Danger in the deep woods: First 60 minutes crucial to rescuing injured firefighters

Danger in the deep woods: First 60 minutes crucial to rescuing injured firefighters

03 July 2010

published by www.redding.com

USA — Before venturing into deep woods to battle summer blazes, federal firefighters this season will devise specific plans for rescuing severely injured co-workers.

The new attention to detail, prompted by the death of a rookie firefighter during fires that swept through the north state two years ago, may signal a major shift in federal firefighting strategy.

“They are really going to set up plans to get firefighters out within an hour,” said Jim Milestone, superintendent of the Whiskeytown National Recreation Area. “The idea is to get that person out of there.”

Like generals planning for battle, managers of major forest fires meet early each morning to devise the day’s strategies.

As part of the planning in the past they’ve outlined basic plans for treating fire-line injuries, discussing only generally how fire crews will respond to a severe injury on the fire line, Milestone said.

This fire season the plans will be more detailed and focused on how to retrieve injured firefighters as quickly as possible.

On the Shasta-Trinity National Forest this year there will be an emphasis on continually creating fire plans that include “solid and effective” medical evacuation plans, said Jim Peña, the U.S. Forest Service’s deputy regional forester for California.

“The idea is to assess where we work in the forest,” he said. “This isn’t just focused on fire.”

The goal is to avoid another death like that of Andrew “Andy” Palmer.

Palmer, 18, of Port Townsend, Wash., died after an 8-foot section of pine tree fell on him while he fought a fire near Junction City in 2008. Palmer’s family and fire officials who reviewed a federal investigation of his death say it could have been prevented by a quicker medical response. The tree broke Palmer’s left leg and severed his femoral artery, but Palmer lay on the ground for more than 2½ hours as firefighters tried to figure out how to get him to a hospital.

A better rescue plan could have saved Palmer’s life, said Milestone, who was a member of the federal team that investigated the death.

Building on the investigative report released last year, the National Wildfire Coordinating Group — which is made up of representatives from federal firefighting agencies and sets standards for training, equipment and operation — issued a memo in late May recommending improvements in medical responses during wildfires.

It focused on standardizing how firefighters from different agencies respond to a major injury during a fire, improving communication and regularly reviewing medical plans while a fire is being fought.

While the group’s recommendations are just that, with no requirement or mandate for implementation, Bill Kaage, the group’s chairman, said fire crews around the country will adopt them.

“It may take time,” he said. “But these aren’t people who say they won’t listen.”

Golden hour

The question is whether the recommendations will result in an injured firefighter making it to a hospital within an hour. Medics call the first hour after an injury the “golden hour,” with a person’s best chances for survival hinging on whether they can get to a hospital within those 60 minutes.

“It’s going to be pretty difficult,” Milestone said, “but it’s not impossible.”

In fighting fire, crews often end up in remote forests. The deeper into the wilderness they go, the more complicated it is to get them out if something goes wrong, said George Chapman, who retired Thursday as Whiskeytown’s fire management officer.

He said the shift to more specific plans will lower the amount of time it takes to haul an injured firefighter out. But he said it will be rare for crews to do so in an hour or less.

“Even if you have the tools,” Chapman said, “that would be difficult.”

And although Milestone said the plans will aim to hit the golden hour, the National Wildfire Coordinating Group’s recommendations don’t give any time guidelines.

Palmer’s Push

A 10-year veteran of wildland firefighting himself, Rob Palmer, 29, Andy Palmer’s older brother, said he’s glad to see the changes outlined in the group’s memo. But he said more needs to happen to make firefighters safer in the field.

“It’s a huge step in the right direction,” he said. “We’ve got a long way to go.”

Since his brother’s death, Rob Palmer said he can’t bring himself to fight a major fire until more changes are made to make conditions safer for firefighters. He’s taken leave from the National Park Service and is now a law student at Seattle University as part of his effort to push for more changes.

“I don’t want my family or co-workers to go through what they did with Andy again,” Palmer said.

In addition to meeting with federal fire managers, Palmer drew a road map of where he thinks federal fire agencies need to go to improve the safety of their firefighters. His paper, the “Palmer Perspective,” was released in January 2009 and made its way to other firefighters via e-mail and wildfire fighting blogs.

He said he continues to expand his ideas about the changes needed, but his focus remains on improving medical response to life-threatening injuries for firefighters in the field.

“The ultimate goal would be to have them to a hospital within an hour,” Palmer said.

He said the group’s recommendations so far fall short of that.

Given the dangers of firefighting, Palmer also argues for more emergency medical technicians (EMTs) on the fire line. He compares the profession to other dangerous occupations and pastimes. While there is one EMT per 499 federal wildland firefighters, there is one EMT per eight to 16 soldiers and two to four EMTs per 22 high school football players, Palmer said.

He calls for a minimum of one field EMT for every 10 firefighters so there will be someone ready to respond to life-threatening injuries.

“Instead of reacting and floundering through an emergency within an incident, we will determine future wildland fire response tactics based on the principles of the golden hour, invoking the first radical change in the history of wildland fire,” Palmer wrote.

Fire crews also should have C-collars and backboards, crucial tools for moving a trauma patient, on their engines so they are prepared to transport an injured firefighter to a hospital, Palmer said.

Palmer, a federal employee himself, said he’s familiar with how long changes in firefighting policy can take. But he’s willing to keep pushing for them.

“I think we can do it,” he said.

Carrying change to the fire line

Kaage, leader of the federal firefighting group, said high-level fire managers have listened to Rob Palmer and respect his thoughts.

“He’s got some really good ideas as we continue to make it safer out there,” Kaage said.

But, he said it’s a long process to approve recommended changes following a death.

When reviewing a death like that of Andy Palmer, Kaage said, the aim isn’t to lay any blame or find someone at fault.

“It’s an issue of finding facts and figuring out what we can learn from the accident,” he said.

And that is a slow process, he said, noting that it’s been nearly two years since Palmer died.

The issue is complicated by the fact that so many agencies are involved. On federal lands, for example, the Park Service, Forest Service and Bureau of Land Management all fight fire. Then there are state, county and city fire departments. Kaage said part of the challenge of his group’s task is creating recommendations for the varied agencies, which may hold differing philosophies about how to do their jobs.

“It’s tough to get one size that fits all,” Kaage said.


A critic of fighting fires that are not immediately threatening people’s lives or their property, Timothy Ingalsbee said Andy Palmer’s death underlines what is at stake — firefighters’ lives.

Ingalsbee, the executive director for Firefighters United for Safety, Ethics, and Ecology, said firefighting is inherently dangerous work but becomes increasingly so in the most remote forest areas. Along with Palmer, seven other men died when a firefighting helicopter crashed in Trinity County’s rugged mountains and a seasoned fire chief on a scouting mission died in Siskiyou County near Happy Camp when a fire burned over him during 2008’s fire siege.

Palmer and the seven men who died in the helicopter crash were fighting fires on Shasta-Trinity National Forest land that weren’t threatening homes or town.

As federal fire managers work to reduce the time it takes to move injured firefighters from the field to a hospital, Ingalsbee said the first question that should be asked is whether a fire is even worth fighting, especially if it is burning far from towns or homes.

“The real issue is avoiding accidents,” Ingalsbee said.

Firefighting safety recommendations

After reviewing Andrew “Andy” Palmer’s death, the National Wildfire Coordinating Group made the following recommendations for fire agencies.

Create a specific medical emergency plan that details:

Options for medical evacuations, evaluating them on efficiency, availability and proximity.

Identifying one on-scene contact through chain of command, the contact will determine who is treating the patient and request transportation based on their condition

Regularly review emergency medical procedures, focusing on:

Time frames, how long it takes to get to and from specific locations.

GPS coordinates for key locations, such as drop points and helicopter landing spots.

Ambulances and other equipment available if requested.

Gauge how geographical and environmental factors, such as smoke, may slow response.

A secondary plan for evacuation if aviation is the first plan, including time frames.

Standardize how emergency medical information is communicated by going through a checklist:

Determine the nature of the emergency.

If the emergency is medical, is it life-threatening?

If it is life-threatening, clear a radio frequency for communication.

Identify a contact person at the scene.

Contact top medical official immediately.

Identify the number injured, patient conditions and locations immediately.

Identify medical personnel at the scene.

Determine preferred method of transporting patient from the scene.

Determine if any more help or equipment is needed.

Document all communications on radio or phone.

Document any changes to who is the on-scene contact or changes to the medical personnel.

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