Welcome, 2010

It is that time of year, the time when new resolutions are made with the intention of self-improvement. This month's column offers some resolutions that we all could make to help us return home after every call. At the time of this writing, there were 80 line-of duty deaths in 2009. The causes were the usual: heart attacks, motor vehicle collisions, and firefighters getting trapped and caught in buildings among the most common.

Here are some resolutions for 2010 that will help all of us return home:

  1. Wear your seatbelt — Is there any good reason to not wear a seatbelt? We do (or at least we should) wear them in our private vehicles. So why would we not wear them when we are responding to a call in a 20-ton apparatus that places us at a higher risk of an accident? This is a simple resolution based on common sense. Wearing your seatbelt increases your chance of surviving a crash, so wear it. And it is good standard operating procedure (SOP) to check that everyone on every run has their seatbelts fastened until arrival on scene.
  2. Obey all traffic laws — This is another simple way to prevent firefighter line-of-duty deaths. Why do we open fire service journals every month and find an article reinforcing the importance of driving safely while responding? Because firefighters continue to die in traffic accidents while responding, usually because the apparatus is being driven too fast or a red light is blown. Our apparatus are deceiving, with automatic transmissions, power steering and engine brakes. Apparatus drivers can be lulled into the comfort that they are driving their small, one-ton private vehicle. However, the laws of physics still do apply to fire apparatus. A 20- or greater-ton apparatus will not stop as quickly and is much more top heavy and prone to rolling over than our personal vehicles. Again, this is simple, slow down, stop at all red lights and stop signs and only proceed when safe. Chances are your department already has SOPs covering the above and requiring this. The same goes when you respond in your own vehicle. You represent your department and getting there safely is as important as anything you may do when you get to the firehouse or scene. You owe it to your family to get home safe after every call.
  3. Get a physical — Heart attacks continue to be the number-one cause of line-of-duty deaths. If your department offers annual physicals, take advantage of it and schedule one. If your department doesn't, schedule an appointment with your primary-care provider. Tell your physician you want to reduce your risk of having a heart attack. A recent medical study estimated that as many as 70% of our nation's firefighters do not get any sort of scheduled physical. This is an excellent way to be screened for common cardiovascular risk factors. Your physician can then offer strategies to reduce the risk of having a heart attack. Our columns all year discuss the appropriate medical evaluations for fire duty.
  4. Exercise — Exercise is the first step to controlling high cholesterol and high blood pressure. Aerobic exercise can also help reduce your risk of having a heart attack. Current recommendations call for 30 to 45 minutes of aerobic exercise three to four times a week at a minimum. Exercising regularly should also help your performance on the fireground by increasing your work capacity and stamina. You can reduce the risk of having a heart attack and become a better firefighter by taking some time out of your week to commit to exercising. Be aware of how you feel during exercise, and if something doesn't feel right, see your doctor and get it checked out.
  5. Eat a healthier diet — Diet is also another initial strategy to control blood pressure and cholesterol levels. An ideal diet should be high in fiber, low in sodium, low in saturated fat, and high in fruits and vegetables. Many resources are available to find information on healthy diets. A good reference to start with is the National Volunteer Fire Council's Heart Healthy website at www.healthy-firefighter.org. If you want to lose weight, try eliminating three simple items from your diet: yeast or dough, potatoes and sugar. Those three things make up way too much of our caloric intake. Yeast means anything made with dough, including all breads, crusts like pizza, pasta, cookies, crackers, cakes and the like. You can do it and when you do, you will quickly see how much of what you eat is filler.
  6. Perform a 360-degree size up before committing resources — Chief William Goldfeder highlighted the importance of a proper size-up throughout 2009 in his Close Calls column (see Close Calls, March, April, June and September 2009). The location and intensity of a fire may not be easily recognized from three sides of a building. The layout of a building may be drastically different from the rear and can be deceiving if only viewing the building from the front and/or sides. A full 360-degree size-up will also help identify alternative means of egress and exit. The only way to fully comprehend the situation in front of you and to deploy the resources available to you in the safest possible manner is to properly size-up a building by visualizing all four sides.
  7. Wear all of your protective gear — There is a reason your department spent thousands of dollars of public or hard-earned money and bought you that nice structural gear: to protect you from getting burned and inhaling the bad stuff. Too often, we hear of firefighters getting burned or injured because they failed to wear all of their protective gear. This includes self-contained breathing apparatus (SCBA). We should be wearing full gear at all structure and car fires — that thick, black smoke at car fires produced by burning petroleum products is not good for you. A dumpster fire is another example where SCBA may be necessary: if personnel are up close to the dumpster for extinguishment and being exposed to unknown products of combustion, SCBA is warranted. Also, does your department meter structures during overhaul before giving the all clear to come off air? Carbon monoxide (CO) levels can be very high during the overhaul period, making firefighters without SCBA susceptible to CO poisoning. Also, some of the worst chemicals come with overhaul. So keep that gear on a little longer and perhaps live a little healthier.

These are some personal New Year's resolutions that do not take much effort to implement. Many of these resolutions are probably already established policy in your department. Share them with your department, get everybody to try and adopt them. They are simple, but they also will increase your chance of returning home to your station and also, more importantly, to your families. On behalf of the authors, we wish of all the readers a happy, safe and healthy 2010.

DR. RAYMOND BASRI, MD, FACP, is in the private practices of internal medicine and diagnostic cardiology in Middletown, NY. Dr. Basri is a Diplomate of the American Board of Internal Medicine and president of the Mid-Hudson Section. He received the 2008 Laureate Award of the American College of Physicians, of which he is a Fellow. Dr. Basri also is clinical assistant professor of medicine at New York Medical College, attending physician in the Department of Internal Medicine at Orange Regional Medical Center and on the consulting staff in cardiology at The Valley Hospital in Ridgewood, NJ. He is a member of the Excelsior Hook and Ladder Company in Middletown and a deputy fire coordinator for Orange County. Dr. Basri is the senior physician of the Disaster Medical Assistance Team (DMAT NY-4). He is a senior aviation medical examiner for the Federal Aviation Administration (FAA) and chief physician for Health & Safety Specialists in Medicine, which does onsite medical examinations for the fire service and consultant to FirePhysicals.com. ERIC BERGMAN, PA-C, is a physician assistant practicing internal medicine at Hartford Hospital in Hartford, CT. He earned a bachelor of science degree in allied health from the University of Connecticut and a master's degree from Albany Medical College. He is a member of the Killingworth, CT, Volunteer Fire Company; a past company officer and life member of the Avon, CT, Volunteer Fire Department; and a past member of the Shaker Road-Loudonville Fire Department in Colonie, NY.