My latest blog post asking a serious question about real life fireground emergencies

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Robert - Great post brother... I train our firefighters on RIT, one of the tools for which I expect to be seen on our RIT tarp is an AED.  Not to take inside during RIT deployment but it is for the downed firefighter having a medical emergency or post removal of the interior downed firefighter. We also trained on the proper removal of super heated gear. But you are correct, most of these medical emergencies are exterior of the dwelling.  In my department this "play" is not a difficult one, as everyone here is cross trained and we run the bus. More than half of the firefighters here are paramedics.   


Great post though, as most RIT or RIC curriculums do not consider any type of exterior medical emergency and figure the stand by ambulance is responsible for this emergency. But the stand by ambulance might be staged further away than RIT and those seconds might make the difference in resuscitating a fallen brother.

Thats great stuff, probably something I will recommend we start doing, (having an AED or monitor with us) just makes good sense.


I know once our ambulance gets there they are supposed to bring full cspine immobilization, Monitor, o2, aide bag and stretcher and set up rehab. Thay way they can deploy with most everything they need in the event something happens. But what about until they get there, what about the rural systems? Gotta have a plan, thanks for the reply

I agree, and our bus sets up the same for rehab. But often rehab/EMS is about a block away dependant on the amount of hose laid out. They multi-task and we do not have an EMS crew just standing in front waiting to deploy for a firefighter down, that is all RIT.  

Good post.


We don't have a seperate SOG for this, but we would initially handle this as a MAYDAY that required no search and no IDLH entry. 


Once we got the firefighter away from the immediate hazard area, we would treat the downed firefighter according to our standard medical protocols for whatever the problem is - dehydration, heat stress, respiratory distress, bee sting, cardiac event, or whatever.


We carry an AED, oxygen/advanced airways, trauma kit, and a limited amount of non-cardiac drugs that don't require a monitor (diabetic drugs, 1:1,000 Epi) on every engine company.  we also carry iced drinking water and sports drink powder on every apparatus with the ice water kept fresh.


Every firefighter here is at least medical 1st responder after no more than 2 weeks of employment, and at least an EMT-B during the 1st year of employment.  Approximately 45% of our firefighters are also paramedics.  Every line firefighter except Battalion Chiefs rides both the engine and the medic part of the time, and every firefighter maintains medical certifications and training.


We dispatch a medic unit on every report of a structural fire, smoke in a building, or wildland fire endangering a building as part of the initial assignment.  If there is an initial victim, the medic treats that victim and the IC immediately requests and additional medic.  The window for the 2nd medic to arrive is small, but as Robert points out, it does exist.   We also dispatch at least one medic unit to all technical rescues and all hazmats other than small petroleum hydrocarbon or similar spills.  We have an air/rehab utility that responds to all working incidents and a rehab bus that responds to any larger incident so that we can conduct rehab out of the ambient heat/cold/rain or whatever.


Every FD should have a plan to handle problems that occur during that window.

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