... and I don't mean as a firefighting procedure.

I started this as a blog but decided to post it on forums. Stay safe out there Brothers and Sisters.



To date, 28 firefighter fatalities have been reported to USFA in 2008 as a result of incidents that occurred in 2008. USFA does not have a Line-of-Duty-Death (LODD) criterion nor does it make LODD determinations. “Please note, running totals of firefighter fatalities used on these initial notices do not necessarily reflect the number of firefighter fatalities used in totals for the (provisional) monthly year-to-date USFA firefighter fatality reports, or year-end (provisional) reports posted online http://www.usfa.dhs.gov/fireservice/fatalities/statistics/ff_stats....

So, here we are not even 3 months into 2008 and already I have lost 28 Brother Firefighters in the Line of Duty. If this trend continues, 2008 could result in just about 150 Firefighters dying in the Line of Duty. This is totally unacceptable. There are far too many Brothers and Sisters being killed and the trend, according to statistics I have seen, shows it ever increasing. In 2006 there were more deaths than, the previous year and in 2007 there were 9 MORE deaths than in 2006. Now we may be looking at close to 150 this year. This cannot happen, should not happen and something has to be done about it.

I'm tired of seeing the wives and children of people I know suffering through the loss of a husband and a father. I'm tired of seeing that long blue line of Brothers and Sisters bidding a last farewell to another hero and I'm tired of seeing that long red line of fire apparatus carrying the flag draped caskets of another lost to the beast. And that long blue line and that long red line just keep getting longer and longer every time I look at them. Every footstep in the march to the graveyard getting heavier, every beat of the drums, even though muffled in black crepe, getting louder and louder. I'm tired of seeing the tears in the eyes of men stronger than I mourning the loss of a friend and I'm tired of the air of "Amazing Grace" from the pipes and the trumpeting of "Taps" from the horn. I'm tired, tired...

And why are we dying? And more important, what the hell can we do about it? Last year the majority of deaths were still on-scene, meaning the deaths occured at a fire, 37 and then there were 8 more onscene-other, whatever the hell that means. But the next 2 highest losses were while responding to the calls (24) and in training (11). I can see losses on-scene, one things for sure, Firefighters die fighting fires. And we also die in MVA's responding to calls but for that to be the second highest cause of LODD's is amazing. Why? Is it our fault? Are we not teaching our people the proper handling of Fire Apparatus? I'll tell you one thing, if any of my Firefighters think that those few extra seconds they make in getting on-scene by speeding to a call are not going to be apparatus operators for very long. Us getting there 30, 60 or 90 second sooner in most cases isn't gonna make a shit. But us not getting there at all because of stupidity in speeding to a call and being involved in an accident WILL have dire consequences on those in need of our services and on those involved in the MVA. Rule #1, slow the fuc# down and get there. And the third highest loss, TRAINING. I can see guy's dying for not being properly trained, and BTW, training NEVER stops, but why the hell are we killing them before they even have a chance to fight a fire?

I'm an old school Firefighter, maybe some of the things we did way back when aren't the way they do it now-a-days but I'll tell you one thing, we didn't lose as many Brothers. We had our training academies, being what they were at the time, but what you learned about the job you learned on the job. The best partner you could have back then was the oldest guy on the group. He's the guy who would show you the tricks of the trade and he was the guy who would throw your ass into a situation and then show you how to get out of it. It weren't no book lernin' sitziation either, it was real flames, lickin' at your ass and you having to figure out how to get out of it. I guess it doesn't work that way today. Everybody is an expert and every other guy is a "specialist". Kinda like being a Doctor I guess.

And here's a couple of good statitics, in 2007 the 2 main "causes" of LODD's were Stress/Overexertion (55) and 26 vehicle collissions. Vehicle collisions accounted for more causes of deat than caught, trapped, fell or lost, COMBINED. Stress and overexertion, translates to me to stroke, heart attacks and too much rigorous training. Of the 100 and something LODD's in 2007 FIFTY-TWO (52) were from heart attacks. And I'll bet half or more of the 11 training deaths were from heart attacks. Some say the deaths are the "youngsters" because their new at the job and are more likely to become a LODD or it's the guy getting ready to retire that is too old for the work. Think again, the main age group for LODD's is between 30 and 50 years of age. People who have been at this line of work for more than a few years and people who should be young enough to still handle the rigors of the job. So what do you say now, it's not the youngun's running off half cocked and it's not the old fuc#s keeling over with a heart atatck or stroking out. It's what should be middle-aged, well experienced, somewhat health people who are dying.

Let's tackle a few more. On-scene, now that's the way to go. I swear that when my time comes to pass into another world if I don't die in the sack getting.... er, never mind, I want to die at the end of a hoseline on the pipe, cutting a hole on a roof or rescuing a victim of a blaze. I want a Fire Chief's funeral. And that will add one more piece to the long red line. Why are we losing Firefighters on-scene, TODAY. We have to talk about today because what happened in the past is gone. I will compare however, today and the "old days". Some say, I love that, some say, anyway, some say that we are losing more Brothers today because of all of the new products which give off more gases that in days gone by. I say, in days gone by we didn't have SCBA's which, if used when they are needed and how they should be used, SHOULD keep and protect us from harm. They are lighter and last longer than the ones I first used. So how come we weren't dying in the old days from overexertion from carrying these heavy taks around on our backs? When I first started we didn't have SCBA's, all the people I knew way back when are dying now from old age. Way back then, and I'm going back to the early to mid 60's, we had wooden stick that we had to crank to get it up, crank to turn it towards the building and crank it to extend. Now-a-days you push a button here and a lever there and voila, your in position. We weren't dying from overexertion from doing that. We didn't have Nomex suits, Nomex hoods, Nomex gloves, fire retardent station wear. We wore chambrais shirts (look it up) and dungarees. Our boots were made of rubber and so were our turn-out coats. We bought our gloves at the hardware store just like everyone else and we didn't have hoods to protect our ears. Our ears, if you listened to that old-timer that I told you about, were part of our firefighting experience. The oldtimers taught me that when you are fighting a fire and your ears start to burn, get the fu^k out. If it is hot enough to burn your ears it is hot enough to melt your coat, your boots and your helmet. GET OUT... Today we equip our firefighters with the best gear there is and guess what? All it does is allow them to get deeper and deeper into situations they shouldn't be getting into in the first place. And you wanna know what happens then? Firefighters DIE. I don't wear a hood, never wore a hood and will not wear a hood.

And, as Fire Marshal Bill use to say on SNL, "let me tell ya sumptin' else". Some say, here we go again, that some LODD's are caused from the shock of FF's being awoken suddenly from sleep and the resulting stress from this, or mistakes caused because one is not quite alert, are contributing factors to their deaths. Well, in 2007 the majority of LODD's occured between 0900 and 1100 in the morning and between 1900 and 2100 in the evening. As a matter of fact, the number of LODD's which occured between 0100 and 0900 didn't even come to half of those which occured during the other two time frames. So there goes another one shot down.

And here I sit, still tired, tired of seeing the increase in the deaths in our profession and tired of venting to others about how I feel on the matter. But I'll continue to vent, bitch, piss, moan, whatever because, if by me doing that I can help save just one Firefighters life, it will be worth while. Stay safe out there Brothers and Sisters, stay safe and take care. Don't do anything that is not going to bring you home to your wife, your husband, your children, your parents, the woman or man you love, don't do it. People die in fires, but it doesn't have to be you, your partner or any other Brother or Sister. Be smart enough to know when to get the hell out and to go home. One of these days I'll tell you about my good friend who lost his life doing what he loved to do. He went in to rescue two Brothers who were lost. They came out, he didn't. Don't put your loved ones through what his family and friends and Brothers and Sisters went through.

Da Chief

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Yeah; it's called a genetic marker.
Overweight might not be out of shape. I know of people who are 50 -60 pounds overweight, yet have no diabetes, high blood pressure or high cholesterol. But given their proclivity for continued bad eating and exercise habits, they have a good start towards some type of medical malfunction.
When an otherwise fit firefighter goes down with cardiac arrest during training, I know of at least two reasons: (1) Heat stress and (2)Cardiac arrhythmia caused by an undetected congenital problem, such as an enlarged heart or a valve malfunction.
That said, I believe I read somewhere where 65% of our firefighters are mildly to morbidly overweight.
And I can't argue with that!
TCSS.
Art
My point being that being overweight and/or out of shape gets blamed for essentially every firefighter LODD that is attributed to a "heart attack". There are at least four different cardiac events that get lumped into the "Heart Attack" category by the NFPA.

1) Poor diet leads to coronary artery plaque buildup, plaque ruptures, clot forms, and part of the heart muscle dies due to no oxygenated blood being delivered to the heart muscle downstream of the clot. Bad diet, lack of excercise, etc. is a frequent contributor to this one.

2) Coronary vasospasm (temporary artery constriction from unknown source) significantly narrows the diameter of a coronary artery, causing cardiac muscle damage downstream of the narrowed section. This one has a variety of causes, many of which are not linked to obesity, bad diet, or lack of excercise.

3) Heat stress-related blood clots, may be caused or exacerbated by the thickened blood and higher blood temperatures caused by a relatively normal firefighting event.

4) Cardiac dysrhythmia - a disruption in the heart's "electrical" system, unlike the other three mechanisms that are disruptions in the heart's "plumbing". If the power goes out, the heart stops beating. This one may be triggered by any of the above three events, or it may just occur on it's own in an otherwise healthy, non-obese firefighter with a great diet and otherwise healthy lifestyle. This one is what kills young, visibly fit athletes...and some of the firefighter recruits that die doing PT at the fire academy.

My point here is that getting in shape, reducing bad stuff (sugar, cholesterol, triglycerides) in the blood, staying hydrated, etc. may reduce your chances of the heart attacks that stem from coronary artery disease and ruptured coronary artery plaques, but that there is no guarantee. The best we can say is that being in shape and having a decent amount of cardiac reserve will probably help you do your job better. It will not, however, prevent you from having one of the heart attack types listed in 2, 3, and 4 above. Many firefighters talk (and write articles) focused entirely on the weight and excercise part of the issue as if good fitness levels are a panacea to prevent every heart attack LODD in the future. They demonstrably are not.

So...what do we do about it?

Regards,
Ben
Good points.

We just put a RAD 57 pulse carbon monoxide monitor in service and will be using it in Rehab to check for the exact problem you discussed.

We're also going to be more proactive about air monitoring fire buildings before allowing overhaul sans SCBA.

Why aren't you a chief yet? :-)
Overexertion, Heat, Adreleline, lack of sleep/generally tired, Stress of type of call, lack of food, (back to back calls) lack of accountable rehab, (everyone goes whether they feel they need it or not) Dehydration are just a few more reasons I feel that Cardiac issues are on the forefront of the LODD's. Being overweight is just a scapegoat in many cases. At times AGE is also a major factor which many are not accounting for.

In all fairness, some departments aren't strict with yearly physicals. Having a physical twice a year wouldn't kill anyone. (prostate exams not that often lol)

We all need to take care of ourselves to maximize the potential we have for a longer span of time. Eating healthy, a good exercise routine, and physicians overview is just the start. Departments need to face reality and offer more rehab sooner. Being inside a burning house at 12 noon on a 90 degree day will drain you much faster than working a fire on a day thats 40 degrees. (you have time to cool off) All departments have a lot of mutual aid (even if calling another alarm for more firefighters) and it isn't used to it's fullest potential. Have more people take on smaller assignments and preserve the crews energy and health over the entire call. These firefighters on scene are not just facing the call at hand, but the potential of another call at anytime. Without proper rehab, we are only compounding the extent of the potential injury.
We carry baby asprin on every medic company, and at least one goes to every working fire. Asprin is part of our MONA protocol for all chest pain/chest discomfort calls, be we haven't considered it prophylactically for rehab yet.

Maybe we should. I'll toss this one out at our next protocol committee meeting and see what our medical directors think.
Good points, Engineco913.

Firefighter LODDS, particularly the ones attributed to heart attack, are not single-variable problems, regardless of how they're classed by the NFPA and NFFF, and how they're percieved by the more fitness-minded among us.

I politely disagree with one of your points, though. You stated that "all departments have a lot of mutual aid..." Mine does not. We're the only department on a barrier island off the coast of South Carolina. We have one neighboring department that is fairly close. We can usually get one engine in 10 to 20 minutes and either a 2nd engine or a quint tower ladder in 10 or so more than that....and as Daffy Duck would say..." That's all, folks!

The next mutual aid we have is 30 miles or so away, so we're a long way from additional help. When I moved to Hilton Head, it was pointed out on my first day that King Neptune isn't too great of a mutual aid resource.

I'm also familiar with some places like the southern end of Clark Co., Nevada and numerous towns and villages in Alaska that are geographically isolated and have little or no mutual aid.

Folks, if you have lots of mutual aid, use it early and often. If you don't have it, your command staff will have to intervene early in the John Wayne syndrome to ensure that your firefighters don't literally kill themselves for their community.
From Thesecretlist:
ANNUAL NFPA FIREFIGHTER DEATH REPORT:
While the NFPA, USFA, IAFF, NFFF and others each have their "own way" of calculating and determining FIREFIGHTER LINE OF DUTY DEATHS for various reasons, but as always, the annual NFPA report is filled with extremely valuable information (see below to access the report).
According to the NFPA's stats, in 2007, a total of 102 on-duty firefighter deaths occurred in the U.S. This is a sharp increase over the 89 firefighter NFPA acknowledged fatalities that occurred in 2006, but returns to the long-term trend of close to 100 on-duty NFPA acknowledged deaths annually. The largest share of deaths (38 deaths) occurred on the fireground based upon their stats. Stress, exertion, and other medical-related issues, which usually result in heart attacks or other sudden cardiac events, continued to be the leading cause of fatal injury. Of the 40 stress-related fatalities in 2007, 38 were classified as sudden cardiac deaths by the NFPA.
From thesecretlist:
PA. FIRE INSTRUCTOR LODD:
It is with deep regret that we advise you that PA. Fire Instructor Sean Whiten, 47 of Stockdale (PA) a former Chief and Captain of the Roscoe VFC died in the Line of Duty yesterday during a training burn.
F.I. Whiten was operating at the Westmoreland County (Western PA) Fire Training Academy (South Huntingdon) and had lead several training burns when he decided to go to rehab. While at rehab, his vitals were determined to be good, he sat in front of cooling fan, felt better and went to an area to relax. Following that, he was found down, suffering from a medical emergency...personnel worked on him, an AED was used and he was transported to the hospital where he passed away.


My thoughts and prayers to all affected.
TCSS.
Art

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