Transcript Battalion Chief Keith Long Fairmount Fire Protection District Golden, Colorado Who is this Guy?

Battalion Chief Keith Long
Fairmount Fire Protection District
Golden, Colorado
Who is this Guy?
Our Journey
• Perception vs. Reality
• Our Mission has
Changed
• Situational
Awareness
• Infectious Disease
• MRSA
• Where do we go from
here?
Perception vs. Reality
• Finished files are the result of years of
scientific study combined with years of
experience.
How many letter “F”s in previous
slide
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3?
4?
5?
6?
Character
“The ultimate measure of a person is not
where they stand in moments of conflict
and convenience, but where they stand in
times of challenge and controversy”
MLK
C
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reserved
Then
• Wildfire
• Wildfire
• Wildfire
Our Mission is Changed
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Wildfires
Hurricanes
Tornados
Earthquakes
WMD
911
Snow Storms
Pandemics and Epidemics
Etc
Infectious Disease
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Foodborne
Waterborne
Airborne
Bloodborne
Zoonotic/Vectorborne
Pathogens Transmitted in Camp
• We will be specifically talking about
strategies for containing pathogen
potential spread person to person.
Transmission Modes
• Respiratory – e.g. influenza
• Direct Contact – e.g. Staph Infections
• Contaminated Environments - e.g.
Norovirus
Questions?
• How many of you folks are on Teams?
• How many of your teams have Emergency
Response Plans?
• When did you last practice the Plan?
• How many of your Teams have Infectious
Response Plans?
• Have you ever practiced the Plan?
IDRP/ERP for IAP
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Position Checklist – Field Organization
Division/ Group Supervisor
Medical Group Supervisor
Triage Unit Leader
Treatment Unit Leader
Transportation Unit Leader
Four Routes of Entry
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Inhalation
Ingestion
Absorption
injection
Its too late to duck!
Preparation
• N95 Masks for all members
*Must be fit tested*
• Safety Glasses
• Exam Gloves
• Hand Sanitizer
Masks and Respirators
• N95 Mask or
Respirator (goes
on you)
Surgical Mask (goes on them)
Resources
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Local Health Department
Local clinic or Hospital
State Health Department
Center for Disease Control
Specific
• MRSA – Methicillin – Resistant
Staphylococcus Aureus
MRSA
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Background
Signs and Symptoms
Incubation Period
Treatments
MRSA and Firefighters
• Methicillin Resistant Staph Aureus is a
Staff infection that is resistant to normal
antibiotic treatments.
• It exists on the skin and in nasal passages
and is “colonized” in 20 to 30% of all
people with no symptoms
MRSA and Firefighters
• The Centers for disease control estimates
that by 2015, all of us will carry some form
of MRSA.
• It used to be solely a hospital problem but
is now found in the community.
• MRSA can survive on some surfaces for
up to 2 months.
MRSA and Firefighters
• Why Fire Fighters?
• FF’s move through the community, hospitals and patient environs
more that the general public.
• Combined living/working environment
• High potential for skin irritation/lacerations
• Do not regard small injuries as a threat.
• Why be concerned?
• If MRSA enters the bloodstream it can cause death or damage that
makes you disabled.
• Most MRSA treatments average cost to treat is between $15000.00
and $20000.00.
MRSA and Firefighters
THIS IS NOT A NEW PROBLEM
FOR FIRE FIGHTERS
It is a problem in many fire stations, fire
crews and at least one case of MRSA has
been found in every state across the
nation.
MRSA and Firefighters
• It starts as a pimple with red tender edges.
• What does it look like?
MRSA and Firefighters
• Progresses into an abscessed infection
quickly.
• If it enters the bloodstream it is hard to
treat. – Only two antibiotics can cure it
then.
• Can result in Fever, Malaise,
Hospitalization and lost work time.
MRSA and Firefighters
• Almost all MRSA can be treated by
drainage of pus with or without antibiotics.
• If antibiotics are used, a sample must be
analyzed first to determine the strain and
type of antibiotics to use.
• Open skin wounds must be covered and
dry. Do not use ointments for treatment
of MRSA.
• Regard breaks in skin as potentially
serious issues
MRSA and Firefighters
• What can we do?
• MRSA cannot live if there is not moisture. Dry PPE,
shirts and pants after use.
• Make new bleach solutions everyday… Needs a ten
minute contact time to be 100% effective.
• Use alcohol cleaners with at least 70% alcohol.
• Cover any skin irritations or lesions with a dry bandaid.
• Don’t wear the same clothes consecutive days when
sweating a lot.
MRSA and Firefighters
• What can we do cont.
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WASH YOUR HANDS, FACE and ARMS
»
Wear Gloves and PPE
&
• CLEAN! CLEAN ! CLEAN!
Alcohol Based Hand Sanitizers
• What about alcohol based hand sanitizers!
A Gift from the NLW
• Myclyns – immediately after contact with
– Blood
– Saliva
– Vomit
– Coughing
– Feces
– Open wounds
Myclyns
• Kills 50 pathogenic bacteria upon contact
99.99%
• MRSA
• TB
• Hep A, B, and C
• H1N1
• Hepatitus
ExtendaClyns
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Hand Sanitizer
Non Alcohol based
Broad Spectrum
Last up to 4 hours
Kills 99.99% of germs
Leadership Development In High
Risk Environments
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Training
Field Experience
Self Development
Exercises
Fireline Leadership Challenge
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Time Pressure
High Stakes
Inadequate Information
Ambiguous Objectives
Poorly Defined Procedures
Rapidly Changing Conditions
Requirement of Team Coordination
Train as you fight, fight as you train
Cognitive Memory System
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Complex and connects memories together
Well integrated
Treats information neutrally
Subject to control and filtering
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Emotion & Fear Memory
System
Responsible for special emphasis
Stimulus-driven
Direct and quick
Highly emotional, inflexible, and fragmentary
Connected directly to fear responses
Are we setting ourselves up for
failure?
• Wildland vs. Structure vs. All Risk
• Emergency Response Plans Incident
within an incident
• Infectious Disease Response Plans
Lessons Learned
• 95% of illness comes from inadequate
washing of Hands, Sleeping in Dirty
Clothes
• Incident Emergency Medical Task Group
Ideas and Suggestions
• Medical Unit Leaders utilize Isuite Injury/
Illness section.
• Brief your folks, Give Expectations
• Have your people do evaluations on you
6 Priorities in Fire Camp
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Case Isolation or cohorting
Personal Hygiene
Environmental Sanitation
Crowding
Education and Awareness
Pre-deployment Interventions
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Final Thoughts
• I don’t have all the answers, Hopefully I
never will. When I do it’s time for me to
leave. Empower your people. Mentor your
people. Utilize SME (subject matter
experts)
• Thank you for all you do!