First off if you aren't reading Urban Firefighter go now and start. This is the baby of Erich Roden (Milwaukee FD) and Ray McCormak (FDNY) two guys who created a magazine with amazing content to inspire, educate, and remind those of us whose vocation it is to crawl down a fire ravaged hallway to "keep fire in your life." Read it now, thank me later.
Second, my post today has generated some great conversation. I was on the phone with a friend of mine who is an aggressive Fire Officer and Career Battalion Chief who brought up some good points. It is important that we remember that each and every fire is the first time we are seeing it, sort of like each time a surgeon removes a skull based tumor its the first time he or she has done it in that persons head (even if they have removed them thousands of times before). That means we need to be vigilant in our size-up and allow good information to guide our decision making on the fireground.
Your size-up should be starting before you ever get on the rig in the morning. Who are the brothers and sisters you are riding out with that day? What are the strengths and weaknesses of the individuals and the crew? I had a Lieutenant who looked at his assembled crew one morning and said, "These guys are like dogs on a chain. If we get a fire its going to be like turning three pitbulls loose on a hunk of raw meat." Those are people you can trust to do things like Vent Enter Search, or allow an Outside Vent Member to go to the rear alone. Conversely if you have new, or less talented, folks on your crew you MUST reduce the speed of the fireground operation.
Unfortunately we do not always get to dictate that the crew for the day will have all of the abilities we would love. Not everyone willingly assumes that mantel of being a Fire Service Warrior. Or, we may not have the staffing we need to operate safely.
I've discussed the Line Of Duty Death of a 24 year-old volunteer firefighter (NIOSH F2008-34) in the past. He was one of three people operating on the scene of a house fire, where there we reports that the occupants were out, and he entered alone, became disoriented, and was caught in a Flashover. That is unacceptable. Not because he wanted to be aggressive, but because he didn't have a solid Standard Operating Guideline to follow that spelled out how many people needed to be on scene to make the building behave BEFORE we commit to interior operations. He did not belong in there, but his personal condition: his view of his Duty, compelled him to act. Rather than relying on an inexperienced member to stop we should have training or SOGs that spell out the minimum safe standards when they can go. It shouldn't be about deciding if the victim might be savable, it should be about deciding if our department can make the building behave to afford us a relatively safe battleground.
Thursday, October 28, 2010
%$#@ "Victim Survivability Profiling"; Do Your Primary Search
The Fire Service is constantly finding new buzzwords and phrases to describe what we do and how we should do it. One of the newest, trendiest, phrases around is “Victim Survivability Profiling” (VSP). The phrase was coined by FDNY Captain Stephen Marsar; he has presented his view of the topic in multiple articles. (1, 2) The difficulty with buzzwords and phrases is they attempt to distill complicated ideas to chicken nugget sized bites of information.
The core idea of VSP is that firefighters have to conduct a through size-up of a structure fire and conduct an analysis to determine the likelihood of a victim being rescueable. This is a perfectly reasonable idea. We should be conducting a dynamic, ongoing, size-up regardless of our position on the fireground. If we hope to maintain Situational Awareness we must constantly be observing conditions. We must use our judgment and training alongside our personal condition to decide what we are willing to risk.
I take issue with the application of Victim Survivability Profiling as a way of approaching the fireground operation. In his 2010 article the very first statistics that Captain Marsar presents are correlations of civilian fire deaths to firefighter line of duty deaths. For the three year period that he discusses (2007-2009) there were 102 firefighter line of duty deaths that occurred in structure fires while only five civilian fatalities occurred at the same fires.
The first likely place for us to jump in our conclusions is that our brothers and sisters must be acting far too risky. They are rushing head long into “lost causes” and getting killed as a result. After all if firefighters had conducted their survivability profiles they would have asked themselves, “…if people are suspected or known to be trapped—is there a reasonable assumption that they may still be alive? If not, we should slow down and attack the fire first and complete the searches when it is relatively safe for our operating forces to do so.” (3)
Here is where I find fault with the correlation of these statistics, there weren’t fatalities in these fires where our members died. IF we were seeing a ratio of one firefighter fatality to one civilian (or even ten fire fighter fatalities to one civilian because we operate as teams) I would say that we are being too aggressive in scenarios where civilian lives are beyond being saved. That isn’t that case. We killed 25.4 firefighters for every civilian fire fatality during the time period examined. So we aren’t necessarily doing a poor job of deciding if the occupant may or may not be alive we are doing a terrible job of making the fireground safe for our personnel.
Captain Marsar makes the case that once the ten minute mark has been reached from fire department notification that any victims will have been exposed to temperatures or Carbon Monoxide levels that would likely be fatal. In those circumstances were we are being told that the building is both vacant and derelict, or where a significant forcible entry problem is present because of HUD windows or Vacant Property Security systems we should take on less risk. There is nothing to save.
However our mission is to save lives and property. If you have a building that is still salvageable, or you have a stated victim in the building then we should be aggressively attack the fire to save the victim and the property. The NIOSH Fire Fighter Fatality Program report 2010-10, which examines the line of duty death of Brian Carey of the Homewood, IL, fire department, states, “Ensure that a complete 360 degree situational size-up is conducted on dwelling fires and others where it is physically possible and ensure that a risk-versus-gain analysis and a survivability profile for trapped occupants is conducted prior to committing to interior fire fighting operations.” (4)
If we are conducting a “proper” survivability profile then should responding crews ignore the information that they are receiving of victims trapped and the information from an occupant of the house who has exited the building saying something to the effect of, “My husband is in there!”? Would the “right” answer have been to decide from the front lawn that because there was a significant volume of fire and a building charged with smoke that there was no possible chance of Mr. Wendell Elias, the 84 year-old homeowner reported trapped, being alive and attacking from a defensive mode?
I would say no. I would say that while our objective must be to make the building behave and control the fire to create a relatively safe environment for our personnel, that in the face of a believable report of a trapped occupant that we must enter the building and search. That is why we are firefighters.
If an agency is not going to conduct primary search operations of burning buildings because there is a risk of members being hurt or killed then we can cut staffing to two people per Station and run with ARFF vehicles rather than attack Engines and Trucks (has anyone thought that some politician who doesn’t actually care if citizens live or die might use this argument to “reduce risks to firefighters” while also cutting staffing?). Anything beyond an incipient fire can be fought from the outside and we can return to the day and age when the job of the Hook & Ladder Company was to hook the walls down to create a fire break.
This is not a safe job. I know that may come as a shock to people, but you can get hurt fighting fire. If your primary concern is not getting hurt you may have chosen the wrong career. I am not saying that Captain Marsar is advocating a position of “zero risk”, I have not sat down and talked with the Captain. As we can see from the Homewood LODD NIOSH report an attempt there are attempts to advocate a risk adverse agenda when dealing with a dynamic, high risk environment.
A firefighter who is unwilling to risk his or her life to save the lives and property of the community they have sworn to protect is of no more value than a police officer who will not use their weapon to stop a crime or a member of the military who refuses to go on patrol in Afghanistan.
I am afraid that if the risk adverse mentality that has slowly, and insidiously, taken hold in the fire service continues then we will be pitted against the communities we are there to serve. We will find ourselves either not fulfilling the expectations of our citizens, or we will see increased litigation and disciple for Incident Commanders, Company Officers, and Firefighters who make a decision, literally in the heat of battle, that results in a line of duty death or injury.
While egregious errors in decision making must be dealt with through discipline the fact remains that we do not have perfect knowledge on the fireground. We do not have a Google Earth™ view of the fireground with built in thermal imaging and ultrasound technology. We must make decisions rapidly, using a proven system of size-up and in accord with our department (and community’s) values. We must make sure that each and every member on the fireground is trained to operate there and make life and death decisions in a timely manner. Then when injuries and fatalities occur, and they will, we must learn from them and do what we can to reduce the avoidable errors.
We must also recognize the times we get it right, like in Oak Park, IL, where a teenage boy was rescued from a reportedly “vacant” building on October 10, 2010. Or the case of the Gilmore Street fire in Baltimore, MD, where crews rescued a homeless man who had taken shelter inside a rowhouse. He was burned, but he was rescued and transported. Would these fires have been blasted for “mistakes” had a firefighter been seriously injured or killed? Is it only a “mistake” if there is no victim saved?
What we are really talking about defining, nationwide, the virtues and values of the American fire service. While fires happen locally, movements, like survivability profiling, become the cause célèbre on a national level. The time has come for this debate to extend beyond the firehouse kitchen table, or the bay floor. We must decide, at a national level as well as at a local level, what level of risk we will accept. We must decide what value we place on protecting both the lives and the property of the communities we serve. We must train our members to be Fire Service Warriors, consummate professionals, who are able to thrive on in the dynamic and high risk environment of the modern fireground.
It may be worth remembering for a moment a passage from the speech that Teddy Roosevelt gave at the Sorbonne in 1910, “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” 5
2. http://www.fireengineering.com/index/articles/display/1153940879/articles/fire-engineering/survival-zone/2009/12/survivability-profiling.html accessed October 20, 2010
3. Marsar 2010
4. NIOSH FFFP Report 2010-10, p.2
5. http://www.theodore-roosevelt.com/trsorbonnespeech.html accessed October 27, 2010
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