Spinal Precautions for First Responders

The times are a changing regarding Spinal Precautions in regards to better patient care but it is important to follow your level of training and protocols.

If you are curious what the current protocols are for Spinal Precautions according to BCAS then check it out at this site; https://bctg.bcas.ca/Condition/Principles/13

The medical principles in the BCAS document refer to an online course titled "Evolving Practices in Trauma Care".  I did a bit of research and believe I have found that course offered at;
https://www.itrauma.org/education/itls-etrauma/

The ITLS has a document outlining their thoughts on the use of long backboards, etc. just for patient extrication.  You can read about that at; https://www.itrauma.org/wp-content/uploads/2014/05/SMR-Resource-Document-FINAL.pdf

A really good article is "The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury". It states the following;
The vacuum mattress, while not rigid enough for extrication, is a useful transportation device. As vacuum is applied, the mattress moulds to the patient’s contours, minimising point pressure, making it more comfortable, less painful and, arguably, less likely to produce ulceration [73, 138–141]. The vacuum mattress has been shown to provide a similar, or superior, degree of stabilisation when compared to that of the backboard [132, 139, 140, 142].

According to the BCAS FR Intervention guidelines a FR is to provide manual stabilization and avoid any unnecessary movement.  (at one higher level up, an EMR is to Immobilize patient following principles of spinal immobilization).

The BCAS recently issued an advisory on how they will be changing their treatment guidelines.  This was done in the BCEHS Spinal Motion Restriction Briefing document.

Overdose Deaths in British Columbia and FR Protocols

If you are curious on the statistics on overdose deaths in British Columbia as of October 2017 look no further than just clicking this link.    You will find out that there were 1208 deaths in B.C. in 2017 of which the highest percentage occurs on Fridays.


If you are a first responder you can find read the BCEHS document on Administration of INTRAMUSCULAR Naloxone for Suspected or Confirmed Opioid Overdose.  Keep in mind that I do not believe that a First Responder is required to phone EPOS in order to get authorization to administer Naloxone.    The reason for that is that you can confirm the First Responder treatment guidelines at the BCEHS Treatment Guidelines for Central Nervous System Depressant Poisoning /Overdose

The Emergency Medical Assistants board of B.C. recommends that all first responders review safety when around Fentanyl by viewing this site;  https://www.fentanylsafety.com/

Firefighter Ladders and tieing the Halyard

Portable Ladders and Halyards
If you are studying for a firefighter exam, you know that the proper way to deploy a extension ladder, is as follows;
A) Select the proper ladder for the job
B) Remove the ladder from the apparatus
C) Carry the ladder to the worksite.
D) Raise the ladder (which may involve untying the halyard).
E) Extend the ladder and position.
F) Tie the halyard.






I was recently at a course, where the instructor, advised, that during emergency situation, the time that is spent dealing with tying of the halyard could probably be spent more efficiently doing something else.  Sure untying and tying off the halyard only takes seconds but since the halyard's only purpose is to raise the fly, then what is the point of tying it off, other than just getting it out of the way.

The following is copied directly from a firerescue 1 article;

On an extension ground ladder, the halyard is tied off to secure the fly section to the bed section when not in use. It is common to use a clove hitch knot, incorporating the halyard in the middle of the knot with the clove hitch tied around the third or fourth rung up from the bottom of the ladder.

This adds time when trying to deploy and raise the ladder. The time it takes to untie the knot, unwrap the rope and then extend the ladder will complicate the operation.

Instead, try tying the halyard around only the bottom rung of the bed section. This allows the ladder to be extended without having to untie the knot, thus saving time in the operation. If the rope needs to be tied off after the raise, the halyard can be tied using a clove hitch on a bight.
https://www.firerescue1.com/fire-products/ladders/tips/97635039-Different-way-to-tie-the-halyard/

Piercing Nozzles - Some research....

This is a blog post regarding piercing nozzles, especially as they pertain towards use in residential structure fires. 

Under the right circumstances when a fire is compartmentalized and isolated in a confined space, using a piercing nozzle for extinguishment is safe, quick and efficient.

The piercing nozzle throws a 25-foot diameter, umbrella-type, spray pattern which, when converted to steam, can cover a 2,400 square foot area with dense fog. The steam cools the temperature of the fire gases, reducing the heat. It also cools the temperature of the fuel and displaces oxygen, thus smothering the fire.

In live fire tests conducted by the Hoquiam (Wash.) Fire Department, a fully-involved, normal-sized, room fire in a house was extinguished by a piercing nozzle in 6-8 seconds using 3-5 gallons of water. Again, under the right circumstances, using the piecing nozzle is excellent for booster tank attacks when there are a limited number of personnel or when the water supply is limited, delayed, or unavailable.
Read more about this at;  piercing-nozzle-can-be-among-the-most-effective.html

There are quite a few variations of piercing nozzles on the market.  Have a look...
Fyrestick - $879 - Invented in Billings, MT -https://www.youtube.com/watch?v=RVTHk85gD08
First Attack - https://youtu.be/mKJObsukXx0
and More; 

Boom truck

How about put a piercing nozzle on a boom on a firetruck?  Check it out;
https://youtu.be/Z5a7foK88DQ


Some information on tactics:
A piercing nozzle, particularly if fed by Class A foam or compressed air foam, may be a particularly effective tool on attic fires if it’s pushed through the ceiling and flowed into the attic from below. These nozzles can provide a widely distributed flow of the suppression agent, reaching all around the attic space. For larger buildings, such as garden apartments, two or more of these nozzles placed under a trench cut can make an awesome firebreak, stopping horizontal fire spread. Remember: When applying water overhead, you’re adding weight to the ceiling, which can increase the potential for a ceiling collapse.
Read more about it at; ReadMore 

More tactics at; http://www.targetsolutions.com/featured-contributors/strategic-tactical-and-task-level-considerations-for-attic-fires/
and
http://www.firerescuemagazine.com/articles/print/volume-9/issue-7/firefighting-operations/using-alternative-attack-devices-for-concealed-space-firefighting.html

Tactics on Attice fires without piercing nozzle  - video from fdcam.

There is quite a bit of research on the science of attic fires.
NIST - Simulation of an attic fire in a wood frame residence This involved a FF LODD.

The new Canadian National Fire Information Database is now available.  I can't wait to get access and map out where all the fires are happening.  Check out these stats - chimney fires (heating) are actually quite low according to stats.

Chimney Fires - tis the season.

It is the time of year when fireplaces are being used quite often and of course during the holiday season they are used more frequently.   Chimney fires may occur.  This blog post just contains some references to some information that might be of value.

1. Underwriter's Labs has a informative training video on Residential Attic and Exterior Fire Hazards.
    You can view that training material at;  UL Labs Residential Attic and Exterior Fire Hazards

2. If you are going on a roof, make sure you do it according to your SOG's.  For a refresher
    on some basic ladder safety, watch this video;  https://youtu.be/5QY8MKxehmQ

3. Somone's tactical approach to Chimney Fires is available in powerpoint here;
    https://www.mfri.org/dom/Drill_pdf/DM_1508.ppt

4. Every fire contains danger.  This NIOSH report on a firefighter fatality gives some lessons learned;
    https://www.cdc.gov/niosh/fire/pdfs/face201520.pdf

Now, back to studying at; http://www2.jblearning.com/my-account/login

Washington State and British Columbia Wildfires Info for August 21st, 2015

There are a few large wildfires affecting the area I live close to so I thought I would post a few links to some informative sites.  The fires I am referring to are around Grand Forks, British Columbia and Stevens County, WA;

Esri fire mapping; http://www.esri.com/services/disaster-response/wildlandfire/latest-news-map

Public Meeting held August 20th about the wildfires close to Grand Forks

Ferry County Sheriff's Office Facebook Page

BC Wildfire News

Wildland Firefighter courses available online; http://www.nfaonline.dhs.gov/

Stickpin Wildfire Mappingsupport; 

Washington State Department of Transportation Road Closures

DriveBC road conditions and events

Treewell safety

I recently got back from a ski trip and thought I would post some information regarding tree well safety when skiing. 

If you don't know what a treewell is or how to be safe around them - then you should read this;
www.deepsnowsafety.org

An informative video on a treewell rescue is here;

















Maybe an avalung could help prevent....

Be safe!