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Firefighter Dies in Training Maryland recruit firefighter Andrew Waybright collapsed during a training exercise in extreme heat. Academy personnel dismissed seriousness figuring that the recruit was just “played out” First aid was not provided to the recruit until it was too late. He was pronounced dead at hospital temperature was 107.4°F Lack of Planning and Preparation Contribute to Tragedy Training Officer alleged to be “an untrained leader, for failing to provide hydration, failure to provide basic first aid, and failure to inform recruits of the exercise session”. Failed to meet duty “to provide training exercises in a reasonable and safe manner such that they did not endanger the health of the recruits”. Waybright’s parents suing for $1 million This tragic incident was completely preventable. In a training environment, everything can and should be controlled. Emergency calls cannot be planned, and often, the scene conditions are out of control. We must prepare ourselves in advance for the planned, unplanned and the uncontrolled emergency environment. Heat related illness/injury is a serious concern for firefighters in the Northwest. Extreme physical demands, hot and sometimes superheated environments, heavy protective clothing, and unstructured rehabilitation all contribute. Hydration level, level of fitness, preexisting medical conditions, and medications, all affect the ability to deal with heat stress. Hydration Sweating is an important cooling mechanism of the human body. The rate at which people sweat is determined not only by genetics, but by hydration, state of acclimation and aerobic fitness. You can’t sweat if your body doesn’t have enough water. In order to maintain normal body function, fire fighters must pre-hydrate and replace fluid as soon as possible during or as soon as possible after exertion. Acclimation Acclimation is a physiological adaptation that the human body makes with repeated exposures to heat stress during exercise. It increases our rate of sweat production and shortens the time it takes for the sweating response to start and conserves sodium. Physical fitness can help with acclimation. Fitness Regular and sustained aerobic exercise can help with acclimation. Fire fighters who maintain an adequate level of fitness will have reduced cardiovascular strain and lower core temperature for the same level of heat stress. Fit fire fighters also tend to have reduced levels of body fat – and aren’t carrying extra non-functional weight. Therefore, less energy is required by a fit person to do the same job as a less-fit person. Predisposing Conditions Sustained exertion in the heat by unacclimatized workers. Lack of physical fitness and/or obesity Recent alcohol intake. Dehydration. Individual susceptibility. Chronic cardiovascular disease. Failure to replace water lost in sweat. A. Heat Exhaustion vs. B. Heat Stroke For more detail go to: http://www.emsonline.net/ Log in and click on CBT 385 Environmental Emergencies If signs or symptoms of heat illness are seen: Notify supervisor immediately Move patient to a cool place. Remove protective clothing and loosen work clothing. Provide cool water Apply cool packs Call Medic One if ALS indicators are present. Provide oxygen or ventilatory assistance as needed. To maximize your chances of avoiding heat illness: Stay hydrated by drinking 8 ounces of water each hour throughout the day. Stay physically fit by performing aerobic exercise for at least 30 min. per day, 4 days per week minimum. Avoid alcohol consumption the day before you report to duty. Ensure optimal health by getting an annual medical examination. Make appropriate rehabilitation part of all training exercises and/or emergency scene operations. Zone 3 Rehab Tracking Form Zone-3 Rehab Tracking Form Date______________ Department____________________ Location______________________ Incident #____________ Rehab Area Manager______________ Unit Name CAD # Time In Time on Air Time Vitals BLS Unit_____________ B/P HR Temp Allow 5 minutes of rest prior to first set of vitals If HR exceeds 100 a temperature should be taken Guidelines for Medic Evaluation: Systolic <100 or >160 after 10 minutes of rest = evaluation Diastolic >100 after 10 minutes of rest = evaluation HR >100 after 10 minutes of rest = evaluation Temp >100.6 F = evaluation CO >5% = evaluation Neurological Status-- altered mental status = evaluation Unless firefighter qualifies for ALS evaluation, allow 10 minutes of rest between repeating vitals Mental Status Explorer Advisor_________________ CO Level O2 Sat Skin Condition and Color Treatment Disposition PO Fluid (1000ml) Snack Bar or Meal Cooling or Warming O2 Monitor or ECG PO Fluid (1000ml) Snack Bar or Meal Cooling or Warming O2 Monitor or ECG Full Service Out of Service To Medical See MIRF PO Fluid (1000ml) Snack Bar or Meal Cooling or Warming O2 Monitor or ECG Full Service Out of Service To Medical See MIRF PO Fluid (1000ml) Snack Bar or Meal Cooling or Warming O2 Monitor or ECG Full Service Out of Service To Medical See MIRF Full Service Out of Service To Medical See MIRF Guidelines for Release to Active Duty Able to follow commands Good color and dry skin Free of symptoms (dizzy, headache, SOB, CP, etc) HR <100 Systolic >110 and <160 Diastolic <100 Temp <100 CO <5% Allow a minimum of 15 minutes of rest and P.O. fluid before reassigning crew Time Out ZONE 3 REHAB AT EMERGENCY INCIDENTS AND TRAINING EXERCISES It is the responsibility of all Department personnel to incorporate this policy into their daily activities as needed. Review King county Policy in its’ entirety .