FIR Unit III

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 1

Course Learning Outcomes for Unit III Upon completion of this unit, students should be able to:

3. Recognize the importance of standards as they apply to health and safety. 3.1 Describe the importance of physical and mental wellness in the fire service.

5. Express the importance of identifying causes of fatalities and injuries.

5.1 Discuss the types of threats to life and health associated with the fire service. Required Unit Resources Chapter 6: Developing Medical and Fitness Standards Chapter 13: Providing Emotional Support Unit Lesson

Introduction Please view the Unit III Video. Closed captioning will be available once you access the video. As we move into Unit III, we will discuss some threats to the life and health of those who provide fire and emergency services. It is important to understand the myriad risks that are associated with the fire service. Some of the threats are well documented and understood, while others are new and emerging. We must ensure that we are fully aware of the risks associated with the profession and do what we can to prevent their harmful effects. It is 3 a.m. on an August morning. The weather is hot and humid. You are dispatched to a report of an odor of smoke in a two-story, single-family residence in your first due area. The dispatcher states that there are reports of people trapped on the second floor. Regardless of whether this is a frequent occurrence for you and your jurisdiction, this type of incident is fraught with risk once on firefighters are on scene. Where is the fire? How advanced is the fire? Where are the occupants? How many occupants are there? Are they able to flee on their own? How big is the home? How many personnel can we assemble on scene? Will we be able to access the victim(s) without the use of a ground ladder? There is risk from fire and smoke, and there are products of combustion and collapse possibly operating above the ground floor. Yet, we may not immediately recognize some of the other risks to our life and health. It is imperative that we begin to recognize the threats to our own life and health. Let's walk through some of the risks.

Risks In the previous scenario, more than likely, you are waking up from a sound sleep. Whether it be in the firehouse or responding from your private residence, when your heart rate instantly goes from resting to rapid, it causes tremendous stress to the cardiovascular system. In what shape is your cardiovascular system? Do you prioritize physical health? Do you prioritize cardiovascular activity in your fitness regimen? Do you have a fitness regimen? These are questions that we should be asking ourselves as first responders. We “do know that heart attacks are an enemy for firefighters, and we even know the major risk factors. We cannot eliminate them all, but with some evasive maneuvers, we could eradicate or reduce the frequency and severity of the rest” (Zimmerman, 2021, p. 120).

UNIT III STUDY GUIDE Health and Wellness

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 2

UNIT x STUDY GUIDE Title

Now that you are awake and approaching alertness, you recognize that you are responding to a significant life threat. What will you face when you arrive on scene? Are you searching for an adult, or are you searching for a child? Although our training prepares us to rescue people from dangerous circumstances, does our training prepare us to deal with the aftermath of a fire fatality? As we get into our fire apparatus or into our personal vehicle to respond, are we trying to make up precious seconds in our response by ignoring our seatbelt? Are we justifying putting ourselves at risk of injury or death in this circumstance? Once we arrive on scene, we are met on the front lawn by the neighbor who points to the second-floor window where the occupant is located. As we get the ladder to the side of the building, will we remember to don all our personal protective equipment before we enter the fire building? After all, we can surely rationalize a burn injury if we are going to affect a rescue. After our primary search is completed, it is determined that the occupant is not home. After a significant fire suppression effort on a stubborn first floor fire, the fire is finally under control. Due to our fire department staffing, you were required to participate in the initial search for the victim, as well as the significant overhaul activities that were required. The total amount of time for fire suppression operations was just over two hours. It is now 5 a.m. It is time to support the fire investigation activities. Regardless of whether this is a typical fire scenario for your fire department, it is important to recognize the threats associated with this type of activity. There is a tremendous amount of physical stress associated with firefighting. Your body and mind are under stress from the time you receive the initial alarm for a stressful call, wearing heavy personal protective equipment and carrying tools, engaging in vigorous firefighting activities, operating in dangerous environment filled with superheated gases and toxic chemicals, and performing strenuous overhaul activities to expose hidden fire. These types of activities take a toll on us physically and mentally. As we consider the threats to safety and health, we can group them into some broad categories. Physical Illness/Injury Firefighters are exposed to life-threatening injuries at every incident. There is no such thing as a safe emergency incident. Whether it be the risk of an apparatus accident, slip and fall, lift injury, burn injury, smoke inhalation, or other injury, firefighters are constantly at risk. But they must also be aware of the risks associated with wear and tear on the body over time. You would be hard pressed to find a firefighter who has not sustained some type of back injury or lives with back pain. Additionally, cardiovascular health is at risk from poor lifestyle choices. One of the leading causes of firefighter fatalities is cardiac-related issues. The choices we make pertaining to diet and exercise contribute or detract from our overall health. It is important to get frequent medical screenings to ensure your fitness for duty. It truly is a matter of life and death. Guidelines have been developed to improve cardiovascular health of firefighters, which include guidelines that call for medical evaluations to ensure physical ability and capability (Eastlake et al., 2015). Occupational Cancer There has been much progress in the realm of education and supportive legislation as it pertains to occupational cancer. Firefighters are exposed to toxic products of combustion and other carcinogens regularly. Preventative measures such as exhaust removal devices in fire stations, post-fire decontamination procedures, and the replacement of personal protective equipment (especially hoods) are becoming the industry standard. Some apparatus manufacturers are designing fire apparatus with a clean cab concept. The rationale behind this concept is to reduce the transfer of contaminants from the fire scene to the personnel compartments of the apparatus. Removing the self-contained breathing apparatus and firefighting personal protective equipment from the cab and placing in exterior compartments significantly reduces the transfer of contaminants to the cab area. These strategies coupled with decontamination on scene and immediately after are geared toward reducing exposure and improving health and safety. It is important to consider the effects of chronic exposure to toxic byproducts and other carcinogens on your health and wellness long term. The two most important practices to prevent and mitigate exposures to carcinogens is to decontaminate regularly and immediately after a fire, and to go for routine medical checkups (“Taking Care,” 2022).

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 3

UNIT x STUDY GUIDE Title

Infectious Disease The fire service is not new to dealing with infectious and communicable diseases. However, the COVID-19 pandemic has impacted the world in many ways not formerly experienced. The impact on the fire and emergency services is significant, as we are the primary prehospital point-of-entry to the health care system for a large portion of the population. In addition to the impact on departments and agencies that provide emergency medical service (EMS) transport services, the fire service is not immune from the health implications of exposure, including fatalities associated with work-related COVID-19 exposure. As an industry, we are expected to provide these types of essential services to the communities we serve in times of great danger and at great risk to life and health. We need to approach this emerging issue with greater intentionality than we have before with issues such as exposure to smoke or seatbelt use. The risks are simply too great not to do so. Mental Health Now that have addressed several significant physical health issues, it is important to recognize the impact of providing fire and emergency services on our mental health. The topic of mental health has been receiving more attention recently, as we increase awareness and strive to reduce the stigma associated with mental health issues including anxiety, depression, substance use disorders, posttraumatic stress disorder, and suicide. The impact of managing our own lives while balancing the demands of work and other activities can take its toll. It is important to strive for a healthy work-life balance and not underestimate the stress and trauma associated with the provision of fire and emergency services. Additionally, it is equally important to understand the potential impact on those around us, including family and loved ones. There is no physical health without mental health. Physical Fitness Standards It is imperative that we address our physical health early and often and understand the importance of the relationship between physical and mental health. Firefighters and emergency services personnel must be aware of and adhere to the National Fire Protection Agency (NFPA) standards for health and wellness as the minimum standard in the industry. There is nothing more important than our health. Without it, we have nothing.

References Eastlake, A. C., Knipper, B. S., He, X., Alexander, B. M., & Davis, K. G. (2015). Lifestyle and safety practices

of firefighters and their relation to cardiovascular risk factors. Work, 50(2), 285–294. https://libraryresources.columbiasouthern.edu/login?url=https://search.ebscohost.com/login.aspx?dire ct=true&db=bsu&AN=101330145&site=ehost-live&scope=site

Taking Care to Prevent Cancer: Early Detection Saves Lives (2022, Spring). iChiefs Magazine, 8–10.

https://www.iafc.org/docs/default- source/1assoc/ichiefsmag_2022spring.pdf?utm_source=IAFCwebsite&utm_medium=iChiefspage&ut m_campaign=iChiefsMagazine_Spring22

Zimmerman, D. (2021). Fire fighter safety and survival (3rd ed.). Jones & Bartlett Learning.

https://online.vitalsource.com/#/books/9781284206128 Suggested Unit Resources The resources listed below provide additional information from regional and national organizations on topics such as mental health and occupational cancer. This is not an exhaustive list of resources, but it is an excellent introduction to the wealth of information that exists and continues to emerge. In order to access the following resources, click the links below.

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 4

UNIT x STUDY GUIDE Title

Seavey, J. P., McQueen, B., Beecher, S., Logan, R., Barker, S., Bonilla, J., Cash, J., & Bullock, R. (2018,

August). Lavender ribbon report: Best practices for preventing firefighter cancer: 11 actions to mitigate the risk of cancer. National Volunteer Fire Council and the International Association of Fire Chiefs’ Volunteer and Combination Officers Section. https://www.nvfc.org/wp- content/uploads/2018/08/Lavender-Ribbon-Report-Final.pdf

Review the websites listed below. First Responder Center website Redline Rescue website Florida Firefighter Safety website

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 1

Course Learning Outcomes for Unit III Upon completion of this unit, students should be able to:

3. Recognize the importance of standards as they apply to health and safety. 3.1 Describe the importance of physical and mental wellness in the fire service.

5. Express the importance of identifying causes of fatalities and injuries.

5.1 Discuss the types of threats to life and health associated with the fire service. Required Unit Resources Chapter 6: Developing Medical and Fitness Standards Chapter 13: Providing Emotional Support Unit Lesson

Introduction Please view the Unit III Video. Closed captioning will be available once you access the video. As we move into Unit III, we will discuss some threats to the life and health of those who provide fire and emergency services. It is important to understand the myriad risks that are associated with the fire service. Some of the threats are well documented and understood, while others are new and emerging. We must ensure that we are fully aware of the risks associated with the profession and do what we can to prevent their harmful effects. It is 3 a.m. on an August morning. The weather is hot and humid. You are dispatched to a report of an odor of smoke in a two-story, single-family residence in your first due area. The dispatcher states that there are reports of people trapped on the second floor. Regardless of whether this is a frequent occurrence for you and your jurisdiction, this type of incident is fraught with risk once on firefighters are on scene. Where is the fire? How advanced is the fire? Where are the occupants? How many occupants are there? Are they able to flee on their own? How big is the home? How many personnel can we assemble on scene? Will we be able to access the victim(s) without the use of a ground ladder? There is risk from fire and smoke, and there are products of combustion and collapse possibly operating above the ground floor. Yet, we may not immediately recognize some of the other risks to our life and health. It is imperative that we begin to recognize the threats to our own life and health. Let's walk through some of the risks.

Risks In the previous scenario, more than likely, you are waking up from a sound sleep. Whether it be in the firehouse or responding from your private residence, when your heart rate instantly goes from resting to rapid, it causes tremendous stress to the cardiovascular system. In what shape is your cardiovascular system? Do you prioritize physical health? Do you prioritize cardiovascular activity in your fitness regimen? Do you have a fitness regimen? These are questions that we should be asking ourselves as first responders. We “do know that heart attacks are an enemy for firefighters, and we even know the major risk factors. We cannot eliminate them all, but with some evasive maneuvers, we could eradicate or reduce the frequency and severity of the rest” (Zimmerman, 2021, p. 120).

UNIT III STUDY GUIDE Health and Wellness

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 2

UNIT x STUDY GUIDE Title

Now that you are awake and approaching alertness, you recognize that you are responding to a significant life threat. What will you face when you arrive on scene? Are you searching for an adult, or are you searching for a child? Although our training prepares us to rescue people from dangerous circumstances, does our training prepare us to deal with the aftermath of a fire fatality? As we get into our fire apparatus or into our personal vehicle to respond, are we trying to make up precious seconds in our response by ignoring our seatbelt? Are we justifying putting ourselves at risk of injury or death in this circumstance? Once we arrive on scene, we are met on the front lawn by the neighbor who points to the second-floor window where the occupant is located. As we get the ladder to the side of the building, will we remember to don all our personal protective equipment before we enter the fire building? After all, we can surely rationalize a burn injury if we are going to affect a rescue. After our primary search is completed, it is determined that the occupant is not home. After a significant fire suppression effort on a stubborn first floor fire, the fire is finally under control. Due to our fire department staffing, you were required to participate in the initial search for the victim, as well as the significant overhaul activities that were required. The total amount of time for fire suppression operations was just over two hours. It is now 5 a.m. It is time to support the fire investigation activities. Regardless of whether this is a typical fire scenario for your fire department, it is important to recognize the threats associated with this type of activity. There is a tremendous amount of physical stress associated with firefighting. Your body and mind are under stress from the time you receive the initial alarm for a stressful call, wearing heavy personal protective equipment and carrying tools, engaging in vigorous firefighting activities, operating in dangerous environment filled with superheated gases and toxic chemicals, and performing strenuous overhaul activities to expose hidden fire. These types of activities take a toll on us physically and mentally. As we consider the threats to safety and health, we can group them into some broad categories. Physical Illness/Injury Firefighters are exposed to life-threatening injuries at every incident. There is no such thing as a safe emergency incident. Whether it be the risk of an apparatus accident, slip and fall, lift injury, burn injury, smoke inhalation, or other injury, firefighters are constantly at risk. But they must also be aware of the risks associated with wear and tear on the body over time. You would be hard pressed to find a firefighter who has not sustained some type of back injury or lives with back pain. Additionally, cardiovascular health is at risk from poor lifestyle choices. One of the leading causes of firefighter fatalities is cardiac-related issues. The choices we make pertaining to diet and exercise contribute or detract from our overall health. It is important to get frequent medical screenings to ensure your fitness for duty. It truly is a matter of life and death. Guidelines have been developed to improve cardiovascular health of firefighters, which include guidelines that call for medical evaluations to ensure physical ability and capability (Eastlake et al., 2015). Occupational Cancer There has been much progress in the realm of education and supportive legislation as it pertains to occupational cancer. Firefighters are exposed to toxic products of combustion and other carcinogens regularly. Preventative measures such as exhaust removal devices in fire stations, post-fire decontamination procedures, and the replacement of personal protective equipment (especially hoods) are becoming the industry standard. Some apparatus manufacturers are designing fire apparatus with a clean cab concept. The rationale behind this concept is to reduce the transfer of contaminants from the fire scene to the personnel compartments of the apparatus. Removing the self-contained breathing apparatus and firefighting personal protective equipment from the cab and placing in exterior compartments significantly reduces the transfer of contaminants to the cab area. These strategies coupled with decontamination on scene and immediately after are geared toward reducing exposure and improving health and safety. It is important to consider the effects of chronic exposure to toxic byproducts and other carcinogens on your health and wellness long term. The two most important practices to prevent and mitigate exposures to carcinogens is to decontaminate regularly and immediately after a fire, and to go for routine medical checkups (“Taking Care,” 2022).

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 3

UNIT x STUDY GUIDE Title

Infectious Disease The fire service is not new to dealing with infectious and communicable diseases. However, the COVID-19 pandemic has impacted the world in many ways not formerly experienced. The impact on the fire and emergency services is significant, as we are the primary prehospital point-of-entry to the health care system for a large portion of the population. In addition to the impact on departments and agencies that provide emergency medical service (EMS) transport services, the fire service is not immune from the health implications of exposure, including fatalities associated with work-related COVID-19 exposure. As an industry, we are expected to provide these types of essential services to the communities we serve in times of great danger and at great risk to life and health. We need to approach this emerging issue with greater intentionality than we have before with issues such as exposure to smoke or seatbelt use. The risks are simply too great not to do so. Mental Health Now that have addressed several significant physical health issues, it is important to recognize the impact of providing fire and emergency services on our mental health. The topic of mental health has been receiving more attention recently, as we increase awareness and strive to reduce the stigma associated with mental health issues including anxiety, depression, substance use disorders, posttraumatic stress disorder, and suicide. The impact of managing our own lives while balancing the demands of work and other activities can take its toll. It is important to strive for a healthy work-life balance and not underestimate the stress and trauma associated with the provision of fire and emergency services. Additionally, it is equally important to understand the potential impact on those around us, including family and loved ones. There is no physical health without mental health. Physical Fitness Standards It is imperative that we address our physical health early and often and understand the importance of the relationship between physical and mental health. Firefighters and emergency services personnel must be aware of and adhere to the National Fire Protection Agency (NFPA) standards for health and wellness as the minimum standard in the industry. There is nothing more important than our health. Without it, we have nothing.

References Eastlake, A. C., Knipper, B. S., He, X., Alexander, B. M., & Davis, K. G. (2015). Lifestyle and safety practices

of firefighters and their relation to cardiovascular risk factors. Work, 50(2), 285–294. https://libraryresources.columbiasouthern.edu/login?url=https://search.ebscohost.com/login.aspx?dire ct=true&db=bsu&AN=101330145&site=ehost-live&scope=site

Taking Care to Prevent Cancer: Early Detection Saves Lives (2022, Spring). iChiefs Magazine, 8–10.

https://www.iafc.org/docs/default- source/1assoc/ichiefsmag_2022spring.pdf?utm_source=IAFCwebsite&utm_medium=iChiefspage&ut m_campaign=iChiefsMagazine_Spring22

Zimmerman, D. (2021). Fire fighter safety and survival (3rd ed.). Jones & Bartlett Learning.

https://online.vitalsource.com/#/books/9781284206128 Suggested Unit Resources The resources listed below provide additional information from regional and national organizations on topics such as mental health and occupational cancer. This is not an exhaustive list of resources, but it is an excellent introduction to the wealth of information that exists and continues to emerge. In order to access the following resources, click the links below.

FIR 2302, Principles of Fire and Emergency Services Safety and Survival 4

UNIT x STUDY GUIDE Title

Seavey, J. P., McQueen, B., Beecher, S., Logan, R., Barker, S., Bonilla, J., Cash, J., & Bullock, R. (2018,

August). Lavender ribbon report: Best practices for preventing firefighter cancer: 11 actions to mitigate the risk of cancer. National Volunteer Fire Council and the International Association of Fire Chiefs’ Volunteer and Combination Officers Section. https://www.nvfc.org/wp- content/uploads/2018/08/Lavender-Ribbon-Report-Final.pdf

Review the websites listed below. First Responder Center website Redline Rescue website Florida Firefighter Safety website