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1 Emergency Services, LLC / Copyright 2007 / Volume TRAINING Click here to view this PowerPoint in its entirety Click here to view this PowerPoint in its entirety FIRE MEDICS Shock Treatment, Pt. 1 Quiz EVOLUTIONS 2000 Kramer vs. Kramer Program Quiz Answers FIRELINE Barn & Hay Fire Bettendorf Water Rescue Discussion Questions HANDS-ON Half-Attic Fires, Pt. 3 Quiz Air Crash Simulator, Pt. 1 Quiz Working Fire Training Training Materials

2 Emergency Services, LLC / Copyright 2007 / Volume TRAINING Click anywhere on page to view show in its entirety Click anywhere on page to view show in its entirety Working Fire Training Training Materials All training methods and procedures presented in this Working Fire Training (WFT) video program and training materials are based on IFSTA, NFPA, NIOSH, OSHA and all other relevant industry regulations and standards and are presented as a part of generally accepted and acknowledged practices in the U.S. Fire Service. WFT should be used under the supervision of certified trainers in conjunction with national, state, and local training standards and protocols, and the standard operating guides and procedures of the Subscriber. WFT is intended to be an ancillary source of training information and should not be used as the sole source of training for any emergency service organization. WFT accepts no responsibility for how the Subscriber implements or integrates this program into the Subscriber’s own training program, nor does the use of this program by the Subscriber imply that WFT approves or endorses any specific training methods presented by the Subscriber to its own organization. WFT accepts no responsibility for the correct understanding or application of its training methods and procedures by emergency service personnel who view this program; nor for any performance or lack of performance by emergency service personnel who may view this program and use or apply these training methods and procedures incorrectly; nor does it accept any liability for injuries or deaths of emergency service personnel who may view this program and use or apply such training methods and procedures incorrectly. By presenting this program for viewing to its organization’s members, the Subscriber, and by viewing or reading materials presented by WFT, the members and students of the Subscriber, agree to hold harmless WFT, the University of Cincinnati, VFIS, and any persons or organizations who participate in the creation and/or presentation of this training material from any legal action which might result from any line-of-duty injuries or deaths of the Subscriber’s members or any other emergency service personnel who view this program and who may use or apply such training methods and procedures incorrectly. LEGAL DISCLAIMER

3 Emergency Services, LLC / Copyright 2007 / Volume DISPATCH/SIZE-UP Called in around 4 a.m. by a sheriff’s deputy running radar. Originally toned out as a field fire then changed to a barn fire. The change made the fire chief/incident commander alter his thinking: –What was in the barn? –Were there other structures involved? –Were residence occupants involved? Training Materials Fireline Incident: Barn & Hay Fire

4 Emergency Services, LLC / Copyright 2007 / Volume DISPATCH/SIZE-UP Upon arrival, responders found two metal barns side-by-side. One was filled with farm machinery and the other (about 70’ X 100’) was completely filled with hay bales weighing approximately 1200 lbs. Both were fully engulfed Training Materials Fireline Incident: Barn & Hay Fire

5 Emergency Services, LLC / Copyright 2007 / Volume ACCESS A one-lane road was the only access to the fire scene for apparatus and water shuttling. –Responders drove in from the north through a farmer’s bean field. Since it was dark, the I.C. couldn’t tell if the adjacent field of soybeans were brown (combustible) or green (not combustible). –These crops could be “organic exposures.” Clear access to the metal barns for fire suppression was impossible Training Materials Fireline Incident: Barn & Hay Fire

6 Emergency Services, LLC / Copyright 2007 / Volume ACCESS To the west there was a cornfield that was only 12 feet from the burning barn. –The corn was also combustible Training Materials Fireline Incident: Barn & Hay Fire

7 Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND /INCIDENT ACTION PLAN Upon arrival, I.C. called for mutual aid with a tanker/tender for shuttling water. Four additional departments responded with mutual aid, some to cover the local department’s jurisdiction. To get access to the fire, a front-end loader was requested which arrived in about 20 minutes. –The burning hay had to be removed from the barn to be extinguished. –The machinery in the other barn was removed Training Materials Fireline Incident: Barn & Hay Fire

8 Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND /INCIDENT ACTION PLAN After the first hour, a combine and grain cart were brought in. After exhausting the city water supply (105,000 gallons -- it fed the tanker shuttles initially), additional water supplies had to be drafted from bodies of water Training Materials Fireline Incident: Barn & Hay Fire

9 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Electricity to the machinery barn was shut off. A combine and grain cart were brought in to pick 3-4 acres of the cornfield adjacent to the burning hay barn to remove organic exposures. Burning bales were hauled out with the front-end loader to be extinguished outside the barn Training Materials Fireline Incident: Barn & Hay Fire

10 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS A bulldozer and excavator were also brought in to move hay bales Training Materials Fireline Incident: Barn & Hay Fire

11 Emergency Services, LLC / Copyright 2007 / Volume EMS EMS provided rehab: taking vitals, offering fluids and hydration, etc. There were no medical casualties Training Materials Fireline Incident: Barn & Hay Fire

12 Emergency Services, LLC / Copyright 2007 / Volume EVENTS There were two burning barns at the end of a long lane, wide enough for one vehicle. Mutual Aid was dispatched for water transport and station fill-in; eventually five tanker-tenders were used. A combine was dispatched to harvest acreage around the barns. A front-end loader removed burning bales for the barn Training Materials Fireline Incident: Barn & Hay Fire

13 Emergency Services, LLC / Copyright 2007 / Volume EVENTS The wind picked up after daybreak, so flying embers became an issue with a lot of combustible crops nearby. A second front-end loader was brought in. After flowing 105,000 gallons of water from the city water supply, they began drafting from bodies of water. A bulldozer and excavator were also brought in to move hay bales Training Materials Fireline Incident: Barn & Hay Fire

14 Emergency Services, LLC / Copyright 2007 / Volume REMARKS The fire was smoldering a week after the fire was extinguished. This fire was similar to a tire fire in that the fire was concealed from water attacks and continued to burn unless burning surfaces were exposed for extinguishment. The fire was extinguished and there were no injuries or lives lost. Only one tractor and all the hay were lost Training Materials Fireline Incident: Barn & Hay Fire

15 Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES Keep your head during a long fire such as this. –There was nothing to be saved so just follow the plan and keep the fire contained until extinguishment. Exercise extreme safety when hauling water. –Narrow, often soft, roads, heavy loads, and uncooperative motorists can all lead to trouble for tanker/tender drivers. After flowing 105,000 gallons of water, the fire was still working. –At that point, consider a change of strategy Training Materials Fireline Incident: Barn & Hay Fire

16 Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES You may never have a barn fire in your jurisdiction, but you might have some kind of fire in another situation that’s hard to get to. Draw on what you know (i.e. tire fires) and apply it to a similar situation (a pesky fire that’s hard to extinguish) with different materials burning Training Materials Fireline Incident: Barn & Hay Fire

17 Emergency Services, LLC / Copyright 2007 / Volume DISPATCH/SIZE-UP A father and son went canoeing on a rain-swollen creek and soon got into trouble. Both wore life vests and the son was able to work his way ashore. But the father got hung up in the current as the water level continued to rise and found himself against a tree. Bettendorf Fire Department rescuers arrived to find a swift-running creek and the victim whom police had already located Training Materials Fireline Incident: Bettendorf Water Rescue

18 Emergency Services, LLC / Copyright 2007 / Volume ACCESS The river bank on the far side was heavily wooded, steep (about a 30-degree angle), and muddy due to a recent rain, making footing dangerous. The creek was about 40 feet wide at the point of the rescue. The victim was about 15 feet from the far side of the creek Training Materials Fireline Incident: Bettendorf Water Rescue

19 Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND /INCIDENT ACTION PLAN A progression of rescue options were attempted, from the least risk to the most risky: –The victim was too far away from shore to be grabbed with a pike pole or similar device. –Rope bag throws from the near side were ineffective. –Swift water rescue (putting a man in the water) was decided upon with multiple scenarios mapped out (whether the victim would hang on, lose his grip, etc.) Training Materials Fireline Incident: Bettendorf Water Rescue

20 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Rescue snag lines were established in two downstream locations and were moved closer to the scene as more personnel arrived Training Materials Fireline Incident: Bettendorf Water Rescue

21 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Rescuers attempted to reach the victim from the heavily wooded, muddy hillside. Rope bags were thrown upstream of the victim from the near side of the creek, with the idea of floating the bags down to the victim but the trees, debris, and current prevented that Training Materials Fireline Incident: Bettendorf Water Rescue

22 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Water Rescue –It was decided that a rescuer would go into the water wearing a swift water rescue suit. This is a flotation device with a line attached from the back. –A haul team was set up to control the rescuer via the line on his suit. –Using a pendulum rescue procedure, the rescuer is put in the water upstream of the victim. He then swings out and floats down in an arc until he’s in contact with the victim Training Materials Fireline Incident: Bettendorf Water Rescue

23 Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Water Rescue –Once the rescuer has the victim, the victim lets go and the two are swung into shore where they are retrieved by rescuers Training Materials Fireline Incident: Bettendorf Water Rescue

24 Emergency Services, LLC / Copyright 2007 / Volume COMMUNICATIONS The victim was given psychological support by emergency personnel on scene. The victim later said he could not hear the rescuers over the sound of the water even thought they were only feet away. EMS The victim was treated at the scene and released Training Materials Fireline Incident: Bettendorf Water Rescue

25 Emergency Services, LLC / Copyright 2007 / Volume EVENTS Police located the victim in the creek up against a tree about 15 feet from shore. Snag lines were strung downstream should the victim lose his grip. Rope bags thrown from shore weren’t able to reach the victim due to trees, debris in the water, and the water current. A water rescue was mounted using a pendulum rescue technique The patient was checked out by EMS on scene and released Training Materials Fireline Incident: Bettendorf Water Rescue

26 Emergency Services, LLC / Copyright 2007 / Volume REMARKS That day the creek was not suited for a leisurely canoe ride. The creek’s water level was rising during the rescue. Its normal depth of two feet had risen to eight feet. The victim was exhausted and rescued just in time; he was about ready to let go Training Materials Fireline Incident: Bettendorf Water Rescue

27 Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES The department trains for swift water rescues about every 18 months to two years. A quick start to this incident helped a lot. –The police did an excellent job in locating the victim quickly and then communicating with rescuers about mounting a rescue. There was a progression of Plan A to Plan B to Plan C, from the easiest and safest to the most difficult with more risk. –Know what those “plans” should be and execute them quickly! Training Materials Fireline Incident: Bettendorf Water Rescue

28 Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES Previous training gave the rescuer the confidence he needed to complete the rescue. –However, since all members were trained, if the rescuer became the victim, there were others ready to rescue him. You have to take training seriously so when you have an incident, your actions are second-nature. – Habits take over and you don’t have to think about what to do. Remember, we play like we train! Training Materials Fireline Incident: Bettendorf Water Rescue

29 Emergency Services, LLC / Copyright 2007 / Volume Fireline Incident Discussion The departments involved in this month’s training and WFT pose some discussion questions that you can use as discussion-starters in your own department’s training sessions. How will your department handle these scenarios? Training Materials

30 Emergency Services, LLC / Copyright 2007 / Volume Barn & hay Fire / Orion, IL Fire Chief Larry Anderson, Orion (IL) Fire Protection District Some incidents are a lot more complicated than they first appear. Don’t take any incident for granted. This incident took some creative solutions involving heavy apparatus not normally used by our department. Do you have resources lined up you can call in – even for something non-standard or unusual? Many of our guys were running equipment rather than manning hoses – and they did it for a long time. Skilled manpower becomes an issue. Where are you going to find relief for those equipment operators? Ultimately, we had an organic problem; like moving burning material from a wildland fire and setting it down on dry leaves – or corn, in our case. If you move burning material for extinguishment elsewhere, you better have a place to set it down so it doesn’t ignite other fuels. Fireline Incident Discussion Training Materials

31 Emergency Services, LLC / Copyright 2007 / Volume Bettendorf Water Rescue / Bettendorf, IA Lt. Steve Kingsley, Bettendorf (IA) Fire Dept. Natural structures, like bodies of water and mountains, should be preplanned just like any other man-made structure. You must be familiar with accessing and working around them. As an incident commander, you shudder when you know the only way to effect a rescue is to put one of your own people in jeopardy. If you’re asking yourself, “Are we trained for this?”, you probably aren’t. When you do commit a rescuer to a hazardous situation, make sure you’ve run the progression of all the less-risky options first. It comes down to the fact that citizens don’t respect the power of nature (i.e., floating swollen creeks and outrunning tornadoes). Public awareness and education is your only ally in this regard (short of arresting citizens for stupidity!). Fireline Incident Discussion Training Materials

32 Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: what backdraft and a traveling wave are attic construction and locations of attic fires. CODES, STANDARDS & REGULATIONS NFPA 1410, Standard on Training for Initial Emergency Scene Operations. NFPA 1710/1720, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career/Volunteer Fire Depts. NFPA 5000, Building Construction and Safety Code. Hands-On: Half-Attic Fires, Pt Training Materials

33 Emergency Services, LLC / Copyright 2007 / Volume BACKDRAFT It occurs because you have void space in which smoke can be trapped. We know that smoke is a fuel full of ignitable materials: –Hydrocarbon-type fuel like eurothane foam –Class A wood-type fuel. The smoke fills up the void space and uses up all the oxygen in that space. It’s hot and ready to burn. Then a sudden opening occurs: –A ceiling falls in. –A door opens. –A firefighter’s ax punches through a wall. Hands-On: Half-Attic Fires, Pt Training Materials

34 Emergency Services, LLC / Copyright 2007 / Volume BACKDRAFT Air will then be drafted into the void space, traveling back to that space, premixing with fuel (smoke) as it goes, and igniting, often explosively, when it gets there. The ignition then burns back to the source of the air. Technically, it’s a deflagration to lower-speed ignition. Hands-On: Half-Attic Fires, Pt Training Materials

35 Emergency Services, LLC / Copyright 2007 / Volume TRAVELING WAVE When you have a flame, the burnable gases around it get hot and expand (like lighting a propane grill or, in our example above, the ignitable materials in wood smoke) and begin to move away from the ignition point. That’s a traveling wave. A traveling wave is what blows up the grain dust in a grain elevator, pulverized coal in a power plant, or sawdust in a sawmill. Hands-On: Half-Attic Fires, Pt Training Materials

36 Emergency Services, LLC / Copyright 2007 / Volume TRAVELING WAVE The wave moves along, producing heat, CO2, and positive pressure. That’s what causes a backdraft. Hands-On: Half-Attic Fires, Pt Training Materials

37 Emergency Services, LLC / Copyright 2007 / Volume TRAVELING WAVE Flashovers can be created repetitively in flashover simulators, for training purposes. Unlike flashovers, injuries to firefighters resulting from backdrafts are relatively low; deaths are extremely rare, assuming proper PPE is worn. But backdrafts are not to be dismissed lightly! Hands-On: Half-Attic Fires, Pt Training Materials

38 Emergency Services, LLC / Copyright 2007 / Volume VENTILATION We can ventilate to combat a backdraft developing. We can ventilate to combat half-story construction fires. ONE CAVEAT TO ALL ROOF VENTILATION ACTIVITIES! –Beware! More and more residential construction (and traditionally, lots of commercial construction) are using truss roof construction! –If trusses burn early, the entire roof will be unsafe to support ventilation crews! –Know what’s happening inside before you commit crews! Hands-On: Half-Attic Fires, Pt Training Materials

39 Emergency Services, LLC / Copyright 2007 / Volume APPLICATIONS TO ATTIC CONSTRUCTION The typical attic is open construction: a ridge pole and rafters under the roof following the roof line. To make this space livable, we have to add vertical joists and a hip wall and hang rafters to make a ceiling. This has created at least three concealed spaces! Hands-On: Half-Attic Fires, Pt Training Materials Ridge Pole Rafter Hip Wall , 2, 3 = Concealed Spaces Vertical Joists, Hip Wall Studs Collar Beam, Horizontal Joist Some attic fires burn in just minutes; others take 3-4 hours. What’s the difference? It has to do with attic construction.

40 Emergency Services, LLC / Copyright 2007 / Volume LOCATIONS IDENTIFICATION The hip wall is an “artifical” wall (to the real sloping attic wall/roof line). –So Side 2/Side B downstairs is further to the side of the house than Side 2/Side B upstairs. It is, by necessity, OFFSET from the same wall on the lower level. –We must remember that upstairs, fire on Side 2/Side B is BEHIND the hip wall. Hands-On: Half-Attic Fires, Pt Training Materials 1 3 Hip Wall 1 2 Offset Downstairs Wall 1 = High Attic 2 = Low Attic 3 = Low Attic Side 2/ Side B

41 Emergency Services, LLC / Copyright 2007 / Volume LOCATIONS IDENTIFICATION To help clear up this confusion, communicate such spaces or fire in such spaces as follows: “Command, we have fire in the Side B/Side 2 low attic.” –Use the terms “low attic” for the low triangular spaces behind hip walls and “high” attic for the confined space created above the “artificial” horizontal ceiling. Hands-On: Half-Attic Fires, Pt Training Materials

42 Emergency Services, LLC / Copyright 2007 / Volume LOCATIONS IDENTIFICATION This does two things: –It clarifies to those on the outside that we indeed have half-attic construction with concealed spaces with attic walls offset from the lower level. –It specifies exactly where in the half-attic area the fire is located. Hands-On: Half-Attic Fires, Pt Training Materials

43 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ 1. True or False: A hip wall is really trendy construction. 2. True or False: A downstairs wall will be offset to the vertical wall in a half-attic. 3. True or False: “Command, we have a fire in the Side 4/ Side D low attic” is a confusing way to indicate where a fire is Training Materials Quiz: Half-Attic Fires, Pt. 3

44 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which order describing a backdraft is correct? a. Air drafts to void space – premixing w/ fuel and igniting – burns back to the source of air b. Air premixes w/ fuel and ignites – drafts to void space – burns back to source of air c. Air burns back to source of air -- premixes and ignites – drafts to void space d. b & c above e. None of the above Training Materials Quiz: Half-Attic Fires, Pt. 3

45 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which characteristic does not apply to a backdraft? a. Positive pressure b. Deflagration c. Traveling wave d. Flashover e. None of the above (Answers on Slide 100) Training Materials Quiz: Half-Attic Fires, Pt. 3 Printable quizzes follow the answers on slide 100 in the.PDF version of these training materials.

46 Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: – the safety procedures for fighting aircraft fires – procedures and tactics for fighting aircraft fires – specific information relating to using this particular aircraft fire simulator. CODES, STANDARDS & REGULATIONS NFPA 402, 403, 422, Various ARFF codes & standards; AC 150/5210 – 13A, 14A, 17, 18, ARFF regulations Hands-On: Aircraft Fire Simulator, Pt Training Materials

47 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MOBILE AIRCRAFT FIREFIGHTING TRAINER (MAFT) SAFETY PROCEDURES Live Aircraft Rescue Firefighting (ARFF) fire training –Full PPE must be worn. –No exposed skin is permitted. –Use of PASS devices is encouraged. SCBA Evolutions –All facial hair must be trimmed for a good seal. –SCBA will be worn for all interior evolutions. Hands-On: Aircraft Fire Simulator, Pt. 1

48 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT SAFETY PROCEDURES Safety Zones: Hot, Warm, Cold –Hot Zone: Inside MAFT or active firefighting outside – Full PPE! –Warm Zone: Anywhere inside training area – Full PPE! –Cold Zone: Designated rehab/staging areas No running on the fireground. Hands-On: Aircraft Fire Simulator, Pt. 1

49 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT SAFETY PROCEDURES Two-in with two backups: –A nozzle person –A person behind the nozzle person –Two hose- minders behind them on each line in each evolution. –That’s four people per line per evolution. Exterior and interior crews will be operating simultaneously. Stay low during interior firefighting operations. Evacuate upwind if there is an emergency. Hands-On: Aircraft Fire Simulator, Pt. 1

50 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY NO straight streams! –Straight streams don’t supply sufficient agitation to develop a good foam blanket. –They damage the simulator equipment. –One exception: see “Tail Engine Fires in ARFF”. In real-world ARFF and in training evolutions such as this, use about a 30%-40% power cone. Hands-On: Aircraft Fire Simulator, Pt. 1

51 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Wheel fires in ARFF –Wheel Fire Assemblies are dangerous! –This is one place where you’ll find a lot of combustible metal (magnesium, titanium, etc.). –High pressure-filled tires (200 – 300 psi of nitrogen) can explode if overheated (a hot brake condition, for example) which can jeopardize firefighters! –There is a fusible link which should release pressure at some point, but it can also become a projectile. Hands-On: Aircraft Fire Simulator, Pt. 1

52 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Wheel fires in ARFF –Proper technique is to approach a wheel fire from the nose or the tail of the aircraft, 90 degrees to the wingtip, to lessen the chance of being struck by projectiles. –Technically, combustible wheel assembly metals, such as magnesium, don’t react well to water but demand dry powder Class D firefighting agents. –However, time and situation constraints of air crashes probably won't allow preparation and discharge of dedicated Class D agents, so expect some Class D fire reaction to the water and foam being deployed! Hands-On: Aircraft Fire Simulator, Pt. 1

53 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Wheel fires in ARFF –However, with sufficient amounts of water being applied, ignition temperatures can be lowered to enable extinguishment. –Aircraft fires need a good 2500 gallons per minute for 10 to 15 minutes to ensure rapid extinguishment. Hands-On: Aircraft Fire Simulator, Pt. 1

54 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Engine Fires in ARFF –Proper technique is to flow agent through the engine intake allowing the agent to flow through the front of the engine or turbine and allow the fire to extinguish itself from the inside out. One drawback of the aircraft simulator prop is that a bulkhead between the intake and exhaust area of the engine prevents extinguishment through the intake. So, for this training evolution only, approach from a 45- degree angle and extinguish fires at the rear of the engine. Hands-On: Aircraft Fire Simulator, Pt. 1

55 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Wing Fires in ARFF –As you attack the engine on fire, remember that there will be substantial radiant heat along the underside of the wing where fuel is stored. –The rising heat will increase the pressure inside the wing, expanding the fuel that’s in that wing. –If the wing becomes over-pressurized, you could split a fuel cell or the fuel could start coming out of the wingtip vent, risking a fuel fire along with the engine fire. –Proper technique demands good agent cooling streams all along the underside of the wing as well as the engine itself. Hands-On: Aircraft Fire Simulator, Pt. 1

56 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Tail Engine Fires in ARFF –Because of the height of this engine off the ground and in windy conditions (especially if you are approaching the engine from a downwind angle), you must change to a straight stream in order to reach the engine. –This is the one exception to using a power cone as recommended earlier. Hands-On: Aircraft Fire Simulator, Pt. 1

57 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Flowing Fuel Fires in ARFF –We can simulate an engine that has had a catastrophic failure and is spreading fuel from the engine which is pooling and burning on the ground underneath. –There are a number of things going on here. A-FFF will extinguish the pool fire, but doesn’t have the clinging capability to cling to the falling fuel from the engine, hence, that fuel re-ignites when it reaches the pool. A dry chemical agent will work very well with the engine fire but has no blanketing capability to be able to sustain a flash ignition on the pool. Hands-On: Aircraft Fire Simulator, Pt. 1

58 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Flowing Fuel Fires in ARFF –There are a number of things going on here (cont.). ARFF vehicles at airports have the capability to discharge a dry agent and a foam agent at the same time, whereas typical firefighting apparatus don’t. However, there might be a situation off-airport where you would like the capability to be able to discharge two agents at once. Here’s how: –Put your foam streams in service –Employ an ABC fire extinguisher off your rig. –Approach/discharge with both simultaneously. –That will net you the same result, up to the limits of your extinquisher. Hands-On: Aircraft Fire Simulator, Pt. 1

59 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Establish Rescue Path/Interior Fire Attack –Human nature indicates that passengers will usually try to exit the same door they entered through – the L1 door or front-left door. –Therefore, it is very important to use initial streams to keep that area clear of fire so passengers may exit safely away from the aircraft. Hands-On: Aircraft Fire Simulator, Pt. 1

60 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Establish Rescue Path/Interior Fire Attack (cont.) –With sizable numbers exiting through the L1 door, how do we gain entry should there be an interior fire? Ladder the plane or wing and enter using an over-wing exit. Make sure only two persons are on the wing at a time and stay down. Have personnel stabilize the ladder. Use tread plates on the wing to improve footing. This gives you entry at the cabin’s mid-point, with shorter space to cover to reach an interior fire in either direction. Hands-On: Aircraft Fire Simulator, Pt. 1

61 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Establish Rescue Path/ Interior Fire Attack (cont.) –With sizable numbers exiting through the L1 door, how do we gain entry should there be an interior fire? Even smaller planes (business and regional jets) have over-wing exits so this works at smaller airports, too. Hands-On: Aircraft Fire Simulator, Pt. 1

62 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Conserve agents! –The reality of ARFF is that incidents occur rapidly and the time to make prudent rescues encompasses a very short window of opportunity. –Therefore, the water on our vehicles is all we have to work with. When it’s gone, we’re done. –Once you’re done extinguishing fire or are waiting for another flare-up, make sure your nozzle is shut off. –Agent conservation is critical! Hands-On: Aircraft Fire Simulator, Pt. 1

63 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Conserve agents! (cont.) –Approach Approach from upwind as much as practical. Discharge within range of stream. –Application Use the proper stream. Use the proper angle. Use the proper flow setting. Hands-On: Aircraft Fire Simulator, Pt. 1

64 Emergency Services, LLC / Copyright 2007 / Volume Training Materials MAFT TACTICS & STRATEGY Conserve agents! (cont.) –Conservation Use short bursts of agent and then evaluate effectiveness. Move streams to get best overall coverage. Remember: You can’t put out smoke! Hands-On: Aircraft Fire Simulator, Pt. 1

65 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: You will never see a Class D fire when fighting an aircraft fire. 2. True or False: Straight streams are acceptable to use at all times in ARFF. 3. True or False: Four personnel on a hose is safe practice Training Materials Quiz: Aircraft Fire Simulator, Pt. 1

66 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. We need to gain entry to fight an interior aircraft fire. Which of the following is NOT correct? a. Ladder the plane or wing and enter using an over-wing exit. b. Make sure that only the four-person hose crew is on the wing at one time and have them stay down. c. Have personnel stabilize the ladder. d. Use tread plates on the wing to improve footing. e. This gives you entry at the cabin’s mid-point, with shorter space to cover to reach an interior fire Training Materials Quiz: Aircraft Fire Simulator, Pt. 1

67 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Proper hose work demands using a 30% - 40% power ________. a. pyramid b. square c. cone d. circle e. None of the above. (Answers on Slide 100) Printable quizzes follow the answers on slide 100 in the.PDF version of these training materials Training Materials Quiz: Aircraft Fire Simulator, Pt. 1

68 Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: an overview of shock, tissue perfusion, and the Fick principle. the progression of hemorrhagic shock and more. CODES, STANDARDS & REGULATIONS USDOT/NHTSA Paramedic National Standard Curriculum and local standards and protocols. American Heart Association guidelines for shock treatment. Fire Medics: Shock Treatment, Pt Training Materials

69 Emergency Services, LLC / Copyright 2007 / Volume Training Materials TISSUE PERFUSION Perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue. It’s the delivery of products that cells need to produce energy -- and shock is a lack of tissue perfusion. If that process isn't reversed by EMS or by someone at the hospital, then the cells are going to progressively die, the organs are going to fail, and the patient is going to die if we don't intervene. Fire Medics: Shock Treatment, Pt. 1

70 Emergency Services, LLC / Copyright 2007 / Volume Training Materials TISSUE PERFUSION As endorsed by the American Heart Association, among others, there’s a big emphasis on perfusing the patient – in many areas: –Hypovolemic shock –When we’re hyperventilating a patient –When we’re doing CPR. Fire Medics: Shock Treatment, Pt. 1

71 Emergency Services, LLC / Copyright 2007 / Volume Training Materials TISSUE PERFUSION All these things drop perfusions so you need to think about perfusion in a lot of different contexts. Fire Medics: Shock Treatment, Pt. 1

72 Emergency Services, LLC / Copyright 2007 / Volume Training Materials AEROBIC METABOLISM Aerobic Metabolism is the normal process by which our body produces energy and it needs two fuels, oxygen and sugar, to produce a normal amount of energy in units called ATP (adenosine triphosphate). You need to have an adequate amount of oxygen for cells to do the work they need to do. Fire Medics: Shock Treatment, Pt. 1

73 Emergency Services, LLC / Copyright 2007 / Volume Training Materials AEROBIC METABOLISM If you don't have enough oxygen getting to the cells if you have inadequate perfusion or oxygenation, then the body will have to produce energy by a really inefficient means called Anaerobic Metabolism. Fire Medics: Shock Treatment, Pt. 1

74 Emergency Services, LLC / Copyright 2007 / Volume Training Materials ANAEROBIC METABOLISM Anarobic Metabolism means “without oxygen,” so the body can produce some energy with poor perfusion but it doesn't produce it as well. This process also produces some toxic byproducts like lactic acid. –Our body doesn't like to work in an acidic environment and that's what happens during anaerobic metabolism. So if the cells aren’t producing enough energy and the cells are producing acids, the organs can't do their work and the whole body system starts to fail. Fire Medics: Shock Treatment, Pt. 1

75 Emergency Services, LLC / Copyright 2007 / Volume Training Materials STAGED DEATH As the body fails, a staged death can occur. First, there's poor perfusion so the cells don't get enough oxygen. The body switches over to an inefficient energy production method in a stop-gap attempt to survive and starts producing acids. The cells start to die, the organs fail, and the patient dies if we don't do something to change that. Fire Medics: Shock Treatment, Pt. 1

76 Emergency Services, LLC / Copyright 2007 / Volume Training Materials FICK’S PRINCIPLE Fick’s Principle describes all the processes that need to happen for the oxygen to get to the cells. There are three different stages. –First, oxygen has to come into the lungs. This means there must be an adequate amount of oxygen in the ambient air. (A fire situation, haz-mat, or something similar where there isn’t enough oxygen in the ambient air, could interfere with that.) –Oxygen must be able to pass across the alveoli on to the red blood cells and there has to be a sufficient number of red blood cells that are able to carry the oxygen to and through the heart. Fire Medics: Shock Treatment, Pt. 1

77 Emergency Services, LLC / Copyright 2007 / Volume Training Materials FICK’S PRINCIPLE There are three different stages (cont.). –Then the body has to be able to transport those red blood cells from the heart down to the end cells in the capillary level and transfer the oxygen through the capillaries and into the individual cells. If edema is present, that wouldn’t be able to happen. If carbon monoxide poisoning is involved, the cells would want to give up their oxygen. If cyanide poisoning is involved, the cells won't be able to use the oxygen in an efficient manager to produce energy. Fire Medics: Shock Treatment, Pt. 1

78 Emergency Services, LLC / Copyright 2007 / Volume Training Materials FICK’S PRINCIPLE Along Fick’s pathway there are a lot of things that can go wrong, especially in the trauma patient: –If you have massive chest trauma, you can have interference with the heart portion of the equation. –If you have hemorrhage you may not have enough red blood cells. –If you have hypovolemic shock or even distributive shock the heart/pump system might not work well to transport red blood cells (oxygen) to the end organs. Fire Medics: Shock Treatment, Pt. 1

79 Emergency Services, LLC / Copyright 2007 / Volume Training Materials FICK’S PRINCIPLE There are lots of things that can interfere with this process in a trauma patient. Fire Medics: Shock Treatment, Pt. 1

80 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS Your patient is a 30-year-old woman who lost control of her vehicle and struck a light pole. There is significant damage to the vehicle. The scene is safe. The patient was unrestrained and you find the patient slumped over in the driver’s seat. You see that the steering wheel is bent. Her airway is patent, she's breathing fast, breath sounds are clear, there's no external hemorrhage, her pulse is weak but rapid, with cool and diaphoretic skin. Fire Medics: Shock Treatment, Pt. 1

81 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS GCS score is 14 and verbal is 4 (confused). She's anxious. She has group bruising across her abdomen and her right thigh is deformed. Do you think she's in shock? Why? –Her blood pressure is fine but she has an elevated heart rate, increased respiration, and she's anxious and confused. That's a big tip-off. Fire Medics: Shock Treatment, Pt. 1

82 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS What kind of shock is she in? Is she in compensated shock or uncompensated shock? –She is compensated because her pressure is still normal so all of the other compensatory mechanisms have kicked in and are able to keep the blood pressure up. But you still see lots of other signs and symptoms of shock. Fire Medics: Shock Treatment, Pt. 1

83 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS What's the most likely cause of the patients shock? Probably internal bleeding. From what? From where? –The abdomen is a good choice. –The femur is a possibility because we did say she had a swollen/deformed thigh. –If that symptom were not present and she had unexplained shock, then where do you always look first? –The Abdomen -- always look at the abdomen first. Fire Medics: Shock Treatment, Pt. 1

84 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS Blood loss –It can either be: external which is very obvious and sometimes easy to treat or internal as the body cavities create potential spaces which can make it difficult to treat. –We have to indirectly infer that the patient is bleeding because we can't see the bleeding. Fire Medics: Shock Treatment, Pt. 1

85 Emergency Services, LLC / Copyright 2007 / Volume Training Materials SCENARIOS Blood loss (cont.) –Can you say that the patient doesn’t have any belly bleeding because the abdomen doesn't look distended? –No, abdominal distention is a really poor indicator of whether or not they have bleeding in the belly. –The belly can hold a lot of blood without really showing anything externally. Fire Medics: Shock Treatment, Pt. 1

86 Emergency Services, LLC / Copyright 2007 / Volume Training Materials BONES We mentioned that the femur could be a potential cause of shock and absolutely it could be because you can lose mls of blood from a femur fracture. Not every femur fracture will cause the loss of a lot of blood. –But if you had an angulated femur fracture with a lot of disruption of the blood vessels you can lose that much blood. Fire Medics: Shock Treatment, Pt. 1

87 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HEMORRHAGIC SHOCK CLASSES It's not really important to understand and be able to distinguish between the different classes of hemorrhagic shock, but view it as a continuum. Class 1 Shock –A typical example might be blood donations. Some donors might look pale and cool to the touch. A typical donation of 500 cc’s of blood could be enough to put someone into Class 1 shock if his/her tank was a little low to begin with, perhaps from prior exertion. –With Class 1 shock your body can compensate fairly well and typically you won't see anything except for maybe a small increase in heart rate. Fire Medics: Shock Treatment, Pt. 1

88 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HEMORRHAGIC SHOCK CLASSES Class 2 Shock –Some people could possibly be in Class 2 shock when they give blood if they are already a little bit dry when they donate. –Once you get to Class 2 shock you start to see normal blood pressure but increases in heart rate, and increases in breathing rate. –By then, you're definitely going to be seeing skin signs as well, kind of cool clammy skin. –You probably have an anxious patient. Fire Medics: Shock Treatment, Pt. 1

89 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HEMORRHAGIC SHOCK CLASSES Class 3 Shock –With Class 3 the patient moves into an uncompensated shock. –That's when the body’s compensatory mechanisms don't work well enough to keep the blood pressure up anymore. Fire Medics: Shock Treatment, Pt. 1

90 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HEMORRHAGIC SHOCK CLASSES Class 4 Shock –With Class 4 shock there's going to be no question that the person is in shock when you see them at that point. –Again it's really not very important that you distinguish between these classes but look at the progression of what's happening to the patient. Fire Medics: Shock Treatment, Pt. 1

91 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HOW THE BODY DEALS WITH SHOCK When you go into shock your body has some really elegant systems that try and compensate for it and usually they do it very well -- that's why so many people survive these injuries. –The respiratory rate is going to increase to try and get more oxygen into the patient. –The sympathetic nervous system and the fight or flight response is going to kick in. –This leads to an increase in blood pressure, so the body works against that. Fire Medics: Shock Treatment, Pt. 1

92 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HOW THE BODY DEALS WITH SHOCK Remember, your heart rate times the stroke volume = cardiac output. Heart rate and strokes volume times systemic vascular resistance = blood pressure. So in order to maintain your blood pressure the body is going to have to do things to increase all of these in shock. Fire Medics: Shock Treatment, Pt. 1

93 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HOW THE BODY DEALS WITH SHOCK If one thing goes down, the body is going to compensate by increasing something else. –Alpha receptors are going to be affected when your body has a sympathetic response and it’s going to cause extreme vasoconstriction of the skin and of the gut. –That's why you see pale cool clammy skin in shock and that can shunt a tremendous amount of blood into the core where it's essential. Fire Medics: Shock Treatment, Pt. 1

94 Emergency Services, LLC / Copyright 2007 / Volume Training Materials HOW THE BODY DEALS WITH SHOCK If one thing goes down, the body is going to compensate by increasing something else (cont.). –You'll also see increased heart rate and strength of contraction from the beta receptors. –And then you have other hormonal responses, such as aldosterone and anti-diuretic hormone, that prevent the kidneys from losing any water when the body’s in shock. –These hormone responses are going to conserve water and both of those also cause vasoconstriction so they're all working together to try and maintain blood pressure. Fire Medics: Shock Treatment, Pt. 1

95 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: A lack of tissue perfusion must sometimes be addressed by EMS intervention. 2. True or False: Anaerobic metabolism produces some toxic byproducts like sulfuric acid. 3. True or False: Ultimately, a staged death results from a lack of oxygen to the cells Training Materials Quiz: Shock Treatment, Pt. 1

96 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. The basic order of Fick’s principle is: a. Oxygen comes into the lungs – Oxygen passes through the brain and then to the heart – Red blood cells transported from heart to cells at capillary level. b. Red blood cells transported from heart to cells at capillary level – Oxygen comes into the lungs -- Oxygen passes across the alveoli to red blood cells. c. Oxygen comes into the lungs – Oxygen passes across the alveoli to red blood cells – Red blood cells transported from heart to cells at capillary level. d. Oxygen passes across the alveoli to red blood cells – Blood passes through the pericardium to the heart -- Red blood cells transported from heart to cells at capillary level Training Materials Quiz: Shock Treatment, Pt. 1

97 Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Match the Hemorrhagic Shock classes with the correct set of presentations: a. Class 1 1. Marked tachycardia, decreased systolic BP, decreased (or no) urinary output, cold & pale skin. b. Class 2 2. Marked tachypnea and tachycardia, decreased systolic BP, and significant changes in mental status. c. Class 3 3. Min. tachycardia, no changes in BP, capillary refill > 3 secs. d. Class 4 4. Tachycardia (rate >100 BPM), tachypnea, decrease in pulse pressure, cool, clammy skin, delayed capillary refill. Printable quizzes follow the answers on slide 100 in the.PDF version of these training materials. (Answers on Slide 100) Training Materials Quiz: Shock Treatment, Pt. 1

98 Emergency Services, LLC / Copyright 2007 / Volume Kramer vs. Kramer Essay Questions Firefighting in Wood vs. Metal Buildings 1. Which in your opinion are more difficult to fight: fires in wooden buildings or fires in metal buildings? 2. From a tactical perspective, list the benefits and drawbacks of metal vs. wooden buildings. 3. What special equipment is required by the fire department for effective fire control in either wood or metal buildings? If you’re enrolled in the Open Learning Fire Science Program at the University of Cincinnati, complete written responses to the following three essay questions to earn one college credit hour for watching Working Fire Training Training Materials Evolutions 2000 – Continuing Education

99 Emergency Services, LLC / Copyright 2007 / Volume ENROLLMENT INFORMATION: For more information on enrolling in the Open Learning program to gain college credit, call Working Fire Training at for a brochure or, to register directly, call the University of Cincinnati at 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 Training Materials Evolutions 2000 – Continuing Education

100 Emergency Services, LLC / Copyright 2007 / Volume Thanks so much for viewing Working Fire Training! See you next month – stay safe! Answers: Hands-On – Half-Attic Fires, Pt. 3: Quiz on Slides 43-45: 1. False 2. True 3. False 4. a 5. d Aircraft Fire Simulator, Pt. 1: Quiz on Slides 65-67: 1. False 2. False 3. True 4. b 5. c Fire Medics – Shock Treatment, Pt. 1: Quiz on Slides 92-94: 1. True 2. False 3. True 4. s 5. a-3, b-4, c-2, d-1 TRAINING Working Fire Training Training Materials Printable quizzes follow these answers in the.PDF version of these training materials.


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