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DISCRIMINATORY HARASSMENT TOPS LIST OF
LEXIPOL’S 2018 FIREFIGHTER TRAINING TOPICS
Issues of sexual harassment, bullying and retaliation have received increasing attention in the fire service in recent years. So it’s no surprise that discriminatory harassment was the top training topic represented in Lexipol’s Daily Training Bulletin (DTB) program for fire departments in 2018.
Departments using the DTB program had access to 120 unique firefighter training bulletins last year, providing nearly 4 hours of training. Lexipol strives to keep the training program closely associated with issues making headlines in the fire service.
An end-of-year summary from Lexipol organizes the training topics into 11 main categories and more than 100 subtopics. General Operations accounted for 26% of the DTBs, featuring subtopics such as fireground accountability, emergency driving and hazmat response. Personnel topics accounted for 21% of the DTBs issued. In addition to discriminatory harassment, this category includes subtopics such as modified duty assignments, promotions and transfers, and outside employment. Safety (9%) and Training (8%) were the third- and fourth-highest categories, respectively.
DTBs use a proven system of realistic and verifiable training to expose firefighters to their department’s policies and help them apply policy to real-world situations. The bulletins are authored by Lexipol’s Training Team and use scenarios to bring policy to life and enhance firefighter understanding of their policies.
“Our Training Team members are current and former fire department instructors, so we benefit from a wealth of practical knowledge relating to critical topics such as firefighter safety, technical rescue, and conduct and behavior,” says Don Weaver, Training Director for Lexipol. “We design our training bulletins to focus on a specific aspect of the department’s policy and present them in the form of scenarios because we know this helps enhance learning retention— the firefighters are being asked to consider how their policy works in the real world.” The DTB program also takes into consideration current events and emerging trends.
To access the complete listing of 2018 topics, click here.
Sign up to receive email updates from Lexipol, strategic partner of the Southwestern Division IAFC members.
ADDRESSING FIREFIGHTER DEVIATION FROM POLICY
By Scott Eskwitt
Why do firefighters deviate from policy? And when it happens, what is the right way to address the deviation? Before we delve into these questions, let’s look at two recent firefighter deviations from policy that made headlines.
In Dallas, firefighters deviated from a newly instituted policy when they entered a home during a shooting incident. The firefighters knew two people, including a woman who was eight months pregnant, were inside the home. They knowingly deviated from the policy requiring them to wait for police before entering a violent scene. Although the mother died, the baby was later delivered via C-section at the hospital.
In Phoenix, a fire marshal was demoted for violating the department ethics policy after he accepted a $100,000 check, while on duty, from a philanthropist whose business had failed its fire inspection 11 months earlier. The check was a donation to a non-profit organization in which the fire marshal and his family were involved. The City of Phoenix Human Resources Department imposed the discipline even as it concluded there was no indication the philanthropist’s business received any special treatment when it came to a fire code waiver.
Deviation from policy is rarely a simple matter for supervisors and administrators. When a member deviates from policy or procedure, don’t accept it as a one-off event or write it off as OK because the outcome was positive. Deviation from policy requires an investigation exploring the following questions:
- Is the policy/procedure written so it is usable and achieves its stated purpose?
- Has the member been trained on the policy?
- Did the policy deviation occur during a time-critical event where the member used recognition-primed decision-making (RPDM)?
- Did the policy deviation occur during a non-time-critical event where a more classic decision-making process was or should have been used?
Two caveats as you begin the investigation: First, until the reason for deviation from policy or procedure is determined, it should not be categorized differently. Using any other term, such as ignored, disregarded or failed to observe, implies the member did something wrong when, in fact, that determination will be the result of the investigation. By contrast, deviation implies no fault; it’s simply a fact.
Second, don’t overcomplicate your conclusion. Generally, the investigation should have one of four outcomes:
- Determination the deviation was the result of poorly written policy or procedure
- Determination the deviation was the result of lack of training on the policy or procedure
- Determination the deviation was proper under the conditions and was made for an articulable reason, based upon the experience and knowledge of the member
- Determination the deviation was improper because it occurred without an articulable reason
With those guidelines in mind, let’s look at each question in detail.
Did the policy/procedure properly account for the situation?
A poorly written policy or procedure is one that does not adequately address law, best practice, current equipment and technology. Importantly, the policy must also reflect the reality of how the organization operates. If your investigation finds the policy or procedure is inadequate, then it needs to be updated before a member can be found to have ignored or disregarded it. It can be as simple as your fire investigation policy failing to require the use of a thermal imaging camera (TIC). If a member fails to use a TIC and the incident commander clears a scene where a fire later erupts, the failure of the policy is glaring.
Was the member trained on the policy/procedure?
Put simply: How can a member be found to have disregarded or ignored a policy on which they were never trained? Initial and continuous training using policy and procedure is a key part of implementation and use. Consistent training reinforces a policy or procedure and makes it a part of the member’s decision-making process, whether that decision is made during RPDM or classical decision-making.
We all know the phrase “go to your training.” Well, a member can’t go to their training if they never had it. Training is a department responsibility and if a member deviated from policy because they were not adequately trained on it, the blame lies with the department.
Did the policy deviation occur during a time-critical event?
If the policy or procedure is found to be valid and the member was trained on it, we can move on to examine the member’s reason for deviating.
When it comes to time-critical incidents, firefighters usually employ RPDM. A member will quickly, within seconds:
- Evaluate a situation
- Consider a solution based on training and previous experience
- Run a quick validation and either accept or discard the solution, repeating this process until an acceptable solution is determined and then implemented
Any hope of following policy or procedure in RPDM requires continual training on policy and procedure so that when a member in a time-critical situation goes to their training and experience, the policy and procedure is included in that process.
A common example of a time-critical policy deviation is failure to perform a 360-degree assessment, per scene-arrival procedures, when confronted with visible smoke and fire upon arrival. Instead, the crew immediately commences operations based on what the company officer sees in front of him or her, leading to a failure to fully size-up the scene and assess location of victims or fire on the B, C or D sides.
Did the policy deviation occur during a non-time-critical event?
Non-time-critical deviations are easier to assess. Here, a member engages in a more classic decision-making process of identification, analysis, evaluation and implementation. Often this process will include asking for advice from other members before making the decision.
In non-time-critical events, it should be second nature that the policy/procedure is followed (remember, we’re assuming the policy is well written and valid and the member has been trained on it). Firefighter deviation from policy in non-time-critical events is likely due to a conscious decision to disregard the policy. Such decisions are usually attributable to lack of emphasis on policy or procedure from leadership, misplaced priorities or the member simply believing they know better. The member may rationalize his or her decision, especially when there is a lack of consequences, but there is rarely a valid reason for disregarding policy or procedure in non-time-critical scenarios.
Consider the following example of a non-time-critical deviation from the operational readiness policy/procedure: Apparatus operators are required to inspect the personnel accountability materials on the apparatus at the start of their shift. An operator conducts the inspection and finds several tags are missing. Following procedure, the operator reports this to her company officer.
The procedure further requires the company officer to make repair or replacement of missing equipment a priority at start of shift. The company officer receives the information but decides to deal with the missing personal accountability materials after reviewing and finishing incident reports for NFIRS. In the meantime, a structure fire with rescue assignment is received and the company responds. Two members find themselves having to make entry without tagging in.
We don’t need to go further with the example. The company officer clearly made a conscious decision to disregard policy and a chain of events follows. Assuming the company officer was trained on the procedure, his priorities were misplaced.
The Dallas and Phoenix examples we started with further illustrate that deviation from policy is rarely black and white. We’ll assume the members were trained on the applicable policies. The Dallas example is a time-critical situation involving firefighters confronted with the knowledge that there were gunshot victims in a house with the shooter in the vicinity and police not on scene. Perhaps the policy needs to be restated to adequately protect the department and its members while accounting for the realities of such incidents. If it is determined the policy is appropriate, should training evolutions include scenarios where members must wait to reach known victims and mandatory post-incident stress debriefing?
The Phoenix example, where the fire marshal accepted a substantial donation while on duty for a charity in which he was involved and as a result was demoted, is non-time-critical. It required a detailed investigation to determine the circumstances. Here, the city of Phoenix deemed it appropriate to demote the fire marshal, while also finding that the business owner didn’t receive favorable treatment.
The bottom line: Each firefighter deviation from policy should be the subject of a thorough investigation that starts with questioning the validity and applicability of the policy or procedure itself. Next, determine whether the member was initially and consistently trained on the policy. Then review the conditions under which the deviation took place. Only then can you properly determine whether the policy needs to be updated, additional training is required, or the member’s actions were proper or improper.
SCOTT ESKWITT is Operations Manager Fire Development for Lexipol and an active member of the Fair Haven (NJ) Fire
Department, serving as Chief from 2012 to 2015. He is also a member of the Fair Haven First Aid Squad and the Red Bank (NJ) Fire Department. Scott is also an attorney and has spent his legal career advising municipalities and fire departments on risk management, human resources and labor relations issues. His undergraduate degree in Industrial & Labor Relations was received from Cornell University and his law degree from SUNY Law at Buffalo.
“IAFC-SW Division High Performance Coaching & Leadership Academy”
|What it isThe IAFC-SW Division, and 1SmartCareer proudly partner to bring “Cutting Edge”leadership training to the fire service. Our promise to you is that this academy will be considerably different than you ever have attended before and way more powerful.|
Join us to learn the key skills and practices necessary to successfully lead people and manage resources in today’s fire and emergency services.
What sets this training apart from other leadership training courses is that, upon completion of the symposium, 2 coaching and 2 mentoring sessions will be scheduled by phone for each participant.
Who Should Attend: Current Officers, Company Officers, Future Chief Officers, Mid-level Chiefs, anyone in FD Leadership Positions or aspiring to same.
|Academy Topics IncludeYou are the leader; roles, responsibilities and behaviorsCommunicating and Connecting effectivelyMoving Forward and dealing with obstaclesLeading into the Future and developing other leaders|
|When and Where|
This symposium is being held March 12 – 14, 2019 in Lafayette, Louisiana at the Lafayette Fire Training Center; event time 8:30am – 5:30pm.
Pricing at $849 per attendee. Includes a 3-day in person symposium plus 4 online classes, and 2 coaching and 2 mentoring sessions over the following four months, April – July, 2019. Class size is limited to 44 attendees.
|Learn More and to Register for the Academy Here|
|For specific questions or additional information contact: Steven Matzat|
October 4, 2018
By unanimous vote, the IAFC-Southwestern Division elected to adopt a new 2-year strategic plan. The previous strategic plan’s final worksheet
was discussed at the BOD meeting in Fayetteville October 2, 2018. The new plan was reduced into 3 main goals: Lead, Educate Serve
Please see the Strategic Plan below. Or you may visit our governance page to download a copy for your files.
Goal # 1: “To LEAD”
To LEAD by being the preeminent voice and advocate for the fire and emergency services on SW regional policy and in government.
- Improve involvement of SWD between IAFC and State Chief’s organizations
- Continue to work with new Division Governance Committee & Division Policy Manual through outreach to the divisions and annual committee meetings
- Assure each state association has representation through a vice president appointed annually to the board of directors as per the existing policy
- State vice presidents should attend all state meetings and provide a report to the membership of the division’s activity
- Fulfill the organizations financial responsibility by creating and developing additional revenue streams to support programs and initiatives.
- Increase IAFC membership.
- Research and implement new programs to increase Division income.
- Maintain fiscal responsibility by monitoring and controlling expenditures.
- Continue to work with new Division Governance Committee & Division Policy Manual through outreach to the divisions and annual committee meetings
- Continue to advocate current legislative priorities/issues.
- Establish updated legislative resource page to the organization website; include periodic updates via media outlets to include IAFC legislative committee and lobbying efforts
Goal # 2: “To EDUCATE”
To EDUCATE current and future fire and emergency services leaders by providing training, education and professional development opportunities.
- Make the knowledge, experience, and resources within the SW Division easily accessible for research and problem solving
- Supplement, develop, enhance, and effectively deliver education, training, and professional development programs relevant to the members
- Facilitate career progression, mentoring, and succession management at all levels.
- Serve as an educational resource for existing state professional development programs.
- Support leadership development throughout the division membership
Goal # 3: “To SERVE”
To SERVE by providing services and products of value to our membership, affiliates and partners.
- To improve Communications with SW Division membership.
- Remain flexible to evolving technology
- Continue to evolve and enhance the association website
- Promote the Fireground Newsletter by monthly and/or quarterly issues delivered electronically via email and social media
- Continued committee appointments to increase member involvement in Division business
- Seeks ways to provide our membership with additional services and resources to enhance the valve of membership.
- Implement mechanisms to continuously seek out, evaluate and respond to feedback from membership.
Various communication platforms are available via the website, social media and board member direct email and links provided on the website
- Increase membership participation in SW Division committees and business.
- Support the IAFC in developing resources to assist fire and emergency leaders who are confronted with challenges that exceed their resources to manage.
- Support membership by facilitating IAFC and Division resources
Please contact President Shauwn Howell for any questions firstname.lastname@example.org
Human Relations: Managing within the context of a fire organization
• September 2018 • Chief Robert Benoit – 2nd Vice President, IAFC-SW Division – Fire Chief Lafayette Fire Department
The basic principles for managing one’s personal and family life, a private corporation (small or large) and both for-profit and nonprofit businesses are similar to those needed to manage a fire department. These management processes provide an orderly structure to achieving goals and objectives through delegated authority under competent leadership.
Within the context of a fire organization, effective management is a learned behavior that demands continuous training, requires team spirit and provides a strong disciplinary influence.
The NFPA Fire Protection Handbook, Section 10, Chapter 1, states
Almost all fire departments were administered by clearly defined organizational structures long before system techniques were applied to industry and business. A system of task allocation to engine and ladder crews was developed whereby each person on the apparatus performed certain functions in sequence so the team operated as a coordinated unit, without duplication of effort.
Most fire departments are structured around this traditional model, and with it, leaders have a firm foundation to build on; continuous training, team spirit and influence are some of their construction tools.
On June 15, my department held its 101st recruit academy graduation, with 17 graduates who started their training in January. The academies are six months long, with the objective of making sure each recruit has the foundation needed to perform in an effective manner during the working test period, which totals 18 months of probationary status. At the end of the working test period, they’re confirmed as permanent firefighters.
This is where the real training begins, and it will continue throughout their careers.
Effective leaders in the fire service are no different than those they manage. Management principles must start at the top and flow downward through the chain of command. Lower-level officers often find it difficult to practice leadership styles different from their superiors if we are not practicing what we preach.
Common sense is not without its merits. However, it’s just one tool mangers use, along with consistent education and training, to help members understand that decisions made at the member level may resolve an issue temporarily but that some decisions need to be made from a wider perspective, such as seen by the department leadership, to have lasting effects.
If you are going to wear the jersey, become a team player. A spirit of cooperation is a powerful tool, meaning sometimes you will have to change your focus and direction for the betterment of the organization. Staff meetings are critical, can be very efficient and should be inclusive. All aspects of the department, both supervisors and members, should be able to sit at the table and present ideas to management on a regular basis.
The fire and emergency service is a very complex field that is constantly evolving, often very rapidly. Individual skills can make or break an organization and can best be managed when the leaders feel the pulse, which can only happen in a huddle (that is, staff meetings).
When employees are given the opportunity to provide input, self-ownership takes over and the stronger players have a way of getting the weaker players to buy into their goals and objectives. As a manager and part of the team, you have the authority to make things happen. Never let power keep you on the sidelines.
Black’s Law Dictionary defines influence as
“Power exerted over others. To affect, modify or act upon by physical, mental or moral power, especially in some gentle, subtle and gradual way.”
A lot can be said about influence depending on who is in charge. I like the phrase “gentle, subtle and gradual way” because it takes the sting out of having to use force to achieve goals and objectives in running an efficient fire service organization. The truism “you can catch more flies with honey than vinegar” goes a long way in making people feel appreciated.
Managers are held to a higher standard and are always being watched, filmed, recorded and scrutinized. Managers can get in trouble for off-duty actions, sometimes forgetting we’re always on the radar. Fire service leaders who excel do so because they’re on top of their games. More often than not, we forget that we’re human; it’s not the big things hurting us, but the illegal, unethical or immoral acts that destroy us because we don’t think things through.
Education = Knowledge = Success = Power
As an administrator, you have the authority to manage the performance within your organization. It takes a long time to build character and excel to the level of leadership in the fire service. It only takes a split second to crash and burn. As a leader, you owe it to yourself, your family and the entire fire service to finish strong, making a colossal impact on the organization you represent.
Chief Benoit is a member of the IAFC Human Relations Committee and currently sits on the executive board of the IAFC-Southwestern Division
by Dr. Curt Sumners
(and it’s lasting effects of your qualify of life)
Is defined as not obtaining adequate total sleep. When someone is in a chronic sleep-restricted state they’ll notice excessive daytime sleepiness, fatigue, clumsiness, and weight gain or weight loss. In addition, being sleep-deprived affects both the brain and cognitive function.
Firefighters often don’t get enough sleep. Sleep deprivation can lead to real problems, including safety concerns. During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well. You may also find it more difficult to concentrate or learn new things. The signals your body sends may also come at a delay, decreasing your coordination skills and increasing your risks for accidents.
Sleep deprivation negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity
Sleep is a necessary bodily function that cannot be replicated through any other means. Fire service leaders need to let go of the attitude that “we don’t pay you to sleep” and firefighters need to lose the idea that they can function just as well in the 48th hour being awake as they did in the first.
Assuring quality sleep for firefighters is a health and wellness issue whose time is long overdue. Lives depend on it.
Steps for better sleep
1. First and most importantly, departments must recognize that adequate sleep is a wellness and performance issue equal to other priorities such as strength fitness, diet, and agility.
2. Fire departments should evaluate current logistics for sleep and consider changes. Some positive changes can be made quite simply — installing fans or white noise generating machines in common dorms, for example:
The room or place that is used for sleeping, should be relaxing and quiet. Lights, noises, a room that’s too hot or cold, or an uncomfortable bed, can keep people/firefighters from getting the sleep that they need. A dark room is more conductive for sleep, both night and day. The temperature should be 60 to 65 degrees Fahrenheit. Loud sudden noises from outside as well as the inside should be kept to a minimum. How old your mattresses,
Mattresses and foundations do wear out
•Cheaper is not better for the budget you will end up replacing sub standard mattresses more frequently
• Should be supportive and comfortable
• 10 or more inches is good, 8 inches should be a minimum,
• Many of the newer Foam, Cool Gel Mattresses Are good
• The newer Hybrid mattresses (Spring and gel foam) offer superior support and excellent comfort
• A good mattress manufacturer should offer a 10 year manufacturer’s warranty
Reasons Why You SHOULD Replace Your Mattress Every 5 to 7 years
1. Hygiene Your bed is made of absorbent fabrics so over the years as you sleep on it bacteria, germs, sweat and debris such as skin, scales, hair, dust mites etc. are being built up in the mattress materials.
Gross, I know. The good news is if you clean your mattress regularly, change the sheets, and maybe even use a mattress protector you can extend the lifespan of your mattress. 5 to 7 years is the general rule of thumb. If your mattress is particularly grimy you may want to replace sooner.
2. Comfort The second main reason why we recommend replacing your mattress so frequently is for your own good or, at least your own comfort. If you find yourself tossing and turning at night a quick solution may be to replace your old mattress with a new one. Over time, a mattress loses its firmness and begins to sag in the middle. This can make it uncomfortable to sleep in and over time can cause back pain. It may be time for you to replace your old mattress.
3. Health Last but certainly not least the 3rd reason why everyone should consider replacing their mattress every 5 to 7 years is for health reasons. Like it or not our bodies are constantly changing. What was comfortable for you many years ago may no longer suit your sleep now. Not to mention, many common health problems like INSOMNIA , BACK PAIN and SLEEP DEPRIVATION may be caused by your bad mattress. (this is particularly important for the Fire and EMS industry)
4. Do an assessment of the current state of sleep fitness among members. As much as possible, gather data anonymously to get an honest picture of how department members manage sleep both on and off the job.
5. Allow appropriate naps on duty. Numerous studies have shown that brief naps of 30 minutes or less can make a positive difference in cognition and reflexes for someone who is exhausted.
6. Make resources available for those who are suffering from sleep disorders. Do not stigmatize the use of these resources.
7. Reconsider shift scheduling and overtime rules to diminish the effects of sleep deprivation on emergency response.
Taking steps to minimize the effects of sleep deprivation keeps your liability down and improves the overall health of your firefighters.
NFPA releases the world’s first active shooter/hostile event standard with guidance on whole community planning, response, and recovery
Timely, critical document was developed with insight from law enforcement, fire, EMS, medical providers, facility managers, private industry, DHS, the CIA, FBI and others
May 1, 2018 – The National Fire Protection Association (NFPA) released NFPA 3000TM (PS), Standard for an Active Shooter / Hostile Event Response (ASHER) Program to help communities holistically deal with the fast-growing number of mass casualty incidents that continue to occur throughout the world. Serving as the first of its kind, NFPA 3000 provides unified planning, response and recovery guidance, as well as civilian and responder safety considerations.
“The NFPA 3000 process, from start to finish, has been an exceptional example of emergency responders and other safety-focused practitioners swiftly coming together to provide invaluable perspective and address a significant threat in our world,” NFPA President and CEO Jim Pauley said. “The proactive, integrated strategies recommended and defined in NFPA 3000 will go a long way in helping communities plan, respond and recover from active shooter and hostile events.”
This marks only the second time in NFPA’s 122-year history that they have issued a provisional standard. Provisional standards are developed in an expedited process to address an emergency situation or other special circumstance.
After the Pulse Nightclub massacre in June of 2016, Chief Otto Drozd of Orange County Fire in Florida requested that NFPA develop a standard to help authorities come together and create a well-defined, cohesive plan that works to minimize harm and maximize resiliency. NFPA responded by establishing the NFPA Technical Committee on Cross Functional Emergency Preparedness and Response. In mid-April, NFPA 3000 was issued by the NFPA Standards Council, making it the first consensus document related to active shooter and hostile events.
The 46-member Technical Committee responsible for NFPA 3000 is NFPA’s largest startup Committee, to date, with representation from law enforcement, the fire service, emergency medical services, hospitals, emergency management, private security, private business, the Department of Homeland Security (DHS), the Federal Bureau of Investigation (FBI), the Department of Justice, and many more. Committee members provided job-specific insight and real world observations from mass killings at Mandalay Bay Resort, Pulse Nightclub, Sandy Hook Elementary, the Sikh Temple, the Boston Marathon, and other less publicized events.
NFPA 3000 helps entire communities organize, manage, communicate, and sustain an active shooter/hostile event preparedness, response, and recovery program. In addition to offering NFPA 3000 via a new digital subscription – which will be updated automatically when the next edition becomes available – NFPA is offering an Online Training Series (the first of three courses are available now); a downloadable checklist; a readiness assessment document; and fact sheet for authorities to learn more about establishing a proactive, collaborative active shooter/hostile event program.
Some have asked why NFPA would be the organization to develop an active shooter standard. “For more than a century, NFPA has facilitated a respected consensus process that has produced some of the most widely used codes and standards in the world including more than 100 that impact first responders. Our purview goes far beyond our fire safety efforts as evidenced by our ongoing work to address new hazards with professionals in public safety, emergency management, community risk, electrical services, the energy sector, engineering, the chemical and industrial industries, healthcare, manufacturing, research, the government, and the built environment. The recent increase in active shooter incidents and the fire service involvement in them warranted NFPA’s standards development expertise, and the timely development of NFPA 3000,” Pauley said.
About the National Fire Protection Association (NFPA)
Founded in 1896, NFPA is a global, nonprofit organization devoted to eliminating death, injury, property and economic loss due to fire, electrical and related hazards. The association delivers information and knowledge through more than 300 consensus codes and standards, research, training, education, outreach and advocacy; and by partnering with others who share an interest in furthering the NFPA mission. For more information, visit www.nfpa.org. All NFPA codes and standards can be viewed online for free at www.nfpa.org/freeaccess.
Responding to Fentanyl Incidents:
First Responder Safety Considerations
Article provided by Lexipol- Strategic Partner of IAFC-SW Division
Written by Sean W. Stumbaugh, Battalion Chief (Retired)
The use of mind-altering substances by humans is nothing new. Since the first person left a bowl of grain out in the rain, and then the sun and wild yeast did their thing, humans have had access to beer. Additional intoxicating substances followed through different methods of discovery. How people figured out that the milky substance contained in the un-ripened seed pod of the poppy flower is a powerful drug is beyond me. This drug is opium.
Opium use in America is also nothing new. In the 19th and early 20th centuries, a substance called laudanum was very popular. This product was a mixture of 10 percent opium and alcohol. Laudanum was available as an over-the-counter drug. It was basically the aspirin of its time and was recommended for pain relief for many common ailments and for serious diseases such as tuberculosis. The problem with laudanum is that it is highly addictive due to the opium content. As more and more people began to develop addictions, doctors began to discourage its use; government regulations restricting access to opioids soon followed.
Today, opium comes in many natural and synthetic forms. Modern pharmaceutical companies have created synthetic opioids (e.g., fentanyl, Dilaudid, Norco), which are much more powerful than their natural cousin. These medications were created to reduce pain and suffering for patients after injury or surgery and for those living with chronic pain. The problem is that humans tend to abuse these medications and can become addicted; take away the prescribed medications and some addicts will turn to street drugs out of desperation. Four in five new heroin users start out misusing prescription painkillers. Opioid abuse in the U.S. has become epidemic and many people are dying as a result.
I’m not going to get into the current debate on how fentanyl and related substances arrive on our streets; I am more concerned with their impact on first responders. We have seen numerous reports in the past several weeks of police, firefighters and emergency medical personnel being exposed to highly toxic opioids. These exposures have come through casual contact such as searching a car for drugs, brushing off a small amount of white powder (following a search in which the officer had used gloves and mask), touching a patient with a synthetic opioid on their person, or inhaling a drug after it was aerosolized from a flash/bang device. These recent events lead me to believe it might be time for a training refresher.
Risk from the Patient and the Material
A patient overdosing on opioids presents inherent risks to first responders. These drugs cause respiratory depression and we often find patients who aren’t breathing. Our first treatment options are to provide ventilation for the patient and administer Narcan (naloxone) if it is available. Naloxone will reverse the effects of the drug. Sometimes, when the patient becomes conscious, they are very agitated and can become violent. Also, they may have residue or greater amounts of the drug on their person. We need to be aware of these hazards and take appropriate precautions.
Hazardous Materials Refresher
First responders need to start approaching these incidents with a hazardous materials (hazmat) response mindset. I know it’s not practical for all responders to show up in Level A suits; that’s not what I’m talking about. We are taught from the beginning of our careers that hazmat calls are uniquely dangerous. Our first responsibility in these situations is to isolate the area and deny further entry of responders or civilians.
Many of the recent events where police officers and firefighters have been exposed to and become ill from fentanyl and other opiates have occurred through patient contact or contact with the drug by touching a contaminated object. If this happened at a hazmat call we would all say a policy or procedure had been violated. I’m not blaming the victim here but I am asking us to rethink our approach. We need to re-evaluate our mindset about responding to calls involving illicit drugs. We might need to start viewing them as hazmat calls.
Hazmat is defined as “A material or substance that poses a danger to life, property, or the environment if improperly stored, shipped or handled.” Based on the evidence I believe opioids fit this definition.
Routes of Exposure
There are four routes of exposure for a hazmat:
- Absorption (through your skin)
- Inhalation (through your lungs)
- Ingestion (though your mouth)
- Injection (by an object like a needle or through force such as liquid under pressure)
All four of these exposure routes are in play when it comes to illicit drugs. It is easy to understand that if you touched a drug with your finger, and then stuck your finger in your mouth, you would suffer an exposure to the drug. Or, if you were stuck by a hypodermic needle that was contaminated, you could be exposed to the drug. What about inhalation? Well, users often snort these materials through a straw, so exposure from breathing in the powder makes sense.
The most surprising exposure route, as noted by recent exposures to fentanyl, is absorption. The fact that just touching the material, or accidentally getting it on your skin, can cause you to become ill or intoxicated, and even overdose, is what is shocking to me. We need to take this issue seriously and protect ourselves from all routes of exposure.
How can we protect ourselves in a practical way when we encounter overdose calls daily? We need to have a “me first” attitude and use good decision-making, proper procedures and personal protective equipment (PPE).
I joined the fire service in the early 1980s—a time of discovery for bloodborne pathogens. As we encountered new communicable diseases, we realized we were potentially exposed when treating patients. We began training on and using the concepts of Universal Precautions.
Universal Precautions basically means “treat all blood and body fluids as if they were infectious.” We protected our hands with medical exam gloves, our eyes with protective eyewear, and our mouths and noses with medical masks. We didn’t wear masks for every call but we did use them when performing invasive procedures (e.g., intubating a patient’s airway). Many paramedics learned to wear a mask the hard way: by experiencing exposure to blood and other bodily fluids when performing these tasks.
We need to consider approaching drug overdoses, and drug investigations, with these principles in mind. What does this look like?
- If you suspect opioid use, ask safety-related questions about what substances may be present.
- Use hand protection (minimum and mandatory) at all potential overdose/drug investigation calls. To be sure you’re getting the maximum protection, use nitrile gloves rather than latex. One coroner’s office has indicated that latex gloves may allow absorption of synthetic opioids into the wearer’s skin.
- When encountering unknown substances, consider the use of N-95 masks, eye protection and paper covers for clothes and shoes.
- Handle patients and objects as if they were contaminated.
- Avoid (better yet, prohibit) cross-contamination. Only touch items with protected hands. Following the call, don’t touch anything until you have followed proper decontamination procedures
- If applicable under your EMS protocols, carry and be prepared to administer naloxone to patients and first responders who may become exposed.
If these steps sound burdensome, consider that they are common practices in settings such as dental offices.
For more guidance, access “Fentanyl: A Briefing Guide for First Responders,” recently released by the DEA.
Protect Yourself So You Can Protect Them
When we encounter new hazards in the workplace we need to evaluate the risk and develop new engineering and work practice controls to protect ourselves and our employees. The new threat of very powerful synthetic opioids, and the severe harm they cause, must be addressed in this manner. It’s difficult and maybe even impractical to avoid these hazards altogether; however, we need to try. If we can approach opioid overdose calls with a hazardous materials mindset, practice Universal Precautions, and slow down when there is discretionary time, we can reduce the risks and hopefully avoid any further injury.
It’s really about doing our jobs well, serving those we swore to protect—but still going home healthy at the end of the shift. Take care of yourselves and each other out there!
Sean Stumbaugh is a management services representative for Lexipol. He retired in 2015 after 32 years in the American fire service, serving as battalion chief for the Cosumnes Fire Department in Elk Grove, Calif., as well as the El Dorado Hills (Calif.) Fire Department and the Freedom (Calif.) Fire District. Sean has a master’s degree in Leadership and Disaster Preparedness from Grand Canyon University, a bachelor’s degree in Fire Science from Columbia Southern University, and an associate degree from Cabrillo College in Fire Protection Technology. In addition to his formal education, he is a Certified Fire Officer, Chief Officer, and Instructor III in the California State Fire Training certification program. Sean has taught numerous state fire training courses and has been an adjunct professor with Cosumnes River College in Sacramento. Sean is now continuing his career by serving as the volunteer Para-Chaplain for the Daisy Mountain Fire District in New River, AZ.
Lexipol’s Fire Policy Manual and Daily Training Bulletin Service provides essential policies to enhance the safety of firefighters in all areas of department operations, including emergency medical services. Contact us today to find out more.
This article is provided by Lexipol
By Sean W. Stumbaugh, Battalion Chief (Retired)
When I was a supervisor in the fire department, my crews had a nickname for me: The Red Man. I embraced the moniker to some degree and I would joke with them, “Don’t make me take out the Red Man.” This was a term of endearment (at least that’s what I liked to believe) in many cases, but I knew it was born from numerous times that I led with anger. In hindsight this is not a great way to lead.
So, what was really going on here? I hadn’t been brought up in some military academy where I learned to be a drill sergeant when things didn’t go my way. Was there something else at work? Something I couldn’t really put my finger on? After retirement, I realized some of this behavior was born out of stress I was feeling, at work and at home.
I was confident retirement would fix this issue and my life would be a breeze. I soon found out that retirement was something I wasn’t fully prepared for. I went through a two-year transition that was more difficult than being at work. Fortunately, I had some support mechanisms that helped see me through
This experience made me want to know more about the stress we face as firefighters. So I reached out to an expert in the field, Jeff Dill, founder and CEO of Firefighter Behavioral Health Alliance (FBHA). In this article, I’ll share some insights Jeff opened my eyes to, with the hopes that they might be eyeopening for you, too. And in my next article, I’ll share three steps all fire service professionals can take to combat the negative effects of work-related stress.
1,100 and Counting One of my goals when I was a training chief was to design training programs that reduced the risk of line-of-duty deaths (LODDs) by targeting the root causes of LODDs. We commonly use the number 100 to explain how many of us die on the job each year. This number is an average, and the actual figure fluctuates, but unfortunately the deviation is small.
Jeff Dill stresses an entirely different number: 1,102—the number of confirmed firefighter and EMS suicides he has validated since he began studying the issue. “These are not merely numbers, they are the names and faces of brothers and sisters who have left us behind,” Jeff says. “That’s always been our message at the FBHA. We never want to forget them.” Jeff now dedicates his professional life to helping reduce this growing number.
Call It By Name So, what is it we are struggling with? We can—and should—call it Post-Traumatic Stress (PTS) or PostTraumatic Stress Disorder (PTSD). We’re hardly alone in being at risk for PTS; military personnel, police officers and other first responders face it too—not to mention anyone who experiences a traumatic experience, such as being assaulted or witnessing death or abuse.