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Lethbridge, Alta., has operated integrated fire-EMS since 1912. Pictured are dualtrained paramedics/firefighters Craig Nilsson (left), Lee Sagert, Jeff Marriott, Eric Larsen and (standing) EMI-Captain Tom Bond.
PDispatch issues plague Ontario
lunked on the kitchen counter, the Toronto Star headline on that first Saturday in June screamed “Fire teams lose crucial minutes”. I hadn’t yet ingested any caffeine and wasn’t sure I wanted to read the story for fear of the grief it would surely cause Toronto Fire Services. I was wrong. The story made TFS look good but the provincially run dispatch system through which its calls are processed didn’t fare as well.
The story appeared about a month after the Ontario Association of Fire Chiefs annual conference at which Burlington Chief Shayne Mintz outlined the OAFC’s extensive efforts to convince the province that changes to the dispatch system will save lives.
Essentially, the chiefs argue, firefighters can get to calls faster than EMS and can start CPR on cardiac arrest patients before the crucial six-minute mark at which brain death occurs. Seems logical and Community Safety and Correctional Services Minister Rick Bartolucci appears to be on side.
Knowing the OAFC’s agenda, we planned our July edition of Canadian Firefighter and EMS Quarterly around the issue. Our cover story on page 8 looks at the OAFC’s progress and includes a sidebar about fire-based EMS in Lethbridge, where Chief Brian Cornforth and his crew of dual-trained paramedics-firefighters walked me through the fire-EMS system last summer following the Alberta chiefs conference.
In an effort to be comprehensive in our coverage, freelance writer Carla Garrett, looks in depth at Ontario’s dispatch system, which will undergo changes starting in 2010, on page 20, and Vancouver-based Paul Dixon gives a coast-to-coast overview of fire-EMS dispatch relationships on page 18.
We don’t often devote so much space in a single issue of our magazine to one topic but with changes to ambulance operations in Alberta and New Brunswick in the last year and the focus on the wise use of resources and best practices it seemed logical to do so.
• • •
Firefighters often e-mail me asking how to become a writer for the magazine. We talk about ideas and deadlines and issues that are national in scope and I outline my expectations and the importance of knowing who our readers are and what they want.
Peter Hunt contacted me more than a year ago and proposed a Fire IQ column to look at fire fighting-ese – the terms firefighters use on the job. He wanted to make sure the terms were being used and understood consistently across the country. Good idea. We’ve run Fire IQ in several issues now and athough it has been well received, Peter has more to say. He has strong opinions about fire-service issues and articulates them so well we thought it wise to offer him a soap box on which to do so. The column continues to be called Fire IQ but it has evolved into an opinion piece that we hope you enjoy. This month’s Fire IQ is on page 16.
Six minutes. That’s the span between cardiac arrest and the start of irreversible brain death. Firefighters and paramedics know this. But given the complicated dispatch systems and the tiered and varied response protocols for fire and EMS across Canada, it’s clear that many politicians, administrators and taxpayers don’t understand it.
The Ontario Association of Fire Chiefs is trying to change that. At its annual conference in May, Fire Chief Shayne Mintz, chair of the OAFC Pre-Hospital Care Committee, spoke clearly and passionately about the flaws in – and politics of – Ontario’s Central Ambulance Communication Centres (CACCs – pronounced “kacks”) dispatch system and the need for a new protocol that embraces the superior response capabilities of the fire service.
The OAFC’s pre-hospital care committee has spent more than two years researching fire and EMS response times and the benefits of a combined service. Now, despite some anticipated opposition from EMS, the OAFC is lobbying the provincial government for a more cohesive fire/EMS system, following the lead of jurisdictions such as Winnipeg, Lethbridge, Alta., and Seattle, Wash.
“The mission of Ontario’s fire services is to protect and save
lives and property,” says OAFC president and Oakville Fire Chief Richard Boyes. “There are no conflicting agendas.”
Indeed, increased use of the Winnipeg fire service for EMS calls has cut response time in half to 4.5 minutes and is expected to save 10,000 ambulance calls in one year and $8.5 million. In Lethbridge, which has had integrated fire/EMS since 1912, all firefighters are trained paramedics who may ride an ambulance one day and a pumper the next.
“Irreversible brain death starts six minutes after circulation stops,” Mintz told the Ontario chiefs convention. “We have a system that can help avert that.”
The gist of the problem in Ontario is that many fire departments are not being dispatched by the CACCs or they’re being dispatched significantly later than EMS. (The Ontario Ministry of Health and Long-Term Care operates 11 CACCs; five others are operated by hospitals and there are four local ambulance communications services in the province.)
Photo by Laura King
Lethbridge’s integrated fire/EMS, which began in 1912, has proven effective with all firefighters trained as paramedics. Platoon Chief Bill Mellafont confers with firefighter/paramedic on scene during a fire at a high-rise last summer.
In a video on the merits of a fire/EMS response system shown to OAFC delegates, proponents of a strengthened fire/EMS system noted that:
• Firefighters cross trained as EMTs and paramedics can deliver similar care as paramedics;
• Firefighters can and have received 1,200 to 1,800 hours of training to become paramedics;
• Firefighters will always be the front line;
• Firefighters can perform in ways that are patient centred and that single-role paramedics can’t – they can handle an entire incident from an extrication to an elevator rescue because they have different equipment, skill sets and authorities than paramedics.
Lethbridge firefighter/paramedic Dana Terry outlines his city’s program on the video.
“What we see is the built-in efficiency of joint disciplines who are able to come as one and treat the patients. What it comes down to is patient treatment. It provides an efficiency for the city…”
In the U.S. the International Association of Fire Fighters and the International Association of Fire Chiefs are embracing combined fire/EMS system and a national lobby group, Fire ServiceBased EMS Advocates, is raising awareness of the benefits of fire-based EMS.
In Ontario, Boyes, Mintz and others have made it clear that the OAFC supports EMS ambulance services and paramedics but they note that some EMS budgets in Ontario have increased considerably over the last few years yet two-thirds of EMS services still fail to meet prescribed response times.
“It’s not about the EMS people, they’re doing a great job,” Mintz said during the OAFC presentation. “It’s about the lack of us [firefighters] being made aware when we can provide patient centred, lifesaving help to those in urgent need.”
“The EMS skills and abilities are all there – we’re not trying to take over EMS here. This is about citizen and patient centred services that, with timely notification from the ambulance dispatch centres will get the quickest response to citizens in need.”
Fire departments in many Ontario communities were approached in 1995 (or earlier) by the health-care community to come help with emergency assistance; that’s when defibrillators were put on fire trucks.
“Lives are needlessly at risk,” says Mintz. “The current approach
Lobbying for fire-based EMS
The OAFC has asked the Ontario government to:
• Where requested mandate simultaneous dispatch of the community fire department and EMS for life threatening emergencies in communities served by full time professional firefighters.
• Recognize that trained firefighters can provide rapid medical assistance and “stop the clock”. This should be included in all documentation when it comes to capturing response times.
• Create an all-stakeholder committee that will design a proposed integrated system of emergency response for life threatening emergency calls. Also include the fire service in any discussions of a “fully co-ordinated emergency response system” that the province may be currently having with its stakeholders.
is not working. There are people collapsing in the streets needing urgent care.”
Mintz said he’s received letters from people thanking the fire service for arriving quickly to emergency medical calls. One was from a paramedic noting that the fire response time was excellent and crucial to a patient who had collapsed while shovelling snow.
“That’s because in most cases we can get there in six minutes or less, so that’s where we need to be stepping forward and saying, ‘Hey, call us’. No one wants to see their mother or father collapsing at the end of the driveway and needlessly waiting for help because there’s a policy that says the EMS shows up first.”
Mintz says politicians and taxpayers should consider the fire service a health-care partner given that its members have been doing CPR and defibrillation for more than a decade.
The fact is that fire trucks and firefighters trained in life saving and strategically located in municipalities for rapid responses can get to accident scenes or medical calls faster than paramedics and ambulances, the OAFC says.
A November 2008 discussion paper on pre-hospital care by the OAFC and the Ontario Professional Fire Fighters Association, called Saving Lives in 6.0 Minutes or Less by Utilizing the Efficiencies of the Ontario Fire Service, points out the 2005 Ontario auditor general’s findings that says ambulance response times average 13.1 minutes for life-threatening emergencies and notes that standalone EMS providers seem to be having difficulty bettering these times.
“Ontario’s fire services have the ability to respond effectively and quickly to all hazards; fires, motor vehicle accidents, hazmat/chemical, biological, radiological and nuclear (CBRN) incidents, terrorists attacks and yes, with existing medical skills, life threatening medical calls such as cardiac arrest,” the discussion paper says.
“In many cases, patients only require immediate life saving treatment, but they may also require physical rescue, protection from the elements and protection in the way of scene safety. The fire service is structured to address all of the above simultaneously and is perfectly positioned to complement and enhance a struggling
Photo by Laura King
Lethbridge firefighters/paramedics Scott Lane, Chris Carney, Randy Crow and Chris Tomaras handle paperwork after an afternoon fire and other incidents.
EMS delivery system across Ontario, thus significantly improving patient outcomes.”
Getting back to those six crucial minutes after cardiac arrest: obviously, the sooner the patient receives CPR and/or defibrillation, the greater the probability of survival.
According to the OAFC, the average response time for the fire service, as reported by the Ontario Fire Marshal, is six minutes. That means the average response time in many urban areas is less than six minutes. That’s less than half of the average 13.1-minute response time for EMS in Ontario. The chance of successful resuscitation is reduced by between seven per cent and 10 per cent for each minute of delay in intervention.
“Dispatching fire and EMS simultaneously would better en-
The Lethbridge model
The atmosphere at Lethbridge fire headquarters is more charged than usual. On a sunny June day, a visitor from Ontario is observing fire-based EMS, a truck manufacturer is demonstrating a new aerial (driven south from the Alberta fire chiefs trade show in Edmonton) and an EMS trainee is along for the ride. The stars, it seems, are aligned for an interesting day.
Lethbridge has had fire-based EMS since 1912 when it took over the horse-drawn ambulance from Galt hosptial. According to its website (http://www.lethbridge.ca/home/City+Hall/Departments/Fire+Department+-+Emergency+Medical+Services/ default.htm) when the Lethbridge fire brigade acquired the ambulance service it started to emphasize first-aid training. By 1913 all members held St. John Ambulance certificates, making Lethbridge one of the first integrated services in Canada.
Platoon Chief Bill Mellafont says Lethbridge hires only registered paramedics who are then trained as firefighters. All paramedics are firefighters and all department members have worked on the ambulance in their careers, including the officers.
EMS operations officer Lynn Villiger says the most junior department members – who are already paramedics – work almost exclusively on the ambulances but if a fire call comes in they automatically become front-line firefighters.
“Everybody knows exactly what their role is,” Villiger says.
Lethbridge was one of the first cities in Alberta to use advanced life support pumpers equipped with paramedics, drugs and monitoring equipment found in an ambulance. When all ambulances are responding to other calls, ALS pumpers can respond to other emergencies requiring medical assistance and/or fire suppression.
I spent the day riding along with firefighter/paramedics Scott Lane and Randy Crow, who were on EMS duty. Lane has been a paramedic for 19 years and a firefighter for eight; Crow has 18 years as a paramedic and 10 as a firefighter. The morning started typically – a call for shortness of breath at a meat-packing plant. Later, a man fainted in his bathroom at home and hit his head.
It was quiet over lunch so I tagged along with Deputy Chief Mike Ross and a crew who were checking to see if the demo aerial would fit in the alley near an industrial building.
As sure as Alberta has Rocky Mountains, we were there just a short time when crews bolted for the pumper: a fire call had come in from a subsidized housing high-rise.
Like in most centres, structure fires account for a small percentage of calls so the incident provided a key opportunity to see
sure that Ontarians receive prompt and trained emergency medical response when they need it most,” the association says.
Indeed, the OPFFA and the OAFC say they have heard many accounts of ambulances with lights and sirens speeding past a fire hall several minutes before the fire department received a call from the ambulance dispatch centre to respond to the same incident.
Hence, the OAFC argument: “Failure to call the community fire department simultaneously, despite existing agreements to do so, compromises the public well being and severely hampers the fire service’s ability to provide rapid and effective emergency response. While not only being a frustrating situation for both the public and for firefighters this could also have a significant impact on patient outcome.”
Continued on page 25
fire-based EMS in action. Lane and Crow remained on EMS duty while other paramedics changed into bunker gear in a nearby parking lot. Afterwards, crews in bunker pants waited in the hospital with patients they had transported by ambulance – prime examples of the flawless transfer of fire and EMS responsibilities and duties among Lethbridge’s dual-trained firefighters/paramedics.
On April 1, the province of Alberta took over ambulance delivery and service. Lethbridge’s firefighter union was worried that the change would result in the breakup of the dual-service department and lead to reduced response capabilities.
“It’s the model that other cities envy. So to risk breaking it up, and losing a system that’s served the city well for almost 100 years doesn’t make any sense.” Rob Chollak, president of the Lethbridge Fire Fighter-Paramedics Association, IAFF Local 237, said on the union website.
In March, the province and the city agreed to a two-year contract under which Alberta Health Services has responsibility for delivery of ambulance services and Lethbridge is the contracted service provider. The contract expires in April 2010 when three provincial centres will provide ambulance dispatch for the province and Calgary will dispatch Lethbridge’s ambulances.
Lethbridge Chief Brian Cornforth, who is also president of the Alberta Association of Fire Chiefs, said the association worries about the impact of the regional dispatch model.
“We are very concerned that a similar situation that is happening in Ontario will occur here once EMS moves into this new three-centre model.”
Photo by Laura King
Firefighters/paramedics Scott Lane (left) and Randy Crow prepare to attend to patients at the scene of a high-rise fire in June 2008.
The public education conundrum
Impact of prevention programs tough to prove so budgets suffer
by Jay Shaw
Remember in the ’90s when our economy was just coming out of a slow period, and big corporations were starting to create huge profits again? That’s the first time I remember mission statements being part of the corporate identity of major corporations. Those mission statements included mantras such as providing the best customer service possible or assuring that products were of the highest quality while maintaining the best warranty in the industry. These catchy phrases let us know that somebody cared and that companies and their leaders appreciated the fact that we spent our hard-earned dollars on their products.
Something also happened in the fire service; we created a mission statement that actually meant something. A quick scan of websites for a number of major Canadian fire departments revealed that prevention is generally listed as the first step to protect life and property. So, if most fire services publicly state that prevention is the way to go, why does it seem that Canadian municipalities are short changing prevention programs?
A bit of research on this found that just four to six per cent of most fire departments’ budgets are allocated to prevention (even less in rural / paid on call departments). This seemed unrealistic and out of synch with mission statements that often include prevention. Costs for suppression and staffing consume the majority of a fire department’s budget. Indeed, in some departments, suppression eats up more than 85 per cent of the funding. But four per cent for
prevention seems so low, especially when suppression staff often play a key role in getting the prevention message out to the community. Anyone looking at a department budget might figure that departments need to shift resources to better reflect these mission statements. But even a seasoned CFO is unlikely to figure out how to shift the resources around to better fund the prevention side of things. At first glance, it appears to make sense to move a bunch of firefighters to prevention from suppression or other areas but that just creates bigger problems.
So, I went to the experts, starting with the Justice Institute of British Columbia, which suggested I contact John Hall Jr., an acclaimed researcher in fire prevention analysis with the NFPA.
It turned out that I was looking at the problem two dimensionally and did not thoroughly understand how to assess what I perceived to be the uneven distribution of fire department dollars. I was placing the importance of the issue to the fire service on par with how the department allocated funds instead of on evidence-based formulas.
“In suppression, we have a pretty good set of evidence-based, consensus formulas to calculate what we need so that firefighters can respond safely and effectively to whatever fires (or other emergency incidents they cover) may occur,” says Hall.
“Those calculations and our shared history of making decisions based on those formulas create a great deal of inertia behind funding suppression as we have always funded suppression.
“In prevention, we don’t have nearly the same consensus on what should be spent and why. Where we do have some consensus is on the resources needed to provide inspections and related code
Photo by: Matt Hayes
enforcement to commercial buildings.”
The programs we use must be effective, but without having data to help us understand which programs work best, it is difficult for prevention leaders to claim success. We know prevention programs work but finding a value or formula that supports our anecdotal knowledge is a challenge.
So, how do we reinvent the wheel to get the best out of that four per cent? We create open chains of communication among prevention leaders, their subordinates and outside agencies to come up with new ideas. And we have to think outside the box to create new solutions. Inviting the business community into our brainstorming allows for external views in marketing and plan design that have been tested in the private sector and have a track record of success. My contribution to this process is private-public partnerships. Some departments are already looking at this. Having an official sponsor for your fire service could bring in revenue that funds these important programs. The thought of turning an apparatus into a paid advertisement for the local hardware store may not sit well with some traditionalists but it is time to look hard at longstanding opinions and open up to change.
In today’s economy, throwing money at a problem is not an option. Ask questions and see what your neighbouring department is doing right. Many departments run great prevention and education programs and ideas are just a phone call away. Chilliwack is a good example. Its assistant chief, Ian Josephson, is a leader when it comes to innovation. He was never an operational firefighter; his first career was in the insurance industry underwriting fire losses, and his background in civil engineering is a bonus when it comes to understanding those code books we all love so much. These are unique attributes that provide an outside perspective into some of the that’s-the-way-it’s-done-around-here attitudes that are prevalent in the fire service.
Chilliwack does some very cool things. Applicants for recruit positions are required to do a five-minute public speaking presentation. This says volumes about a service that wants its members to be able to deliver its prevention programs properly and, more importantly, willingly. The department raises money through service groups and funds a large portion of its program costs with this revenue. Last year, $100,000 was raised towards funding a safety village that uses interactive methods to deliver the prevention message. Chilliwack is also part of a lower mainland contingency that has embraced residential sprinkler systems and made them law.
Why do other jurisdictions resist this? When asked about the single most important thing we can do to improve prevention , both Hall and Josephson, along with Winnipeg Prevention Director Peter Kloos and Manitoba Association of Fire Chiefs President Andy Thiessen all agreed that sprinklers are among the most important aspects of the prevention message. This is a no brainer, but we have to do a better job of lobbying governments to make this change. We need to use better strategies to improve our plan to accomplish this. We have to fight through the uniformed generalizations and misinformation. Naysayers claim residential sprinklers will reduce firefighter jobs and give councils reason to lay off firefighters. We need to have educated and prepared responses to those claims. Our jobs will be safe if we continue to embrace other mitigation forms like hazmat and medical response as well as other service-oriented programs that we can deliver. We don’t just fight fires anymore; we have to see this clearly.
Thiessen offered a rural perspective on prevention, talking about his 30-member paid on call department in Morden, Man. These
Fire departments with small public education budgets are forced to think outside the box to find ways to fund initiatives.
guys take prevention seriously, especially for a small department with next to no budget. Its members do drills on the first and third Wednesdays of the month and train in public speaking to improve their delivery of the prevention message. Be honest. If you’re a rural chief, have you ever made your crew do a public speaking drill? If you have you’re an innovator; if not, why not do so?
Manitoba has been in the news recently with two fire deaths on First Nations reserves. Both of these tragic deaths have been partially linked to overcrowding and housing conditions. Thiessen says we have to do a better job to get the message out and empower First Nations people to embrace prevention strategies.
“Having outsiders that might not understand the cultural differences and value systems of aboriginal people teaching prevention might not be in our best interest,” he says. “Maybe we need to explore having respected members of the aboriginal community deliver the programs to each other and build on that to create better results.”
Josephson believes “more emphasis needs to be placed on training firefighters in fire prevention including inspections, public education and investigations.”
He also believes we need to look at changing the focus back to residential homes. “After all, if you review the stats this is where we are having the most fire deaths, injuries and frequent property loss.”
Thiessen urges departments to embrace outside resources and experts to help improve the services they deliver. For example, Manitoba’s provincial education co-ordinator teaches the fire and life safety program through the fire college.
“The best part is she is not a firefighter; she is a teacher who properly delivers instructional techniques to our firefighters and students who are first learning the trade. Having a teacher teach is such a simple concept but we need to have more of this to better improve our programs.”
Take a close look at your own departments; if you are in a position to make change from an administrative level I hope you will look at new ideas and embrace the out-of-the-box theories that others across Canada are already implementing. Younger, less experienced firefighters are following your lead and your actions are the foundation for the change. Besides, you probably wrote the mission statement.
Firefighter safety and survival
When I began my fire service career 30 years ago, my department equipped me and my fellow firefighters with the best personal protective equipment available. Our standard issue consisted of a pair of thigh-high rubber boots, a three-quarter-length petch coat, rubber gloves and a pretty decent Cairns helmet with ear flaps.
Our demand-type SCBA was carried in suitcases in the apparatus compartments; we responded in open cabs and we never dreamed of wearing seatbelts.
Throughout the ’80s, fire-service manufacturers made incredible advances in almost every aspect of equipment related to firefighter safety and survival. PPE got better, stronger and lighter while innovative items emerged regularly.
Being a fairly progressive department, supported by a relatively wealthy city, my chiefs, like many others, took full advantage of these opportunities to provide us with a seemingly endless supply of equipment that allowed us to respond faster and advance farther into burning buildings while remaining extremely well protected.
Despite dramatic advancements in firefighter PPE, tools and equipment, there is one area to which the industry, our chiefs and our firefighters have been slow to respond, and one that I am convinced will join the standard-issue list within the next couple of years. Today’s firefighter is going further into and working longer in hotter fires consuming lighter buildings. It seems logical – and anecdotal evidence seems to support this theory – that firefighters will occasionally need to exit these buildings rapidly (rescue themselves) through the nearest window to escape flashover, sudden extension of fire or impending structural collapse.
life-saving tool to their members.
All legitimate NFPA-compliant self-rescue systems have four common elements: a harness (preferably Class II); rope or webbing; a hands-free friction device; and an anchoring device such as a hook, carabiner or loop.
It is essential that firefighters and chiefs understand that in those critical moments, members cannot deploy personal rope stored in their pockets or create the necessary friction with their hands to safely descend.
PETER HUNT
‘I am not aware of any Canadian fire department that has issued selfrescue systems to its members.’
In most cases, as a result of established strategy and tactics, training, ground or aerial ladder placement and a bit of luck, these emergency bails amount to nothing more than close calls and some pretty exciting stories to tell around the coffee table.
Unfortunately, crews cannot anticipate every threat, be aware of every means of emergency egress or ladder every window during a rapidly escalating fire fight. Firefighters have been injured and killed as a result.
Recent tragedies in New York City prompted the FDNY, in collaboration with Petzl (EXO), to equip every suppression member with a state-of-the-art self-rescue system. A subsequent lobby effort resulted in legislation requiring that every firefighter in the state eventually be trained and equipped with a similar system. I am not aware of any Canadian fire department that has issued selfrescue systems to its members.
Due in large part to the events in New York, where a demand was created virtually overnight, fire service manufacturers are responding with effective, affordable, rapidly deployable self-rescue systems that will allow departments to provide this long-overdue
Thanks to the typical ingenuity of firefighters and fire service manufacturers, self-rescue systems have evolved in three distinct ways: external harnesses; harnesses sewn into bunker gear; and harnesses integrated into SCBA. Rope or webbing is typically carried in a cut/heat resistant pouch. A hands-free friction device allows the operator to quickly determine the distance from anchor point to window then use both hands to exit. Systems using external harnesses and those sewn into bunker gear require that departments purchase one system for each member who is then responsible for checking and maintaining the equipment. Systems integrated into SCBA require that far fewer be purchased; however, they demand daily checks by the member and that maintenance become an added responsibility of the SCBA program.
As with any new equipment, training of personnel is critical and will determine the success of any self-rescue program. Since firefighters are skilled in rope work and typically enjoy rappelling, initial training leading to competency should take about eight hours. An ongoing schedule to maintain skills is required.
Like some other fire-service disciplines, self-rescue is a high-risk/low-frequency event, and, as such, many departments will have a tough time justifying the costs, training and maintenance associated with such a program.
A self-rescue program may be more palatable if it can be demonstrated that it works well with DRDs in rescue/removal of downed firefighters and possibly as fall restraint during roof work.
In the 30 years since this story began, more than 100 firefighters have died and thousands more have been injured in the line of duty. Will the inevitable introduction of self-rescue systems affect these tragic statistics when the already long list of new and improved PPE, tools and equipment has not?
I choose to believe that without the continuing innovations of firefighters and fire service manufacturers, countless more lives would have been lost. I am convinced that the ability to safely exit a burning building when all conventional methods have failed is an option that our firefighters must have.
Peter Hunt, a 29-year veteran of the fire service is a captain in the Ottawa Fire Department’s suppression division. He can be reached at peter.hunt@rogers.com
by Paul Dixon
FA fine balance
How to marry emergency response with efficiency, cost and public expectation
orty years ago, pre-hospital emergency medical care was barely a concept. Ambulances were operated by a patchwork of public health departments, fire departments, volunteer societies and private contractors –usually the local funeral home. The term ambulance was appropriate as the service provided was principally one of transporting patients to hospitals for medical attention.
In the 1960s, the field of emergency medicine evolved out of the hospitals and into the street with the realization that the battlefield medical protocols that were successful in drastically reducing the mortality rate in Vietnam could be applied in the civilian world with equally impressive results.
One of the first paramedic programs in North America began in Los Angeles County under the direction of a Canadian, Dr. Ronald Stewart of the University of Southern California Medical Center. While in its infancy, the program came to the attention of Jack Webb of Dragnet fame. The result was the TV show Emergency, which ran from 1972 through 1976. When the TV show first aired, there were three paramedic programs in North America, including Los Angeles. By the time Emergency had gone off the air five years later, hundreds of paramedic programs had been created in communities across North America.
Across Canada, a number of different models were employed in the development of paramedic services capable of delivering increasingly sophisticated on-scene care. At the same time, many fire departments expanded training for their personnel and acquired equipment and apparatus to enable them to provide medical first response. As a result, it was not unusual to find a number of emergency vehicles responding to a single incident, with a fire engine, rescue squad, basic life support ambulance and advanced life support arriving within minutes of each other in large urban settings. While giving the illusion of superior service, this level of response leads to severe strain on resources for even the largest fire departments.
The problem is how to meet the public’s expectations of fire and EMS responses in a timely, cost-effective way without creating new issues.
The challenge is reaching consensus among all parties as to the appropriate level of response to any particular incident – finding the point where the maximum benefit to the client can be achieved from best use of the all too often meagre resources available.
The Toronto model
Norm Lambert, deputy director of Toronto EMS and director of its Central Ambulance Communications Centre (CACC) says a solid relationship with Toronto Fire helps things run smoothly.
“We’re really lucky here. We have a very good working relationship with Toronto Fire. Our chief, along with the fire chief, police chief and regional commander of the Canadian Forces, meet on a regular basis. I meet with the deputy chief from Toronto Fire at least quarterly to discuss common issues and, if required, we will meet to discuss specific issues as they arise. Our CAD vendors [Intergraph for Toronto Fire and VisiCad for Toronto EMS] have been able to interface the two systems, allowing us to post calls directly to fire dispatch as they are created in our centre.”
Toronto EMS uses ProQA software, which categorizes incidents from A (minor) through E (immediate response required). Toronto Fire is automatically included on all D and E category calls and some C calls depending on specific determinants within the incident. Lambert says
Dispatch for B.C. ambulance’s communication centre in Vancouver is responsible for 45 ambulance stations over an area of more than 13,000 square kilometres. The region includes more than 40 fire departments for which dispatch is provided by E-Comm (the regional 9-1-1 PSAP), Surrey Fire Service and Fraser Valley Regional Fire Dispatch.
Photo by PauL Dixon
that the tiered response committee of fire and EMS, in conjunction with Sunnybrook Hospital, regularly reviews incidents to ensure that existing protocols meet the actual need. “We have a well-established tiered response committee which focuses on providing the optimal response.”
Co-operation in Nova Scotia
Nova Scotia’s Emergency Health Services (EHS) is responsible for providing province-wide, pre-hospital emergency medical care, though the actual service is operated by a private contractor – Emergency Medical Care Inc. One dispatch centre in Dartmouth provides service to the province. There is an active first-responder program in Nova Scotia but outside central Halifax and Sydney, it is mostly volunteer fire departments.
Bernie Turpin, administrative chief with Halifax Regional Fire Service, says it is a big advantage to work with the one ambulance service for the entire municipality. “The response time for in our rural areas is generally within 15 minutes for fire crews, whereas the ambulance can be up to 25 minutes”.
Jeff Fraser, manager of the Nova Scotia EMS communication centre, validates the role of medical first responders as vital, describing them as “the heart and soul” of the emergency medical response system. With fire departments usually better positioned to arrive before the ambulance, it means there will be a confirmation of the location of the incident, as well as an update on patient status. While Nova Scotia fire departments across the province are on a variety of VHF and UHF systems. To expedite communications, every first response agency in the province has been given a Motorola radio so responders can communicate directly with EMS. Fraser says having the radio link allows his staff to give direction to first responders who find themselves in situations beyond their level of training while the ambulance is still en route. “We will do everything we can to set a call up for success.”
British Columbia’s E-Comm system
In 1974, the British Columbia Ambulance Service (BCAS) was created by the provincial government under the Emergency Health Services Act to assume responsibility for all privately and municipally operated ambulance services in the province. Today, the BCAS Lower Mainland Communications Centre in Vancouver is responsible for 45 ambulance stations over an area of southwestern B.C. covering more than 13,000 square kilometres with a population in excess of three million. Within this region are more than 40 fire departments, ranging from large urban departments such as Vancouver City to smaller, composite suburban departments down to isolated rural departments crewed entirely by volunteers. Dispatch for these fire departments is provided by three large centres; E-Comm (the regional 9-1-1 PSAP), Surrey Fire Service and Fraser Valley Regional Fire Dispatch, while two departments maintain their own stand-alone dispatch operations.
BC Ambulance is on the same Intergraph CAD system as the fire dispatch at E-Comm. Using the ProQA software package, when an incident is created and posted to dispatch, if it meets the predetermined criteria for tiered response, the call will be simultaneously posted to the fire dispatch position at E-Comm. While the other fire dispatch centres in the region do not have Intergraph CAD, BCAS has provided each centre with an Intergraph terminal. This was done as a low-cost workaround when estimates for actually interfacing the different CAD systems proved prohibitive. The incident is simultaneously transmitted to the CAD terminal in the appropriate dispatch centre, but it must be manually re-keyed into the other
Using the ProQA determinates, BCAS will “fire” all “D” and “E” calls and some “C” calls.
centre’s CAD. One position in the BCAS communications centre is dedicated to monitoring tiered responses. If the fire dispatch centre has not acknowledged receipt of the incident within two minutes, BCAS will contact the fire dispatch by phone to verify receipt.
Using the ProQA determinates, BCAS will “fire” all “D” and “E” calls and some “C”. As Derek McClure, superintendent of the BCAS Lower Mainland Dispatch/Communications Centre, explains, “the decision to include the fire agency in the dispatch is written into the software. It is not left up to the call taker or dispatcher to decide whether or not to call the fire department. We send everything to fire that should be sent to fire as set out in our protocols.”
What is different from other areas is that not all fire agencies in the region are medical first responders. Even so, all calls are sent to the appropriate fire dispatch agency and the decision is made at that point whether the incident is within the dispatch parameters for the particular fire agency. Fire dispatch will acknowledge receipt of the incident from BCAS by responding either “fire responding” or “fire not responding.”
In a step to improve overall fire response times, E-Comm is now employing Locution automated dispatch and fire station alerting system for its fire dispatch service. While the company claims that agencies using its products are “out the door” 30 seconds faster than using conventional voice dispatch, E-Comm’s Director of IT, Glen Miller, says it is too early to make a definitive statement.
In the Metro Vancouver area, BCAS is on the E-Comm EDACS trunked radio system, as are all police agencies in the same region, but only some of the fire departments. In the Fraser Valley, Sea to Sky corridor and Sunshine Coast, BCAS is on the legacy VHF system. This necessitates two radio systems in the ambulances that work in both areas and along the overlap zones. Within the EDACS system, channel 14 has been designated as the PFA (police/fire/ambulance) talk group on all radios. A joint project by BCAS, RCMP, Richmond Fire, Canadian Coast Guard and E-Comm developed a protocol known as combined events whereby police, fire, ambulance and even the Coast Guard hovercraft responding to the same incident could use the PFA talk group to talk to the other responding units. The project was first implemented in Richmond in 2005 and proved hugely successful, as it enabled first responders from all agencies to identify themselves to each other while en route to the call and tell each other what their ETA would be or offer information such as better location details, etc.
Based on the success of the Richmond trial, PFA has been extended to the other municipalities in Metro Vancouver where police, fire and ambulance share the trunked radio system.
Photo by PauL Dixon
by Carla Garrett
IA matter of minutes
Ontario ambulance dispatch system needs overhaul
t’s 10:31 a.m. when a paramedic crew gets rolling to an emergency call with lights and sirens. But as crew members leave the base, speeding down a busy city street toward a residential neighbourhood, they know five minutes have already passed since a middle-aged man collapsed in cardiac arrest.
The man’s wife had called for help at 10:26 a.m.
Central Ambulance Communication Centres (CACC) are expected to dispatch ambulance crews within two minutes of receiving an emergency call. But historically, Ontario has had some of the poorest response times in Canada.
By the time the ambulance reaches the hospital, the three-minute delay has at least tripled. The patient’s chance of survival has plummeted — a devastating reality for awaiting emergency room doctors.
In Oxford County, an urban-rural municipality in southwestern Ontario, it took 20 minutes or more to get an ambulance rolling 27 times in the first half of 2008.
“This is negligent,” says Carmen D’Angelo, who managed the county’s emergency medical services for eight years. He says the current patient priority system in Ontario is to blame. “It’s in disarray,” says D’Angelo.
In 2004, two-thirds of the province’s communications centres were not meeting the Ministry of Health and Long Term Care’s response times. Four of the 18 centres exceeded the two-minute standard by more than 30 seconds — one centre by as much as 110 seconds, as noted in an auditor general’s report. “Failure to arrive in as timely a fashion as possible will result in potentially avoidable deaths,” says London Health Sciences Centre emergency room physician Dr. John Dreyer, who has been pressuring the government to improve its dispatch system.
He says Ontario’s unique system, implemented in the early 1990s, is inferior to that used elsewhere in Canada and abroad. He says it often unnecessarily sends ambulances rushing to calls with lights and sirens, putting patients and paramedics at risk.
And with most municipalities working on a tiered-response system, the problem is passed down to firefighters, who may be called out for improperly assigned calls.
Dreyer describes Ontario’s system, known as the Dispatch Priority Card Index (DPCI), as a “home-grown product” that has “surpassed its usefulness.”
“If you want a Ferrari, you don’t start building it yourself with parts from Ford,” says Dreyer, adding that many physicians in Ontario have concerns about the DPCI
But changes are underway at all provincial dispatch centres. And ministry spokesperson Mark Nesbitt says it’s a goal to learn from past mistakes and prevent future such events. Last year, 28 investigations were launched into land ambulance dispatch-related matters out of about 1.5 million calls. “As in any organization, human error will occur despite sophisticated quality assurance and other related programs,” says Nesbitt.
An enhanced DPCI system has been operational at Hamilton’s CACC since August 2008. A pilot project is also ongoing at Niagara’s CACC.
“Initial operational results of DPCI II are very positive,” says ministry spokesperson Andrew Morrison.
“Consistent with the ministry’s commitment to continual improvement of its business practices, the current dispatch system is being upgraded together with a quality assurance program.”
These improvements have been gradual since the auditor general identified deficiencies in Ontario’s dispatch system in 2000 and again in 2005.
“We were concerned with the number of issues with respect to ambulance dispatch,” says Ontario’s auditor general, Jim McCarter.
He says the ministry dumped a lot of money into its land-ambulance service — almost doubling its costs over four years — but was still not meeting response time standards.
“Ambulance response times increased in about 44 per cent of municipalities between 2000 and 2004, even though the ministry had provided about $30 million in additional funding,” he notes
Critics of Ontario’s ambulance dispatch system say it’s inferior to those used in other Canadian cities and often unnecessarily sends ambulances rushing to calls, putting patients and paramedics at risk.
Photo by John riDDeLL
in his 2005 report, the last provincial audit on ambulance service.
D’Angelo, now director of a regional base hospital program in Hamilton, is attempting to help the province determine the best communication system for Ontario after growing frustrated with the province’s lack of quick action.
“We have had a problem for eight years and nobody was fixing it,” he says.
D’Angelo has prepared extensive research on the issue (http:// www.county.oxford.on.ca/site/2871/default.aspx), comparing Ontario’s dispatch system with that used elsewhere in Canada and abroad.
For example, in Nova Scotia, paramedics are notified in less than two minutes, 90 per cent of the time.
“We average 31 seconds from time call received to unit assigned for emergency calls and 36 seconds for urgent calls,” says Paul Maynard, of the Nova Scotia Emergency Communications Centre. “Overall (emergency and urgent) is an average of 32 seconds.”
Richmond, Va., is not far behind with a call processing time of 58 seconds. Nova Scotia and Richmond use an internationally recognized system, known as Medical Dispatch Priority (MDP).
Toronto has also been using MDP since 1992. The program, Maynard says, provides immediate call triage and medical telephone advice to support safe and appropriate patient care while responders are on their way to the scene.
“This immediate intervention is often referred to as zero response time, because paramedic communications officers use the caller as their eyes and hands to begin interventions while the ambulance is responding,” he adds.
Dispatch response times may not literally be zero; however, they have been reduced at 15 communication centres since Ontario slowly began making changes. Today, 90 per cent of the time ambulances are on their way to an emergency in less than two minutes. Two CACCs still lagged behind the two-minute standard in 2008.
But new legislation, which takes effect in 2010, may be a solution as each municipality and dispatch centre will be required to develop an annual response time performance plan to be submitted to the ministry. Results will be made public.
While Dreyer says Ontario is taking a step in the right direction, he would like to see Ontario implement MDP.
“It’s a standardized system and is proven, tried and true,” says Dreyer, adding MDP more accurately fleshes out real emergency calls while boosting public confidence in what would be a state-ofthe-art product.
With the current system, he says an ambulance is automatically sent out with lights and sirens if a patient is bleeding.
“It could just be a paper cut but would signal an emergency response,” says Dreyer. “MDP will tease out which calls you really need to get to in a hurry.”
And those minutes do matter.
“Brain damage may start after only four minutes of cardiac arrest and irreversible brain damage is certain after 10 minutes,” says Dr. Christian Vaillancourt, a scientist at the Ottawa Health Research Institute. “Likewise, with every minute delay in instituting CPR, chances to recover from a cardiac arrest decrease in a non-linear fashion.”
He refers to a study, which shows a person’s survival rate drops from 98 per cent if reached within one minute to 11 per cent at six minutes.
Morrison, calls Ontario’s system “a world leader in many areas” and says the province’s new call screening tool coming to dispatch centres by the end of this year will “systematically elicit vital location, scene and patient condition information necessary for the rapid, accurate dispatching of ambulances.”
Mayday, mayday, mayday
Training for worst-case scenario key to saving firefighter lives
by Mark van der Feyst
When we hear the word mayday we immediately think of disaster. The word mayday is meant to grab our attention for immediate resolution or help. We often hear the word on television or in movies when a plane is in distress. Pilots are trained to declare a mayday as soon as they encounter any kind of danger. They do not hesitate to call a mayday – they just do it. In the fire service, we are not as quick to call a mayday. But the quicker a mayday is declared, the quicker the rapid intervention team (RIT) can complete the rescue.
When the life of a firefighter is threatened, the entire help system must be initiated through the use of an effective distress signal. A mayday may be declared by fire personnel who are trapped, in imminent danger or in need of immediate assistance, or by the incident commander when a firefighter is missing. This term should be used and applied to firefighter emergencies only. This way, when a mayday call comes in, we know right away that a firefighter is in trouble. For all other fireground emergencies such as building collapse or water supply problems, the term emergency traffic should be used.
All on-scene firefighters should ask themselves if they’re ready for the mayday call. There are two points to consider: Are you ready to declare a mayday for yourself; and are you prepared to deal with a mayday when one is declared? Many firefighters say they are
prepared to declare a mayday when they are in trouble but are they really? Through training we can condition ourselves to react in certain ways. For example, we have trained firefighters to feel the roof before stepping onto it and we have trained them to get off the roof if it feels spongy. The same training must be provided for firefighters to declare a mayday. If we train our personnel to recognize the signs of trouble we can condition them to declare a mayday to quickly activate help. So, what do we do when we have to declared a mayday? Let’s look at some operational procedures for the RIT.
• Allow the troubled firefighter or the troubled team to give the mayday report. If the firefighter or team is not calm and is tying up the radio, interrupt. The IC needs to calm down the firefighter who is declaring the mayday. If the firefighter is not calm, then the message will take longer to get through.
• After the mayday report, notify the RIT to deploy to a designated area with its equipment. Hopefully this designated area will be near the last known location of the firefighter needing help.
• If the troubled firefighter or team did not give you enough information, try to obtain it before the firefighter loses consciousness or loses his radio. You need the firefighter’s location and
by
The rapid intervention team assesses the mayday firefighter.
Photo
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status, conditions, air supply status and the location of other team members. This information is vital to the rescue.
• Contact dispatch. Have dispatch repeat that a mayday has been called and that all other radio traffic is to cease. If you can, move the fireground to another channel. Request another alarm and any other resources that you feel you will need. In some departments, it is policy is to have the RIT operation on one radio channel and the fireground operations on another channel. Dedicated radio channels alleviate any radio cross interference (but some departments do not have enough available channels to do this). If you do switch channels, you need to get everybody else to do so too.
• Pass command of the fire or the mayday to another commanding officer. There are now two separate fireground operations happening at once. You will need to assign another incident commander to handle one of the operations. This person will assume the role of RIT IC or rescue IC but will still report to the initial incident commander.
• Concentrate on helping the RIT with updated information from the troubled firefighter or team. As more information comes in, it needs to be delivered to the RIT-sector officer. This information will help the RIT members in their operation.
• Immediately establish two additional RITs, one to cover the remaining fireground operation and one to back up the initial team in case it needs help. You will need additional manpower (12:1 ratio, 12 firefighters to rescue one firefighter) so get it there as soon as you can.
• If hydraulic tools and airbags are on the scene, get that equipment moved up to a staging area close to the structure before the team calls for it. If it is not on the scene, get it there as quickly as possible. This falls under proactive RIT operations. If the RIT is monitoring the radio traffic it will be able to determine what the initial RIT will need.
• Remember to keep tabs on the fire. It’s probably still burning. If we put the fire out, we remove part of the problem.
• Consider creating an enlarged opening for removal of the downed firefighter if it will speed up the rescue process.
• Keep a strong hand on the freelancing that will start to take place. This is a trend in the fire service. As soon as we hear that a firefighter needs help, we all want to drop what we are doing to assist.
• Keep constant tabs on your RIT members. They are not supermen; they could get into trouble too.
• Start an immediate accounting of all on-scene personnel.
• Make sure you send in a backup hoseline behind the RIT for protection. This will form a part of the defendable space for the downed firefighter. The mayday firefighter may need water to cool off the area around him.
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• Start to prepare the exterior of the building for a removal operation. Clear debris and obstructions, set up floodlights and prepare medical equipment such as stretchers and backboards. This goes back to the proactive RIT operation.
These are a few key points for the receipt of a mayday call. We need to train on all these points so we will be proficient and react promptly and properly to the mayday.
Mark van der Feyst began his career in the fire service in 1998 with the Cranberry Township Volunteer Fire Company, Station 21, in Pennsylvania. He served as a firefighter and training officer for four years, then joined the Mississauga Fire & Emergency Services, where he served for three years as a firefighter and shift medical instructor. He is now with the City of Woodstock Fire Department in Ontario.
6/15/09 2:24:09 PM
Continued from page 10
Indeed, Ontario’s 2005 auditor general’s report noted that two-thirds of ambulance operators were not meeting legislated response times yet the cost of the service increased by 94 per cent over four years. More funding was provided between 2005 and 2007 with no change to overall ambulance response times.
“This clearly demonstrates the current model isn’t effective, and that the current approach to fixing it isn’t working either,” the OAFC says. “We must look at other alternatives within our existing resources to create a truly patient centred system. The best way to reduce response times is to better utilize the fire departments.”
Phase II of the Ontario Pre-hospital Advanced Life Support Study (OPALS) as sponsored by the Canadian Health Services Research Foundation and the Ontario Ministry of Health and Long-Term Care showed that municipalities can more than double its cardiac arrest survival rate, for little cost, if a defibrillator unit can be on scene within five minutes of the call 90 per cent of the time. “Full-time fire departments in Ontario typically can meet this response target,” the OAFC says in its March 2009 update to its 2008 discussion paper.
“The breakdown typically occurs in dispatch. When fire and ambulance are not dispatched at the same time there is a delay between the first emergency call for help and fire’s response. As a result, patient survivability suffers. The fire service is not being used to its fullest potential in critical emergency medical situations.
“Fire trucks already respond to medical calls, so there are no additional costs. We are only highlighting the merits of sending them sooner.”
The OAFC has been working closely with the Ontario Professional Fire Fighters Association on this issue with Mark McKinnon, chair of the OPFFA’s EMS committee co-presenting the discussion papers with Chief Mintz.
“It’s not about EMS services and what they’re doing and fire services and what we’re doing,” he told the OAFC conference. “It’s about making sure the best, fastest service delivery gets to the public.”
ambulance response time standard
The Ontario Ministry of Health and Long-Term Care website (http://www.health.gov.on.ca/english/public/program/ehs/land/responsetime.html#ambulance_dispatch) provides details of the province’s plan to modernize ambulance response times starting in 2011. Essentially, municipalities will determine response times and ambulance services will no longer be required to meet provincially established response guidelines.
In addition, the time that a call requesting emergency ambulance response is first received at the communication service will be included in the overall response time reported by the ministry. According to the website, this change acknowledges that up to the first two minutes of all calls for emergency ambulance response is used by the ambulance communication service call taker to elicit call and patient information, and to determine and dispatch the closest and most appropriate ambulance to the call.
Building a police-fire command centre
Taking time to research options, involve community, made for a better bus
by Cory McMullan and David Gillespie
The Peterborough Lakefield Community Police Service and the Peterborough Fire Department recently transformed a city bus into a mobile command centre for use in support of emergency services.
The vehicle is shared between fire and police services, with fire maintaining logistical control and storage of the vehicle.
After experiencing floods in 2002 and 2004, officials realized that the almost 14-metre trailer with one conference table, a washroom and radio room no longer met their needs. In this case, a bigger trailer didn’t make for a better command post.
Running a few investigations and managing a community wide recovery operation taught police and fire officials that a mobile command centre must be quick to deploy, user friendly for various incidents and affordable.
The previous command post was a fifthwheel trailer that was configured for use in the 1980s. It required a tow vehicle and a licensed driver and was used only as a last resort. Peterborough police and fire knew the new model had to be self-powered and not licensed as a tractor-trailer, rather it needed to be easily operated by a trained and licensed police officer or firefighter.
Representatives from both agencies
toured command posts operated by the Ontario Provincial Police, Durham Regional Police, Mississauga Fire & Emergency Services, Toronto Fire Services, Ottawa Police Service, Palm Beach Fire Rescue and numerous manufacturers at trade shows. They determined, through their research, that most command posts were custombuilt, box-style trucks with privacy areas for command, communications, negotiation and planning tasks. Each agency had shared lessons it had learned: make the command post simple to use and easily accessible; and don’t use checkerplate for the interior, instead use dark, wall carpet to deaden sound and on floors and for easy maintenance.
The next task was sizing a vehicle appropriate for the needs of both agencies.
As a city serving a region of 125,000 people, the Peterborough Lakefield Community Police Service deals with hostage negotiations, crime-scene investigations, bomb-threat responses, missing persons search co-ordination, public protests and R.I.D.E. programs. The fire service deals with house fires, apartment fires, technical rescue, hazardous materials calls, weatherdriven incidents and training activities.
Considering the average number of command and support staff in a simple investigation or emergency, Peterborough police and fire designed the command post for four or five people in the command area and two to
four in the negotiation / rehab area. It was decided to make the command post user friendly for the officers and fire commanders who might be in there only a few times a year.
Police and fire officials trimmed a long list of wants and decided on more needs such as on-board computers with a network printer/
Top: Peterborough, Ont., police and fire worked together to transform a city bus into a mobile command centre.
Above: Interior work station of Peterborough command bus.
Photos courtesy Peterborough Fire DePartMent
copier and future access to wireless and hardline communications. All equipment is easy to use and the entire vehicle orientation takes just 10 minutes. The next step was figuring out how to go outside the sandbox to make the proposed command centre a reality.
affordability
Most custom-built command vehicles range in cost from $250,000 to $600,000, depending on size, number of rooms, slide-outs and onboard technology. Based on priorities in other city services, fleet maintenance and rotation, this project did not fall within our individual or collective capital budgets. Continuing the police/fire partnership was fundamental to making this vehicle a reality.
Peterborough officials turned to the local transit service to determine if an 11-metre city bus could be transformed into a command post. This provided a tangible vehicle around which to base discussions and redesign plans with key stakeholders. A one-dollar ownership transfer cost from one city department to another helped.
Large corporations were not interested in covering the entire cost, so, with guidance from a professional fundraiser, the commandpost team scratched the goodwill sponsorship approach and instead focused on investing in a joint community response. Costs were itemized, such as $4,000 for the kitchen or $2,000 for a command desk. It was surprising to watch various corporate sponsors choose items to help fund that were important to them, and then to quickly get on board.
After reaching out to three firms that specialize in custom-built command posts, and after much discussion about the possibilities and limitations of using a bus, PK VanBodies of Oshawa, Ont., was contracted. PK is well known for fabricating command posts, mobile offices, mobile research labs, and specialty fire and tactical vehicles. It has a long list of municipal, provincial and federal clients across central and eastern Canada.
Making it happen
The 1999 Eldorado bus had 130,000 kilometres on it (low for a bus). Gutting of the seating and the installation of walls, partitions, counters, cabinets, removable desks wiring and a kitchenette came to $60,000. Installing surplus computers and radio equipment was another $5,000. Paint and lettering amounted to $10,000.
Peterborough Lakefield Community Police contributed $40,000 and three corporations donated $20,000 each. Peterborough Fire was responsible for painting the bus and
for mechanical maintenance and other costs.
The new command post has been successfully used 14 times since its arrival in April 2008. Responses have included a few major fires, R.I.D.E. programs, a hostage negotiation, a few public events and training exercises. Emergency personnel have said they appreciate the faster deployment time, the more effective communication among lead officers and agencies, the warm place for rehab and to get out of inclement weather, and the greater awareness of the presence of emergency services on scene.
Members of the Peterborough Lakefield
Community Police Service and the Peterborough Fire Department are proud of their partnership and the creative use of resources towards this command vehicle. It has quickly become a significant tool through which both agencies have improved their efficiency and effectiveness in the community.
Cory McMullan is an inspector with the Peterborough Lakefield Community Police. David Gillespie is a firefighter with the Peterborough Fire Department. The authors can be reached at cmcmullan@peterborough.ca and dgillespie@peterborough.ca
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The
pros and cons
of the CrossFit system
Istill remember my first CrossFit experience. I was about 20 and I didn’t know it but CrossFit had been around for as long as I had. I was exhausted after my final set of squats for the day and began walking through the crowded gym toward the fountain. Out of the corner of my eye I saw something I thought was a little out of the ordinary. I wiped the sweat from my eyes and peered into the training studio to find a small group using Olympic rings, medicine balls, truck tires, resistance bands and what I later discovered were kettle bells.
I stood and watched for a few minutes thinking, “Where am I?” A friend passing by told me those in the studio were doing a training program called CrossFit. They were performing the WOD (workout of the day). I’ll admit I was a bit intrigued – I had never seen anything like it – and the guys in the studio all seemed to be in reasonable shape. Over the next year I continued to see more and more people performing these types of routines and I decided it was time to take a look at CrossFit in a little more depth. I’d like to share what I’ve learned about this revelation in the fitness industry and help you decide whether it’s for you. It may surprise you. It sure surprised me.
I quickly learned CrossFit was created to break the old, mundane mould of the typical workout.
There are basically 10 domains of fitness: cardiovascular; respiratory endurance; speed; strength; agility; stamina; flexibility; power; co-ordination; and accuracy. The goal of CrossFit is to make you competent in all 10 domains. Obviously, then, CrossFit is a very broad, general type of training. The goal of CrossFitters is to be fit through overall completeness in their conditioning.
include things like Olympic lifting, explosive snatches, cleans and other highly advanced exercises. One CrossFit workout calls for 30 snatches at 135 pounds. Anyone with any fitness education will see danger written all over this. A snatch is performed for explosiveness, not for endurance, and 30 reps of an exercise like this is a recipe for disaster.
The same comparison can be made for the deadlifts. Again, CrossFit recommends very high weight and calls for 50 consecutive deadlifts. For anyone not familiar with the deadlift, this is an advanced exercise that could cause catastrophic injuries if performed improperly or when your form fails.
BRad LawRENcE
‘Despite quite a bit of criticism, CrossFit has built an undeniable, almost cult-like following.’
The CrossFit website states, “our specialty is not specializing.” While this sounds good on paper, critics are quick to point out that if your specialty is not specializing in anything, you’ll likely be elite at nothing. The CrossFit critics have a valid point. The experienced CrossFitter should be in good shape. The workouts are definitely challenging whether you agree with the principles behind them or not. A typical CrossFitter should be strong but not nearly the strongest, fast yet not the fastest and so on. For these reasons, if you’re training for anything specific, CrossFit is not the way to go.
Despite quite a bit of criticism, CrossFit has built an undeniable, almost cult-like following. As a non-CrossFitter, I admit there are some attractive features. Every day your workout is planned for you and posted online, requiring no work on your part. The workouts are different every day and CrossFit is popular enough that finding a workout partner is generally easy. For those with time constraints, many workouts are over and done with very quickly, some in less than 20 minutes. For these reasons alone, you can see why fire and police personnel have taken such a liking to CrossFit.
Unfortunately for the CrossFit community, it’s not all roses. As with anything this popular, many critics have made it their mission to expose the flaws in the CrossFit system, and there certainly are a few.
The majority of CrossFit workouts are performed at near maximum intensities with a very high number of reps. Many of these workouts
The programs set out for each day seem random at times. It seems every workout has maximal loads for the shoulders or squat muscles or both, often followed up a day or two later with similar loads. Shoulder muscles simply aren’t built for that type of repetitive maximal load. A former navy CrossFitter was awarded $300,000 after he won a lawsuit against CrossFit, claiming that he sustained a permanent disability due to performing an unsafe CrossFit workout.
All CrossFit workouts are supposed to be designed with a certain degree of scalability involved to make even the most amateur lifter comfortable. Generally, however, with regular training regimes, amateurs will spend months working up to the exercises discussed above with safe, progressive, foundation exercises.
The higher-ups in CrossFit aren’t always doing the program favours either. Listed on the CrossFit website (www.crossfit.com) is the following hierarchy of mass building strategies, in order of most effective to least effective:
• Bodybuilding on steroids
• CrossFitting on steroids
• CrossFitting without steroids
• B odybuilding without steroids
This is a blatant error. I don’t expect anyone to believe that CrossFit would in any way be more effective at mass building than traditional bodybuilding. If it were even remotely close, there would be bodybuilders who do CrossFit. Bodybuilding has a storied history established through decades of competitors using proven methods to achieve their ideal physiques. Bodybuilding is a specialized competition and CrossFit is the self-proclaimed anti-specialization program. Even a diehard CrossFitter must admit this hierarchy is incorrect. Through my training and work I’ve discovered CrossFit isn’t for me but you may find it to be a fine supplement to your workout. I respect those who have taken the plunge and there are definitely some impressive results to be seen from those using the program. I have no intention of persuading you one way or the other but I would recommend that if you decide to try CrossFit, proceed with caution.
Brad Lawrence is a firefighter with the Calgary Fire Department and a certified personal trainer who specializes in training and nutrition for emergency responders. E-mail bradlawrence@ gmail.com
•MUNICIPAL FIRE FIGHTING
• HAZARDOUS MATERIALS RESPONSE
• INDUSTRIAL FIRE FIGHTING
• CONFINED SPACE ENTRY/ RESCUE
• INCIDENT COMMAND SYSTEM
•
CERTIFICATE PROGRAM
•
Continuing education on the job
Education and experience are not the filling of the tank with water, but the lighting and burning of the fire itself.
– William Butler Yeats
At the foundation of our industry there is a core concept; extinguish fires and care for the sick and injured. The beauty of this mandate comes from its simplicity, but often our job is not all that simple. Yeats’ quote epitomizes an integral aspect of our profession: the inherent importance of continuing education and the irreplaceable value of experience.
We have all had service-related education in some regard, be it NFPA 1001 certification through academies, EMS training in a college setting or the many in services in which we participate during shifts. The bottom line is that we all have an understanding of where to start. But where do we go from there? How do we become truly experienced and educated so that we can make the correct and crucial decision when the time comes?
ventilation, ladder raises and tie offs and CPR algorithms. With this list in hand, on every shift I identify one or two things that I will cover that day/night. Often I will enlist one or all members on my crew and we will train together. When we’ve covered the topic for the day/night, that item gets crossed off of my list. With that being said, it seems that for each topic covered, a new one makes it’s way onto the list.
JEssE cHaLLoNER
Our careers as firefighters and paramedics are dynamic and our jobs change from day to day, even from call to call. Because of this it is paramount that we stay on top of the evolutions in practice. If we fail to do this, we are failing the communities we serve and our brothers and sisters in the fire/EMS services. If we are to be the example and embrace the ever-changing environment, we must be versatile, adaptable and open to progressive concepts. By accepting the fact that we will never know all there is about fire fighting and EMS we give ourselves the opportunity to learn and we will inevitably become more rounded and resourceful.
‘ Regardless which path one walks, out of education comes experience.’
Every day presents an opportunity to harness more expertise. This could be through picking up a fire fighting magazines strewn on the coffee table and reading about fire behaviour, or taking a course pertinent to our EMS skills. Personally, I find that most of my education since graduating fire/EMS school has come from watching and listening while on responses. There is an indispensable resource at our fingertips in the members who have done the job for years, particularly in those who make it their mission to continually learn themselves. I have yet to be part of a job where I didn’t learn something for the next time that someone calls 911.
I would like to share a habit that I picked up early in my time on the job. It’s a sort of bucket list that I keep to remind myself of the many aspects of my career in which I would like to become more proficient. I keep a paper list of 20 or so items that require my attention to some degree. The items range from different ways to stretch an attack line, pump operations and calculations for discharge pressure to rope knots and tactics, medication dosing, positive pressure
I suggest taking a personal account of your education and experience level from all possible aspects of your position. There are areas of improvement for all of us and it is our responsibility to be accountable for deficiencies in our skill set. It is not a weakness to require additional experience or education in any area. The real problem is in not stepping up and actively changing the situation. We must be progressive and possess the fortitude to continually challenge ourselves to always move forward with our knowledge and competence.
This ideology holds true for further education also. I am a proponent of continuing education in all regards. For some, this entails obtaining a university degree; for others it means taking courses geared toward their niche. Regardless which path one walks, out of education comes experience. When we are able to apply the education that we have acquired through reading, study, or lectures in a practical setting we establish the experience to refine, hone and improve our expertise.
Another way to practice continuing education is through teaching. Becoming an instructor of a concept or skill forces us to become thoroughly proficient in that area. This helps us identify our strengths and weaknesses and enables us to rectify any inconsistencies. Teaching can be a valuable tool for two main reasons: we pass on our knowledge to those who lack the experience; and we polish and maintain our own skill set so we don’t get rusty.
If you take one thought from this, let it be to not settle, but to progress. This self-development comes from the inherent drive firefighters and paramedics have to be the best, period. Understand that in a dynamic field such as ours, we must push ourselves to excel and to have the expertise required to answer the call. I know I will never be finished learning; it is those around me who help me to realize my own potential, and push me to be better every day, in everything that I do.
Jesse Challoner has been with Strathcona County Emergency Services for 2.5 years and has been in the emergency services field since 2002. He is an EMT and is completing the two-year paramedic program at the Northern Alberta Institute of Technology. Contact him at jchalloner@hotmail.com
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Raising the roof
Laminated glass removal poses significant danger
When it comes to patient removal from crashed vehicles there are many options to be considered regarding the path of egress – issues such as access to the patient, degree or level of entrapment, and compartment intrusion. Rescuers need to determine the safest, most effective and least timeconsuming path of patient egress based on the patient’s condition.
Once those conditions have been assessed, one other important decision needs to be made: Is this a rapid extrication with a life-over-limb mindset, or is there more time to spend on patient removal? We also need to be clear on what rapid extrication really means.
Rapid extrication is the removal of a patient(s) from a hazardous environment or life-threatening situation as quickly and safely as possible while using as much packaging and stabilization as the situation allows.
From an emergency medical perspective, positioning a patient on a backboard in a straight line with minimal twisting and manipulation minimizes or reduces spinal compromises that cannot be diagnosed on scene. The acronym N.B.T – nose, belly button, toes – reminds us to keep these body parts in line and offer the patient the best possible care.
you to get a hand on the recline lever, the thin, hook end of a pike pole can be inserted from behind to grab and release the lever. For a little extra room, the head rests can usually be removed. For vehicles that have a detachable, cardboard-type trunk deck a four-foot 4x4 can be substituted for support to span across the trunk area. This gives the spreader tips enough support to spread the roof upward. If the patient is quite large, an option is to cut one side of the rear roof pillar; this will reduce the tension on one side and permit the roof to spread open much farther than the first option. This cut, however, will add more time to your platinum 10-minute time frame. Make certain that prior to any spreading or cutting into any roof structure the plastic trim is stripped, including head liners and underneath rear trunk deck bulk-heads – some manufacturers will install roof curtain cylinders in these unsuspecting locations. If the decision is made to remove the roof, remember, as always, that crew and patient safety are paramount.
Removing the roof generally provides the most workspace for rescuers and tools inside the vehicle while offering the maximum amount of removal space for occupants. But, if time is working against a critical patient, leaving the roof intact and creating patient-removal space is sometimes the answer. The rear-window tent is a technique for quickly removing the patient (or if the roof is built with ultra high-strength steel and your hydraulic cutters are not up to the task).
Give this a try. Break and remove the roof’s rear-window glass. Insert a hydraulic spreader in the centre of the rear-window opening – one tip of the spreader must be in contact with the edge of the roof in the centre; the other tip can spread down on the rear trunk deck or the top of the rear seat. Fully extend the spreader arms. This will collapse the trunk deck and create a tenting effect in the centre of the roof, producing a large enough hole through which a rescuer can enter and a patient can be safely removed. (See photo 1.)
Next, the seat(s) need to be reclined. If there’s not enough room for
One other issue that has not had much attention is the cutting of laminated windshield glass. Most rescuers, including me, haven’t put much thought into the hazards of cutting laminated glass. My curiosity about this stems from something I witnessed a couple of years ago when I was judging an extrication challenge on the coast of British Columbia. The challenge was running a bit late and it was just before dusk. The team competing was halfway into its scenario when the call was made to completely remove the roof for a straight up-and-out patient egress. All pillars of the roof were cut from back to front and then one continuous cut was made from A-pillar to A-pillar, including the laminated windshield glass. The roof was then moved to the debris pile about six metres away. The process took a respectable time of about five minutes. At all T.E.R.C.-sanctioned extrication challenges, it is mandatory that all rescuers, including the live patient, wear an N95 dust mask while removing glass. These personal protective barriers were in place at the time for the competing team. I happened to step back from the action circle by about nine metres and was facing into the sun. What I saw was a real eye opener. Everywhere I looked, for at least a 15-square-metre radius, were fine particles of glass dust that would not dissipate. I moved around the working area and every time I looked into the sun I could see the fine dust; it even extended
RaNdy scHmiTz
Photos by ranDy schMitz
Photo 1: Extend arms to collapse trunk deck and create tenting effect.
Photo 2: Cuts must be in line with bottom of the windshield.
Photo 3: With two to four rescuers, start to lift the rear of the roof.
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into the crowd and no one was aware of it because the spectators were not facing into the sun. I ordered all spectators to move back until the dust settled, and told the competing crews to keep their masks on until it was safe. I had known glass dust could linger but I hadn’t realized to what extent. When I got back home I started doing some research on glass dust and the associated hazards. In discussions with many glass-replacement and windshield-glass manufacturers I was informed that today’s laminated glass is made up of 70 per cent silica and other raw materials. Modern laminated windshield glass is made of poly vinyl butyral, iron oxide, silica sand, soda ash, dolomite and limestone.
Reading the Material Safety Data Sheet on Silica (see sidebar online at www.firefightingincanada.com) should prompt rescuers to wear a N95-style dust mask when working around glass dust and particles. But not everyone involved at the scene wears a mask when windshield cutting is taking place. I have yet to see those working at an extrication scene put on a dust mask while cutting glass.
And what about our patients? They must be completely covered so that no glass particles or dust reach their lungs or open wounds. What about using our balaclavas or Nomex hoods? Is that not good enough? Here is a simple test: hold your balaclava up to the light. Can you see daylight through it? If you can, it may be able to stop large glass particles but it will do nothing for glass dust. Removing the roof and cutting the windshield aren’t the only methods available to us. Here are a few methods to eliminate cutting the laminated glass and thus reduce the hazard.
• Start by stripping the interior trim on the inside of all the roof pillars to check for and avoid cutting into any un-deployed roof-curtain cylinders or seatbelt pretensioners. If the side window safety glass is still intact, manage it accordingly by rolling it down into the door, breaking it in a safe and controlled manner. Cut the rear pillars first then move onto the B-pillars and finally the A-pillars. Also, don’t forget to cut any seatbelts that may still be attached to the pillars.
• It is important to use a reciprocating saw to make these last two A-pillar cuts; the thin blade will allow a low, clean cut. Ensure the cut is made as close to the dash as possible. The blade should ride just on top of the dash but not enough to cut into it. Cut all the way through the pillar but do not cut into the windshield except for about half a centimetre. These
cuts need to be in line with the bottom of the windshield where it is glued in to the frame. (See photo 2.)
• With a minimum of two rescuers but preferably four, start to lift the rear of the roof up until it is in a position close to 90 degrees. (See photos 3.)
• At this point the rescuers need to take most of the weight of the roof for a moment until it is past the 90-degree break-over point. Then, continue to flip the roof over toward the hood. (See photo 4.)
• If all goes as planned, the bottom of the windshield will dislodge from the black polyurethane glue or mastic where it attaches at the top of the dash. (See photo 5.) You can relocate the roof and windshield out of the action circle as one.
• Glass fragments should be minimal. If you suspect there may be a small number of fragments, a disposable blanket can be stuffed in between the windshield and the dash to catch any stray fragments before lifting the roof.
• Another option is to follow the procedure but instead of cutting low on the A-pillar, make the cut high. Make two relief cuts at the top of the A-pillars roughly five centimetres back from the top of the windshield, about 15 to 20 centimetres long with either a hydraulic cutter or a reciprocating saw. Be sure to avoid the strengthened areas where the sun visor bolts to the roof on the inside and check under the head liner for roof-curtain cylinders, as some manufacturers, such as Ford, hide them near this location. Now, fold the roof forward and secure it to the front of the vehicle. This procedure works well if the A-pillars are constructed of ultra high-strength steel and/or the windshield/ A-pillars will not hinder other procedures or reduce working space.
• For an upside down vehicle, stabilize the vehicle, taking care to support the weight with strut systems and remove the weight bearing down on the roof pillars to avoid further roof crush damage and injuries to patients. If there is severe roof crush, the vehicle may have to be lifted and the roof displaced or detached to assist with patient removal.
• If displacing the roof, start by cutting the C, B and A-pillars, in that order. (See photo 6.)
• When it is time to cut the A-pillars, make the cut with hydraulic cutters at the top corners of the windshield as indicated. (See photo 7.)
Photo 6: If displacing the roof, start by cutting the C, B and A-pillars.
Photo 7: To cut A-pillars, make cut with hydraulic cutters at top corners of windshield.
Photo 8: A 2.5-centimetre void from thickness of cutter blades.
Photo 9: When tips are expanded, roof will break away.
Photo 5: Bottom of windshield will dislodge from top of dash.
Photo 4: Flip roof toward the hood.
• There should be an approximately 2.5-centimetre void from the thickness of the cutter blades, which will be enough to insert the tips of a hydraulic spreader. (See photo 8.) When the spreader tips are expanded inside the cut, the roof will break away and leave the complete windshield attached to the vehicle. (See photos 9 and 10.) The vehicle will be left supported by the struts and the roof can be slid out from underneath the vehicle for access to the patients.
There are always a few negatives for every procedure:
• There is no question that a high wind will cause problems for flapping a roof over, but the odd occasion that it is strong enough to cause a problem will be far outweighed by the number of times you’ll create airborne glass dust and shards using the standard methods. The windshield must not be too severely damaged and must still be firmly mounted in the frame after a crash.
• Some A-pillars will be difficult to cut low enough to meet the bottom of the windshield; a few popular mini vans will have this issue. Judge your procedures accordingly.
• A few late-model, high-end vehicles are using laminated glass in the side windows to avoid ejections in a rollover, and as extra security against theft. A small sticker in the corner that says “security glass” identifies this type of glass. If possible, roll down these windows to avoid having to cut them. When you have no alternative but to cut the laminated glass, duct tape across the windshield and cut through it to minimize the glass dust.
By taking advantage of options, the roof can be eliminated as a cause of entrapment or impediment to the function or effectiveness of other procedures.
Calgary firefighter and extrication instructor Randy Schmitz has been involved in the extrication field for 16 years. He can be reached at rwschmitz@shaw.ca
Photo 10: Windshield stays attached.
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a Fire-Safe Community: A Guide for Fire Safety Educators
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Get out of the kitchen if
you can’t
take the heat
The boy gripped his hockey stick and crouched in front of the net, his body rigid. The puck bounced like a pinball from player to player, and then across the blue line into his zone. He shifted back and forth, then tensed as the opposing team rushed in for the shot. It came. He dove and missed. The puck clinked off a post and onto the stick of one of his teammates, who whisked it down to the other end. The boy relaxed.
This wasn’t his job. He was filling in –without proper gear – for the goalie who must have overslept on this tournament morning.
“That kid has guts,” I commented to a friend. “No proper pads, and probably no training.”
“The goalie’s job isn’t complicated,” he replied. “All he has to do is keep that black thing out of the net.” A cruelly succinct job description but I’m sure Martin Brodeur or Patrick Roy would tell you it isn’t a cakewalk.
Our job can be summarized quite easily too. A firefighter puts water on . . . well, on fires. Public opinion about us waxes and wanes with the moon, like it does with hockey. There is one major difference though. People care about the NHL. They rarely give the firefighter a thought, especially the volunteer firefighter. If you want an example, look at an average player’s salary. It’s more than the combined budgets of 20 northwestern Ontario volunteer fire departments. And what do you think the television ratings would be for Volunteer Night in Canada, or Firefighter’s Corner ?
by the guy who wore it. The public may not like it when there is just a basement full of water left to show for our work but, as they say, you get what you pay for.
Years ago I wrote a pamphlet delineating the timeline of a fire response – 10 easy steps to watching your home burn down: ignition; detection; escape; call for help; page out; assembly at the hall; gear up; respond to the scene; set up; apply water. In rural Canada, this doesn’t happen in five minutes, or even 10 usually. The message was simple – get yourself out, because we won’t make it in time. The truth isn’t always popular.
Tim BEEBE
‘ It’s time to take a deep breath and reassess our goals based on the support that we can realistically expect. ’
Sure, people shower praise when they see a guy dangling from a helicopter or bringing a baby out from a smoke-filled building. And they should. Politicians like to talk about us saving taxpayers a billion dollars. Talk is cheap. And what happens when we don’t measure up to public expectations? We become pincushions in the coffee shop gossip sessions.
You’ve heard the expression, “If it walks like a duck and quacks like a duck, then it is a duck.” My experience is that people at least expect it to be a duck. When we show up with a big red truck and a crew in turnout gear, people want the hero show to begin. Never mind that our numbers are few, our trucks were built when Mats Sundin was in grade school and our volunteers have less time to train than the peewee hockey team. As a fire chief, my biggest fear is that the duck in a white helmet might turn out to be a goose.
It’s time to take a deep breath and reassess our goals based on the support that we can realistically expect. I once heard that cabinet makers count their fingers before a job then count them again afterward – if the numbers match, it was a good day. This is a realistic perspective for many departments. The whole incident can go south but all is not lost if every helmet is put away
The Japanese have a proverb: “We learn little from victory, much from defeat.” It’s time to enlighten the public about our defeats. This is tough, because it goes against the grain. We’re supposed to put our best foot forward. No one wants to board a sinking ship. The flip side is that our citizens need to know that they’re already on board, like it or not. It’s time to tell them that our options are limited when we show up with four firefighters – and no more – at a structural fire. And that reliance on a 25-year-old pumper is like racing the Indy 500 in a Model T. If we lose, our failure is the community’s failure. We’re on the same team. Somehow that message gets lost when we’re in the penalty box of public opinion, or worse, the courtroom.
Up until 1988, Upsala’s fire department was a bucket brigade. The neighbours swarmed to smoke like bees to honey. We knew we were going to lose, but it felt good to try. Public expectation soared with our first fire truck but our supply of resources levelled off. There are fire departments that have no business doing interior attack on most days. My department is one of them. This is not going to change, so it’s time we speak up.
Upsala does a lot of things well. We rescue people on the highway and help dozens more. We save exposures and occasionally the structure of origin. Firefighters are experts at improvisation – we know how to make do. If necessity is the mother of invention, then firefighters are the Edisons of emergency response. This is a tremendous strength but potentially an Achilles heel. “Why should we buy you a new truck? You’ve been keeping that one running for 25 years.”
The poor kid at the beginning of this column did eventually get relief. The real goalie showed up well rested and ready to keep “that black thing” out of the net and save the day. There is no one to save the day for us. We are it, ready or not.
Tim Beebe is the fire chief in Upsala, Ont. Contact him at upsalafd@tbaytel.net and check out his blog at http://www. beebewitzblog.blogspot.com
VERY
FEW THINGS CAN SURVIVE AN INFERNO.
OUR MISSION IS TO MAKE SURE YOU’RE ONE OF THEM.
The flames build. The smoke gets thicker and more intense by the second. People are fleeing. And what do you do? You push forward ready to do battle. It goes against every natural human instinct. But then again, firefighters are a different breed. For your infinite courage and selfless dedication, we salute you. But more importantly, we’re going to do everything we can to protect you. We’re MSA. And we equip firefighters with the most advanced thermal imaging cameras, helmets, air masks and gas detection devices available. Coincidentally, we’re somewhat of a different breed ourselves. You see, we’re a safety innovations company that’s been on a relentless crusade to protect lives for more than 90 years. Today we protect firefighters, soldiers, construction, iron and steel workers, oil riggers, utility workers, miners, consumers and hundreds more. Wherever there are workers who need to be protected, we will be there.
