Firehouse Expo in Nashville, TN, is once again your one-stop shop for high-quality training and education. For those who can’t make it to the show this year, we’ve compiled summaries of some of the hottest educational sessions. Seek out additional information from the show at Firehouse.com or on social media using #FHExpo18.
Defensive Tactics for Offensive Scenes
By Shawn Tompkins
Engine 5 is dispatched to an elderly female complaining of chest pain and trouble breathing. Upon arrival, the crew grabs its EMS gear and enters the home, where they find a 75-year-old in moderated distress. As the EMTs begin to assess and treat the patient, the front door opens and an irate male enters, yelling to get away from his mother. The son continues to become aggressive, pushing a crewmember back while shouting that the last crew to treat her almost killed her. What do you do?
This scenario is an everyday call. No shots fired, no violence reported, and no drugs or other substances involved. However, these “everyday” calls provide us with some of the most unsafe situations and routinely catch us off guard.
Firefighters need to learn to use defensive tactics to see indicators of potential violence. Most people connect the phrase “defensive tactics” to hands-on techniques—and they wouldn’t be wrong—but the most important elements of defensive tactics are awareness, avoidance and communications.
With this in mind, following are some common misnomers related to violence on the job:
· “We don’t really have ‘bad areas’ in my district”: Do you have “good areas” where people call 9-1-1 when they are sick? What about folks who suffer from dementia, diabetes, strokes and seizures? Do citizens in your area get into car accidents and sustain head injuries from falls? If so, then you have the potential to respond to aggressive or violent incidents. Remember, not all people who are violent or aggressive are bad people. In fact, usually they are good people having a really bad day.
· “We just call the police; that’s their job”: As you should. But if that is your only option, that’s not much of a plan. We need to be better at recognizing, preventing and then responding to a violent action. Give your responders the tools they need to stay safe and go home. Further, if someone is becoming aggressive, crews need to know how to carefully restrain and treat the patient under these circumstances.
· “It doesn’t happen that often”: Recent independent studies indicate that between 5 and 8 percent of all calls for EMS involve a violent person. Even the Centers for Disease Control and Prevention (CDC) has published data stating that in 2014, more than 21,000 emergency service personnel were hospitalized after a violent incident.
So, what can we do?
Learn to be more aware of our surroundings: Reinforce size-up on EMS calls, not just building fires. When something changes, re-evaluate the scene. Avoid tunnel vision. When approaching a person down on the ground, think of the many reasons that they could be there. Were they shot or assaulted? Did they get exposed to a hazardous chemical? Could they have been electrocuted? Get your mind thinking about these things.
Stop classifying scenes as “safe” or “unsafe”: To put it simply, there are no “safe” scenes anymore. Every call to 9-1-1 has the potential to harm one of our brothers or sisters.
Encourage management to provide the physical skills needed to get out of trouble or to control a violent patient: I have sat with many training officers, fire chiefs and EMS managers, and many say the same thing: “I don’t want to train my people how to fight.” My response is always the same: “Perfect, neither do I. I want them to recognize and prevent something bad from happening. Then I want them to have the skills to control the situation and get out of trouble.” This means allowing firefighters to use the aforementioned techniques to get free or help treat somebody.
Shawn C. Tompkins, B.S., EMT-P, has been a firefighter and a paramedic for over 20 years in the upstate New York region. He has been trained as both a “Defensive Tactics” and “Verbal Judo – Communications and De-escalation” instructor and has spent hundreds of hours training fellow emergency responders across the nation to manage aggressive behavior.
Think Like an Incident Commander
By Thomas Dunne
Firefighting is a multifaceted experience. Just about every incident we respond to presents both a challenge and a sense of accomplishment. At the same time, it is also one of the most stressful occupations that exists. Multi-tasking, confusion and uncertainty are as much a part of the job as are the excitement and fulfillment we experience in our line of work.
On the fireground there is much to do and little time to do it. Firefighters of every rank must often make rapid life-and-death decisions within the confines of a loud, distracting and smoke-filled environment. Under these conditions, even the simplest decision can be very difficult to make, and the task of establishing a safe and effective strategy is especially challenging.
Fortunately, there are several tools to help. One such tool is knowing how to make intuitive decisions on the fireground as opposed to the traditional, and somewhat limiting, checklist approach to firefighting. Specifically, this means being able to tune in to that body of firefighting knowledge and experience that has already accumulated within you. Have you seen this type of fire before? Is there something familiar about this kind of construction? Does the nature of the smoke condition remind you of a previous operation? Your intuitive responses will most often guide you to the most appropriate strategy—the strategy that has worked for you in the past. Such an approach often results in a quicker and more effective size-up of any emergency.
A firefighter, company officer and most certainly a chief must be capable of displaying a command presence—an ability to project an air of calm confidence, a sense that, regardless of the challenges, you will be able to overcome any hurdles and resolve the incident successfully. Inexperience and stress can make this a difficult task. The key is to slow down and communicate in a controlled and accurate manner; this is the most effective method of establishing a sense of command presence and will allow for a safer and calmer operation. The first step is to briefly pause and think about what specific information you want to communicate. Then speak in a clear, confident voice. If you are feeling somewhat stressed, a bit of “acting” may be required to accomplish this. Remember, your tone of voice will affect everyone working around you. If you sound confident, you will set the tone for the entire operation.
Performing a size-up, establishing a strategy, overcoming stress, projecting a sense of confidence—these are some of the tasks required of all ranks in the fire service. And while there is much to be said for explaining concepts, there is nothing quite as effective as hands-on learning. I had the benefit of working with some of the best chiefs and firefighters in the country and I tried to borrow something from each of them. As I gathered experience and developed my own leadership style, I carried their example with me.
The key is to enable you to make use of the attributes that are already inside you and to make you a more confident decision-maker on the fireground.
Thomas Dunne is a retired deputy chief and a 33-year veteran of the FDNY. He has been the incident commander at hundreds of fires and emergencies in residential, commercial, and high-rise buildings. Dunne served as training and safety coordinator of Division 7 in the FDNY and was a liaison with the media and community groups. He is currently lecturing through his “Third Alarm Fire Training” seminars.
A Deadly Dose—Fentanyl, Synthetic Opioids & the Fire Service
By Scott Burgess
Since 2013, synthetic opioid overdoses have increased 500 percent. In a direct correlation, fire department responses to overdoses and hazardous materials calls have also increased.
The risk of exposure is the most misunderstood area of synthetic opioid response. Fueled by media reports and anecdotal stories, routes of exposure have been greatly exaggerated. Incidental dermal contact will not result in an accidental overdose by the responder. For a solid to be absorbed through the skin, a significant surface area must be covered, pressure applied, and the presence of moisture is needed. A position paper released by the American Academy of Toxicologists explained scientific studies that validated the low risk of absorption. The study showed that under the above-described conditions, it took 14 minutes to receive a therapeutic dose. This is a dose well below the overdose range. Obviously, any breaks in the skin can increase the rate of absorption.
So how does this information help the firefighter in the street? First, your risk of an accidental overdose is relatively small. This risk can be reduced even more with the use of proper PPE and good hygiene practices. Level A suits are not needed for fentanyl-related responses. The only time Level A may be indicated is when there is a presence of precursor chemicals associated with a clandestine lab. PPE selection should be risk-based and mission-specific. Your respiratory tract and mucous membranes are the vulnerable areas, so you should take appropriate steps to protect these areas. So what is the proper PPE needed? Long pants, long sleeves, eye protection, two pairs of nitrile gloves, and a NIOSH-approved N95 or higher respirator will provide the needed protection. Nitriles gloves are recommended over latex, as there are permeation issues with latex. In addition, many people are allergic to latex. These PPE recommendations are based on guidelines released by the Interagency Board for Equipment Standardization and Interoperability (IAB, interagencyboard.org), whose mission is to strengthen the nation’s ability to prepare for and respond safely and effectively to emergencies, disasters, and CBRNE incidents.
Common sense, good hygiene, and proper PPE will allow fire service personnel to operate safely on the scene of synthetic opioid related responses.
Scott Burgess is a 31-year veteran of the Nashville Fire Department, currently assigned as an engineer. He is a certified paramedic and hazardous materials technician. Additionally, he is a CBRNE/WMD instructor with Homeland Security’s Center for Domestic Preparedness in Anniston, AL. Burgess has over 20 years’ experience as a fire service instructor.
Preventing Harassment & Discrimination in the Firehouse
By Eric Rosoff
Fire service professionals across the country are dedicated to critically examining threshold operational events in order to identify common behaviors that jeopardize employee safety. These behaviors are then considered when developing policies, strategies and training designed to overcome the dangers.
It is time for us to approach workplace environment issues in the same fashion and with the same passion. If we critically examine claims of harassment, discrimination and retaliation in firehouses across the country, we can determine common dangerous behaviors and be better suited to adjust policies, strategies and training.
For example, a common factor in fire service harassment claims is an alleged pattern of behaviors occurring over an extended period. When taken as individual occurrences, these behaviors frequently appear to be nothing more than petty annoyances, slights or isolated incidents and are therefore not considered a violation of law or policy.
However, when it is revealed through testimony that the behaviors were frequently repeated over several months and never addressed, these petty annoyances, slights or isolated incidents are redefined as being “pervasive” behaviors in the workplace. Pervasive behavior is the federal definition of “hostile work environment,” and establishing a hostile work environment is routinely looked at as “game over” for the agency in any claim of harassment, discrimination or retaliation. What we can take from this common factor is that petty annoyances, slights or isolated incidents must be immediately addressed to prevent them from becoming pervasive.
Many agencies already have professional interactions or courtesy policies in place. It is time to consider adding language to these policies that addresses petty annoyances, slights and isolated incidents. The new language should:
· Acknowledge that from time to time there may be petty annoyances, slights or isolated incidents that occur in the workplace.
· State that these behaviors are contrary to agency expectations.
· State that supervisors are expected to immediately address infractions of this policy within the organizational culture of corrective behavior, preferably with documentation of action(s) taken.
· Emphasize that severe or repeated petty annoyances, slights or isolated incidents are a violation of agency anti-harassment policy.
· State that supervisors who were aware of, or should have been aware of, petty annoyances, slights or isolated incidents and took no corrective action are subject to discipline.
Once your policy is in place, train to it! Make sure all employees understand why this language was added.
Eric Rosoff is a 31-year law enforcement professional. His career included several operational assignments, including gangs and special enforcement. Rosoff accepted an administrative assignment as a professional standards bureau commander and received his basic and advanced POST certificates in internal affairs. He is an expert in personnel investigations and workplace environment issues. Rosoff is sharing his experiences with fire service agencies through training and consultation as the executive manager of the Career Survival Group. He is a graduate of the FBI National Academy and the Sherman Block Supervisor Leadership Institute.
