If We Do What We’ve Always Done, We’ll Get What We’ve Always Gotten…

I see that NIOSH reports have popped up on the radar of the blogosphere recently.  Frankly, I’m surprised at the heat a few have been giving them.  Maybe I’ve been missing something (it’s happened before). So I took a closer look.
We already know that heart attacks and traffic accidents are the main murderers of us firefighters, so I’m sure we’ve already dedicated the necessary resources to firefighter health and safety initiatives and accident scene safeguards to keep these killers from having free reign over our troops.
Right?
So, I went to the Fire Fighter Fatality Investigation Reports page from NIOSH and randomly picked 5 of the reports with deaths involving fire suppression. I was looking for patterns. Guess what I found….
NIOSH Report 2008-26
A residential basement fire had been burning for over 30 minutes. A crew was directed to enter the first floor to perform horizontal ventilation and found a spongy floor. The last (victim) of the four-man crew was just about out when the floor collapsed into the basement on top of working crews. Heavy smoke conditions hampered efforts to locate the victim and he died on the scene.

Among the NIOSH recommendations:

Sizeup, Risk/Gainensure that the incident commander (IC) conducts a 360 degree size-up which includes risk versus gain analysis prior to committing interior operations and continues risk assessments throughout the operations”

SOP’s/SOG’s- “ensure that standard operating procedures are established for a basement fire”

Coordinated Ventilation-ensure that proper ventilation is done to improve interior conditions and is coordinated with the interior attack”

TIC-ensure that interior crews are equipped with a thermal imaging camera”

RIT/RIC-ensure that Rapid Intervention Teams are staged and ready”

NIOSH Report 2008-34

One of only three firefighters on the scene, the victim entered a burning residence alone with a partially-charged 1 ½ inch line and became lost in thick-black smoke, radioing for help from the other two. They couldn’t locate him, a flashover occurred, and the home became fully engulfed. A cop found him an hour later.

Among the NIOSH recommendations:

Size-up, Risk/Gain- “ensure that officers and fire fighters know how to evaluate risk versus gain and perform a thorough scene size-up before initiating interior strategies and tactics”

SOP’s/SOG’s- “develop, implement, and enforce written standard operating procedures (SOPs) for fireground operations”

Staffing-ensure that adequate numbers of apparatus and fire fighters are on scene before initiating an offensive fire attack in a structure fire”

Coordinated Ventilation-ensure that properly coordinated ventilation is conducted on structure fires”

RIT/RIC- “ensure that a rapid intervention team (RIT) is established and available at structure fires”

SCBA-ensure fire fighters are trained in essential self-contained breathing apparatus (SCBA) and emergency survival skills”

Mayday- “ensure that protocols are developed on issuing a Mayday so that fire fighters and dispatch centers know how to respond”

NIOSH Report 2008-08

30 minutes into a residential fire, crews had been pulled out. A decision was made to send a crew back in to extinguish the fire. A crew of 3 (A/C, Capt, FF) made their way into the basement of the burning structure with an 1¾ line. One by one they evacuated due to conditions. The third never came up the stairs. RIT was activated but repelled by the heat. Victim found an hour later.

Among the NIOSH recommendations:

Risk vs. Gain-ensure that the Incident Commander continuously evaluates the risks versus gain when determining whether the fire suppression operation will be offensive or defensive

SOP’s/SOG’s- “review, revise as necessary, and enforce standard operating guidelines (SOGs) to include specific procedures for basement fires and two-in/ two-out procedures

TIC-enforce standard operating guidelines (SOGs) regarding thermal imaging camera (TIC) use during interior operations

Mayday- ensure that fire fighters are trained on initiating Mayday radio transmissions immediately when they are in distress, and/or become lost or trapped

NIOSH Report 2008-06

Without the protection of a charged hoseline, a Lt and FF (victim) were searching a 2-story residence for a trapped occupant. They did not know where the victim was and had no TIC. Conditions deteriorated, trapping the two on the second floor. The LT exited the front door and RIT was deployed to get the victim. Both were hospitalized and the victim succumbed to burn injuries 5 days later.

Among the NIOSH recommendations:

Size-up-ensure the Incident Commander receives pertinent information during the size-up (i.e., type of structure, number of occupants in the structure, etc.) from occupants on scene and that information is relayed to crews upon arrival”

SOP’s/SOG’s- “develop, implement, and enforce written standard operating procedures (SOPs) for fireground operations”

Coordinated Ventilation- “ensure ventilation is coordinated with interior fireground operations”

TIC-ensure that fire fighters conducting an interior search have a thermal imaging camera”

Mayday- “ensure that Mayday protocols are developed and followed”

NIOSH Report 2007-32

Two firefighters died while conducting an interior attack to locate, confine, and extinguish a fire located in the cockloft of a restaurant. One victim had been flowing water into the cockloft from the kitchen, another had been checking for fire extension in the main dining area. At about 5 minutes in, a rapid fire event occurred.

Among the NIOSH recommendations:

Size-up- Risk vs. Gain- “ensure that the incident commander conducts an initial size-up and risk assessment of the incident scene before beginning interior fire fighting operations and continually evaluates the conditions to determine if the operations should become defensive”

SOP’s/SOG’s- “develop, implement and enforce written standard operating procedures (SOPs) that address the hazards and define the strategies and tactics to be used while operating at specific structures known as “taxpayers”

Coordinated Ventilation- “ensure that fire fighters understand the influence of ventilation on fire behavior and coordinate with interior fire suppression operations”

RIT/RIC- “ensure that a rapid intervention crew (RIC) / rapid intervention team (RIT) is established and available to immediately respond to emergency rescue incidents”

TIC-use thermal imaging cameras (TICs) during the initial size-up and search phases of a fire”

Any patterns?
Size-up, Risk vs. Gain- Does your first in crew perform a 360 and report an accurate size up of conditions to all others? Is a risk vs. gain assessment actually made? Are your initial tactics based upon these findings?
Why not? Didn’t you try to implement the NIOSH recommendations to keep from killing your firefighters?
Are your SOP’s/SOG’s current to the ever-changing tasks being performed at your incidents? Do you follow them? Do you even have any?
Why not? Didn’t you try to implement the NIOSH recommendations to keep from killing your firefighters?
Is ventilation performed early and integrated with your interior attack? Or has ventilation worked its way down to fifth or sixth on your list of priorities? After all, it will eventually vent itself.
Why not? Didn’t you try to implement the NIOSH recommendations to keep from killing your firefighters?
Is a RIT/RIC established early on? If you don’t have the personnel to form a RIT/RIC, do you have a mutual aid response to give you the number of firefighters needed to operate safely?
Why not? Didn’t you try to implement the NIOSH recommendations to keep from killing your firefighters?
Does your department have at least one Thermal Imaging Camera? It’s been called the best thing since SCBA in many firefighting circles. You have SCBA, right? Does your department know to call a Mayday early? Too macho to call it? Does EVERYONE ON THE SCENE know what to do when a Mayday is called?
Why not? Didn’t you try to implement the NIOSH recommendations to keep from killing your firefighters?
WHY ARE WE NOT FOLLOWING THROUGH?
Are the reports too difficult to understand? Perhaps we need to dumb them down or fluff them up? Fine. I’m all for whatever it takes.
But let’s not forget that the reports are just that- reports. We need to make the changes, NIOSH ain’t gonna do that for us.
So read the reports, see how they killed our brothers, and take a hard look at how you and your department operate.
THEN IMPLEMENT THE CHANGES YOU NEED TO KEEP YOUR GUYS ALIVE.
Because if we continue to do it the same way, we’ll get what we’ve always gotten. Another NIOSH report with the same ol’ stuff.

5 Comments

  • sj says:

    Excellent article.
    Good to know I'm not the only one harping on this!

  • sj says:

    Excellent article.
    Good to know I'm not the only one harping on this.

  • Bill Carey says:

    I don't believe that NIOSH should “dumb down” the reports but maybe they should begin presenting them in way that attracts the reader. Instead of the uniform template, how about better promotion of the report with more (if available) multimedia and include excerpts of persons interviewed. They could even tailor the presentation of the reports by department demographics (rural, suburban, urban; volunteer, combination, career). This could lead to more detailed recommendations as opposed to having general recommendations that would fit any department. True, the recommendations do apply to every department, and should, but take the latest released from WVa. Nine out of 10 firefighters randomly asked would probably agree to not enter a working trailer fire without SCBA on and in use. How many of those nine though, would enter a private or multiple dwelling fire without masking up? Sure, it matters on the sizeup and/or SOP, but do we see the gray area, where what could be a rule for one department would be 'guideline' for another? TICs, a fact of life not everyone has one, but are we doing anything with these reports to change tactics if you don't have a TIC? Same applies to strategy and tactics; many departments operate with static SOPs figuring in good staffing and response. How many reports tell a department what they should be focusing on if they only have three people one the scene, for the first few minutes?
    Maybe, like we saw with the Denver drill, some of our yearly HOTS and FDIC hands on training can recreate these fatal firegrounds and run students through, using varied staffing levels and equipment. That could certainly direct interest into a specific investigation report and help tailor it to specific departments.

  • Bill Carey says:

    I don't believe that NIOSH should “dumb down” the reports but maybe they should begin presenting them in way that attracts the reader. Instead of the uniform template, how about better promotion of the report with more (if available) multimedia and include excerpts of persons interviewed. They could even tailor the presentation of the reports by department demographics (rural, suburban, urban; volunteer, combination, career). This could lead to more detailed recommendations as opposed to having general recommendations that would fit any department. True, the recommendations do apply to every department, and should, but take the latest released from WVa. Nine out of 10 firefighters randomly asked would probably agree to not enter a working trailer fire without SCBA on and in use. How many of those nine though, would enter a private or multiple dwelling fire without masking up? Sure, it matters on the sizeup and/or SOP, but do we see the gray area, where what could be a rule for one department would be 'guideline' for another? TICs, a fact of life not everyone has one, but are we doing anything with these reports to change tactics if you don't have a TIC? Same applies to strategy and tactics; many departments operate with static SOPs figuring in good staffing and response. How many reports tell a department what they should be focusing on if they only have three people one the scene, for the first few minutes?
    Maybe, like we saw with the Denver drill, some of our yearly HOTS and FDIC hands on training can recreate these fatal firegrounds and run students through, using varied staffing levels and equipment. That could certainly direct interest into a specific investigation report and help tailor it to specific departments.

  • Bill Carey says:

    I don't believe that NIOSH should “dumb down” the reports but maybe they should begin presenting them in way that attracts the reader. Instead of the uniform template, how about better promotion of the report with more (if available) multimedia and include excerpts of persons interviewed. They could even tailor the presentation of the reports by department demographics (rural, suburban, urban; volunteer, combination, career). This could lead to more detailed recommendations as opposed to having general recommendations that would fit any department. True, the recommendations do apply to every department, and should, but take the latest released from WVa. Nine out of 10 firefighters randomly asked would probably agree to not enter a working trailer fire without SCBA on and in use. How many of those nine though, would enter a private or multiple dwelling fire without masking up? Sure, it matters on the sizeup and/or SOP, but do we see the gray area, where what could be a rule for one department would be 'guideline' for another? TICs, a fact of life not everyone has one, but are we doing anything with these reports to change tactics if you don't have a TIC? Same applies to strategy and tactics; many departments operate with static SOPs figuring in good staffing and response. How many reports tell a department what they should be focusing on if they only have three people one the scene, for the first few minutes?
    Maybe, like we saw with the Denver drill, some of our yearly HOTS and FDIC hands on training can recreate these fatal firegrounds and run students through, using varied staffing levels and equipment. That could certainly direct interest into a specific investigation report and help tailor it to specific departments.

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John Mitchell

Firefighter/Paramedic and a Lieutenant in suburban Chicago

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