Post by 1900 on Dec 31, 2008 16:21:23 GMT -5
Here is the meat and potatoes of a recent publication done by NIOSH, the CDC and the Dept of Health and Human Services...
NIOSH Fire Fighter Fatality Investigation and Prevention Program
Leading Recommendations for Preventing
Fire Fighter Fatalities, 1998 – 2005
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention (CDC)
National Institute for Occupational Safety and Health (NIOSH)
A. Recommendations for Preventing Fatalities Related to Medical Conditions
a. Medical Screening
i. Conduct annual medical evaluations to screen all firefighters for risk factors for coronary artery disease (e.g., smoking, diabetes mellitus, high blood pressure, high blood cholesterol, physical inactivity, obesity, and a family history or coronary artery disease).
ii. Conduct exercise stress tests on firefighters who have coronary artery disease or who are at increased risk of this disease and sudden cardiac death. Increased risk for sudden cardiac death is defined as male firefighters older than 45 years of age (older than 55 years for female firefighters) with two or more risk factors for coronary artery disease (listed above).
iii. Ensure that firefighters are medically cleared by physicians who are knowledgeable about the cardiovascular demands of firefighting and ware of published medical guidelines for firefighters.
Assess your department
1. Does our fire department physician know the status of member’s risk factors for coronary artery disease?
2. Does our fire department require exercise stress tests for firefighters at increased risk for coronary artery disease and sudden cardiac death?
3. Are members under the care of medical providers that are aware of fire service guidelines regarding medical clearance for duty?
b. Fitness and Wellness
i. Develop individualized fitness and wellness programs for all firefighters.
ii. Conduct annual fitness evaluations by a fitness coordinator under the supervision of a physician who is knowledgeable about the physical demands of firefighting and ware of published medical guidelines for firefighters
iii. Include health promotion components (e.g., smoking cessation, cancer screening, diet and nutritional education, and immunizations) in the fire department’s wellness program.
Assess your department
1. Does our fire department offer a fitness program and do members participate?
2. Do firefighters receive a fitness evaluation every year?
3. Does our fire department offer a wellness program that includes help with smoking cessation and health screens, and do members participate?
B. Recommendations for Preventing Fatalities Related to Trauma
a. Standard Operating Procedures (SOPs) and guidelines
i. Ensure that the department’s SOPs are developed and followed and that refresher training is provided.
ii. Develop and enforce SOPs for the safe and prudent operation of emergency vehicles.
iii. Enforce SOPs in the use of seat belts for all emergency vehicles.
iv. Establish and implement an incident command system (ICS) with written SOPs for all firefighters.
v. Ensure that SOPs addressing emergency scene operations such as basement fires are developed and followed on the fire grounds.
vi. Develop and implement written maintenance procedures for SCBA.
Assess your department
1. Have we ever worked an incident without SOPs? How organized and in control were we during this incident?
2. Do all firefighters in the department follow SOPs and how are they enforced?
3. Is our department trained in SOPs?
4. Where do we keep our SOPs?
5. When was the last time our SOPs were reviewed and updated?
b. Communications
i. Establish a method of fireground communication that permits coordination between the incident commander and the firefighters.
ii. Ensure that firefighters are equipped with radios that do not bleed over, cause interference, or lose communication under field conditions.
iii. Consider providing all firefighters with portable radios or radios integrated into their facepieces.
iv. Ensure that a tone or alert recognized by all firefighters is transmitted immediately when conditions become unsafe for firefighters.
v. Instruct and train firefighters in initiating emergency traffic (mayday –mayday) and activating their personal alert safety system (PASS) device when they become lost, disoriented, or trapped.
vi. Whenever a change in personnel occurs, make sure that everyone is briefed and understands the procedures and operations required for that shift, station, or duty.
vii. Ensure that properly functioning communications equipment is available and can adequately support the volume of radio traffic at fire scenes.
viii. Establish and maintain regional mutual-aid channels to coordinate and communicate activities involving units from multiple jurisdictions.
Assess you department
1. Have we ever experienced radio interference and bleed over? What have we done to correct this?
2. Does our department have communications SOPs with the mutual aid companies?
3. Does our department have SOPs regarding fireground radio traffic, such as interior reports, size-up, completion of assignment, mayday, and evacuation signals?
c. Incident Command
i. Clearly identify the IC as the only person responsible for the overall coordination and direction of all activities at an incident.
ii. Ensure that the IC maintains the role of director and does not become involved in fire fighting operations.
iii. Implement the ICS for the management of all fires and establish an incident command post (ICP) as needed to facilitate command and control, especially on complex fires involving multiple agencies.
iv. Appoint a separate Incident Safety Officer (independent from the IC).
v. Ensure that the IC conducts a complete size-up of the incident before initiating fire-fighting efforts and continually evaluates the risk versus gain during operations.
vi. Convey strategic decisions through the IC to all suppression crews on the fireground.
vii. Maintain accountability for all personnel at the fire scene.
viii. Train firefighters to communicate interior conditions to the IC as soon as possible and to provide regular updates.
Assess your department
1. Does our department implement ICS at each incident – large and small?
2. What training does our department provide in ICS? Is this training sufficient?
3. What accountability system is used in our department? Does the IC know the location of company members at all times?
4. Do we evaluate risk versus gain before initiating each offensive, interior attack and continually throughout an incident?
d. Motor Vehicle
i. Ensure that all fire apparatus are equipped with set belts.
ii. Ensure that all firefighters riding in emergency fire apparatus are wearing seat belts and are belted securely.
iii. Do not permit drivers of fire apparatus to move vehicles until all occupants are secured with seat belts.
iv. Inform all drivers of fire department vehicles that they are responsible for the safe and prudent operation of the vehicle under all conditions.
v. Instruct drivers of emergency fire apparatus to come to a complete stop at intersections having a stop sign or a red signal light before proceeding through the intersection.
vi. Instruct drivers of fire department vehicles to come to a complete stop at all unguarded railroad grade crossings during emergency response or non-emergency travel.
vii. Provide drivers of fire department vehicles with driver training at least twice a year.
viii. Develop comprehensive apparatus maintenance programs in accordance with manufacturer’s specifications and instructions. Make sure these include regularly scheduled inspections, documentation, and procedures for removing apparatus from service until major defects are repaired.
ix. Provide baffles for all apparatus equipped with water tanks to control water movement.
x. Determine a safe operating weight for water tankers based on vehicles characteristics, and remove overweight vehicles from service.
xi. Make sure that the placement of additional equipment (e.g., radios and map card boxes) on an apparatus does not interfere with the driver’s ability to operate controls.
Assess your department
1. Are our vehicles equipped with seat belts?
2. Do firefighters buckle up when traveling to and from all incidents?
3. Does our department have an SOP for ensuring seat belt use?
4. Are the apparatus drivers in the department trained, licensed, and careful operators?
5. Does our department maintain emergency vehicles properly? Do we have SOPs to remove unsafe equipment?
6. What is our department’s SOP for training drivers?
e. Personal Protective Equipment
i. Properly inspect, use and maintain SCBAs to ensure they function properly when needed.
ii. Ensure that officers enforce the use of and that firefighters wear their SCBAs equipped with integrated PASS (including initial assessment) whenever they might be exposed to a toxic or oxygen-deficient atmosphere.
iii. Ensure that firefighters wear and use PASS devices when involved in firefighting, rescue, and other hazardous duties.
iv. Ensure that personnel wear PPE suitable to the incident while operating at an emergency scene (e.g., a highly visible reflectorized flagger vest).
v. Ensure that adequate PP (e.g., SCBA) is available while firefighters are engaged in fire activity.
vi. Provide all rescue personnel with appropriate PPE (i.e., water rescue helmet and an appropriate personal flotation device) when operating at a water incident and ensure its proper use.
Assess your department
1. What PPE does our department have for responding to roadway incidents?
2. How does our department ensure that all firefighters wear and use their PASS appropriately?
3. Does our department have a SCBA maintenance program?
f. Strategies and Tactics
i. Ensure that fire-fighting tactics and operations do not increase hazards on the interior (e.g., opposing hose streams).
ii. Ensure that firefighters from the ventilation crew and the attack crew coordinate their efforts.
iii. Evacuate firefighters performing fire-fighting operations under or above trusses as soon as it is determined that the trusses are exposed to fire.
iv. Establish a collapse zone and clearly mark it at structure fires where buildings have been identified at risk of collapsing.
v. Monitor the collapse zone to ensure that no fire-fighting operations take place in the danger zone.
vi. Ensure that fire fighters, when operating on the floor above the fire, have a charged hoseline.
vii. Ensure that any hose line taken into the structure remains inside until all crews have exited.
viii. Ensure that the IC conducts a complete size-up of the incident before initiating fire-fighting efforts and continually evaluates the risk versus gain during operations.
ix. Ensure that a backup line is manned and in position to protect exit routes.
x. Ensure that backup lines are equal to or larger that the initial attack lines.
xi. Consider using a thermal imaging camera as a part of the exterior size-up.
Assess your department
1. How does our department ensure that tactical operations do not increase hazards to firefighters?
2. When entering a hazardous structure, do our team members always lay a hose line, rope, or some other type of exit guide?
3. Can all firefighters in our department identify a truss roof or floor system and understand its collapse characteristics?
4. Do we evaluate risk versus gain each time before initiating an offensive interior attack and continually throughout an incident?
g. Rapid Intervention Team
i. Ensure that an RIT is established when firefighters enter an immediately dangerous to life and health (IDLH) atmosphere and that the RIT is properly trained and equipped.
ii. Ensure that once an RIT is established, they remain the RIT throughout the operation.
iii. Ensure that only the assigned RIT completes search and rescue operations.
Assess your department
1. Does your department always implement an RIT?
2. Have we ever been caught without an RIT ready when we needed one?
3. Have we had any near misses?
h. Staffing
i. Ensure that at least four firefighters are on the scene before initiating interior fire-fighting operations at a structural fire: two-in and two-out.
ii. Ensure that adequate fire control forces and fire suppression equipment are on the scene and available for deployment for fire control activities.
iii. Ensure that adequate staffs are available to immediately respond to emergency incidents.
iv. Maintain team continuity.
Assess your department
1. How does our department ensure and enforce two-in and two-out?
2. How well does our department coordinate with mutual aid companies? Do we work together or are there conflicts? How does this affect outcomes? How can we improve coordination?
3. Do we have sufficient staffing and equipment on the scene necessary to begin fire0fighting operations based on the expected fire conditions?
NIOSH Fire Fighter Fatality Investigation and Prevention Program
Leading Recommendations for Preventing
Fire Fighter Fatalities, 1998 – 2005
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention (CDC)
National Institute for Occupational Safety and Health (NIOSH)
A. Recommendations for Preventing Fatalities Related to Medical Conditions
a. Medical Screening
i. Conduct annual medical evaluations to screen all firefighters for risk factors for coronary artery disease (e.g., smoking, diabetes mellitus, high blood pressure, high blood cholesterol, physical inactivity, obesity, and a family history or coronary artery disease).
ii. Conduct exercise stress tests on firefighters who have coronary artery disease or who are at increased risk of this disease and sudden cardiac death. Increased risk for sudden cardiac death is defined as male firefighters older than 45 years of age (older than 55 years for female firefighters) with two or more risk factors for coronary artery disease (listed above).
iii. Ensure that firefighters are medically cleared by physicians who are knowledgeable about the cardiovascular demands of firefighting and ware of published medical guidelines for firefighters.
Assess your department
1. Does our fire department physician know the status of member’s risk factors for coronary artery disease?
2. Does our fire department require exercise stress tests for firefighters at increased risk for coronary artery disease and sudden cardiac death?
3. Are members under the care of medical providers that are aware of fire service guidelines regarding medical clearance for duty?
b. Fitness and Wellness
i. Develop individualized fitness and wellness programs for all firefighters.
ii. Conduct annual fitness evaluations by a fitness coordinator under the supervision of a physician who is knowledgeable about the physical demands of firefighting and ware of published medical guidelines for firefighters
iii. Include health promotion components (e.g., smoking cessation, cancer screening, diet and nutritional education, and immunizations) in the fire department’s wellness program.
Assess your department
1. Does our fire department offer a fitness program and do members participate?
2. Do firefighters receive a fitness evaluation every year?
3. Does our fire department offer a wellness program that includes help with smoking cessation and health screens, and do members participate?
B. Recommendations for Preventing Fatalities Related to Trauma
a. Standard Operating Procedures (SOPs) and guidelines
i. Ensure that the department’s SOPs are developed and followed and that refresher training is provided.
ii. Develop and enforce SOPs for the safe and prudent operation of emergency vehicles.
iii. Enforce SOPs in the use of seat belts for all emergency vehicles.
iv. Establish and implement an incident command system (ICS) with written SOPs for all firefighters.
v. Ensure that SOPs addressing emergency scene operations such as basement fires are developed and followed on the fire grounds.
vi. Develop and implement written maintenance procedures for SCBA.
Assess your department
1. Have we ever worked an incident without SOPs? How organized and in control were we during this incident?
2. Do all firefighters in the department follow SOPs and how are they enforced?
3. Is our department trained in SOPs?
4. Where do we keep our SOPs?
5. When was the last time our SOPs were reviewed and updated?
b. Communications
i. Establish a method of fireground communication that permits coordination between the incident commander and the firefighters.
ii. Ensure that firefighters are equipped with radios that do not bleed over, cause interference, or lose communication under field conditions.
iii. Consider providing all firefighters with portable radios or radios integrated into their facepieces.
iv. Ensure that a tone or alert recognized by all firefighters is transmitted immediately when conditions become unsafe for firefighters.
v. Instruct and train firefighters in initiating emergency traffic (mayday –mayday) and activating their personal alert safety system (PASS) device when they become lost, disoriented, or trapped.
vi. Whenever a change in personnel occurs, make sure that everyone is briefed and understands the procedures and operations required for that shift, station, or duty.
vii. Ensure that properly functioning communications equipment is available and can adequately support the volume of radio traffic at fire scenes.
viii. Establish and maintain regional mutual-aid channels to coordinate and communicate activities involving units from multiple jurisdictions.
Assess you department
1. Have we ever experienced radio interference and bleed over? What have we done to correct this?
2. Does our department have communications SOPs with the mutual aid companies?
3. Does our department have SOPs regarding fireground radio traffic, such as interior reports, size-up, completion of assignment, mayday, and evacuation signals?
c. Incident Command
i. Clearly identify the IC as the only person responsible for the overall coordination and direction of all activities at an incident.
ii. Ensure that the IC maintains the role of director and does not become involved in fire fighting operations.
iii. Implement the ICS for the management of all fires and establish an incident command post (ICP) as needed to facilitate command and control, especially on complex fires involving multiple agencies.
iv. Appoint a separate Incident Safety Officer (independent from the IC).
v. Ensure that the IC conducts a complete size-up of the incident before initiating fire-fighting efforts and continually evaluates the risk versus gain during operations.
vi. Convey strategic decisions through the IC to all suppression crews on the fireground.
vii. Maintain accountability for all personnel at the fire scene.
viii. Train firefighters to communicate interior conditions to the IC as soon as possible and to provide regular updates.
Assess your department
1. Does our department implement ICS at each incident – large and small?
2. What training does our department provide in ICS? Is this training sufficient?
3. What accountability system is used in our department? Does the IC know the location of company members at all times?
4. Do we evaluate risk versus gain before initiating each offensive, interior attack and continually throughout an incident?
d. Motor Vehicle
i. Ensure that all fire apparatus are equipped with set belts.
ii. Ensure that all firefighters riding in emergency fire apparatus are wearing seat belts and are belted securely.
iii. Do not permit drivers of fire apparatus to move vehicles until all occupants are secured with seat belts.
iv. Inform all drivers of fire department vehicles that they are responsible for the safe and prudent operation of the vehicle under all conditions.
v. Instruct drivers of emergency fire apparatus to come to a complete stop at intersections having a stop sign or a red signal light before proceeding through the intersection.
vi. Instruct drivers of fire department vehicles to come to a complete stop at all unguarded railroad grade crossings during emergency response or non-emergency travel.
vii. Provide drivers of fire department vehicles with driver training at least twice a year.
viii. Develop comprehensive apparatus maintenance programs in accordance with manufacturer’s specifications and instructions. Make sure these include regularly scheduled inspections, documentation, and procedures for removing apparatus from service until major defects are repaired.
ix. Provide baffles for all apparatus equipped with water tanks to control water movement.
x. Determine a safe operating weight for water tankers based on vehicles characteristics, and remove overweight vehicles from service.
xi. Make sure that the placement of additional equipment (e.g., radios and map card boxes) on an apparatus does not interfere with the driver’s ability to operate controls.
Assess your department
1. Are our vehicles equipped with seat belts?
2. Do firefighters buckle up when traveling to and from all incidents?
3. Does our department have an SOP for ensuring seat belt use?
4. Are the apparatus drivers in the department trained, licensed, and careful operators?
5. Does our department maintain emergency vehicles properly? Do we have SOPs to remove unsafe equipment?
6. What is our department’s SOP for training drivers?
e. Personal Protective Equipment
i. Properly inspect, use and maintain SCBAs to ensure they function properly when needed.
ii. Ensure that officers enforce the use of and that firefighters wear their SCBAs equipped with integrated PASS (including initial assessment) whenever they might be exposed to a toxic or oxygen-deficient atmosphere.
iii. Ensure that firefighters wear and use PASS devices when involved in firefighting, rescue, and other hazardous duties.
iv. Ensure that personnel wear PPE suitable to the incident while operating at an emergency scene (e.g., a highly visible reflectorized flagger vest).
v. Ensure that adequate PP (e.g., SCBA) is available while firefighters are engaged in fire activity.
vi. Provide all rescue personnel with appropriate PPE (i.e., water rescue helmet and an appropriate personal flotation device) when operating at a water incident and ensure its proper use.
Assess your department
1. What PPE does our department have for responding to roadway incidents?
2. How does our department ensure that all firefighters wear and use their PASS appropriately?
3. Does our department have a SCBA maintenance program?
f. Strategies and Tactics
i. Ensure that fire-fighting tactics and operations do not increase hazards on the interior (e.g., opposing hose streams).
ii. Ensure that firefighters from the ventilation crew and the attack crew coordinate their efforts.
iii. Evacuate firefighters performing fire-fighting operations under or above trusses as soon as it is determined that the trusses are exposed to fire.
iv. Establish a collapse zone and clearly mark it at structure fires where buildings have been identified at risk of collapsing.
v. Monitor the collapse zone to ensure that no fire-fighting operations take place in the danger zone.
vi. Ensure that fire fighters, when operating on the floor above the fire, have a charged hoseline.
vii. Ensure that any hose line taken into the structure remains inside until all crews have exited.
viii. Ensure that the IC conducts a complete size-up of the incident before initiating fire-fighting efforts and continually evaluates the risk versus gain during operations.
ix. Ensure that a backup line is manned and in position to protect exit routes.
x. Ensure that backup lines are equal to or larger that the initial attack lines.
xi. Consider using a thermal imaging camera as a part of the exterior size-up.
Assess your department
1. How does our department ensure that tactical operations do not increase hazards to firefighters?
2. When entering a hazardous structure, do our team members always lay a hose line, rope, or some other type of exit guide?
3. Can all firefighters in our department identify a truss roof or floor system and understand its collapse characteristics?
4. Do we evaluate risk versus gain each time before initiating an offensive interior attack and continually throughout an incident?
g. Rapid Intervention Team
i. Ensure that an RIT is established when firefighters enter an immediately dangerous to life and health (IDLH) atmosphere and that the RIT is properly trained and equipped.
ii. Ensure that once an RIT is established, they remain the RIT throughout the operation.
iii. Ensure that only the assigned RIT completes search and rescue operations.
Assess your department
1. Does your department always implement an RIT?
2. Have we ever been caught without an RIT ready when we needed one?
3. Have we had any near misses?
h. Staffing
i. Ensure that at least four firefighters are on the scene before initiating interior fire-fighting operations at a structural fire: two-in and two-out.
ii. Ensure that adequate fire control forces and fire suppression equipment are on the scene and available for deployment for fire control activities.
iii. Ensure that adequate staffs are available to immediately respond to emergency incidents.
iv. Maintain team continuity.
Assess your department
1. How does our department ensure and enforce two-in and two-out?
2. How well does our department coordinate with mutual aid companies? Do we work together or are there conflicts? How does this affect outcomes? How can we improve coordination?
3. Do we have sufficient staffing and equipment on the scene necessary to begin fire0fighting operations based on the expected fire conditions?