1. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 1 Working Fire Training 06-4 Training Materials TRAINING Click here to view show in its entirety Click here to view show in its entirety FIRE MEDICS Medical/Legal Issue, Pt. III Quiz EVOLUTIONS 2000 Kramer vs. Kramer Program Quiz Answers FIRELINE Birch Pointe Condo Fire Fatal Bus/5 Vehicle Crash Discussion HANDS-ON Fire Attack Basics, Pt. V Quiz Hotel Response, Pt. I Quiz

2. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 2 DISPATCH/SIZE-UP Two quints with 75 squirts arrived. First-in crews found fire coming through the roof toward the B side. One quint crew laid a 4 supply line from a hydrant 800 feet away; the other pulled ¾ handlines and made entry to 3rd floor to pull ceilings. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

3. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 3 STRATEGY/TACTICS Called for additional personnel; a lot of mutual aid involved. Asst. Chief arrived and set up Command and Accountability next to each other. All crews were advised to come out and a ladder pipe was put in service. Interior crews moved to that building to try and stop it there. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

4. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 4 STRATEGY/TACTICS A second alarm was struck which brought additional manpower and the ability to set up two RIT teams in front of both structures. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

5. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 5 STRATEGY/TACTICS –The second alarm companies helped with water supply issues, rehab, apply water from the rear (C side), overhauling and hosing down hotspots once the fire was under control. Asst. Chief arrived and set up Command and Accountability next to each other. Safety Officer positioned on side of structure to caution firefighters proceeding down slippery slope to apply water from behind. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

6. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 6 STRATEGY/TACTICS Two additional master streams were set up for a little more than half-an-hour whereupon the fire was brought under control. A hose crew went back inside to mop up. Total time on scene was approximately 5 hours. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

7. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 7 EVENTS Fire gained too much headway and began to spread along the roof through a common attic space. Fire came through the roof. Fire spread to next building with incredible speed. A car was blocking access to mutual aid companies to get in position to mount more aerials. –10 firefighters picked up a car up and moved it. At that point a collapse occurred on the C side of the second structure; that crew was evacuated. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

8. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 8 EVENTS Heaviest damage was on the third floor, with collapse and fire; 2nd floor sustained some fire and collapse damage, and the 1st floor sustained mostly smoke and water damage. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

9. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 9 LESSONS LEARNED One disadvantage was the building was on the last street of the complex, three stories in the front, four in the back; access to the rear was impossible. –All equipment had to stage on Side A and to get any kind of hoselines to Side C, they had to run a large-diameter hose leader line off the side of an engine down the side of a hill and then use a gated wye connected to two 1 3/4 lines. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

10. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 10 LESSONS LEARNED Other water supply problems – responders hand-stretched a line to a secondary hydrant 200 ft. beyond the initial 800- foot line. But the initial quint was having problems supplying a ladder pipe; handlines and blitz lines were encountering hydrant pressure problems. A third water supply was brought on line to a second quint brought in, that took what it needed and pumped the extra to the initial quint to augment its needs. Fireline Incident: Birch Pointe Condominium Fire 06-4 Training Materials

11. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 11 DISPATCH Interstate highway crash involving a tour bus and 5 other vehicles. –heavy traffic due to highway construction; traffic directed into chutes via concrete jersey barriers; no areas to pull off. When accidents occur in traffic chutes, drivers try to take evasive action but theres nowhere to go. –Cars bounce off the barriers back into traffic lanes, often overturning and involving more vehicles. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

12. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 12 DISPATCH When accidents occur in traffic chutes, drivers try to take evasive action but theres nowhere to go. –Cars bounce off the barriers back into traffic lanes, often overturning and involving more vehicles. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

13. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 13 SIZE-UP Asst. Chief Ziller arrived first in his own vehicle by driving up new portion of highway. –Typical response is usually an incident commander and an engine company. Upon arrival, he immediately struck a second alarm. Initial engine en route got stuck in the chute and had to work its way through the traffic. Ziller triaged bus passengers who were basically okay. Found a patient in Astro van who was heavily entrapped. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

14. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 14 STRATEGY/TACTICS Command Structure: Ziller passed command to deputy chief and became Operations Officer. County ambulance service oversaw medical sector. Access to water: used a hydrant on the interstate but in many areas they dont have them. –Be prepared to lay hose across traffic lanes which means shutting down the interstate. –Or bring it in via tankers often by mutual aid. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

15. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 15 STRATEGY/TACTICS Tools: used cutters and spreaders on most of the vehicles. On the van they used cutters to remove the roof and then had a wrecker hook on to the roof to peel it back since it was so tall, due to compression from the accident. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

16. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 16 EVENTS Patient in van died before air medivac could arrive. His extrication would have been lengthy. Left him and began to attend to other patients who were deteriorating. There were 12 responders on the scene at this point. Orange F.D. has an excellent 800 mhz radio system. They use dispatch and tactical channels. IC uses a earphone/microphone system so he can hear and speak without hands. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

17. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 17 LESSONS LEARNED Be mindful of temperature and humidity on scene. Work in smaller groups that you can rotate in and maintain a rehab area with ice water or cold drinks. Orange Fire Dept. makes sure they have ice water on the apparatus every morning. PIO handed out ice water to motorists waiting for the scene to be cleared. They were there for nearly four hours, many with small children. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

18. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 18 LESSONS LEARNED Preplanning the interstate – when theres construction going on, it all comes down to keeping track of whats changed, traffic rerouting, jersey barriers being moved, staying in touch with the highway dept. Maintaining access to the highway is critical. Fireline Incident: Fatal Bus/5-Vehicle Crash 06-4 Training Materials

19. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 19 Department Discussion The departments involved in this months training pose some discussion questions that you can use as discussion-starters in your own departments training sessions. How will your department handle these scenarios? 06-4 Training Materials

20. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 20 Birch Pointe Condo Fire / Wilmington, DE Asst. Chief Les Brown, Mill Creek (DE) Fire Company This fire was really moving; one of the swiftest fires I had ever seen. If conditions (either material being consumed or wind) quicken the pace of a fire, are you ready to respond as quickly? We tried to make interior attacks and slow the fire that way, but safety concerns forced us to pull crews out a number of times. Do your interior crews communicate changing conditions so your Incident Commander can make safety adjustments and/or manpower redeployments? 06-4 Training Materials Fireline Incident Discussion

21. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 21 Birch Pointe Condo Fire / Wilmington, DE Asst. Chief Les Brown, Mill Creek (DE) Fire Company We had to move a car that was blocking access. Ten firefighters lifting got the job done quickly, and even though it was a move of expediency, its something that should also be trained for. Try moving a vehicle some time in a training session just so you know whats involved. 06-4 Training Materials Fireline Incident Discussion

22. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 22 Fatal Bus/5 Vehicles Crash / Orange, TX Asst. Chief Jerry Ziller, Orange (TX) Fire Department Does your department preplan construction zones? You should, because they change regularly and sometimes contractors do crazy things that end up inconveniencing the fire department during a response. You might also find some code violations that should also be addressed. Just as you triage medical patients, you might have to triage extrications based on severity of injuries. And you might literally have to triage the vehicles once occupants are removed, since vehicles accordioned in a multi- vehicle crash may have to be removed in a certain order. 06-4 Training Materials Fireline Incident Discussion

23. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 23 Fatal Bus/5 Vehicles Crash / Orange, TX Asst. Chief Jerry Ziller, Orange (TX) Fire Department If a long incident ties up traffic for hours, you have to start thinking of the needs of waiting motorists and their passengers. Are you equipped to handle their needs? Do you have services like the Red Cross or an auxiliary organization you can call in to pass out water, etc.? 06-4 Training Materials Fireline Incident Discussion

24. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 24 SIZE-UP REFRESHER Upon Arrival –Upon arrival, the incident scene will often be chaotic. –The company officer tries to gather as much information as possible as many things are running through his mind. –The occupants may not be home or may be present, but hysterical. –Sometimes neighbors will report what they see; for example, a vehicle speeding away from the scene may indicate arson or foul play. This might mean the police should be involved. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

25. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 25 SIZE-UP REFRESHER Size-up –The company officer would continue his 360, trying to establish fire location and noting where all openings are which could be used for points of ventilation/escape. –This should all be done systematically so the fire can be knocked down and all occupants rescued as quickly as possible. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

26. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 26 SEARCH PATTERNS REFRESHER Determining Search Pattern –Usually a search crew will run from 2-4 members depending upon available manpower. –From the initial entry control point, the crew leader will determine the search pattern, either a left- or a right-hand search pattern. Depending which way they go, they stay on that wall so subsequent crews will know whats been searched and go the other way or where theyve been if someone is missing. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

27. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 27 SEARCH PATTERNS REFRESHER Finding the Fire –Once they find the fire room, if they have a hoseline, the crew simulates extinguishing the fire. To this point, theyve been restricting searches to the first floor in the normal scenario. Continuing the Search –They spread out with a tool and a hose in hand or are backed up with a hoseline crew. –As they continue the search, crew members communicate with each as to what they see, if anything, or what they feel. Theyre feeling for window sills, door hinges, any opening which might be used for ventilation or egress to save themselves or for occupant removal. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

28. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 28 SEARCH PATTERNS REFRESHER Continuing the Search –All fire rooms are very smoky and blacked out until ventilation can be achieved through some opening. –In Part 4 of this series (06-3), an occupant was found and removed by knocking out a door. Suspicious Conditions –As you search, if you were to find two fire locations, immediately suspect foul play or arson. The typical residence fire only has once source of origin. More than one indicates the fires may have been set. Therefore, firefighters should also be aware that flammable materials and maybe even booby traps may be present – use extreme caution in this case! 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

29. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 29 SEARCH PATTERNS REFRESHER Secondary Search –A secondary search is always recommended, just in case an occupant was missed in the primary search. Next Steps –Following the searches would be fire suppression, salvage and overhaul, and mopping up the scene. –If arson is a factor, be very careful in overhaul and mop-up as you are now working on a crime scene and preservation of evidence is essential. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

30. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 30 THE EVOLUTION Responders find bars on windows when they arrive on scene. Size-Up –Company Officer begins size-up. –Does his 360 to ascertain fire location, if possible. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

31. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 31 THE EVOLUTION Tactics –Upon arrival of 2nd-in engine, secondary water supply is established. –Since the windows are barred, the initial search and rescue team begins an initial entry on the second floor and works its way downstairs. –The fire attack crew enters on the second floor. The hose is not charged when carried up the ladder to make the rubber hose easier to carry and manipulate. Rubber hose will need flaking and slack pulled. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

32. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 32 THE EVOLUTION Tactics –Truck crew does forcible entry with K-12 saw and removes bars. –Search and Rescue is begun. –Location of fire is found. –Back window opposite the front door is ventilated. Once heaviest smoke has ventilated via PPV, additional windows are vented to augment smoke clearing. Additional venting could be done even if not all the bars have been removed. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

33. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 33 THE EVOLUTION Tactics –An occupant is found in a closet and removed through a downstairs window. –Second search and rescue is conducted. –The fire attack crew extinguishes fire. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

34. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 34 THE EVOLUTION Post-Briefing –Forcible entry: Remove all security bars from all windows and doors as crews working inside may need to exit in case of an emergency. Do all openings since you wont know where everyone is working. –Carrying a dry line up the ladder was a good move due to hoses increased flexibility 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

35. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 35 THE EVOLUTION Post-Briefing –Great Tip! if the nozzleman carries the hose over his shoulder, its better to carry the hose so the nozzle goes over the shoulder and then under the armpit facing backwards rather than under the armpit and up over the shoulder facing backwards. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

36. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 36 THE EVOLUTION Post-Briefing Should the line become prematurely charged, the hose will kick forward, possibly knocking the firefighter off the ladder if the line passes under the armpit first. –Ventilation: Initial PPV should be worked first, with the window behind the fire opposite the location of the fan, BEFORE additional openings are vented. If additional venting is done too soon, the PPV effect will be compromised. –Mini-Preplan: Based on the dispatch and initial first-in report, responders on second and third arriving trucks should talk via radio or Nextel in advance, if possible, if suggestions or maneuvers come to mind that the crews would like to try. This way, the crews are more on the same page when they pull up and less explanation is needed on the fireground. 06-4 Training Materials Hands-On: Fire Attack Basics, Pt. V

37. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 37 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: Search patterns are determined by a consensus of the search crew. 2. True or False: A search crew may or may not take a hoseline with them. 3. True or False: A circular K-12 saw is a good choice for cutting window bars. Fire Attack Basics, Pt. V: Quiz

38. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 38 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. In this evolution, which tactic is out of order? a. Location of fire is found. b. Since the windows are barred, search and rescue begins an initial entry on the second floor and works its way downstairs. c. Fire attack crew enters on the second floor. d. Truck crew does forcible entry with K-12 saw and removes bars. e. Occupant is found. Fire Attack Basics, Pt. IV: Quiz

39. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 39 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. In this evolution, which of the following statements is incorrect? a. Rubber hose is really easy to handle when charged; it rarely needs to be flaked. b. Carrying a dry line up the ladder can be a good move. c. With ventilation, initial PPV should be worked first, with the window behind the fire opposite the location of the fan. d. Based on the dispatch and initial first-in report, responders on second and third arriving trucks should talk via radio or Nextel in advance, if possible. e. None of the above. (Answers on Slide 65) Fire Attack Basics, Pt. IV: Quiz

40. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 40 PRE-BRIEFING Company Officers: Thought Process –Whats different here compared to a house fire versus a small apartment building versus a small industrial complex, as far as hoseline stretches are concerned? –Whats your first concern upon arrival? Taking enough hose. –Its a big building and the fire could be hundreds of feet from the stairwell/standpipe. Searching –Could you get lost in this building? Absolutely. –Keep your crews together and keep your orientation. –Company officers should know that accountability is very important here. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

41. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 41 THE EVOLUTION Arrival on Scene/Size-Up –Engine company rolls up. –The manager says they have a fully-occupied building with 350 guests. Two stairwells in the building, one at each end. One is being used for evacuation, the other for the fire attack team. Smoke detectors are sounding on Floor Four and Six, guest rooms 2 -5. –Normally, Staging and Command would be two floors below the fire; because of constraints in todays scenario, it will be one floor below the fire. Instructors will tell teams when to mask up. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

42. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 42 THE EVOLUTION Evolution in progress –Be prepared to hump and flake hose, pulling slack around corners in stairwells and corridors when necessary. –Youll also have to deal with stairwell doors leading to floors. –Make connection to the nearest standpipe to the fire floor. If you have any doubt about having enough hose, radio back for another coil. –If you have a long hump to get to the fire room, you will consume a lot of air. Keep an eye on your air supply. –Radio for relief before youre going to need it. As you pass the relief team, brief them on conditions and occurrences. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

43. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 43 POST-BRIEFING Dispatch/Size-Up –These are labor-intensive responses. If you get a dispatch to such structure, call for backup, additional alarms, mutual aid immediately. –Upon arrival and size-up, reassess again for manpower needs. –Sizing up the building is crucial for estimating ultimate hose needs. Where are the standpipes? Are they close to the fire floor? How long are the corridors? 06-4 Training Materials Hands-On: Hotel Response, Pt. I

44. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 44 POST-BRIEFING Dispatch/Size-Up –If youre going to need more hose, attach and lengthen in the stairwell in the light where you can see, probably right at the standpipe. Strapping hose as it comes off the pre-connect tray is one way to grab another stretch of hose easily. –You can see where a good preplan can supply you with the information you need to make these decisions quickly. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

45. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 45 POST-BRIEFING Fire Attack Team moving down hall –Use your senses and instincts. –Check doors for temperature. In this case, poking the ceiling revealed a concrete structure. Know what youre dealing with! –If the doors were closed and we didnt check them, we could easily go past the fire. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

46. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 46 POST-BRIEFING Fire Venting Strapping hose as it comes off the pre-connect tray is one way to grab another stretch of hose easily. –You can see where a good preplan can supply you with the information you need to make these decisions quickly. –If not hot, open the door and check for cooler air, then continue. –During the scenario, a call came in that the fire had vented. Whats the concern then? –The fire, wherever it is, will be accelerating due to new oxygen or air movement. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

47. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 47 POST-BRIEFING Attacking the fire room –Depending on wind direction, the fire could be venting outside away from the doors, or it could be venting toward the door. If you open that door, you could be faced with a severe issue. –This is why its so important to be aware of what affects fire, especially in relation to your position or the task youre working on (checking and maybe opening doors). –2.5 hose is really your hose of choice. If there is a real working fire in progress, youll need the higher flow rate the 2.5 will give you over an 1 ¾ hoseline. –Another option for entering the fire room would be to breach through the wall from an adjoining room, especially if there is fire just behind the fire room door. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

48. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 48 POST-BRIEFING Attacking the fire room –If you know the fires position, i.e. what side of the building its on, you could throw a ladder or an aerial to the opposite side for possible exit opportunities. 06-4 Training Materials Hands-On: Hotel Response, Pt. I

49. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 49 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: Its obvious at such an incident that youll never need more hose than whats on the first-in engine. 2. True or False: Since theres a phone in every hotel room, concern over getting separated from you crew is minimized. 3. True or False: Why bring hose at all? Theres usually plenty of it already connected to the standpipe in the stairwells. Hotel Response, Pt. I: Quiz

50. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 50 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which of the following tasks are not part of initial engine company tactics? a. Humping hose b. Command ordering an accountability check c. Connecting to standpipes d. Flaking hose e. All of the above Hotel Response, Pt. I: Quiz

51. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 51 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. What is not an example of good search and rescue technique? a. Poking the ceiling to investigate building construction b. Venting has occurred and you open the next door you encounter to find out where c. Lengthening your hose line before you need the extra d. Breaching the fire room through the wall from an adjacent room. e. None of the above (Answers on Slide 65) Hotel Response, Pt. I: Quiz

52. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 52 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials PROTECTIVE CUSTODY Custody vs. Protective Custody –There may be different jurisdictions and different ordinances and judges and law enforcement may use different terms, but there really is no legal standing for protective custody. –You wont hear a lawyer use that term. A person is either in custody or theyre not. –If someone is in custody, it means the person is not free to go. –If they are not in custody, they may be detained, but their rights to leave a particular situation are not deprived. –Being in custody or not does not take away a persons ability to make medical decisions for herself.

53. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 53 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials PROTECTIVE CUSTODY In custody but also incompetent –It may be that a person in custody is also incompetent, and their consent status is implied, but it doesnt mean they have transferred those rights to a police officer just because they are in custody.

54. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 54 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials PROTECTIVE CUSTODY Police Custody –For police to take custody of someone, they need either: a court order from a judge, whereupon the person is picked up and brought to court, a nursing home, a psych unit, etc. or an arrest warrant. –If a person is sitting in a police car for questioning, legally he can walk away as opposed to being under arrest where he cant leave. However, he can still make healthcare decisions for himself.

55. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 55 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials PROTECTIVE CUSTODY Police Custody –A person can be put in custody because police dont want him to flee, or perhaps during a dispute, police dont want people getting back into it. But that still doesnt take away a persons right to make healthcare decisions for oneself. –However, police might not want you to think that or know that, but no statute appears to exist that takes away that right. (Ed. - Although it may be possible that there is one, in 15 years of dealing with this issue, Dan has never seen one).

56. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 56 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials DO YOU HAVE CONSENT? You have to make a choice –You take in all the information you have available, from the patient, family, witnesses, etc. and then you have to decide whether you have consent or not. –Use the Consent Checklist covered in previous segments of this series and depending on how the various answers you acquire add up, you make the call. But document all the issues and describe your decision path! If your report documents that you followed a systematic procedure for discerning consent, youll be on solid ground.

57. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 57 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials DO YOU HAVE CONSENT? You have to make a choice –Use the Consent Checklist covered in previous segments of this series and depending on how the various answers you acquire add up, you make the call. –The court will ultimately use the Reasonable Person Standard when evaluating what you did via your report and documentation.

58. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 58 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials DO YOU HAVE CONSENT? Other suggestions –Use good communications skills in your reports. Good writing skills and use of English will add to your credibility. Through your questions and the patients answers, show a logical development of your opinion and consequent action. –Develop patient treatment routines. These are the questions you always ask on a call, that others can testify on your behalf that you do, and if you can list those with confidence, its very believable and persuasive.

59. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 59 Fire Medics: Medical/Legal Issues, Pt. III 06-4 Training Materials DO YOU HAVE CONSENT? Lack of minor consent –In the case of a minor who refuses care and he gives you the phone number of a parent, or dials the number and hands you the phone, verify that you are actually talking to the parent. –Taking the parents Social Security Number is not a bad idea. –Have them describe the minor, what they look like, whats the minors middle name, the kind of car the minor drives – and then document that entire discourse.

60. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 60 Medical/Legal Issues, Pt. III: Quiz Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: If police say a patient is in Protective Custody, paramedics have to accept that status legally. 2. True or False: Police might like you to think that a person in custody has no right to speak for themselves. 3. True or False: Ascertain the identity of a minors parents before you make a Judgement as to a minors consent or lack of same.

61. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 61 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. The court will evaluate your documentation in terms of the: a. Typical Persons Standard b. Average Persons Standard c. Reasonable Persons Standard d. Rules of Consent Acquisition. e. None of the above Medical/Legal Issues, Pt. III: Quiz

62. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 62 Medical/Legal Issues, Pt. III: Quiz Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which of the following will not make you credible in court? a. Strong documentation b. The inability of others to testify on behalf of your routines with patients. c. Good communications skills d. Being dressed in uniform e. None of the above (Answers on Slide 65)

63. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 63 06-4 Training Materials Evolutions 2000: Continuing Education Kramer vs. Kramer: Wearing SCBA on the Fireground Complete written responses to the following three essay questions: 1. Describe the deployment and effectiveness of RITs (Rapid Intervention Teams) used at the large condo fire seen this month on Working Fire Training. 2. In your opinion, is there an over-emphasis, a lack of emphasis, or neither regarding the use of RIT teams in the fire service today? Briefly explain. 3. What is the policy regarding RIT, FAST, or similar rescue teams in your jurisdiction? What recommendations for improvements -- if any -- would you make? If youre enrolled in the Open Learning Fire Service Program at the University of Cincinnati, heres your opportunity this month to earn one college credit hour for watching Working Fire Training.

64. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 64 ENROLLMENT INFORMATION: For more information on enrolling in the Open Learning program to gain college credit, call Working Fire Training at 800-516-3473 for a brochure or, to register directly, call the University of Cincinnati at 513- 556-6583. Associates and Bachelors programs are available. Call to have your transcripts evaluated. Send your responses to: Professor Bill Kramer University of Cincinnati College of Applied Science 2220 Victory Parkway, ML #103 Cincinnati, Ohio 45206 06-4 Training Materials Evolutions 2000: Continuing Education

65. Emergency Services, LLC/ Copyright 2006 / Volume 06-4 65 06-4 Training Materials Thanks so much for viewing Working Fire Training! See you next month – stay safe! Answers: Hands-On Fire Attack Basics, Pt. V on Slides 37-39: 1. False 2. True 3. True 4. a 5. a Hands-On Hotel Response, Pt. I on Slides 49-51: 1. False 2. False 3. False 4. b 5. b Fire Medics Medical/Legal Issues, Pt. III Quiz on Slides 60-62: 1. False 2. True 3. True 4. c 5. b TRAINING