If it took less than 10 minutes to learn a scientifically proven way to save someone’s life in the event of a heart attack — and that lesson was free — would you take the time? Would you be willing to teach others the same technique?
Individuals experiencing a heart attack had a much higher survival rate if bystanders administered continuous chest compressions (CCC) rather than the traditional CPR of alternating compressions with mouth-to-mouth breaths until emergency medical service arrives or an automatic external defibrillator, according to research conducted by Gordon A. Ewy, MD, director of the University of Arizona’s Sarver Heart Center. Only 5% of cardiac-arrest victims survive if nobody performed CPR. For those receiving standard CPR (alternating between 30 compressions and two breaths), survival was marginally higher at 6%. In contrast, 11% survived if bystanders kept pumping on their chest and did not stop for mouth-to-mouth breaths until emergency medical services arrived.
I first heard about cardiocerebral resuscitation in 2007, when Bentley J. Bobrow, MD, medical director of the Bureau of Emergency Medical Services & Trauma System at the Arizona Department of Health Services, presented the statistics on CCC versus CPR administered by bystanders at a meeting of the Arizona Fire Chiefs Association. A year later, FIRE CHIEF published an article and a poster to introduce the method — then referred to as cardiocerebral resuscitation (CCR) — to a wider audience.
Bobrow has promoted CCC statewide. For instance, 1,800 middle and high schools received CCC-CPR instructional kits last year. The kits contained a letter from the governor and a nine-minute DVD instructional video of students teaching CCC.
Bobrow is encouraging public-information officers in Arizona to “[make] this message a priority in your community through your media channels. Also, this is a perfect message for your civic and community leaders to endorse. Simply put, this will save a lot of people in our state, and I am confident that you will know how to best promote this life saving message.”
The number of saves in the six years since Bobrow introduced the concept has been amazing. And fire and EMS departments in other states, including Wisconsin and Missouri, also have introduced the new CCC procedures to their communities.
On Sunday, Ewy presented the statistical data collected on CCC-CPR to the American Heart Association. The AHA is preparing to launch a public-information campaign across the country titled “Hands-Only CPR” and will include brief and ultra-brief television spots.
Next week, families and friends will gather to celebrate Thanksgiving. Why not take nine minutes to watch the report on Mayo Clinic’s CCC program? Teach yourself and others how to save a person’s life.
You never know when they may use CCR on you someday.
Recently I wrote about how Chicago Mayor Richard Daley requested that all first responders take 24 days without pay, which would save the city millions in 2010. Some readers were supportive of the mayor, and I was surprised.
One reader wrote, “I applaud Mayor Daley’s courageous and principled stand on furloughs. Firefighters, police, and EMTs are no different from other municipal employees, or for that matter, the millions of other Americans who have lost their jobs or suffered cuts in hours or benefits as a result of the financial crisis.”
I feel for Americans who’ve lost jobs — I have friends and family members among them. But I’d like to be assured that their lives are somewhat secure; if they were in an accident or a house fire, I want them to survive because our first responders are on the job. Public-safety still is a priority, even when citizens are losing their jobs.
The same reader commented that, “Your thesis assumes that the community depends on firefighters, police, and EMTs in a way that if true suggests the community has lost more than just its economic footing. In a functioning community, police, EMTs and firefighters serve as an extension of the community’s capacity to organize itself to provide for mutual security.”
I agree with him — an engaged citizenry in Chicago would be great. If people took responsibility for their community and showed 5% more courtesy, it would be a safer, warmer place to live.
But it’s totally unrealistic.
It just doesn’t happen in this city, which is segregated by either ethnic or socio-economic standards. In addition, Chicagoans are self-absorbed. In fact, children in the city are taught to yell “fire” versus “help” if in danger because residents are more willing to react if their own safety is threatened instead of the safety of others. It’s sad to say, but generally in people the city are not helpers. In fact, folks usually just try to stay out of each others’ way.
Finally, he wrote, “When Chicago firefighters went on strike many years ago, the number of fires actually went down. Something very similar happened in the United Kingdom during their recent industrial dispute with firefighters.”
I am unfamiliar with the case in the United Kingdom. I lived through the Chicago Fire Strike in 1980 — and I learned there was an uptick in fires and violence throughout the city. In addition, union leaders jokingly called it “the second Chicago fire.” So I doubt fires go down if fewer firefighters are on the job.
Maybe looking at the way funding is distributed would help the budget crunch, even more than furlough days, implied another reader. I’d be interested in hearing other readers’ thoughts on his suggestion below:
“[I] consider Chicago my hometown. Many of my friends and family are firefighters and paramedics on the city. My only concern is this; most cities have a very large fire department with millions of budget [dollars] for equipment and salaries. Most buildings have fire sprinklers. Would it not be better to have a fire department that does 80% EMS response and have more ambulance personnel with two per ambulance and less fire apparatus with four to six people per vehicle to save lives and decrease the budget by decreasing salaries and equipment expenditures?”
In the end, I agree with a reader who said society needs first responders as their first line of defense against a disaster.
“[T]he nation’s first responders are — whether anyone wants to pay them or not — our nation’s first and last line of defense against any catastrophe, manmade, intentional or accidental,” he said. “We need those men and women to show up and be compensated for placing their lives on the line daily and not have to worry about anything but being the best they can at what they do, protect you.”
The past few weeks have been difficult for military personnel and their families, between the tragedy at Fort Hood and the high number of casualties overseas. Perhaps that’s why I was so taken by military-spouse Angela Smith’s link to “101 Ways to Thank a Veteran,” written for a military-support blog. Even though Veterans’ Day has passed, there is no expiration date on remembering servicemen and -women.
Firefighters who also are soldiers activated and deployed during war time is stressful enough for fire departments, but coupled with a flailing economy, fire chiefs across the country are struggling with severe staff reductions.
I spoke with Frankfort (Ky.) Fire Chief Wallace Possich after he submitted two of his firefighters’ names for our double-duty holiday greetings list. Frankfort Fire and EMS provides services to the state capital with 88 sworn personnel out of four fire stations. According to Possich, his department is currently down 11 personnel: nine retirees who will not be replaced and the two firefighter/paramedics serving overseas.
“Since 9/11, I’ve had about eight fire personnel who have been activated to serve,” Possich said. “I’ve had people in both Iraq and Afghanistan, and a drill sergeant who was gone two years training recruits close to Fort Knox.”
Frankfort firefighter/paramedics Steve Clark and Scott True also are members of the National Guard. They were sent to Kosovo last August. Clark and True are in the same unit, both serving as medics.
The Frankfort department is required by federal regulations to hold the positions for serving military.
“We would do that anyway, so we just count their absences as military-leave vacancies and back-fill with overtime,” he said. “The military activation combined with the economy that has implemented hiring freezes it hasn’t helped at all.”
Possich is hoping to get authorization from his city officials to apply for a SAFER grant this week. The city has not yet applied for SAFER funds; however, Possich is hopeful officials will reconsider.
In 2001, Frankfort implemented a policy on how they would handle military activation and the benefits program. In addition, the state of Kentucky training system requires firefighters be certified and maintain 100 training hours annually in exchange for $3,100 on top of their salaries.
“If one person doesn’t get his 100 hours, the whole department loses their stipend,” Possich said. “Part of the rules on the stipend system is you have to be affiliated with the fire department. The state law is waived while serving in the military.” The fire department agreed to keep personnel serving in the military on their books as paid employees by paying $10 a week.
The city maintains the health-care payments for serving personnel and also covers the families; the city pays the insurance and the employee can pay it back upon his or her return. Pension and seniority are not affected. Possich said he has received three “Employer Support of the Guard and Reserve” awards for his support.
“We try to maintain our communication with our serving personnel and maintain contact with their families too,” Possich said. “One firefighter who was deployed for two years was concerned about his young family, so the department went over and painted his house and did the landscaping.”
So here is one more way to thank a veteran or soldier. Send me the name and mailing or e-mail address of a firefighter or EMS person serving in the military. Starting next week, the names will be available on the FIRE CHIEF Web site.
And a belated happy 234th birthday to the Marines.
I always wanted to be a firefighter. I didn’t become one because I was born about 10 years too early. No one in my family ever had attended college, and my blue-collar parents believed that a college degree was the key that would open the door to a better life. They insisted that I be the first. Unfortunately, few — if any — colleges at the time offered fire service — oriented curricula. So, I became a journalist. But the dream still lingers within, like a faintly glowing ember.
Given that, it should come as no surprise that I jumped at the chance to participate in firefighter training at the University of Illinois a few weeks ago. Each year, Motorola brings product managers, marketers and design engineers to the training facility. The belief is that product design shouldn’t be conducted in an ivory tower; ergo, the opportunity to experience what firefighters experience, albeit in a controlled environment, will provide valuable insights that will help them to develop products that are more effective in the field.
That’s quite important, said lead instructor Mark Krizik — a Motorola systems engineer who doubles as a lieutenant with the fire department in the Chicago suburb of Posen, Ill. — as there’s just too much to deal with when on the fireground. Equipment must be donned, breathing gear must be working properly, instructions have to be understood and myriad hazards must be avoided — for instance, it’s generally not a good idea to fall through a floor, especially if it means landing in the basement where the blaze started — a common occurrence, I was told, as basements generally are where heat-generating devices such as furnaces and clothes dryers are located. Then there’s the weighty matter of knocking down the fire and rescuing victims.
“The radio is the last thing a firefighter wants to think about,” Krizik said.
After an initial orientation, we were divided into teams and issued gear, including helmets, air tank and mask, turnout coat and gloves — everything but the pants and boots. Then we were put through the paces, replicating over several hours the duties of an engine company, a ladder company and incident command. After one of our rotations, I overheard one of my teammates, a Motorola marketing manager, tell a colleague, “I had to take off my gloves in order to use the lapel mike.” She added that the experience was an eye-opener, as she discovered that using the lapel microphone while wearing heavy gloves was much tougher to do than she had thought.
The day was filled with other similar revelations. The Motorola people learned a great deal about the rigors of firefighting and how those rigors affect how firefighters use their products — what works and what doesn’t. And I learned a little something about Motorola.
Last weekend, I delivered a presentation on fire service trends at the Buffalo Trace Regional Fire Academy in Maysville, Ky. More than 400 firefighters — primarily volunteers with ages ranging from 18 to 70 — were signed up for the three-day academy.
Because Kentucky firefighters are required to meet certain hours for state certifications, State Fire Commissioner Ron Davis said the state provides the regional training at no charge. One of the most popular classes at the academy was a two-day basic firefighting course for new firefighters and seasoned firefighters who want to brush up on their skills. Also among the 16 classes being offered were highway crash–site management, occupant protection and an eight-hour firefighter survival course.
The evening before my presentation, I had the opportunity to meet several firefighters at a nearby pub. They shared with me a number of their concerns as volunteer firefighters who are trying to balance work and family, and over the need for more training in the current economy. One training officer explained that the lack of jobs has sent volunteers out of the region, some driving 50 to 60 miles each way to work. “There’s no time to train and even less time to respond to calls,” he said.
Recruiting and retaining members and balancing budgets are universal problems, and managing them can be very stressful. In fact, firefighter stress was one of the trends I identified in my presentation.
Recently I heard a fire chief say that volunteer firefighters are most susceptible to emotional stress because “when they respond to a call, they know the people they are working on in their town.” When I shared that comment with the volunteers, they nodded in agreement.
After my presentaion, a young firefighter came up to me and told me he once had to help cut his brother and a friend out of a car after a bad accident. The brother survived, but the friend was killed. I told him that he had a long career ahead of him and I hoped he would learn how to deal with the stress he would encounter.
Of course, support of family and friends goes a long way to relieving some of that stress. To that end, FIRE CHIEF once again will be gathering names and contact information of firefighters and emergency personnel who either are serving our country overseas or are veterans recovering back home.
If you know firefighter, EMT, paramedic or other first responder who would appreciate receiving a holiday card or package from fire departments or fire families here in the U.S., send his or her contact information to me, and we will post it on our Web site.
It’s time to remember those who are away from home for the holidays and let them know we care.
I take the bus to work. And yesterday, my fellow riders and I were startled by a middle-age man who was screaming angrily about the current government, taxation, health care, 401K fraud and cutbacks in public services. Nutcases on public transportation add to the joy of living in Chicago. It’s a daily event to hear someone off his rocker preaching about one issue or another. But when he started to yelp about the city’s plan to force police and fire personnel to take furlough days, he caught my attention.
Last week, the city rolled out its 2010 budget. Mayor Richard Daley included 24 unpaid days (12 holidays, 12 furlough days) for all non-union and many union city employees — including the city’s firefighters and police officers. Of course, the mayor can’t force the departments to take furlough days based on union contracts. But he seems determined to strong arm the city’s first responders into being team players and making sacrifices like the rest of the city’s workers. In fact, he said publicly that, “Everyone has to be part of the solution, not part of the problem. And that’s why I’m taking 24 days without pay, and I got other people to take that, because you have to show that government understands the suffering that is going on throughout your communities.”
If police and fire unions agreed to furloughs, the city would save $120 million, city Budget Director Eugene Munin said publicly at a city council budget hearing. That is a huge cost savings. It’s great the city can save money by forcing folks to take a month off. But to save money at the expense of public safety is ridiculous. Many will argue that there are not enough first responders on the street already, especially after nationally publicized events like the beating death of a Fenger High School student. And a time when the nation is at war against domestic and international terrorists, as well as facing threats from biological, chemical and radiological attacks and then the potential swine flu pandemic, don’t we need our first responders at work more than ever?
In fact, cutting the amount of first responders on the street may actually cost the city money. Imagine the lawsuits and liability coming from this. If it takes an ambulance or fire department 10 minutes longer to reach a victim who then dies, will a lawsuit ensue? And how much money would it cost the city’s lawyers to fight the suit, and then ultimately settle it to keep the victims’ families quiet? My guess is somewhere in the millions of dollars.
I give Daley credit because he also plans on taking furlough days. I understand the city’s broke. But the firefighter union shouldn’t have to take these days. I have another idea. Maybe the city should look at the layers of leadership and cut from there. Instead of 50 aldermen, maybe we should combine districts and cut that number by half. Or maybe they only need to meet once a week, and get paid for 52 days. Or maybe, just maybe, being an alderman shouldn’t be a full-time job. Maybe instead it should be a calling to public service. Yes. Maybe they should work for free. Cost-savings should come off the backs of politicians and their cronies, not first responders. Because in the end, an alderman rarely saves a life — while for police and firefighters serving and protecting the community is part of their moral code. We need them on the streets, 24/7. If not, the consequences may be great.
Once again, October has proved to be a busy month. My notebook is filled with interesting information and quotes from a wide range of sources across the country, some from group discussions and therefore unattributed. Here are my tricks and treats to think about this Halloween weekend:
Ergonomics. “We’re seeing Kevlar belts being worn with suspenders to help take the weight off of the shoulders,” said Ken Busch of Scott/Honeywell, during a turnout gear presentation.
Story-telling. “To be successful in the environment we are in, you have to be able to tell our story. The mantra we deal with over and over is efficiency, efficiency, efficiency,” Chief Adam Thiel, Alexandria (Va.) Fire Rescue, said.
Prescreening. “Why is the concept of mental health not in our curriculum at the entry level of our fire academies?” asked Deputy Chief Pat Kenny of the Western Springs (Ill.) Fire Department.
Safety. “Why don’t [manufacturers] build something to tell when gear is about to exceed the capacity to protect a firefighter?” asked Chief Alan Brunacini (Ret.).
Global outlook. “If we want to look for apparatus models that really work … look at the rest of the world and how they are doing it,” Thiel continued.
Common sense. “You can’t change without trust,” said one chief during a discussion about changing cultures, unions and consolidations.
Staffing. “Are city managers decreasing their personnel, too?” asked a cash-strapped chief.
Attention deficit. “You’re lucky if you have even five minutes of attendees attention,” quipped one chief.
Change. “When you have a downturn in the economy, it forces us to think differently — whether we like it or not — and it creates a lot of anxiety.”
CCR. “What kind of CPR are they going to do on you if [EMTs] do that on the public?” asked Deputy Chief Chuck Montgomery of the Glendale (Ariz.) Fire Department while explaining the increased benefits of cardio cerebral resuscitation over CPR.
Going the distance. “Why is it OK in a rural area to respond in 10 minutes, but it’s not OK in a suburban area?”
Opposites. “When things are going good, the authority having jurisdiction goes up, and when things are going bad, it goes down.”
Firefighting? “Nothing in the laws says we have to put it out.”
Volunteerism. “How do you cut a volunteer fire department? Citizens Emergency Response Training is filling the gap for police and fire….”
Agreement. “The classic answer to all public service officials’ questions about cutting budget or service is the same: ‘it all depends ….’”
Vision. “There’s a difference between a growth and a survival mode.”
Mind’s eye. “Mental health is a key component of overall firefighter safety,” Kenny continued.
Volunteer stress. “Mental wellness is critical for firefighters, and it’s worse for volunteer departments because they know the local people.”
Superheroes. “Take the cape off before it chokes you.”
Five keys to success. “Vision: Do you know where you want to go? Values: Will your values take you there? Will you be satisfied when you get there? Action: Do you act to insure success and eliminate failure? Attitude: Do you reject psychological blocks from the past or imposed by others? Connections: Can you establish strong ties and relationships with people?” By Dr. Joseph Mancusi
Reminder. Change your clock and change your batteries.
By Jesse Herman
Firefighters are exposed to many risks on a daily basis, but one that can go unnoticed is the danger of asbestos exposure, a mineral fiber that used in construction applications throughout the 20th century. The life of a firefighter brings many potential threats that can be easy or hard to see. The profession itself takes a great deal of courage. One of the hidden threats that are not so glamorous is asbestos exposure.
The Environmental Protection Agency issued the Asbestos Ban & Phase Out in 1989. This ruling was overturned in the highly contested court decision that left many asbestos-containing products in the public realm. This led to millions of workers and civilians being wrongfully exposed to the substance.
The threat of asbestos for firefighters is subtle, and there are seldom warning signs to allow a firefighter to know whether they are or have been exposed to asbestos. Firefighters who have been exposed to asbestos usually have been in situations where they had reasons to believe they are safe.
The mineral was mixed into paint, combined with cellulose to make fiberboard and wallboard, mixed with cement to make siding shingles and formed into felt for use as roof felting and backings on vinyl flooring. Asbestos was even used in joint compound, which was used in dozens of different kinds of applications.
The mere presence of asbestos in a home or a building is not hazardous. If a firefighter located any asbestos, the best thing to do is leave it un-disturbed, as this will not allow its fibers to become airborne.
Any home or building built before 1980 has a good chance of still containing asbestos. Even firehouses should be inspected for asbestos as many of them were constructed prior to any asbestos ban.
In the case of a fire, asbestos fibers get released and when breathed in, can scar the lungs. While asbestos has been banned for most of its uses since the early 1980s, there is still a probability that asbestos fibers can be released in the air. This can only happen when asbestos-laden materials are deteriorated or broken down.
The inhalation of asbestos fibers can lead to the development of a rare, but severe form of asbestos lung cancer known as mesothelioma. This illness has and continues to affect firefighters who were unknowingly exposed while on duty.
If you are a firefighter and believe you have experienced asbestos exposure, it is important to receive regular screenings by physicians to identify a possible disease. It should be known asbestos exposure does not always lead to a disease, but because the latency periods associated with asbestos illnesses can last 20 to 50 years, a regular check up is advisable.
Jesse Herman is with the Mesothelioma Cancer Center.
While doing some Internet research last week, I came across a U.S. Fire Administration firefighter fatality notice from Feb. 23. The notice read that 34-year-old Firefighter Derek North of the Stockton Fire Department in Lakeland, Ga., died while responding to a fire call. North’s brother was driving the department’s 1966 Ford Fire Knocker when he swerved to avoid a collision. The vehicle overturned and Derek North, who was in the officer’s seat, was killed while Chad North sustained serious injuries.
Several years ago, the Fire Apparatus Manufacturers Association issued a white paper that claimed that 50% of apparatus in the United States is older than 15 years and not in compliance with NFPA standards. But even if a fire truck might is old and non-compliant, if it is properly maintained and safely operated, no one should die.
The current economy is making it more difficult for fire departments to purchase new apparatus and the future is not looking much better. Fire chiefs across the country are looking closely at all aspects of apparatus specifications, leasing options and preventive maintenance.
In last week’s Command Post, I wrote about a fire chief roundtable at the recent FEMSA/FAMA meeting, where leaders from various size departments responded to questions about apparatus purchasing.
Chief Jeff Johnson of Tualatin Valley (Ore.) Fire & Rescue talked about how his department is considering “zippy” cars that would be placed on located on highways during rush hour for EMS response. Johnson said that such vehicles could save time and money, compared to dispatching a larger apparatus. The quick response makes sense when accidents add to traffic congestion and make it even more difficult for emergency vehicles — especially large vehicles that may not be needed — to get through.
Richmond (Va.) Fire Chief Robert Creecy said that he repeatedly reminds his staff that they are caring for other’s property. “We live in rental property and drive rental cars,” he said. “The buildings belong to the city and the vehicles belong to fleet services.” Right now, Richmond faces a monumental task of replacing a fleet of quints purchased in 1997.
Several fire departments are trying to extend the life of their apparatus and buying standard demo units to save money. Chief Don Oliver of Wilson (N.C.) Fire Rescue told me that when the department was purchasing new vehicles for officers, it chose a demo SUV and van from their local Chrysler dealership. Oliver said that they saved a good chunk of money by buying used.
Can you continue to cut your budget and not affect the safety of your community and your department?
The Fire and Emergency Manufacturers and Services Association and the Fire Apparatus Manufacturers Association held their annual joint meeting earlier this month. The event gave several fire chiefs the opportunity to speak up on issues facing their departments — and some of those chiefs pushed back on FEMSA/FAMA members.
Rob Brown, chief of the Stafford County (Va.) Fire Department and chair of the International Association of Fire Chiefs’ Economic Task Force, provided insight on fire department budgets. The IAFC created its economic task force following the economic downturn to provide fire chiefs with information and guidance. In his presentation, Brown encouraged the manufacturers and vendors to understand and work with fire-service leaders during a tough economy. “We need vendors to be our partners,” Brown said.
Brown suggested focusing on the increasing costs associated with NFPA standards, lower-cost options for equipment and apparatus, and renewable resources and the environment. “It’s a lot easier to ask for a piece of equipment that is environmentally friendly,” he said.
Brown also encouraged the fire service to break from tradition thinking and be more open to technological advances. Citing the changes in pilots’ helmets from World War II designs to the high-tech helmets fighter pilots wear today, Brown suggested that the fire service hasn’t moved far from the leather helmets of 60 years ago.
During the buyers’ roundtable, moderated by CFSI Executive Director Bill Webb, six metro, urban, suburban, volunteer and Canadian fire chiefs shared their opinions with the FEMSA/FAMA members.
“We’ve been cutting for so long there’s nothing left to cut,” Richmond (Va.) Fire Chief Robert Creecy said. “We’re browning out on a day-to-day basis. It’s the leanest of times. Richmond has been recession-proof, and now it’s worse than during the Great Depression.”
Conversely, Jeff Johnson, chief of Tualatin Valley (Ore.) Fire & Rescue and current IAFC president, said based on the government structure, TVFR controls its own money and currently is involved in $77 million worth of fire-station construction.
The chiefs on the panel all agreed that they are more involved in the purchasing process because of current economic conditions.
“It’s very important that we are closest to the work,” Alexandria (Va.) Chief Adam Thiel said. “My role is to really show everybody where the box is and stay within.”
Chief Tim Beckett from Ajax, Ontario, Canada, said his department is running its trucks a lot longer, and his council has suggested buying standard apparatus or even buying demo units. “We’re looking at practical versus bells and whistles,” he said. “We’re seeing an increase on our maintenance side, too.”
Chief Joseph Chornock, Germantown (Md.) Volunteer Fire Department, also has had to rethink apparatus purchases. “By purchasing all the apparatus alike our maintenance and mechanical costs are reduced. We don’t have to stock all kinds of parts,” he said. “It’s good for our firefighters, too, because different pumps operate differently.”
The chiefs on the panel all agreed that the fire service needs to re-think the business of emergency response and manage public expections. The chiefs anticipate more mergers and consolidations and more cooperation and collaborations on equipment purchases.
“Local money will be used to solve local problems, but local money will never solve national problems — a lot of fire chiefs need to learn to share,” Johnson said. “We have got to continue to think better about our business and use data and science to solve our problems. Apparatus and radios got better in my 32 years. What’s going to change our fire service is science and technology.”
The meeting gave FAMA/FEMSA members a lot to think about: smaller apparatus, leasing vehicles and response to routine calls and activated fire alarms. Lack of money changes everything.
