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Transcript of Emergency Services, LLC / Copyright 2007 / Volume 07-41 TRAINING Click anywhere on page to view show...
Emergency Services, LLC / Copyright 2007 / Volume 07-4 1
TRAINING
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FIRE MEDICS• Medforce
Emergency Transport• Quiz
EVOLUTIONS 2000• Kramer vs. Kramer• Program Quiz Answers
FIRELINE• Illinois Extrications• Trapped Firefighters’ Escape• Discussion Questions
HANDS-ON• Mezzanine Training Space(Expande
d Segment)• Quiz
Working Fire Training07-4 Training Materials
Emergency Services, LLC / Copyright 2007 / Volume 07-4 2
TRAINING
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Working Fire Training07-4 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 07-4 3
DISPATCH/SIZE-UP – MONMOUTH EXTRICATION • A car had rolled three times and plunged 25’ into a
creek bed. • It landed on its roof in six inches of water, trapping
the female driver and her male passenger inside.• Though ten miles away, Monmouth F.D. responders
arrived quickly.
Fireline Incident: Illinois Extrications
07-4 Training Materials
Emergency Services, LLC / Copyright 2007 / Volume 07-4 4
STRATEGY/TACTICS – MONMOUTH EXTRICATION • Not having a solid base, responders were not able to
secure the car with cribbing.– They found out the car was stable on the bank side of the
creek.
• Responders attached the truck winch to the back of the vehicle because they were worried it would slide further down into the creek.
– They secured the vehicle first, before they could do any cribbing to stabilize the car.
Fireline Incident: Illinois Extrications
07-4 Training Materials
Emergency Services, LLC / Copyright 2007 / Volume 07-4 5
STRATEGY/TACTICS – MONMOUTH EXTRICATION • Driver Extrication
– As the extrication team started to open the door, the driver was so close to the bottom of the door that it started to push in on her.
– Instead, the team started cutting the door away from the car, rather than separating it from the vehicle.
Fireline Incident: Illinois Extrications
07-4 Training Materials
Emergency Services, LLC / Copyright 2007 / Volume 07-4 6
STRATEGY/TACTICS• After looking at the car, the team found that if they
spread the doors on the driver’s side and opened it a little bit, then they could cut the B post.
– This allowed them to open up the door, then use their cutters to cut the door off the hinges completely and remove the door from that side.
Fireline Incident: Illinois Extrications
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 7
STRATEGY/TACTICS – MONMOUTH EXTRICATION • The passenger was upside down and had taken off
his seat belt but could not get out of the vehicle.• Cutters and spreaders were used to remove him from
the vehicle.• One of his legs was out the window. The team cut
the bottom part of door (which was at the top, as the vehicle was upside-down) and slid the door over his leg.
Fireline Incident: Illinois Extrications
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 8
STRATEGY/TACTICS – MONMOUTH EXTRICATION • Since the passenger was face-down in the vehicle,
responders took him out face-down on a backboard with a C collar.
– They removed him in a stokes basket to get him up to level ground so they could actually secure him to the board instead of working in the muddy water.
Fireline Incident: Illinois Extrications
07-4 Training Materials
Emergency Services, LLC / Copyright 2007 / Volume 07-4 9
EVENTS – MONMOUTH EXTRICATION • Found the car upside down in a creek.• Stabilized the car initially with a winch.• Driver was seat-belted with one arm out the
window. She was airlifted with multiple fractures.
• Passenger was extricated using spreaders and cutters and transported via helicopter.
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Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 10
REMARKS – MONMOUTH EXTRICATION • Part of our concern was we could not get to the
electrical system of the vehicle to disconnect the battery which would defeat air bag deployment.
– We started tearing the interior apart to look for seat belt tensioners as placed by the manufacturers and parts of the air bags
– We were worried about the air bags because no air bags had deployed; we didn’t want them deploying during the extrication.
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Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 11
REMARKS – MONMOUTH EXTRIC.• Part of our concern was that we could not get to the
electrical system of the vehicle to disconnect the battery which would defeat air bag deployment. (cont.)
– We didn’t know if the car was shut off or if the ignition was actually on. It was not running.
07-4 Training Materials
Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 12
REMARKS – MONMOUTH EXTRICATION • This was the first extrication for some of our new
recruits.– It was a good opportunity for our veterans to work with the
newbies and give them a hands-on lesson.– We also had a post-briefing back at the station after the
incident which provided good instruction.
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Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 13
DISPATCH/SIZE-UP – PORT BYRON EXTRICATION• A drunk driver crossed over the highway and collided
with two elderly people.• Chief Chuck Smalley of the local Cordoba department
was yards away from the accident when it occurred and called 911.
• He knew plenty of EMS would be needed and started calling for resources immediately.
– Extra ambulances, air support, rescue companies, etc. You can always send them back!
Fireline Incident: Illinois Extrications
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INCIDENT COMMAND – PORT BYRON EXTRICATION• Chief Smalley took Incident Command.• The first-arriving ambulance took Medical Command.
Fireline Incident: Illinois Extrications
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STRATEGY/TACTICS – PORT BYRON EXTRICATION• Both cars were stable and only needed minor
stabilization to keep them from rolling.– Frames of both vehicles were intact.
• The drunk driver in a red Blazer was fairly accessible.– The rescue crew popped a door to extricate him.
• In the 2nd car, the female passenger was extricated with a single door pop.
Fireline Incident: Illinois Extrications
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STRATEGY/TACTICS• The dash was in on the male driver in the 2nd car.
– Both doors were removed on the driver’s side. – Rescuers did a dash push using rams from their heavy
rescue. – They cut the electric seat, brought it back, and pulled him
out the back on a backboard.
Fireline Incident: Illinois Extrications
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 17
STRATEGY/TACTICS – PORT BYRON EXTRICATION• Vehicle damage and hazards to the driver or
passenger determine how to proceed. – You have to access them safely, but you have to look at the
damage they are positioned in.– When you are making an extrication on one side, you have
to be sure you are not forcing problems to the driver or passenger on the other side.
– It’s a real team effort, with paramedics and firefighters talking to each other as to what’s going on.
Fireline Incident: Illinois Extrications
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EVENTS – PORT BYRON EXTRICATION• Port Byron F.D. arrived with a small set of hydraulic
tools.• Cordova’s light rescue unit arrived.• Air medical response was en route• The drunk driver was not wearing his seat belt and
had slid over his air bag. He suffered facial lacerations.
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EVENTS – PORT BYRON EXTRICATION• The elderly couple were badly battered.
– Both had multiple compound fractures (legs, wrist, hand, ankle) and they were seat-belted.
• The steering wheel and dash were pushed in on the elderly couple.
• A dash push freed the male driver.• Both were airlifted to area hospitals.
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Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 20
REMARKS – PORT BYRON EXTRICATION• Within half an hour we were able to dismantle the car
on the driver‘s side.• The vehicle’s front end was gone on the driver’s side
where the brunt of the force was.• We removed both doors on that side, the entire divider
post, cut the electric seat, ram it back, backboarded him, and pulled him out the back. It went well from there.
07-4 Training Materials
Fireline Incident: Illinois Extrications
Emergency Services, LLC / Copyright 2007 / Volume 07-4 21
REMARKS – PORT BYRON EXTRICATION• We still had battery power but could not get to it until
after we opened the driver’s side up.
• The battery under the back seat was the problem. We had to access that first but couldn’t until after removal.
• Once we had access to him and removed him, we could make the cut on the battery later…not preferred!
• On assessing staff…with a grisly incident, you have to be checking your staff and see if they’re being affected.
– Check for that “deer-in-the-headlights” look”.– Use CISM and get your people help if they need it.
07-4 Training Materials
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 22
LESSONS LEARNED – PORT BYRON EXTRICATION• We had some problems starting our extrication tool.
– We have monthly maintenance one night a month. Part of our process is pulling the tool out, cleaning it, and running it.
– In spite of that, we had trouble starting it. – This may upset some folks, but we feel that corn alcohol in
gasoline is not good for engines that sit around. – We have made some changes to remove that from our
systems and go with straight gasoline.
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LESSONS LEARNED – PORT BYRON EXTRICATION• We had some problems starting our tool. (cont.)
– We feel that corn fuel sitting around starts to turn. With apologies to the corn growers, we feel it’s not good in this application.
07-4 Training Materials
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LESSONS LEARNED – PORT BYRON EXTRICATION• Cross-training with your mutual aid partners is
essential. – The days of stand-alone training are gone. – We’re into MABAS (Mutual Aid Box Alarm System, Illinois’
extended mutual aid partner system) and inter-departmental training.
– No one has budget to buy what they need. • We may buy something that works for our whole area and
someone else may, also. Then we share.
• They’re just a phone call away…they train with us, we with them.
• Port Byron uses their local Explorer’s post for recruiting…something to think about.
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DISPATCH/SIZE-UP • Lyndon Crew on duty
– Captain Kevin Baker– Firefighter Stephen Dunlany– Sergeant Jeremy Leffler– Engineer Casey Burrows
• Response was to a structure fire at a condominium complex.
07-4 Training Materials
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 26
DISPATCH/SIZE-UP• Upon arrival, the crew saw plenty of smoke and knew
there was a large body of fire somewhere in the structure.
• The Middletown Fire crew also responded.
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INCIDENT COMMAND• Upon arrival, IC ordered an interior fire attack.• When the collapse occurred, a Mayday and an
evacuation was called.• Communicated a PAR of all firefighters once they
were out of the structure.
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STRATEGY/TACTICS• An interior fire attack was begun.
• While Engineer Burrows continued his job at the truck, the Lyndon crew of Cpt. Baker, Firefighter Dunlany and Sgt. Leffler went upstairs to the second floor.
• The Middletown crew entered the first floor.
• A ventilation crew went to the roof to cut a vent hole.
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 29
EVENTS• The crew had just returned from a false alarm
in the same area. At first, they thought this was another one.
• The Lyndon crew on the second floor encountered a lot of heat and zero visibility but could see no fire.
• Over the next eight minutes the crew was working in the structure, calling for equipment, as the heat began to rise.
– Crew members could feel the effects.
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EVENTS• Then, just as the roof crew cut a hole for
ventilation, the second floor partially collapsed, dumping, Baker, Dunlany and Leffler into the first floor where the Middletown crew was located.
– The heat and force were overwhelming. – Leffler, who was shooting a fog pattern at the
ceiling, had the hose ripped out of his hands.
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EVENTS• Now dumped into the first floor, the crew was
disoriented, feeling around for something familiar, trying to find a way out.
– The heat sensors on their PASS devices were sounding; the effects of the heat were getting severe.
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EVENTS• With a Mayday having been called, the crew was
trapped in a pitch-black hole.– Captain Baker attempted to give clear information
regarding their location.– Firefighter Dunlany thought he was on fire.– Sergeant Leffler was getting no radio traffic as his
microphone cable had burned through.
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EVENTS• Sergeant Leffler found a window and told
Captain Baker to follow him. – Leffler exited the window and landed on the air
conditioner unit below the window. – He expected to see Baker behind him but he
wasn’t there.
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 34
EVENTS• Firefighter Dunlany, searching around, found
himself in a bathroom and realized he had no exit there.
– He came back out and found Captain Baker. – He gathered his thoughts for a moment to
consider options for egress. – He then headed toward a glimmer of light, found a
window, and exited.
07-4 Training Materials
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EVENTS• Captain Baker ended up in a bedroom and found a
window there. – This window was up off the ground and firefighters outside
put a ladder up for him. – He went down the ladder head first.
• All three Lyndon firefighters found each other outside.
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 36
POST-INCIDENT• The crew received minor burns, but were alive. The
Middletown crew escaped as well.• Previous firefighter survival training helped the
firefighters keep their heads, assess their surroundings, and follow their options.
– A will to survive was also in evidence.
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 37
LESSONS LEARNED• Should a collapse or some kind of disorienting
event occur, immediately radio to Command the situation and your location.
– Fight the adrenaline and speak slowly and calmly. – Don’t let your emotions obscure the transmission. – The guys outside need to hear you clearly.
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Emergency Services, LLC / Copyright 2007 / Volume 07-4 38
LESSONS LEARNED• Communicate with your crew members and try to
stay together, even though that wasn’t possible in this case.
– The odds are better to find one exit solution for the whole crew, rather than separate exits for each member.
• If crew members do get separated and radios are functioning, if one finds an exit, he/she should radio to the others and direct them to it.
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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?
07-4 Training Materials
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Illinois Extrications / Monmouth/Cordoba, IL Asst. Chief Patrick Spears, Monmouth (IL) Fire Department Chief Chuck Smalley, Cordova (IL) Fire Department Asst. Chief Don Carey, Port Byron (IL) Fire Dept.
• An overturned vehicle in a creek with six inches of water was something we hadn’t seen before. I suggest departments try to rig such and evolution and train on it. Get a wreck from a salvage yard and dump it upside-down in a creek or ditch somewhere.
• Work hard at finding ways to disconnect batteries and/ or airbags when you can’t get good access to them.
– It’s possible you could access the battery through the grill, if it’s in the engine compartment, even if the vehicle is upside-down.
– In the Port Byron incident, the battery was under the back seat. It’s possible access could have been gained by removing the back seat through the trunk. We’re going to work on that.
Fireline Incident Discussion
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Trapped Firefighters’ Escape / Louisville, KY Captain Kevin Baker, Lyndon Fire Department
• During size-up, try to make a mental picture of where exterior windows, doors, and other points of egress are.
– Once you’re inside the structure, you can translate the positions of those egress points and determine which ones are closest to your position.
• On the outside, firefighters should be breaking and laddering windows, providing for means of egress.
– In this case, since a ventilation hole was cut in the roof, opening windows on the first floor should help clear the smoke.
• Consider the use of Positive Pressure Ventilation (PPV) to clear smoke even before attack crews enter the structure.
– Though it might initially fuel the fire depending on its location (it might also blow the fire out!), the interior will be a lot safer with better visibility for firefighters if they do make an entry attack.
Fireline Incident Discussion
07-4 Training Materials
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OBJECTIVES/OUTCOMESAfter watching this segment, the student shall understand:• how an area of unused space can be repurposed into a
training space.• the method and materials used to construct such a training
area.
CODES, STANDARDS & REGULATIONS• NFPA 1402: Guide to Building Fire Service Training Centers
Hands-On:Mezzanine Training Space (Expanded Segment)
07-4 Training Materials
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HISTORY• We designed a training facility when we built our new fire
station with the intent of having room for additional training in the building.
• We ended up with the mezzanine area which is 81 feet long and 16 feet wide.
• The guys looked at the plans and decided that we could build a confined space prop into the facility and over time, we've come up with more ideas in ways we could use the facility.
07-4 Training Materials
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HISTORY• These include:
– SCBA confidence training as we can smoke the area. – forcible entry training with two doors with a steel frame so
we can practice making entry into a structure. – thermal imaging training as we have props that can be
warmed up in order to make a heat signature. – RIT training– accountability training– firefighter lost/firefighter down, and other scenarios.
07-4 Training Materials
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DYNAMIC CONFIGURATION• It’s a dynamic prop that allows for change so the
rooms are never the same. – The training space can be used to simulate a miniature
apartment or small residence structure by rearranging the walls which adds versatility for different scenarios.
• There are three walls that all pivot. – Trainers can configure a long hallway with doors or three
separate rooms. – Doors can be set to swing in or out.
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DYNAMIC CONFIGURATION• There are three walls that all pivot. (cont.)
– The training area offers a simulated smoke and ventilation system run by fan and vent at each end of the mezzanine. In the event of an emergency, the entire mezzanine can be cleared of smoke in about two minutes.
07-4 Training Materials
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CONSTRUCTION• The construction basically has two sizes of walls, a 91-
1/2” and 45-3/8” that all interchange. – The plywood used is 7/16 inch thick wood and is pretty
durable can easily be replace should something become damaged for about $6-$7 a sheet.
• The builders used a hole saw and put access holes in the walls.
• The walls are then fastened together with lag screws with washers.
07-4 Training Materials
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CONSTRUCTION• The holes are dual-purpose.
– They give access to the lag screws for attaching the walls together.
– They serve as handles to move the doors around.
• The walls are stored in a special rack at end of the mezzanine.
– Trainers use a pick list from a list of possible arrangements and layouts to decide what will be needed to produce the desired configuration.
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ARRANGEMENTS & FEATURES • The training space can become an office building, a
residential structure, or apartments with a common hallway between the two sides.
– Kitchen cabinets that can be put against virtually any wall. – A bathroom can be configured as a full or half bath and the
bathroom can be configured just about anywhere.
• The department has acquired a number of pieces of furniture.
– They have been donated or harvested from many locations.– The furniture add to the realism of our training evolutions.
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ARRANGEMENTS & FEATURES • Red lights are available that can be moved around
and simulate the red glow of flame if students are working in smoke.
• There is also a bunk bed prop, inspired by an incident where a firefighter didn't realize the child was in the upper bunk.
– This encourages firefighters to reach up and always check bedrooms for bunk beds.
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EVOLUTIONS• Breaching Walls
– We have some drywall that's precut for a certain-sized opening for a wall breaching scenario
• You can simulate being stuck inside, needing to get out, and using your tool to break through.
• It's a typical 16” on center for a 14-1/2” opening.
• You can also remove the drywall and perform low-profile moves.
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EVOLUTIONS• Spongy Soft Floor Prop
– The mezzanine features a hole in the concrete floor that is open to the next level below.
– This opening is usually covered by plywood. – A second, larger piece of plywood covers the hole itself and
the area around the hole. – This leaves a depressed area that can be filled with sponge
rubber and then covered over with carpeting. – The sponge rubber simulates a soft, spongy floor as if fire
were below it.
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EVOLUTIONS• Spongy Soft Floor Prop (cont.)
– A firefighter on all fours can test the floor by sounding it with a tool.
– The sponge rubber can also be covered with an electric blanket to simulate a heat source which can be read by a thermal imager.
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EVOLUTIONS• Spongy Soft Floor Prop (cont.)
– Finally, both plywood covers can be removed, revealing the opening to the next level. This allows below-grade rescue evolutions to be practiced, confined space props, etc.
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EVOLUTIONS• Forcible entry can also be practiced using wooden or
metal doors that are mounted to a 4” metal strip attached to the hinges.
– As the door becomes banged up, it can be removed from the metal strip and turned for around and reused or replaced entirely.
– Additional scenarios make use of various kinds of door jambs made either of wood or metal depending on whether the simulation is residential or commercial. These can also be replaced out as they become used or beaten up.
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EVOLUTIONS• Forcible entry can also be practiced using wooden or
metal doors that are mounted to a 4” metal strip attached to the hinges. (cont.)
– There is also a feature where a metal door can be reinforced using a metal dowel rod, similar to what might be found in a commercial installation.
– This Forcible Entry prop can be used for search and rescue teams either with or without fire suppression.
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GROWTH THROUGH NEW IDEAS• Blackjack Fire Protection District gets lots of new
ideas from other departments who use the facility and who specifically asked for a particular kind of training prop or suggest that that the department create one.
• There is a real interchange of information.
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Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____1. True or False: When thinking about finding space to build
such a prop, it’s a good idea to look up.
2. True or False: Blackjack demands that only their props and evolutions be used. Other departments may not practice using their own ideas.
3. True or False: Real furniture provides obstacles to search & rescue drills, especially in smoked-up environments.
07-4 Training MaterialsQuiz: Mezzanine Training Space (Expanded Segment)
Emergency Services, LLC / Copyright 2007 / Volume 07-4 59
Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____Select the best answer:
4. What kind of training could NOT be conducted in this training space?
a. SCBA confidence training.
b. Forcible entry training and thermal imaging training
c. Vehicle extrication training
d. Search & rescue training using a soft floor
e. RIT training
07-4 Training MaterialsQuiz: Mezzanine Training Space (Expanded Segment)
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Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____Select the best answer:
5. Which order is NOT correct?
a. Nails and washers are used to attach the walls.
b. Walls can be rotated 90 degrees.
c. Bathrooms of various styles can be configured.
d. A kitchen can be put against different walls.
e. Theatrical smoke and ventilation increase versatility.
(Answers on Slide 82)
07-4 Training MaterialsQuiz: Mezzanine Training Space (Expanded Segment)
Emergency Services, LLC / Copyright 2007 / Volume 07-4 61
OBJECTIVES/OUTCOMESAfter watching this segment, the student shall:• Know the latest in working with helicopter responses• learn the issues of coordination between EMS and helicopter
transport teams.
CODES, STANDARDS & REGULATIONS• Check local department protocols and guidelines in working
with helicopter transport facilities.
• See Working Fire Training issues 96-5 through 96-9 for Safe Helicopter Landing Zones training.
Fire Medics: MedForce Emergency Transport
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AIR TRANSPORT TEAM• Pilot, Nurse, Paramedic
– All three must coordinate as a team before the flight.
• Safety is the prime consideration for:– the crew– the patient– all responding agencies the crew interacts with.
• The team will fly in nearly any weather beside fog and ice.
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DISPATCH• Often, very little accurate information is available from
the dispatch to the air transport team.• Additional information is sometimes supplied while the
team is in flight.• Ground teams should not assume that air transport
knows anything about the incident.
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PREPARATION FOR LANDING• Ground teams should be prepared to communicate with
incoming air transport and have relevant information ready.
– Nature of incident– Nature of injuries– Landing information
• Helicopters try to get as close to the scene as possible.– However, pilots try not to disrupt activities on the ground.
• The pilot will do a reconnaissance fly-over to become familiar with the location, terrain, position of vehicles, etc.
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PREPARATION FOR LANDING• The fire/police department should select and prepare a
helicopter landing zone.– The pilot has the right to call the site off, if he is not
comfortable with it.– This could be the result of an obstruction, a road sign, or
debris which may not be apparent to the ground crew but which can be seen from the air and which could jeopardize the safety of agencies on the ground.
– The pilot will have special needs and considerations the ground crew may not be sensitive to, not having airborne experience. For example, prop wash might disturb things which the ground crew might not think about.
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THIS MONTH’S FIRELINE CALLS: MONMOUTH• Two different extrications with patient care.• Fire, police, sheriff, and EMS were all on scene.• Car was upside-down in a creek• Coordination among all agencies went very smoothly
– this is not always the case!
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THIS MONTH’S FIRELINE CALLS: PORT BYRON• Three different extrications with patient care, with two
critical patients.• The elderly couple were badly battered.
– Both had multiple compound fractures (legs, wrist, hand, ankle) and they were seat-belted.
• Both were airlifted separately to different area hospitals.
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ON-SCENE CARE RESPONSIBILITIES• Once the helicopter transport team arrives, they take
primary medical responsibility.– The helicopter becomes the primary caregiver.
• Safety issues may force the air crew to wait.– The air crew may see what treatment the patient needs but
can’t begin it because either the patient or the rescue scene is not stabilized or safe enough for care to begin.
– The crew may have to suffice with things like IVs and other “holding actions” in the short run.
– While it’s waiting, the crew can make sure that they have all resources ready to go so upon extrication, treatment may begin immediately.
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ON-SCENE CARE RESPONSIBILITIES• Speed is always an issue.
– Golden Hour considerations are always present.– But air transport can “stretch” the Golden Hour since they fly
directly to trauma centers – and quickly – leaving more time for rescue on-scene.
– In addition, ground transport in report areas may bring patients to a smaller hospital where they are triaged and transported on to a larger trauma center. Air transport skips that middle step, gaining more time.
– Sometimes, because of the helicopter’s speed, they can arrive at the trauma center TOO quickly – before the hospital is ready for them. This is important for incident commanders and medical branch officers, too!
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ON-SCENE CARE RESPONSIBILITIES• Speed is always an issue. (cont.)
– Communicate with the receiving hospital as early as possible as to patent condition and extent of injuries so that the hospital will be ready for the patient.
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AIR TRANSPORT OPTIONS• Being able to transport patients quickly provides
the option of where to take the patient.– Air transport tries not to overburden one hospital with
additional critical trauma patients.
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AIR TRANSPORT OPTIONS• Being able to transport patients quickly provides the
option of where to take the patient. (cont.)– Air transport can query hospitals as to their capacity and
available resources and elect to take multiple trauma patients to multiple hospitals in separate locations.
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AIR TRANSPORT OPTIONS• In the Port Byron incident, the first patient was
taken to Illini Hospital, Silvis, IL, and the other to Trinity West, about 4 minutes further away, in Rock Island, IL.
– The first patient was taken by one helicopter while a second helicopter waited for the second patient to be extricated.
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AIR TRANSPORT OPTIONS• Sometimes the element of speed is mitigated by the
severity of the extrication.– Air Transport tries to spend no more than 10 minutes on the
ground rendering care, knowing they can continue giving care while in the air.
– This is similar to ground EMS who would rather not spend more than 10 minutes at the scene before beginning transport.
– Sometimes the pilots kill the engines if the wait will be extensive. They have waited for up to two hours for a patient to be removed from a horrific extrication.
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AIR TRANSPORT -- OTHER SERVICES• Sometimes MedForce will transport a fire chief over a
large fire scene to give him a perspective view of its progress – usually in cases where accessibility is a problem.
• MedForce assists in:– finding lost people or missing children– executing river rescues – or any emergency where assistance will reduce the jeopardy
of other responders who might be put on unsafe situations otherwise.
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AIR TRANSPORT -- OTHER SERVICES• MedForce presents an extensive education program to
local agencies on setting up landing zones.– It is important that ground agencies become familiar with
what air crews are looking for in terms of safe landing zones, especially in unprotected areas.
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Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____Select the best answer:
1. True or False: Having a helicopter at your disposal may mean you can spend more time rendering care in the
air.
2. True or False: Air Transport helicopters must only be used for transporting patients.
3. True or False: Setting up a helicopter landing zone is not the fire department’s responsibility.
07-4 Training MaterialsQuiz: MedForce Emergency Transport
Emergency Services, LLC / Copyright 2007 / Volume 07-4 78
Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____Select the best answer:
4. Which is NOT correct?
a. Air Transport allows the Golden Hour to be “stretched.”
b. Air Transport allows the skipping of smaller “triage” hospitals.
c. Air Transport can get a patient to the hospital too quickly.
d. Air Transport may sometimes have to wait at a scene.
e. None of the above.
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Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____Select the best answer:
5. Which is correct?
a. Air Transport allows for delivery of trauma patients to different facilities, spreading out the burden of trauma care.
b. An Air Transport crew consists of a pilot, a copilot, and a nurse.
c. Search & Rescue is not something that air transport is good for.
d. Air Transport prefers to spend more than 10 minutes on the ground rendering care.
e. All of the above(Answers on Slide 82)
07-4 Training MaterialsQuiz: MedForce Emergency Transport
Emergency Services, LLC / Copyright 2007 / Volume 07-4 80
1. As auto safety has evolved, how well do you feel victim survivability has been improved? What are the implications for rescuers?
2. As auto safety has evolved, do you feel the job of victim extrication has become easier or more difficult? Briefly explain.
3. Briefly list the subjects that should be covered in a modern-day vehicle extrication course. Which of these are new because of advances in auto safety?
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.
Kramer vs. KramerAuto Response Safety
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ENROLLMENT INFORMATION:
For more information on enrolling in the Open Learning program to gain college credit, call Working Fire Training at 800-516-3473 for a brochure or, to register directly, call the University of Cincinnati at 513-556-6583. Associates and Bachelors programs are available. Call to have your transcripts evaluated.
Send your responses to:
Professor Bill KramerUniversity of Cincinnati
College of Applied Science2220 Victory Parkway, ML #103
Cincinnati, Ohio 45206
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Thanks so much for viewing Working Fire Training!
See you next month – stay safe!
Answers:
Hands-On – Mezzanine Training Space: Quiz on Slides 58-60:1. True 2. False 3. True 4. c 5. a
Fire Medics – MedForce Emergency Transport: Quiz on Slides 77-79:1. True 2. False 3. False 4. e 5. a
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