"I Am Not Going To Make It!" - Part 2

Last month's Close Calls column featured very personal accounts by Fort Worth, TX, MedStar Medic Selena Schmidt, describing how she and fellow responders were struck and nearly killed while operating on a highway, and Fort Worth Firefighter Glenn R. Scarbrough Jr., who witnessed the incident. This month, we feature Chief Goldfeder's observations and communications with the writers and others regarding this incident:

Responding to a motor vehicle accident is generally considered "routine" by many of us, but as we've learned, no response on a highway or anywhere else should ever be treated as "routine", and for good reason. Of course, that is much easier said than done. That's why we have this column, to "drive home" the close calls (or worse) that have happened to other members so we can learn from what has happened to "them." So what can be done to protect our members on the roadways? In my discussion with Selena Schmidt while working on this column, one idea we talked about is that units simply should NOT start working on patients until the work area is safe. As you see by her comments, of course, that is not always an option, but it sure is worth thinking about.

The fact of the matter is that we must act as if every motorist is planning to hit us, and then operate knowing that. ResponderSafety.com is a great website dedicated to protecting members responding to, operating at and returning from incidents. On that site are several excellent sample standard operating procedures and guidelines. It suggests certain specific tactical procedures (shown below in bold) that should be taken to protect all crewmembers and emergency service personnel at the incident scene including:

2. Avoid turning your back to approaching traffic. That may mean that if only you and your partner arrive on a scene, one of you does the initial size-up and the other monitors traffic conditions until the arrival of additional resources. Will that delay patient care? Sure, but if you get hurt attempting to deliver that care, there is now a need for a lot more care.

3. Establish an initial "block" with the first-arriving emergency vehicle or fire apparatus. This should be done based on local laws and policies and with full understanding by your local law enforcement agency. In other words, your leadership should be meeting with law enforcement leaders now, as opposed to just doing it when you arrive on a scene. Pre-planning highway incidents is as critical as building pre-plans and can be done by type of roadway and specific roadway features.

4. Always wear Class III high-visibility reflective vests during daylight operations.

5. Always wear a structural firefighting helmet. While EMS personnel may not have firefighting helmets, approved safety helmets should be issued to all EMS responders for this protection, as well as when working in hazardous areas.

6. Wear full protective clothing plus the highway safety vest at all vehicle-related emergencies between the hours of dusk and dawn or whenever lighting levels are reduced due to inclement weather conditions. Sure, it's hot out and it may make it difficult for you to work on your patient, but you must take care of you before you can take care of them!

7. Turn off all sources of vision impairment to approaching motorists at nighttime incidents, including vehicle headlights and spotlights. If vehicle headlights and spotlights are impairing oncoming vehicles, move the lighting or stop the traffic. Emergency warning lights are critical to do their job, and that's the point. If they are causing a problem, they are not doing their job and changes are needed. Take your apparatus out to a non-traffic area at night and determine for yourselves what your "scene" may look like to approaching motorists.

8. Use fire apparatus and police vehicles to initially redirect the flow of moving traffic. This requires training and full coordination and cooperation by all affected agencies. Standard operating procedures (SOPs) with applicable training and inter-agency drills will help make this work.

9. Establish advance warning and adequate transition area traffic control measures upstream of incident to reduce travel speeds of approaching motorists. This may not always be simple in the first five minutes, so determine what you will do, how it will be done and who will be responsible.

10. Use traffic cones and/or cones illuminated by flares where appropriate for sustained highway incident traffic control and direction.

11. Establish a fire department member assigned to the "flagger" function to monitor approaching traffic and activate an emergency signal if the actions of a motorist do not conform to established traffic control measures in place at the highway scene. This "flagger" takes on the role of "watching our backs" when we are operating and is a position to be taken seriously. Make sure the "flagger" also has a working radio (heard by all on-scene units) so, if needed, a warning can be transmitted to members operating at the scene.

These are just a few of many suggestions that must be considered by all fire and EMS responders-in order to provide a safer working area on the roadways. Other websites with related information include www.Firehouse.com, www.FirefighterCloseCalls.com and the National Institute for Occupational Safety and Health (NIOSH) site: http://www.cdc.gov/niosh/firehome.html.

The duty for us to respond and provide service when we get to a scene is generally pretty clear. While we want to do whatever we can to assist those who need our help, we have to take care of us first. There may be some situations where we simply cannot initiate service because we can't do it with a reasonable amount of safety. Once again, it is the "risk-versus-benefit" model and it is up to the initial-arriving members (not just police, fire officers and chiefs) to do all they can to conduct their size-up and initiate actions based on their risk (and further risk to others) and the planned benefit to all concerned. Because if we don't, who suffers?

In this case, our brothers and sisters in Fort Worth suffered, and continue to. But who else is left to suffer? Those who love us. Your kids, your spouse, your folks, your friends and relatives.

Sometimes, we are willing to take risks; it's what we do as firefighters, medics, etc., and sometimes those risks are calculated and appropriate when attempting to help someone. We are in a risky business. However, there are many more times when "we" take risks and it clearly was not worth it. In this case, the Fort Worth fire and EMS responders did what nearly any of us would do.

But think about other calls you have been on. Sure, we may be very willing to take risks, but is the risk worth the planned outcome? And consider who are we (you and I) leaving behind to deal with the emptiness in their lives if we do something that clearly was not worth the risk. I am not washing away our duty to act and help people by any stretch of the imagination. I am just trying to get all of us to think about what we are risking on certain responses, and for what.

Related:


William Goldfeder, EFO, a Firehouse contributing editor, is a 32-year veteran of the fire service. He is a deputy chief with the Loveland-Symmes Fire Department in Ohio, an ISO Class 2 and CAAS-accredited department. Goldfeder has been a chief officer since 1982, has served on numerous IAFC and NFPA committees, and is a past commissioner with the Commission on Fire Accreditation International. He is a graduate of the Executive Fire Officer Program at the National Fire Academy and is an active writer, speaker and instructor on fire service operational issues. Goldfeder and Gordon Graham host the free and noncommercial firefighter safety and survival website www.FirefighterCloseCalls.com. Goldfeder may be contacted at BillyG@FirefighterCloseCalls.com.

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