On a structure fire call, my captain told me to have my mask on but not on air when I get out of the truck. Of course I will follow his directions, but I was wondering if it's better to mask up before making entry. On some calls, captains got off the truck with their mask on, and their inital size up to dispatch was really difficult to understand, their mask was all foggy, and it's hard to understand their directions. That's just my opinion...brothers and sisters, what do you think?

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We have brand new MSAs with the Firehawk regulators and nose cups.
We sweat like crazy in them, and it's worse when you wear the mask without the cooling effect of using the cylinder air.

The studies to which you refer are not conclusive by any means. They show some elevated cyanide levels in some firefighters, but they don't show a direct link between those levels and firefighter fatalities. Obviously, smoke and everything in it isn't good for us, but it's not the only hazard to firefighters - or even the worst one.

ALL chemicals have levels at which they're IDLH and levels at which the TWA lets you work safely in them for an 8 hour shift or 40 hour week without any protection and without any measurable short-term or long-term health effects.

The studies that show the effects of heat stress, on the other hand, are conclusive. They're prospective studies with scientific controls on multiple other variables. They clearly show that heat stress causes dehydration even in physically fit, well-hydrated firefighters. That dehydration thickens the blood and makes it more vulnerable to clotting. The clots cause heart attacks. It's no surprise that heart attacks - not smoke or smoke product inhalation - are the leading cause of firefighter LODDs. That's why LODDs have autopsies. When the autopsy shows that the firefighter's heart was infarcted by a clot, it's the clotting mechanism, - not cyanide - that caused the LODD.

Wearing the mask and hood restricts evaporative cooling from your head - a major source of evaporative cooling. Blocking a major part of your body's cooling mechanism, especially when the rest of it is blocked by your turnout gear - in a non-IDLH environment where you aren't in smoke adds to heat stress. The mask by itself probably won't kill you, but it adds to heat stress. Every little bit of heat stress we can prevent will help keep us alive.

Or...to put it another way...if wearing your mask without breathing the cylinder air is good for you, why don't the drivers and chiefs do it? More importantly, why don't you just wear your mask for your entire 24-hour shift if wearing the mask without breathing the air is a good thing?
Rain-X isn't an approved product by any SCBA manufacturer that I've ever heard of, and more importantly, it may off-gas toxic byproducts directly into your lungs when it's heated.

Or, to put it another way, if breathing Rain-X is good for you, why don't we use it as an additive in our breathing air cascade systems?

I'll pass, thanks.
For me it has always been up to the person me I like to get a clear look at what I'm going to be going into before i go in. Some people on my dept like to mask up in the truck which again is up to them.
Most of the time the firefighter puts his mask on a couple block from the fire. However the officer giving scene size-up does not have on his mask while he is talking to dispatch.
Cody, With no mask, outside the structure, you are out of the smoke in the vast majority of cases. Even if you get a little smoke, you are not getting it in IDLH quantities. (IDLH equal Immediately Dangerous to Life and Health, if you're not familiar with the term.)

Most of the smoke from a fire isn't going into your lungs, and smoke is only one of multiple hazards at fires. Heat, poor visibility, etc. Masking up enroute may save a little time, but more firefighters get hurt running into action in the interests of being fast instead of slowing down and being safer. My goal is to be safer at fires, not faster.

If you put RainX in your mask and it gets hot and starts vaporizing, it's going right into your lungs. It has nowhere else to go. That means that you are intentionally adding a toxin inside your mask and into your lungs. That just doesn't sound smart to me, no matter how you were trained. Check the label on a big bottle of RainX the next time you get a chance. Look for environmental and health cautions on the label and the active chemical ingredients. Then look up the chemical ingredients in your Hazmat ERG. You may be surprised by what you find.
Say what????

"As you should know, cardiac arrest due to interrupted blood flow to a coronary artery doesn't happen quickly or spontaneously." Cardiac arrest due to interrupted blood flow happens quickly and spontaneously every day.

It's called "Sudden Cardiac Death Syndrome". The firefighter LODD version of it is simply due to dehydrdation causing blood thickening that in turn increases coagulopathy and causes clots. It doesn't even take any coronary artery disease...just a clot big enough to clog a tiny artery.

And...when firefighter LODD autopsys show fully obstructed coronary arteries from acute clots, that's not HCN at work. HCN may mimic infarct damage, but there's no way it mimics the clots that are found on a gross anatomical view of the coronary arteries during an autopsy.

And...we mask up completely out of the smoke on a routine basis. We just take the time to look around with a completely unobstructed view of the scene first. We also stage our RIT team out of the smoke, and out of their facepieces.

Interestingly, the new NFPA standards call for apparatus designs that keep helmets off in the cab. Further, some departments are now going away from SCBA seats, due to the number of firefighters that are injured and killed in apparatus accidents due to fumbling around with their SCBAs so they'll "be ready to go" at the scene instead of riding secured in their seat belts. There's nothing wrong with SCBAs in a compartment.

And...if your RIT is staging near the command post, you might want to station a carbon monoxide monitor with them. Command post vehicles are notorious for the amount of exhaust gases they produce.

And...if your apparatus is parking so close to the scene that it's necessary for you to exit the apparatus in your mask, then according to your arguement, you should be seeing your apparatus operators dropping dead like flies, because they don't wear SCBA while running the pump or the aerial ladder, and they're exposed to the smoke for a lot longer than the few seconds that it takes to stretch a line and then mask up.

Pardon my disbelief in your theory when you tell me that putting chemicals inside your mask is a good thing.
I would put the mask on just before entering . you would want a clear picture of what is going on . Also your assignment may change when you get on scene. be safe
well said Bill...
Cody,

When you said "Ben, slower is not always safer.", can you explain how slowing down and looking at the scene with completely unimpaired vision makes things less safe?

Also, when you said "NO ONE should be near a burning structure without being on air PERIOD!" does that include high-rise fires on the 20th floor? Does that include the chief officers who are running Command, Safety, and Division C? Does it include the pump operators and turntable operators on the aerial ladders?

I don't enter burning buildings nor do I make a habit out of being in even light structure fire smoke without wearing my SCBA and breathing the cylinder air. We don't make a habit out of parking the apparatus in the smoke, so we don't need to exit the rig while wearing the SCBA. It's possible to mask up out of the smoke without wearing it in the rig. If you assume that I breathe smoke just because I don't advocate masking up in the rig, you're mistaken.

As for treating cyanide poisoning, there are only two ways to treat it: the Lilly Cyanide Kit and the Cyanokit (Hydroxocobalamine). The Lilly Cyanide kit is intended for cyanide gas direct inhalation, not cyanide in smoke. If you give it to smoke inhalation patients, it will actually make them worse, as the chemical reactions in the bloodstream actually increase the patient's hypoxemia. The Cyanokit shows promise, but it works in the bloodstream, not in the myocardium. Cyanide's primary method of action is not blocking blood flow to the myocardium, it just blocks the red blood cells' ability to carry oxygen. That makes the myocardium hypoxic from lack of oxygen in the circulating blood, which is a very different mechanism than blood clots forming, as occurs with either traditional heart attacks from coronary artery disease and with heat-stress-induced firefighter heart attacks secondary to dehydration. And...if you're right about cyanide being the big cause of firefighter heart attacks, it shouldn't matter if we all weigh 500 lbs and never take a sip of water after a fire, as would be the case if physical fitness and hydration and rehab are really important. You guys do work out and drink water while on duty, don't you?

The studies that show firefighter exposure to cyanide in smoke have a little secret, too. They track firefighters that enter IDLH atmospheres without SCBA air, not firefighters that mask up in the yard. There's a big difference between going interior without a mask and just masking up in the front yard at a house fire.

And...once again, smoke isn't the only hazard at fires, and if you focus on protecting yourself from smoke before you even exit the rig, you may be creating three or four hazards for every one from which you protect yourself.
I would only mask up in the truck if the truck was on fire....

TCSS
That's a good one Reg LOL
I say wait before you enter the structure... I have done the put your mask on before you exit the truck and it sure does suck entering a burning building when you are fog and can only see out of one eye. I say deff before you enter the burning building!

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