Peanut Butter & Jelly Sandwiches (Under Staffing & Heart Attacks)

I believe that in some cases regarding fire service heart attacks that under staffing is a largely contributing factor. Now that is not to say that lack of physical fitness and unknown preexisting heart conditions are not. In my opinion Under staffing could be playing a major role in the contributing factors.
The following points are reasons for this, again in my opinion.

1. Less firefighters doing more of the work
2. Lack of utilizing mutual aid when under staffed
3. Mindset to focus on rescue & extinguishment first regardless of staffing
4. Advances in equipment

Let me explain these points. First in regards to firefighter under staffing, with a proper incident management personnel count of 10 or more at a minimum being foremost. Ten personnel maybe the agency in some districts or departments as most of could probably agree. So immediately this puts us behind the eight ball so to speak in available personnel for the incident. Ok, mutual aid you say, yes this is an option. And I say option because I have witnessed incident commanders opting out of or standing down a mutual aid response which leads me to point two. This I believe in some cases is due to pride and the "Get R Done" attitude or mentality. And then there is excersise which would mitigate heart attacks right? Well I don't believe that is always the case. Even the most fit individual will get tired and their body and its systems will only compensate for over exertion for so long before overload sets in. We go in deeper, pack more gear in, some times weighing as much or more than the old steel cylinders and yesteryear equipment when combined. We need to use our mutual aid options for additional staffing and set aside the "Get R Done" attitude or mentality when under staffed. Using mutual aid is not a sign of weakness or fear dang it, if anything using it is a very responsible and mindful way to keep your personnel safer.

Point three, in cases where the decision has been made to "Get R Done" with our minimal or less staffing, tunnel vision may be attributed. I believe the tendency is to focus on the bread. What the hell is he talking about you say? Well, rescue and extinguisment, which we all know has to happen its our job and "Lets Get R Done" right? Wrong, it is our job and reason for being but what about the peanut butter and jelly? We have to consider and mitigate the things in the middle of the bread. Oh yeah, RECEO or RECEO VS. But neither of these mention, address or remind us of staffing. And this is what I meant when I said the bit about tunnel vision. Don't get me wrong, Lloyd Layman's RECEO VS was and is great and I use it; however in his day we didn't go deeper, and pack more in thus weighing more. I don't believe there was as much focus on staffing then so there was no need to make a provision for it. We have got to think about staffing, starting from the time of response and account and make adjustments for it.

And finally point four, which I think I have already hammered that nail. Advances in equipment allow us to go deeper, and pack more in thus making us in some cases as heavy as the old equipment. We work harder and are subjected to more strain than before in some cases I believe.

All thoughts, opinions, ideas or suggestions on this topic are welcome and please share.

Jim Cooper
Captain / Training Officer
NORFPD, Oregon

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Permalink Reply by Jim Cooper on February 27, 2008 at 6:33pm

Thanks for your input,

Exactly, I agree they do need to get over the pride thing. I respect your opinion and yes the fire service does need to be more physically fit and those who watch TV need to get off their butts and something productive. Especially if they are being paid to staff a station. I am not looking for something to replace the lack of physical fitness as the "big problem" or the main problem I realize that is whats the major contributing factor. However I do believe that especially in rural America the points I have made may play a small role in the problem.

Jim

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Permalink Reply by Engineco913 on February 27, 2008 at 7:03pm

Cardiac arrest/heart attacks, the almighty 50% of our LODD's.

When we stop and look at the LODD's and the reports of NIOSH on these type of incidents, we see startling facts reguarding the deaths. In more cases than not there are no SOP's, or policies involving physical fitness in the cardiac related LODD's NIOSH investigates. Age is a major factor. Knowling your own physical limitations is important. (this should be enforced by the fire department you are a member of) Yearly physicals and a fit for active duty certification should be mandatory across the globe. Lack of SCBA during operations INCLUDING overhaul leads to LODD's. HCN, Phosgene, and Carbon Monoxide are all killers.

Phosgene (CoCl2): Symptoms are Irritation of the eyes; dry burning throat; vomiting; cough, foamy sputum, dyspnea (breathing difficulty), chest pain, cyanosis; in liquid form : frostbite
The plastic ring around 1 headlight in a car emits enough phosgene to kill you.

Hydrogen Cyanide (HCN): Symptoms Asphyxia; lassitude (weakness, exhaustion), headache, confusion; nausea, vomiting; increased rate and depth of respiration or respiration slow and gasping; thyroid, blood changes. (with the influx of plastics and foams in the home, there is going to be HCN at every fire though varying in severity)

Carbon Monoxide (CO): (forgive me for putting this basic stuff on but making a point)
Symptoms Headache, tachypnea, nausea, lassitude (weakness, exhaustion), dizziness, confusion, hallucinations; cyanosis; depressed S-T segment of electrocardiogram, angina, syncope

Carbon Dioxide (CO2):Symptoms Headache, dizziness, restlessness, paresthesia; dyspnea (breathing difficulty); sweating, malaise (vague feeling of discomfort); increased heart rate, cardiac output, blood pressure; coma; asphyxia; convulsions; frostbite (liquid, dry ice)

Notice the trend? All seem to have a lot of similarities. Either colorless (or near colorless), and all have affects that WILL KILL YOU!

I do agree that some short staffing could be the cause of some Cardiac issues. I do however think this is another issue that could be solved by calling more help earlier, if hiring more isn't an option. If there are not enough firefighters to do each job safely than you need more invites to the "big dance."

When all is said and done, it takes policy, and diligance to commit to the policy to help us save ourselves. We are killing ourselves in an alarming rate and yet things don't change. (and yet the policy stays the same) TAKE CHARGE of YOU AND YOUR FIREFIGHTERS! LEAD BY EXAMPLE!

In my parting I will quote a plaque on the wall of a Church I inspected that I think of daily.
"God helps those whom help themselves"

Stay safe everyone, your family, your friends, and your fellow firefighters need you to be around for tomorrows calls, and those in the future.

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Permalink Reply by Jim Cooper on February 28, 2008 at 4:39pm

Thank you for your input,

Yes, you are right we do need to lead by example and definitely need to wear our SCBA during overhaul/mop up. Also I agree that we need to be more proactive about our members physical fitness levels and require ongoing check ups.