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 PHTLS Training 5: Assessment & Management, Pt. 1PHTLS Training 5: Assessment & Management, Pt. 1 Quiz EVOLUTIONS 2000 Kramer vs. Kramer Program Quiz Answers FIRELINE Swimming Pool Clubhouse Fire Pet Food Factory Fire Discussion Questions HANDS-ON Half-Attic Fires, Pt. 1 Quiz Rescue Search Dogs, Pt. 2 Quiz Working Fire Training 07-9 Training Materials

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 07-9 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

Emergency Services, LLC / Copyright 2007 / Volume DISPATCH/SIZE-UP Temperature, 40 degrees; winds, 30 mph. Heavy smoke was reported from a 75’ X 150’ swimming pool clubhouse/maintenance building located in the middle of a field in a park. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND/INCIDENT ACTION PLAN Upon arrival of the second alarm, heavy smoke and fire were showing. Crews were pulled out and a defensive attack was begun. –Mutual Aid was brought in. –Aerial master streams weren’t as effective since they couldn’t get close enough. A Water Liaison Officer was appointed to oversee water issues. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND/INCIDENT ACTION PLAN 5” LDH was brought in closer across the grass, with smaller attack lines branched off. This impacts manpower usage. –Dragging LDH over 100 yards uses up manpower as do additional crews needed to man these handlines. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND/INCIDENT ACTION PLAN As they were expecting a roof collapse because of truss construction, a collapse zone was set up in preparation for it. Command expected to tow units out. –When throwing lots of water in a park land area, the ground will become so saturated that trucks will become stuck. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Following first-in crews, a second alarm was struck almost immediately. –The fire was well-involved upon its arrival. –There was no knowledge of what the building contents might have been. Crews were pulled out and apparatus was put in place for a defensive attack. –Mutual aid units were set up on all corners of the structure with three aerial units and elevated master streams in operation. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Additional long hose lays had to be stretched 600’ to 1000’ to distant hydrants to increase the water supply. –Tandem pumpers did relay pumping into the system. Monitors branched off LDH helped supply water on the C side where apparatus couldn’t get in close. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume EVENTS A defensive attack was declared and apparatus was put in place to support that. Apparatus began to sink into soft ground and grassy areas and walkways were cracking from the weight. Flying embers were threatening homes in the nearby residential areas. Even with 4” mains, water supply became an issue; one hydrant was initially locked behind a fence. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume EVENTS Pool maintenance personnel were later found who gave information on the building’s contents. There was some gasoline in the building and some explosions were heard inside the building, presumably from igniting vapors. The roof finally collapsed. Tow trucks were brought in to tow out three apparatus that had become mired in the soft ground. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume REMARKS In this incident, the exterior defensive attack was the right thing to do because of the truss roof. –However, the second alarm might have been held off due to there being no exposures to protect. –They probably could have contained the fire with the four first-in crew engines and one truck. –A second truck wasn’t utilized as apparatus but the manpower it brought was useful. Extra alarms are often called for the manpower the apparatus brings, not the apparatus itself. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/ BEST PRACTICES Based on this fire, the department is suggesting a new SOP to allow Incident Commanders to bring in two pumpers automatically for relay pumping when they have to execute long hose lays. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES In general, calling for a second alarm a little sooner might also bring extra apparatus and manpower sooner to help execute the new SOP. Fireline Incident: Swimming Pool Clubhouse Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume DISPATCH/SIZE-UP Heavy fire was showing upon arrival. Second and third alarms were pulled almost immediately. The warehouse facility was almost totally lost with minor explosions heard. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume INCIDENT COMMAND /INCIDENT ACTION PLAN A third alarm was pulled, bringing in tankers from rural mutual aid departments. A defensive attack was mounted against the warehouse. With the warehouse nearly lost, it was determined to make an interior attack to try and save the production facility. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS Initial apparatus placement included engines on the west and south sides. Two aerial devices were put in service. A tanker shuttle operation was put in place to assist defensive attack on the warehouse on the east side of the facility. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS To aid the water supply situation on the west side, 5” hose was stretched across railroad tracks to another hydrant. The railroad assisted by tunneling under the tracks so the five-inch could be run under the tracks; thus passenger train service could continue. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS An interior attack was mounted using 2.5” handlines to push back flames advancing from the warehouse. –To do this, exterior defensive crews had to cease operations to conserve water. Exposure Protection –Crews also needed water to protect a 1,000-gallon propane tank nearby. –Water needs were critical. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STRATEGY/TACTICS This necessitated an evacuation by police on the west and southwest side of the facility plus removing onlookers who had gathered. Logistics: a large parking area by the loading docks allowed multiple fire trucks and tankers to work simultaneously. –Police had blocked off roads around the factory so apparatus could gain entry. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume EVENTS There was a heavy fire load due to pallets, shipping materials, and dry dog food and biscuits. Three alarms were pulled in rapid succession bringing approximately 80 firefighters to the scene. –Two aerials, six engines, and nine tankers were eventually in place. IC mounted a defensive attack with aerials on the warehouse. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume EVENTS IC also launched an interior fire attack in an attempt to save the production facility. Communications was important here because of the number of mutual aid units but it went well. –Due to the length of the incident, radio batteries started to die and had to be replaced. Four personnel went down from the heat including three chiefs. –Always remember to maintain adequate fluid replacement; chiefs as well as firefighters! –This is one of the main functions of Rehab. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume REMARKS The city department wasn’t as familiar with drafting techniques as the rural departments were. An interior attack was attempted in the production facility in part because water pressure problems were limiting the effectiveness of the aerials. The propane tank exposure, possible additional hazardous materials inside the building, and possible runoff outside extended the evacuation area to a number of blocks in radius. The interior crews had success but due to a lack of water would have to keep pulling out. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume REMARKS Stacked dog food pallets created a chimney effect pushing air up through the pallets and whatever material was on fire there (dog food, packing material, cardboard, etc.); large fire load! Always remember to maintain adequate fluid replacement. –But do commanders go to rehab for fluids as often as they should? Two million gallons of water were eventually pumped on this fire. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES Always preplan your mutual aid departments and their radio frequencies; then pick a common frequency. Understand how they operate. –Conduct a face-to-face with mutual aid commanders upon their arrival to get on the same page. –It’s too late once you’re both at the incident. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume LESSONS LEARNED/BEST PRACTICES Preplan and conduct inspections at large venues such as this, especially if they have lots of fire load and/or hazardous materials. In hindsight, we would like to have changed the aerial apparatus placement. Don’t always expect your hydrants to give you what you think they should. Fireline Incident: Pet Food Factory Fire 07-9 Training Materials

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? 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume Swimming Pool Clubhouse Fire / Wilmington, DE Ops. Chief Joseph Kalinowski, Wilmington (DE) Fire Dept. Battalion Chief Edward Hojnicki, Wilmington (DE) Fire Dept. This was an unusual fire because of the difficulty of getting apparatus close. This kind of venue is a good one to preplan so you’ll know what to do immediately if and when it happens. Anticipate heavy manpower needs when you have to haul hose long distances. This will mean manpower replacement sooner than expected. This is also a good example of a fire where mental preparedness of firefighters en route is important. This pool venue was well-known to all of us, which meant we should have mentally preplanned what might be waiting for us. Chlorine was first on the list; cleaning agents were also a good guess. Get in the habit of doing this mental inventory. Fireline Incident Discussion 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume Pet Food Factory Fire / Monmouth, IL Asst. Chief Brian Moorefield, Monmouth (IL) Fire Dept. Asst. Chief Patrick Spears, Monmouth (IL) Fire Dept. The fire load at this location was enormous. When you encounter this, immediately think about water sources. We had railroad tracks adjacent to the plant which were an obstacle to reaching hydrants. Your preplan should have prepared you for this; therefore, en route you should be calling for support from the railroad. We did and got great help from them. Factory/warehouse structures often have truss roofs. This means crews and commanders alike must be watching the progress of the fire when doing interior work. If you have doubts, get out! On a hot day at a hot fire, always remember to hydrate – commanders as well as firefighters! Fireline Incident Discussion 07-9 Training Materials

Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand how: to reduce firefighter risk and the cause of firefighter deaths to increase firefighter efficiency in fighting fires in these special buildings. 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

Emergency Services, LLC / Copyright 2007 / Volume HALF-STORY CONSTRUCTION Fires in these buildings are always serious by their very nature. –It is the cause of many firefighter deaths each year. Strangely enough, half-story architecture does not pose an abnormal risk for occupants if smoke alarms are in place and operating correctly. However, the mechanism of the fires in these structures presents great danger to firefighters –In addition, these fires are relatively rare which increases firefighter risk. Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume HALF-STORY CONSTRUCTION These fires occur in high-hazard, concealed spaces as a result of the half-attic construction style. They go by a variety of names: –Dutch Colonial –Half-Story –Salt Box –Victorian –Cape Cod and Mansard which are not technically half-story but present similar hazards and risks. Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CAUSES OF HALF-STORY FIRES Children smoking in hip-wall closets Bottle rockets on eaves of roofs Burning paint or heating shingles Over-lamping, recessed ceiling fixtures, and faulty fireplace chimneys. Hands-On: Half-Attic Fires, Pt Training Materials Fires get into these confined spaces from other places.

Emergency Services, LLC / Copyright 2007 / Volume FIRE DYNAMICS There are two basic reasons why these fires are so dangerous but they are rarely studied in Firefighter I & II. –Fire under pressure –Fires that burn with insufficient oxygen. Fire under pressure leads to flashover, backdraft, and other fire behavior such as swift-moving fires. –Remember, a typical roof-and-contents fire can flash over in 42 seconds from point of ignition! –Fire can move rapidly and get out of control quickly! Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume FIRE CHEMISTRY In the typical, clean-burning methane or propane fire, adequate temperature separates these gases into carbon and hydrogen. –Carbon and oxygen in the air burns and creates CO2 (carbon dioxide). –Hydrogen and oxygen in the air burns and creates H2O (water). When wood burns, it doesn’t burn cleanly, and in fact, creates a fuel that can endanger firefighters. Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume FIRE CHEMISTRY Wood is cellulose, a long polymer molecule (why a baseball bat has its “snap”). It has carbon, some hydrogen, and some oxygen, similar to methane or propane, but it doesn’t always burn clean. Why not? The yellow-orange smoke tells us this fire has incomplete combustion where the wood products involved are receiving insufficient oxygen. Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume FIRE CHEMISTRY The only other things that could burn with that color are nitrous oxide or nitric acid which would not be found in the typical residence. This incomplete combustion will be covered further in subsequent parts of this series. Hands-On: Half-Attic Fires, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ 1. True or False: Yellow-orange smoke is due to incompatible combustion. 2. True or False: Wood is a long, cellulose molecule. 3. True or False: A room can flashover in 42 seconds Training Materials Quiz: Half-Attic Fires, Pt. 1

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which construction style does not involve a half-attic? a. Salt box b. Victorian c. Split-foyer d. Dutch Colonial e. Mansard f. None of the above 07-9 Training Materials Quiz: Half-Attic Fires, Pt. 1

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which of the following could be caused by an outdoor fire under pressure? a. Backdraft b. Flashover c. Wind-driven exposure fire d. Two of the above e. None of the above (Answers on Slide 80) 07-9 Training Materials Quiz: Half-Attic Fires, Pt. 1 Printable quizzes follow the answers on slide 80 in the.PDF version of these training materials.

Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: – procedures for a dog and handler – working in confined spaces – rappelling from a building – working with a zip line. CODES, STANDARDS & REGULATIONS NFPA 1670: Standard on Operations and Training for Technical Search and Rescue Incidents Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CONFINED SPACE EVOLUTION Purpose –To lower the K-9 team into a tube to simulate entry to any venue that cannot be accessed directly from a below-grade location: a cavern, cave, or some outdoor venue of that type a man-made environment such as a building collapse where a dog could be used to search lower-floor void spaces. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CONFINED SPACE EVOLUTION Rigging –A tripod is rigged over the hole and rigged with (in this case) a 4:1 mechanical advantage to lower the handler and dog. –The dog is attached to the handler’s harness so the handler can control the dog with his free hands or work with the ropes safely and assist with the descent. –Approximately two to four people are necessary to assist with this operation. –The rigging is set up to do raises as well as lowers, so the K-9 team can be retrieved. –All rigging is double-checked for safety. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CONFINED SPACE EVOLUTION Operation –The handler, with the dog between his legs, positions himself over the opening. –He then carefully loads the system with his weight. –On command, the haul team controls the descent and begins to lower the handler and dog. –Team members help with attending to the dog, moving his paws off the edge of the opening so they don’t get caught, watching the dog’s head, etc. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CONFINED SPACE EVOLUTION Operation (cont.) –It is advisable for K-9 team members to call ahead so rescuers can have the rigging ready in advance. –Anticipate the need for a K-9 team early on, just as you would any specialty rescue team. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume CONFINED SPACE EVOLUTION Operation (cont.) –A K-9 team may not be available in or nearby your area, so call early if they have to come from a distance – travel takes time! –Understand that like people, dogs have their strengths and weaknesses. Not all dogs like confined spaces and want to hold on to things. Be ready to help pull the dog’s paws in and protect the dog’s head. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume BUILDING RAPPEL EVOLUTION Purpose –To lower the K-9 team from a higher grade to a lower level that is not accessible directly from that lower level, such as: being lowered from a roof or upper part of a structure being lowered from a cliff or peak at some outdoor venue. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume BUILDING RAPPEL EVOLUTION Rigging –The handler controls the rate of descent using a rope rack system. –The anchor point in this evolution is from a higher point above. –Always use a safety or belay line which would be controlled by the support team. These support team members are critical to safe operations! –Again, the dog is attached to the handler’s harness. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume BUILDING RAPPEL EVOLUTION Operation –The dog is held by a support team member while the handler’s rigging and rope rack are secured. –The team member releases the dog gently as the dog loads the system with his weight. –Another support team member spots the K-9 team at the bottom of the descent. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume BUILDING RAPPEL EVOLUTION Operation (cont.) –In terms of high-angle rescue technique, a K-9 team rappel is very similar to a two-person descent; for example, a rescuer and a rescue victim). –As does the dog, the rescue victim would also have his/her own harness and be connected to the rescuer’s harness. –However, the dog is trained for this and works well with the handler. In a rescue situation, the victim is often not so accommodating. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume ZIP LINE EVOLUTION Purpose –A zip line would be used, for example, where a river has to be crossed but is too wide to use an aerial ladder rappel. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume ZIP LINE EVOLUTION Rigging –Rig the zip line with the starting side higher than the destination side. –A 4:1 mechanical advantage is again a good choice for the rigging, using a figure-8 descender device on the rescue rope to control descent. –On command, the haul team on the lower side of the zip line controls the descent as well as controlling the height of the line by tightening the rigging; this carries the K-9 team over obstacles that might be encountered. –This is another example of rigging that could be set up before the K-9 team ever arrives on the scene. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume ZIP LINE EVOLUTION Rigging (cont.) –This evolution is very labor-intensive. –Someone needs to help the dog and handler get set up and launched on the zip line –Another person on the starting side will control the safety line of the dog and handler, controlling the slack on that line. –An additional four people will operate the 4:1 mechanical advantage rigging and manage the slack and weight on the main line. –Rigging is double-checked for safety before loading it. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume ZIP LINE EVOLUTION Operation –The handler connects the dog’s harness to his own. –As with the building rappel evolution, the K-9 team is assisted by a support team person who holds the dog as the handler gets ready. –The haul team on the destination side is responsible for the raising or lowering of the zip line and the rate of descent from the starting side. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume COMMUNICATIONS Communications are very important in all these evolutions by using: –verbal communications by radio or by shouting commands –non-verbal communications using hand signals. A zip line might cover hundreds of feet in which case verbal communications could only be achieved by radio. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume COMMUNICATIONS As the haul team controls movement of the K-9 team (starting and stopping the haul and controlling the rate of descent), clear commands must be given to the haul team, either verbally or by hand signals. –In this training, that would be the confined space and zip line evolutions. These commands should be understood and trained on in advance. Hands-On: Rescue Dogs, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: Most K-9 team evolutions can be executed by just the handler and dog. 2. True or False: A handler can perform a building rappel using a 4:1 mechanical advantage. 3. True or False: A zip line would be the right solution for raising a K-9 team to the top of a ridge Training Materials Quiz: Rescue Dogs, Pt. 2

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which of the following are NOT involved with a building rappel? a. A lower-level anchor point b. A rope rack c. A crew member holding the dog while rigging is completed d. A safety line e. All of the above 07-9 Training Materials Quiz: Rescue Dogs, Pt. 2

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which of the following are NOT involved with a zip line? a. 4:1 mechanical advantage b. Figure 8 descender c. Voice or hand signals d. Haul team controls the height of the line e. None of the above (Answers on Slide 80) 07-9 Training Materials Quiz: Rescue Dogs, Pt. 2 Printable quizzes follow the answers on slide 80 in the.PDF version of these training materials.

Emergency Services, LLC / Copyright 2007 / Volume OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: the importance of scene assessment the components of the primary survey the distinction between critical and non-critical patients the need for early transport of critical patients when to perform a secondary survey. CODES, STANDARDS & REGULATIONS Pre-hospital Trauma Life Support Training, National Association of Emergency Medical Technicians and the American College of Surgeons. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #1 It’s mid-January and you have been dispatched to a multi-vehicle crash on the Interstate. Initial reports say there are multiple patients and a fuel tanker is involved. –When does your scene assessment begin? Immediately upon dispatch! –En route, you should be running “what-ifs” in your head: What do I need to do? What may be the potential hazards I may experience? What challenges may I face on scene? Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #1 Components of Scene Assessment –Scene safety should be #1 – our safety as well as that of the patient. Especially if scene hazards (such as haz-mat issues in this scenario) present a threat. In fact, our patient may be a by-product of these scene hazards. Threatening situations may include: –Fire Traffic –Electrical lines Weapons –Hazardous materials Environmental conditions –Blood and bodily fluids Are there other hazards? Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #1 How do we react to these threats or hazards? –We usually take a cautious path. –We don’t panic, we stay cool, assess the situation, and make decisions based on our experience and the needs of our patient. –We tend to make decisions based on a global perspective, taking into account everything at the scene including the other agencies and the roles they play. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Your patient is a 32-year-old female, unrestrained driver who is found slumped over in the vehicle. –She has no obvious external hemorrhage, is breathing rapidly, and is mumbling inappropriate words. What do these findings suggest? How should you assess this patient? Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Scene Situation –What really happened? For us, what really happened is that we have injured patients to care for. Finding out additional details from fire or police may be helpful or interesting later, but they are not as important as, in this case, the young female patient. –What are the kinematics? What kind of energy was involved? Do we have a rapid de-acceleration of some kind? Do we have a high-speed projectile or a low-speed puncture wound, for example, from a knife? Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Scene Situation (cont.) –We often can tell what occurred as we approach the scene; for example, how the vehicles look in a vehicle crash. In this case, our female patient wore no safety belt. That should tip you off as to what kind of injuries you might expect. –How many patients are involved and how old are they? Check out the ages of the patients Patients less than 5 years and over 55 years are at higher risk due to poorer compensatory mechanisms and their conditions can deteriorate more rapidly. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Scene Situation (cont.) –Are additional resources needed? This will depend a great deal on how many patients exist. –Can you handle all the patients? Sometimes it’s tough to know. A protracted motor vehicle incident could be spread out over a quarter-mile with onlookers getting in the way. It might take a while to find how many patients there are. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Scene Situation (cont.) –Such a situation calls for START triage. Using a basic RPM checklist, ask, “Is this patient okay? If not, stay with him/her and direct your partner to another patient. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume SCENARIO #2 Scene Situation (cont.) –How will patients be transported? This decision will be mitigated by the severity of trauma you discover and any Golden Hour implications. –The female patient here may have severe trauma. Ground transport might not be quick enough for a severely injured patient and air transport might be your best option if it is accessible. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STANDARD PRECAUTIONS Gloves –These are pretty standard in all cases. Eye protection –It’s an excellent idea but we often don’t think about it until later in the incident. Masks –That’s another precaution we often don’t take. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume STANDARD PRECAUTIONS Gowns (Turnout Gear) –Gowns or turnout gear, as well as eye protection and masks, are all, in theory, a good idea in an obvious blood-borne pathogen situation or where there is a high presence of blood or bodily fluids. However, in a situation where a person is leaking bodily fluids and is unstable, it would be hard to justify the delay in rendering care by stopping to put on a gown because you’re afraid of getting some blood on your clothes. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume PATIENT ASSESSMENT Primary survey –Whether PHTLS, ACLS, or BTLS, they all begin with some kind of a primary survey covering the ABCs. –You look for life-threatening injuries or anything that could end the patient’s life quickly. –These need to be dealt with; i.e. “Treat as you go”. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume PATIENT ASSESSMENT Resuscitation –Not only patients in cardiac arrest might need resuscitation. –Other patients might also need it if: they are unstable due to an internal bleed and are in a hypovolemic state they have an altered level of consciousness because of a possible head injury they are volume-depleted due to poor blood circulation to the brain and have a mentation issue, secondary to their hemodynamic instability. –With these patients as well, resuscitation is a real possibility. Be thinking about their airway. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume PATIENT ASSESSMENT Resuscitation –And when patients are packaged in the ambulance taking some big IVs – that’s resuscitation, too. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume PATIENT ASSESSMENT Secondary survey –This is something we can spend a little time with in the field once we’re sure that any primary life threat has been dealt with. Definitive care in the field –These would be techniques that we might be called upon to do that are rather invasive in nature. For example, a cricothyrotomy or a needle thorencentesis. –But IVs and using a bag valve mask (BVM) when someone is breathing too fast or too slow are also examples of definitive care – just not as flashy nor nearly as invasive. Fire Medics: PHTLS 5: Assessment & Management, Pt Training Materials

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: Scene assessment starts as soon as you’re dispatched. 2. True or False: A paramedic’s or EMT’s safety on scene is not nearly as important as the patient’s safety. 3. True or False: When we’re on scene we have to focus on the patient; we can’t be worried about what fire or police is doing Training Materials Quiz: PHTLS 5: Assessment & Management, Pt. 1

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. When we arrive on scene we may find threatening situations. Which of the following would NOT be considered threatening? a. A police dog barking angrily b. Downed electrical lines c. Hazardous materials d. Blood and bodily fluids e. None of the above 07-9 Training Materials Quiz: PHTLS 5: Assessment & Management, Pt. 1

Emergency Services, LLC / Copyright 2007 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ 07-9 Training Materials Quiz: PHTLS 5: Assessment & Management, Pt. 1 Select the best answer: 5. Which of the following is one of the standard precautions providers SHOULD take when on scene? a. Antihistamine b. Gloves c. Rain coat d. Sunglasses e. Athletic supporter Printable quizzes follow the answers on slide 80 in the.PDF version of these training materials. (Answers on Slide 80)

Emergency Services, LLC / Copyright 2007 / Volume Kramer vs. Kramer Essay Questions Large Apparatus vs. Small Vehicles 1. Should a fire department expand its fleet to include all-terrain vehicles (ATVs) or other equipment to ensure that it can access all properties in its jurisdiction? Why or why not? 2. Briefly estimate the cost of additional ATVs in a fire department fleet and do a brief cost/benefit analysis to determine if they are worth the investment. 3. What recommendations would you make in updating your fire department fleet? Or why do you feel that no updates are necessary? 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

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

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. 1: Quiz on Slides 37-39: 1. False 2. True 3. True 4. c 5. c Rescue/Search Dogs, Pt. 2: Quiz on Slides 56-58: 1. False 2. False 3. False 4. a 5. e Fire Medics – PHTLS Training 5: Quiz on Slides 75-77: 1. True 2. False 3. False 4. a 5. b TRAINING Working Fire Training 07-9 Training Materials Printable quizzes follow these answers in the.PDF version of these training materials.