Two Words: “Routine” And “Size-Up”

Each and every year, too many firefighters are killed or injured on the fireground. The average number killed is in the neighborhood of 100 a year. Factoring in the data that links over 50% of the fatalities with heart/lung or other health-related issues...


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Each and every year, too many firefighters are killed or injured on the fireground. The average number killed is in the neighborhood of 100 a year. Factoring in the data that links over 50% of the fatalities with heart/lung or other health-related issues, that still leaves an unacceptable number actually killed while operating on the fireground.

If you read the investigation reports about these fatalities from the National Institute for Occupational Safety and Health (NIOSH) or through the National Fire Academy, you will see that two words seem to appear consistently. These two words are "routine" and "size-up."

The District of Columbia Fire and EMS Department killed three firefighters in 18 months at incidents where "size-up" and "routine" appeared in the reconstruction reports as direct causes of the fatalities. But D.C. was not alone in this situation. You can add Seattle (four dead), Pittsburgh (four dead), Memphis (two dead), Brackenridge, PA (four dead), Kansas City, MO (six dead) and Detroit (three dead). These are not indictments against any of these entities, but what is irrefutable is that the words "routine" and "size-up" are listed as direct causes of death for ALL of them.

The question could be posed as to exactly when an incident becomes labeled as "routine." What magnitude must it be to be considered dangerous to firefighters? I don't profess to be that profound, so I researched the concept and I think some thoughts of others need to be shared. Besides understanding emergency situations and variables, it is crucial to understand some basics about emergency responders. During an emergency response, certain psychological occurrences take place within the minds of responders. A wide range of possibilities exists, depending on the individual, amount of training and education, length of service, experience and type of incident.

It may seem odd to have to make this statement, but emergency scenes are dangerous and potentially lethal! Why? Because of the lack of control. There is no other job that allows or requires its employees to work in an uncontrolled environment. Isn't that what emergency responses are all about? If events were not to some degree out of control, emergency responders would not be necessary (Slovic, 1974, pages 68-71).

Although the psychological responses vary, responders share certain reactions. First, upon being dispatched, most individuals have a basic adrenaline rush - there is excitement. The more extraordinary (due to magnitude, type, etc.) the response, the more adrenaline is likely to flow. On the other hand, the more ordinary and routine the response is for the individual, the less adrenaline is likely to flow. Either case can be extremely dangerous to responders if they do not realize what is happening.

At whichever end of the emotional spectrum the responder is found, emotion has the tendency to put the brain in neutral. The responder is not thinking, but reacting. As a result the responder is at the mercy of the emergency situation.

When responders perceive the incident to be highly unusual, dangerous or emotionally charged, they often experience tunnel vision. Tunnel vision occurs when responders focus on one aspect of the situation and lose sight of the overall incident. On the other hand, if the responders perceive the incident to be routine, they may go on autopilot. In either case, they become oblivious to their surroundings and thus are at the mercy of the incident (Initial Response to Hazardous Materials Incidents, August 1992).

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