incident. The Safety Officer requested the area of the incident within the incident be flagged off to preserve the scene for the investigation process.

At approximately 1100 a crew member from the DFFM Type II crew began flagging off the area of the incident within an incident. The employee was approximately 7’ to the south of the location on the berm, the employee utilized hose line to cool the area and a tool to probe the area as the employee moved forward. The employee stepped through the berm into an ash pit. The employee had forward downhill momentum and “tucked and rolled” down the berm through the ash pit.

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Second employee’s hard hat with burn damage.

The injured employee completed the flagging of the area. At approximately 1120 the injured employee notified the IC of the incident. The injured employee was evaluated by the emergency medical technicians on Fish and Wildlife Engine 2162. The employee suffered first-degree burns to the right ear, right upper arm (triceps area), left arm lower arm, right thigh, right and left shin, and right calf. The injured employee was wearing full PPE at the time of the incident.

The employee opted not to be transported to the hospital at that time because he was the ranking crew member present. The other crew overhead accompanied the previously injured employee to the emergency department. At approximately 1230 a supervisory crew member arrived back to the incident from the hospital. The injured employee was directed to go to the hospital and was driven in a crew vehicle to the hospital. The employee was evaluated, treated, and released by the emergency room with first-degree and possibly a few second-degree burns to travel home with the crew.


 

Do YOU think of mop-up as “dangerous”?

Does it matter if you do or don’t?

(Tell us in the comments)

Read both incident reports here: Laguna Fire Burn Injuries

Embers In The Safety Zone

This is an excerpt from the Rice Ridge Fire Hahn Cabin Entrapment FLA.


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Two New Firefighters Take Over Point Protection Operations

On September 11, this crew swap occurs via helicopter and the new pair of firefighters take over protection of the Hahn Cabin. These two firefighters, one Single Resource Boss (SRB) and one Firefighter Type 2 (FFT2), transitioned with the other two firefighters who had been at Hahn Cabin the previous 13 days to continue Point Protection operations.

Prior to this insertion, both incoming firefighters had a satellite phone call with the outgoing firefighters. During the call, a brief operations update and a discussion of supply needs occurred.

Although the incoming firefighters flew to the cabin and attempted an aerial reconnaissance of the cabin and adjacent area, visibility was poor, adding to the less-than-ideal flight conditions due to smoke and wind (Red Flag conditions).

Because these conditions precluded the helicopter from shutting down, cargo and backhaul was swapped out quickly while the incoming and outgoing firefighters engaged in a short face-to-face briefing.

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Map of fire edge and cabin area.

Identifying Escape Routes and Safety Zones

Upon arrival at the cabin, the two incoming firefighters’ first task was to scout out Escape Routes and Safety Zones. They located two Safety Zones. One Safety Zone was in the black, with minimal snags, about a 25-minute walk west of the cabin but required an escape route through unburned vegetation. The second Safety Zone was a gravel bar situated to the north along Youngs Creek, located approximately 0.5 miles (a 7-minute walk) from the cabin.

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Path to gravel bar

The SRB believed that the fire would impact the cabin site during the course of the next few days and therefore wanted to ensure Safety Zones and Escape Routes were identified. Once their Escape Routes and Safety Zones were established, the two firefighters set to work replacing parts, repairing the water handling system, and test-firing the pumps.

In conjunction with ensuring the function of the water handling system, the two also scouted to the south, trying to establish a vantage point from which they could observe fire activity.

They spent the rest of their first day monitoring fire activity and working on projects at the cabin, in which they stayed overnight.

Fire Activity Increases

The next day, September 12, the firefighters moved between the cabin and the gravel bar, monitoring the progress of the fire. This day was another Red Flag Day and fire activity was increasing as the morning turned into afternoon. (While the previous day had also been a Red Flag Day, the fire that day hadn’t made significant expansion.)

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Photos from gravel bar

With the increase in fire behavior it became difficult for the personnel on Jumbo Mountain Lookout to serve as their lookout. In fact, given the direction of fire spread, the firefighters at the cabin were alternatively moving throughout the day between the cabin and the gravel bar to get eyes on Jumbo Mountain Lookout as well as the fire activity.

At this same time, from their location on the gravel bar, the two firefighters observed that the fire had spread closer to the southern Hahn Cabin area. They then headed back to the cabin to start the pumps and fire out around the cabin.

It was approximately 1800 when the firefighters at Hahn Cabin reported they would be starting pumps, firing and moving to the gravel bar. Once at the cabin, the FFT2 secured the cabin, set out the SRB’s overnight gear, grabbed FFT2’s own overnight gear and hurriedly headed for the gravel bar.

The SRB remained at the cabin to start the pumps, firing a few tactical fire strips north of the cabin. After that, the SRB snatched his overnight gear and started down the path for the gravel bar.

While exiting the area, the SRB noticed the fire was burning about 20 yards to the west into the timber.

The SRB was moving at a fast pace toward the gravel bar, noting that the main fire was paralleling him and there was group torching to the west. This observation caused the SRB to contemplate dropping his gear to expedite his retreat. However, he opted to just continue to the gravel bar without disposing of his drip torch and overnight gear.

Fire Progresses Around Gravel Bar – Enveloping Firefighters in Smoke and Ember Wash

The SRB arrived at the gravel bar approximately ten minutes behind the FFT2 after starting the pump and completing firing operations. The SRB noticed that the FFT2 had their fire shelter out of their pack, still in the plastic container, holding it in their arms. The SRB and the FFT2 settled in at the gravel bar and made a satellite call back to the local unit to let them know that they had completed their work and had retreated to the gravel bar.

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Photo from Jumbo Mountain Lookout

The two firefighters planned to spend the night on the gravel bar and had their overnight gear to do so.

Over the next 3-4 hours the fire would progress around the gravel bar. The fire burned in pulses. Each pulse of fire growth enveloped the firefighters in more smoke and more ember wash.

Decision Made to Deploy Fire Shelter

At approximately 2000 hours, during the second pulse of smoke and embers, the pair made the decision to deploy FFT2’s fire shelter. Both firefighters then climbed into this single shelter to provide protection from the smoke and embers that were encompassing them.

For the most part, the two stayed inside the deployed shelter until 2130. Occasionally the SRB lifted the edge of the shelter to survey the fire behavior. By this time, the fire activity near the gravel bar and cabin had subsided. However, the pair felt the safest option was not to return to the cabin due to snag hazards and areas of unburned fuel between the gravel bar and the cabin.

At 2230, the firefighters pulled out their overnight gear and spent the night on the gravel bar.


Why do we carry Fire Shelters?

(tell us in the comments)

Please read the full report here: Rice Ridge Fire Hahn Cabin Entrapment FLA.