WPA

KN, p. 87 “How many bodies at the scene?”

 

 

(WARNING: Some photos may be disturbing to some viewers)

 

Not long ago, Sheila and I spent a pretty intense afternoon with a group of students and professionals doing a simulation of an explosion and its aftermath at a local campus. Here’s how it played out.

“You have reached 911. What’s the nature of your emergency?”

 

“A bomb just went off at the campus! There must be a dozen people hurt…there’s blood everywhere…”

 

Someone – a fellow student or perhaps a passing motorist – had called 911 and while sobbing or yelling the words into the phone, had begun the process to get help to the scene. The caller was kept on the phone in order to get any “who, what and where” details they might have known.

 

The 911 dispatcher made the appropriate call and told the First Responder, “There’s a possible explosion at the college. There may be multiple injuries.”

 

In general throughout the USA, the groups that respond will be from the Police/Sheriff, Fire, and Emergency Medical Services (EMS) Departments in the area. The unit that responds first is the First Responder and it is their responsibility to secure the scene. When the Law Enforcement agency arrives, they will determine if they are looking at a crime scene or whether something has accidentally exploded. In both cases, a perimeter is established.

 

If it is a crime scene, then access inside the perimeter will be limited to essential personnel and a sign in/out log will be used. An officer will guard the access point as long as is needed. This insures that evidence can be preserved as much as possible and that curious onlookers will not get in the way of either treatment of the victims or investigation of the scene.

 

Multiple victims, multiple injuries, an explosion and several agencies involved? How do they keep from tripping over each other? How do they know what to do next?

 

Each of the groups has a Command person in charge of that group. In addition, an Incident Commander is in charge of the entire scene, coordinating the efforts of everybody concerned.

 

 

 

Victims are prioritized by type of wound, and then tagged with a card that identifies the level of injury, before they are eligible for transport. In general, the tag colors indicate:

 

*Black tags – not breathing

*Red tags – will die if not treated immediately, but still breathing on own

*Yellow tags – broken bones, but alert

 

The ones having sustained the most serious injuries and who have the greatest likelihood of survival, are treated and transported first by EMS Transport Command.

Other victims who have superficial cuts and abrasions are treated at the scene and released from care.

 

One of the simulation victims had a piece of glass ‘stuck’ in her arm as a result of being too close to windows that shattered during the explosion. The EMS gal treating her explained that the glass would keep the wound from bleeding until the victim reached the hospital. Basically, it was plugging the hole in her arm. If the police considered the glass a piece of evidence, it would be collected, bagged and tagged at the hospital. The piece of glass would only be removed at the scene if the patient could not breathe or if it got in the way of doing CPR. Since the glass was in her arm, it was left there and bandages were wrapped around it.

 

The Incident Commander explained that the first priority was the treatment of the patients and that all evidence on (or in) the victims would be collected later at the hospital. The EMS does not remove anything from the scene if they can help it.

 

The police began to take statements from the witnesses after treatment was in progress, but prioritized the questioning – least hurt, most alert, were questioned first. The EMS people are under HIIPA rules, so are not allowed to share any information they see or gather from the victims being treated. The police have to get that info on their own. At some point, the law enforcement officers would obtain an order for medical records of the person who caused the explosion.

 

Sadly, one of the victims ‘died’ during the simulation, as would happen in real life. This lady did not make it because her injuries were so severe. (only a simulation – that’s a great makeup job)

If all this were really happening, area airports and highways would be shut down until the threat level was determined. Was it an accident in a lab? Or was it a terrorist action? Unless the investigators get lucky and somebody confesses or does the ‘big reveal’ right at the scene, the truth is, that at an hour after the initial explosion, all that is known for sure is that lots of people have been hurt.

 

Sheila and I were impressed with how well the simulation went and how well organized it was. Great experience for us to see how a well-trained group can bring sanity to a potentially chaotic situation.

 

 

 

*Photos taken by Patti Phillips at a real simulation conducted in Guilford County, NC at the Writers’ Police Academy.

*Sheila and Charlie Kerrian are fictional characters, but the simulation actually took place.

 

 

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KN, p. 122 “How many bodies at the yard sale?”

 

(WARNING:  Some photos may be upsetting to some people.)

Last month, Sheila and I had a chance to attend a simulation with law enforcement, firefighters, EMS professionals, and students in action at a multi-casualty accident scene. We saw how their skills are tested when a drunk driver runs a traffic light and smashes into a yard sale, killing and maiming several people.

 

How do the EMS, firefighters, and police learn to work together to handle the horrific scene? They practice, in demonstrations just like this one.

 

Typically, an onlooker at an accident calls 911, gives whatever details are available – location of the accident, number of people injured, whether or not there is more than one car involved. Rarely are the callers calm and collected, but the dispatcher has to keep his/her cool, no matter how bad it sounds. The information is passed on to the agencies that can help and usually, the closest one to the accident site responds.

 

The First Responder assesses the accident, notifies Dispatch as to what other help may be needed, and establishes a perimeter. In this scenario, the First Responder was a deputy from the Sheriff’s Department.

 

He took a look at the scene, called for backup, made some decisions, checked to see who was still alive, and helped those he could while he waited.

 

 

Fire and Rescue arrived at the scene next.

 

The driver of the car did not appear to be injured, was not pinned inside, and no gasoline was leaking from anywhere, but the Firefighters were needed to lift the car off two victims who were trapped underneath it. One was ‘dead,’ but one was still alive.

 

The Firefighters used a Hurst Spreader (commonly known as the ‘jaws of life’) in addition to assorted chocks and lumber in order to stabilize the car before pulling the victims free.

 

Standard procedure indicates that after the initial assessment and after additional help has arrived, law enforcement takes care of the driver issues and rescue takes care of the victims. Law enforcement continues to help where needed.

A Breathalyzer test was administered to the driver, since the road was not wet, and there was no other apparent reason for him to plow into a front yard full of people. Witness statements were taken from those involved at the scene. Onlookers were kept at a safe distance throughout the simulation.

 

 

 

The ambulances arrived and EMS workers evaluated the injured people.

While cries of “Please help us,” and “She needs help,” were heard continuously in the background, one of the EMS workers assigned black, red and yellow tags to the victims.

Yellow tag:  broken bones, but alert

Red tag:  will die if not treated immediately, still breathing on own

Black tag:  not breathing

 

After the car was elevated, the person underneath was pulled out, strapped onto a stretcher, then transported to the hospital.

 

 

 

EMS workers enlisted the aid of lightly injured victims and urged them to talk to the more seriously hurt. Keeping the injured awake and alert was an important part of assessment. If the victims lost consciousness, or had slurred speech, then they went to the head of the line for treatment and transport.

 

 

 

One of the EMS gals told us later that it’s not unusual to have to talk people into leaving others behind in order to get help for themselves at the hospital. Some victims appear to be fine, but wander around the area in confusion and shock, unaware of cuts and more serious injuries of their own.

One of the victims who kept crying out for help for others, eventually collapsed, was put on backboard and then lifted to a gurney for transport.

 

The last victim was treated and transported, the driver was arrested and taken to jail and all that remained was the cleanup. The firefighters took off their jackets, gathered their gear and re-stowed it in the rescue truck.

What was the difference between this simulation and the explosion simulation we witnessed last year? That one included unknown perpetrators and a continuing threat that widened from the campus to the airport and public transportation. Both law enforcement and EMS personnel gathered evidence at the scene (which in some cases was embedded in the victims).

 

At the Yard Sale simulation, the evidence collected was in the form of photos of the scene, the Breathalyzer test, as well as witness statements from onlookers and victims. The threat was specific to the scene and dealt with.

 

Both were crime scenes, but played out quite differently.

 

As we saw last year at the explosion simulation, the three groups at the ‘Yard Sale’ were professional and took the simulation seriously. Their interaction appeared seamless and we were impressed by the way they worked near each other in order to complete their assigned tasks and then jumped in to help each other when needed. Well done!

 

*Photos by Patti Phillips, except one.
All taken at Guilford County Community College, in North Carolina.

 

*Photo taken and shared by Terry Odell, writer. Thanks! Follow her blog and find out about her books at www.terryodell.com

 

 

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KN, p. 119 “What does a firefighter wear?”

 

Firefighters have one of the most dangerous jobs in the world. Walking into a house fire that could reach 1000 degrees in under a minute (that’s not a typo) or a chemical fire that may reach double or triple that temperature in seconds, while  battling smoke inhalation as well, means a firefighter’s life depends on being supplied with the best equipment that money can buy. Without the proper gear, firefighters can’t stay inside a burning structure long enough to rescue victims or fight the fire successfully.

 

So, what is the right gear that keeps them safe and still allows them to do their jobs?

 

Tim Fitts, a veteran firefighter in North Carolina, and Coordinator of certification classes for firefighters and rescue squads at Guilford Technical Community College, demonstrated his gear on a 95 degree day in September. Fire isn’t selective about the weather, so it’s a good thing for us that firefighters train and work under all kinds of conditions.

 

The firefighter uniform is generally called ‘turnout gear’ by firefighters because they turn it inside out when not in use, so that they can step into it quickly and pull it on/up when the fire bell/siren sounds. Firefighters need to get completely dressed in about a minute, so any safe system that will speed up the process is used. Some guys pull on the boots and pants, grab the rest of the gear and finish getting dressed in the truck as it pulls out of the fire station.

 

The official name for the gear is Personal Protective Equipment (PPE).

 

Parts of the firefighter uniform:

 

While on the job at a fire or rescue operation that might result in a fire, most firefighters will wear these pieces of clothing:

 

  • Boots, insulated with steel toes and steel shank
  • Cotton t-shirt
  • Gloves, insulated leather
  • Helmet, with neck flap and eye protection
  • Hood, Nomex
  • Jacket, insulated, with Velcro and spring hooks
  • Pants, insulated, with Velcro and spring hooks, with extra padding and pockets
  • Suspenders

 

These three hoods are made of different fabrics: Kevlar blend, PBI/Kevlar, and Nomex.

 

Firefighters put a hood on before the jacket, so that it sits properly on the shoulders. They tend to wear two hoods to protect against a flashover, giving their heads the extra defense needed in the intense heat. If a flashover occurs, the firefighter will have about two seconds to get out of the building. If the hoods are not providing enough coverage, it will feel like 1000 bees stinging the ears at one time – it’s too hot to stand. It’s time to get out.

 

The helmets are made of thick, heat resistant plastic and often include Kevlar or Nomex flaps for the ears.

Firefighters are taught to fight fires on their knees (not while crawling) so the extra padding helps cushion the wear and tear on the knees.

 

 

In addition, the firefighters put on:

 

  • Airline and pressure gauge
  • Flashlight
  • Positive pressure mask
  • PASS device
  • Radio
  • SCBA shoulder straps, airtank bottle and backpack frame

 

The PASS device (Personal Alert Safety System) is a personal safety device used by firefighters entering a hazardous environment – a burning building. When the firefighter does not move for 30 seconds, it makes a loud, shrill, really annoying  sound, letting others in the area know that something is wrong.

 

The mask on the left is a newer model, the one on the right? Older. There has been an upgrade in technology for the plastic in the mask, developed because at high temperatures, the old plastic would fail (melt). It was the weakest part of the uniform. The new version will not fail as quickly.

 

 

                         

 

 

 

 

 

 

 

Note that even the air tank is protected with a fire retardant fabric.

 

The idea is to be protected from the fire and to be able to breathe safely while he/she works. The positive pressure mask on the SCBA (Self Contained Breathing Apparatus) gear keeps the toxic air out as much as possible by allowing the tank air to flow continuously, even if the firefighter is not inhaling. By the way, the tanks are full of compressed air, not oxygen.

 

Most of the clothes have reflective tape so that the firefighter can be seen more easily through the smoke and low light/darkness. Some departments are large enough that they use color-coded reflective tape in order to tell the full-time firefighters and the volunteers apart.

 

The uniforms are sized to the individual firefighters, so that when they bend over, there is at least a two-inch overlap with the fabric pieces, and no skin is exposed to the crippling, blistering heat.

Hip boots of years ago, are now old school because of the area of the body they left unprotected from heat. Now the boots have steel toes and shanks and are calf high or knee high in length.

 

When fully dressed, the firefighter is wearing about 70 pounds of equipment. Add more weight for the tools they have to carry – picks, axes, etc – needed to fight the fire.

 

After ten years, all turnout gear must be thrown away. It wears out because of repeated exposure to the intense heat and toxic elements. Many large, active fire departments dispose of the clothing after only five years, because of their more frequent use and improvements in technology.

 

Firefighting gear is not fireproof. It is fire retardant.

 

Some of the clothing has 3 layers, each layer performing a different function. People can only tolerate temperatures to 135 degrees, so the specialized fabrics extend the time available to do the job. Firefighters get very uncomfortable at 250 degrees, and the time limit for the firefighter at that point is about 30 seconds to reach someone and get out. One of the firefighters at Command keeps track of the men/women – where they are in the structure and how long they’ve been working the fire.

 

Nomex degrades at 400 degrees, so needs to be used in addition to other fabrics if fighting a structural fire. It tends to split when the wearer is running. When combined with Kevlar, it becomes more flexible and the fabric breathes a bit better.

 

PBI degrades at 1100 degrees, allowing a much better chance for the firefighter to stay safe while fighting a house blaze. It stays intact in the extreme temperatures and allows the firefighter extra time to get to a victim and then get out.

 

Gortex helps shed water.

 

Heat goes through each layer a bit at a time. Each layer is a necessary barrier, in its place to protect the firefighter and keep his body from getting hotter than is safe.

 

After fires, all of the clothing needs to be taken apart and washed, because everything in a fire is carcinogenic. Hmm…that means that the entire time a firefighter is working the fire, his equipment has to protect him from the flames and the smoke, as well as anything else thrown into the air, both in the active fire and in the area outside the building.

 

Some fire Captains insist that the clothing be stored away from the sleeping area at the station, because it may still contain toxins even after being washed. If you get a chance to visit a Fire Station, you might be able to tell where the gear is kept, before you ever reach the room. The smoky odor is sharp and unforgettable.

 

Cost of Basic Turnout Gear (approximate)

  • Pants, jacket, gloves – $1,150.
  • Boots – $175.
  • Helmet – $150.
  • Nomex hood – $60.
  • PASS device – $300.
  • Airpack with mask – $4,500.

 

      

 

 

 

 

 

 

 

Tim Fitts told us about the testing going on at NC State’s College of Textiles, in the search for better, more effective, fire retardant fabrics.

 

To see a demonstration of how a firefighter’s uniform reacts to fire, click here for NC State’s PyroMan video:

https://textiles.ncsu.edu/tpacc/heat-and-flame-protection/pyroman

 

Every second counts when rescuing you or your pets in a fire. We know that a simple house fire can fully engulf an 8’x10’ room in 90 seconds. That’s not a typo. If the firefighters are on the scene before that happens to the entire house, they need as much lead time as possible in order to keep a rescue operation from becoming a recovery operation. That’s when the best turnout gear on the market is worth every dime.

 

 

*Photos by Patti Phillips, taken at Guilford Technical Community College, NC, during The 2014 Writers’ Police Academy.

Thanks to Tim Fitts for generously sharing his knowledge and expertise. As of this writing, in 2014, Tim, a veteran firefighter and Fire Occupational Extension Coordinator at GTCC, was in charge of all Con Ed certification and non-certification classes in Fire and Rescue subjects to members of NC fire departments and rescue squads. Any errors in fact are mine, not his.

 

If you’re curious about what it takes to qualify for Firefighter Training, read “How do you become a firefighter?”

 

 

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