Carolina Fire Journal | Vol. 38 No. 3 | Winter 2023

Page 1

TURNOUT GEAR INSIGHT FROM THE EXPERTS

THE FIRST RESPONDER’S RESOURCE
VOLUME 38 | NUMBER 3 | WINTER 2023 | WWW.CAROLINAFIREJOURNAL.COM
The First Responder’s Resource

The

23 NVFC | National Volunteer Fire Council

MAGGIE MOJAB AND DR. CANDICE MCDONALD

Sixty-One Delta One

25 Operations Plus — Often Overlooked But Very Important

GLENN CLAPP CSP, EFO, CHMM, CFPS

Update from the NCSFA

27 Update from the NCSFA

DOUG BISSETTE, EASTERN DIRECTOR

Fire Station Profiles

28 Jackson Community Volunteer Fire and Rescue Inc. UNION COUNTY, NC

Sixty-One Delta One

30 So You Want to Become a HAZMAT Technician — Now What

GLENN CLAPP CSP, EFO, CHMM, CFPS

32 Yoga 101 BRANDON DREIMAN Preserving

36 Dr. Newt T. Enloe and His “Pig Trough” of an Ambulance

BETH KRAH

38 The Training Officer and Using Scenarios in Rescue Training BOB TWOMEY

STAFF

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EDITORIAL BOARD

Jim Bell President

Bobbitt Design Build, NC Division

Bill Carter Director of Fire/EMS Business Development , Civic Federal Credit Union

Glenn Clapp Division Chief –Fuquay Varina Fire Dept.

Doug Cline President, International Fire Service

Kent Davis — Consultant, Threat Suppression

Dale Folwell N.C. State Treasurer

David Greene Ph.D Ph.D Chief, Colleton County Fire Rescue

David Hesselmeyer President –On Target Preparedness, LLC

Ricky Hesson N.C. Hazmat Association

Beth Krah Krah Corporation

Tracey Mosley - Program Manager, NC Association of Fire Chiefs

Ken Newell Stewart-Cooper-Newell Architects

Lizzy Long — Billy Graham Rapid Response Team

Richard Ray Capt. Durham Fire and Rescue

Mark Rivero — Public Safety Management Programs S. Illinois University

Caroline Schloss Crossword Puzzle

Mark Schmitt Captain, Greensboro Fire Department

Matt Sloane Skyfire Consulting

William Tatum - SC EMS Director

James Winslow NC EMS Director

Bill Webb Ex. Director Congressional Fire Services Institute

Dalan Zartman President, Rapid Response

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WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 1 CONTENTS VOLUME 38 | NUMBER 3 | WINTER 2023
First Responder’s Resource
FEATURES SPECIAL FEATURE SECTION: Personal Protective Equipment (PPE) 2 PPE: Our Last Line of Defense Against Acute and Chronic Hazards DAVID GREENE 5 Everyone Has a Say When It Comes to NFPA PPE Standards CHRIS FARRELL AND CURT FLOYD 8 New Series: The Complicated, Evolving Issue of PFAS in Turnout Gear: Part 1 ANGIE BELL 11 A Classic Piece of Gear in Need of a Modern Update PAUL MCDONAGH AND MORGAN NOONAN 14 3 Ways to Extend Gear Life TODD HERRING 16 A New Standard in Firefighter Gear Cleaning DEPARTMENTS EMS 17 Culture and Quicksand AARON DIX AND PENNY COUILLARD 18 2022 Update from the NC Medical Director DR. JAMES WINSLOW, MEDICAL DIRECTOR, NC OFFICE OF EMS Health & Wellness 19 Strength to Body Weight Ratio and Metabolic Efficiency JEFF CASEBOLT Recruitment & Retention 21 Are Your Interviews Hurting Your Organization DR. ANDREW HOLTER
& Wellness
Health
History
& Prevention
Safety
Leadership
Recruiting & Retention
40 Generations in the Workforce: Culture and Values MARK RIVERO
EXTRAS 41 New Deliveries
40 The After-Action Review Meeting DAVID HESSELMEYER

the exposed areas of the body (neck, face, arms, and hands) should be wiped off immediately using wipes, which must be carried on all apparatus. Use the wipes to remove as much soot as possible from head, neck, jaw, throat, underarms, and hands immediately. Again, when we pull a civilian out of a fire, and they are covered in soot, our next thought is that they need medical attention. If our firefighters are leaving a fire covered in soot, we are unnecessarily exposing ourselves to contaminants. Although it may not be that day or next week, we may end up being the one that needs medical attention years later due to repeated exposures to chronic hazards. The contaminants from structure fires have been proven to be cancer-causing. We wouldn’t leave a hazmat call and high-five the responders that have hydrofluoric acid on their necks. The head/neck/arm/ hand wipe is essential to ensure we leave the contaminants at the scene.

Best Practice #5: Change your clothes and wash them after exposure to products of combustion or other contaminants. Do this as soon as possible and/or isolate in a trash bag until washing is available. I knew a firefighter once whose spouse was often upset whenever he would wash his structural PPE in the washing

machine at his house. Not only does the PPE hold contaminants, but so does the uniform or clothing you wear underneath your PPE. Just like a hazmat incident, entry team members should change their clothes and wash them (separately from any other clothing) as soon as possible. Isolating your clothing in a trash bag until washing is available further reduces the risk of spreading the retained contaminants.

Best Practice #6: Shower as soon as possible after being exposed to products of combustion or other contaminants. “Shower within the Hour.” This one has long been a practice in the hazmat world. Structure fire entry personnel, just like those tasked with entry at a hazardous materials incident, should shower as soon as possible to remove any contaminants that are still present after decontamination was conducted.

Best Practice #7: PPE, especially turnout pants, must be prohibited in areas outside the apparatus floor (i.e., kitchen, sleeping areas, etc.) and never in the household. Unfortunately, I shudder to think the number of times I slept in a fire station with my turnout pants at the foot of the bed or worn them in the day room. Doing this brings

workers and/or families are exposed to them. Our fire stations (outside of the apparatus floor) and our homes should be cold zones. When we exit a technical decon line after stopping an anhydrous ammonia leak, our suits are normally placed in an overpack drum to be disposed of or to be cleaned if they are multi-use suits. We would not bring that Level A suit into the dayroom back at the station and place it on the kitchen table.

Best Practice #8: Wipes, or soap and water, should also be used to decontaminate and clean apparatus seats, SCBA, and interior crew area regularly, especially after incidents where personnel were exposed to products of combustion. In hazmat, we receive direct contamination when we touch something dirty. Cross-contamination occurs when something clean comes into contact with something dirty. If I am in a Level A suit and grab the shipping papers that are in the middle of a chemical leak, I have direct contamination. If I fail to seal or decontaminate those papers and deliver them to the command post and the IC grabs them to read them, the IC is now cross-contaminated. The IC, who was clean, has now contacted something dirty. Think of it this way. We wouldn’t roll up the salvage cover that sat under

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our technical decon after a hazmat incident and throw it back on the truck. Although it never entered the hot zone, the salvage cover likely has tons of contaminants from the decontamination process on it. When it is not disposable, regular decontamination, especially after a fire, of regularly used areas of our apparatus seats, SCBA, and interior crew area should further limit our exposures.

Best Practice #9: Get an annual physical, as early detection is the key to survival. Anyone with an annual fire brigade clearance or using a respirator should be required, by law, to get an annual physical. That physical should include a blood panel that detects the potential presence of cancer (Prostate Specific Antigen [PSA], CA-125 [Ovarian Cancer Protein Test], Leukocytes [White Blood Cells], etc.). Annual physicals can also detect the presence of heart disease, which is the number one killer of firefighters.

Best Practice #10: Tobacco products of any variety, including dip and e-cigarettes, should never be used at any time on or off duty. As a former smoker, I can relate to how hard it is to quit. Not only does tobacco use increase your risk for many cancers, it can increase

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your chance of heart disease. As I wrote earlier, we already experience a 1.1 to 2.1 times greater chance of developing cancer due to our occupation. We should probably not try to increase it any further through tobacco use.

the material involved. That report clearly lists who made entry and was exposed to the product(s) present, and those records are maintained for 30 years after the firefighter’s retirement. In a structure fire report, there is usually only a list of personnel

Best Practice #11: Fully document ALL fire or chemical exposures on incident reports and personal exposure reports. This is a new one for structure fires, but not so much for hazmat. In a hazmat incident report, we fully document pre- and post-entry vital signs of the entry personnel and any signs and symptoms they had related to

and the apparatus to which they were assigned. We do not always clearly delineate who was exposed to the toxic products from the fire and who was not. This is something we need to change. Following the hazmat routine, we should do a better job of documenting who specifically was exposed to the fire as opposed to those that may have been in support roles.

By now, I hope you have recognized that structure fires are, in fact, hazardous materials incidents. Although we have been aware of the acute hazards structure fires pose to our personnel for some time, we have just begun to appreciate the chronic risks to our personnel. Decades ago, when legacy fuel packages such as wood, cotton, etc., fueled structure fires, heat release rates were much lower, and the smoke was much less toxic. Today’s structure fires have fuel packages powered by polyethylene, polyurethane, and other synthetic materials with much higher heat release rates, increasing the acute hazards. More importantly, the byproducts of incomplete combustion (smoke) as a result of contemporary fuel packages in today’s structure fires are capable of harming us long after the fire is out. Applying the hazardous materials incident tactics that we have used for decades to today’s structure fires by utilizing the best practices above can help reduce the chronic risks that we encounter. Many of us know a firefighter that has battled and perhaps lost a fight to cancer. Do not take these best practices lightly. Young firefighters today, who will

be exposed to contemporary fuel packages and extremely toxic smoke their entire careers, are more at risk than those of us that dealt with legacy fuel packages and less toxic smoke early in our careers. Get behind these recommendations and use as many as possible in your department so that our young firefighters can have long careers followed by healthy retirements. Be safe and do good.

David Greene has over 31 years of experience in the fire service and is currently the deputy chief with Colleton County (S.C.) Fire-Rescue. He holds a PhD in Fire and Emergency Management Administration from Oklahoma State University and an MBA degree from the University of South Carolina. He is a certified Executive Fire Officer through the National Fire Academy, holds the Chief Fire Officer Designation from the Center for Public Safety Excellence, holds Member Grade in the Institution of Fire Engineers, is an adjunct instructor for the South Carolina Fire Academy and is a Nationally Registered Paramedic. He can be reached at dagreene@ lowcountry.com.

4 | CAROLINA FIRE RESCUE EMS JOURNAL | WINTER 2023 WWW.CAROLINAFIREJOURNAL.COM
Today’s structure fires have fuel packages powered by polyethylene, polyurethane, and other synthetic materials with much higher heat release rates, increasing the acute hazards.

EVERYONE HAS A SAY WHEN IT COMES TO NFPA PERSONAL PROTECTIVE EQUIPMENT (PPE) STANDARDS

Ask any firefighter what is one of the most important pieces of equipment they have throughout their career, and many would tell you it is their personal protective equipment (PPE). From the very early stages of probie school to the time they retire, firefighters will have had a few sets of “turnouts,” including helmet, hood, coat, gloves, pants, and boots. These items and the way they are constructed - from the stitching in the coat and pants to the material in the inner layer, vapor barrier, and outer shell, to the lettering and other aspects that go through intensive design scrutiny, construction, testing, and maintenance – help ensure that firefighters can do their jobs safely. But what helps guide how all these elements of PPE come together and do their job of protecting firefighters? The answer is simple: consensusbased standards.

WHAT ARE CONSENSUSBASED STANDARDS FOR FIRST RESPONDERS?

The National Fire Protection Association (NFPA), based in Quincy, MA, serves as the main facilitator of first responder standards in the United States. In general, a standard is a document that contains mandatory language including the word “shall,” which makes it usable as a “mandatory reference by another standard or code” or for incorporation by reference into law.

All NFPA standards are written as minimum requirements that work to ensure adequate levels of safety. It is important to note that NFPA does not write these standards. Instead, NFPA facilitates the open, consensus-based development process for more than 300 standards, including 114 that are fire-service related documents, which are typically updated every three to five years. This work is done by Technical Committees comprised of subject matter experts and a diverse range of volunteers who dedicate their time to this undertaking, operating in strict adherence to NFPA’s established standards-making process.

To learn more about how the NFPA standards process works, visit https://www.nfpa.org/Codes-andStandards/Standards-Development/

How-the-process-works WHY

SHOULD FIREFIGHTERS HAVE AN INTEREST IN STANDARDS?

There are more than 100 NFPA codes and standards that impact each and every firefighter from the very first day they become one. For any jurisdiction that incorporates NFPA standards into law, the fire departments within that jurisdiction must comply with those standards and the provisions within them. Even jurisdictions that do not incorporate NFPA standards by reference into law may still need to follow them as an industry best practice.

Everyone has a say as to what goes into each standard (except for NFPA employees). If you do not like a provision within a standard, you can submit an input to make

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Special Feature Section Personal Protective Equipment (PPE)

a change. The process is open to the public. The NFPA standards development process allows anyone to submit input directly to the Technical Committee (TC) that is responsible for each standard. As a requirement of the NFPA process regulations, the TC must then provide a response, which may come in the form of a revision (also known as a change to the requirements) or an explanation as to why the standard was not revised. In addition, all NFPA committee meetings are open to the public, which allows anyone to witness the committee’s deliberations and, when requested, to address the committee directly. This exchange of ideas with people that are subject to or directly affected by the standard is at the core of the NFPA process.

THE EMERGENCY RESPONSE AND RESPONDER SAFETY CONSOLIDATION PROJECT

One of the major projects currently underway at NFPA is the Emergency Response and Responder Safety Consolidation Project. During its April 2019 meeting, the NFPA Standards Council reviewed a consolidation plan for the NFPA Emergency Response & Responder Safety (ERRS) standards and voted to support the plan, which is designed to better serve ERRS stakeholders and create better efficiencies for the TC members that volunteer to serve this audience. This consolidation effort pertains to all NFPA Standards that the ERRS team is responsible for, including various guides and best practices that will be combined, by topic, into consolidated standards over the next five years.

The consolidation plan is being undertaken to improve the overall experience of the ERRS standards development process. This effort

applies to the standards that cover everything from operational concerns, professional qualifications for responders, and the care, selection, and maintenance of PPE. The transition began in January 2020 and will take place over the next five years. By 2025, all the ERRS standards will be in their proper cycle and will reflect a wellrounded view of topics. The project was created to benefit anyone who uses NFPA ERRS standards, as well as the thousands of volunteers who work to develop these key documents.

Custom revision cycles, specifically for ERRS standards, are being developed for each group that make up the consolidation plan and individual ERRS standards will be moved into appropriate revision cycles. Users of the codes and standards want related information conveniently packaged so that they can be more efficient and effective

workers. To meet these expectations, the NFPA Technical Committees will serve as designated content groups charged with producing more inclusive guidance as needed. The current standards will appear as different chapters within an “umbrella” standard.

The majority of current Technical Committee members will remain in place and maintain responsibility for the same information contained in their current standard. Of the approximate 2,000 principal and alternate Technical Committee members, a small number may find themselves serving on multiple standards that have conflicting meeting schedules however an effort will be made to avoid that. As of this time there is no plan, nor is this intended to, disband, or eliminate any current Technical Committees.

NFPA 1971 IS THE CURRENT FIREFIGHTER PPE STANDARD

NFPA 1971, Standard on Protective Ensembles for Structural Firefighting and Proximity Firefighting serves as the premier standard for firefighter PPE. The 2018 edition contains the current requirements related to firefighter PPE and is currently in its revision cycle. The Technical Committee will meet in early 2023 to discuss any further proposed changes and consider any further revisions that need to be made in the next edition of the standard.

HOW CAN YOU SUBMIT PROPOSED CHANGES TO NFPA 1971 AND MAKE YOUR VOICE HEARD?

NFPA 1971 is being consolidated into a new document NFPA 1970. Going forward, all of the requirements and information found in NFPA 1971 will be combined with NFPA 1975, Standard on Emergency Services Work Apparel; NFPA 1981, Standard on Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services; and NFPA 1982, Standard on Personal Alert Safety Systems (PASS) to create a new document that will be known as NFPA 1970, tentatively titled Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting; Emergency Services Work Apparel; Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services; Respirators for Wildland Fire Fighting Operations; Personal Alert Safety Systems (PASS); Breathing Air Quality for Emergency Services Respiratory Protection. (Note: The committees are likely to adopt a shorter title before final publication.) This means that you will be able to submit your suggested change(s) directly to the draft of the new, consolidated NFPA 1970 and that any proposed changes to the

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requirements of NFPA 1971 should be submitted to the new document NFPA 1970. You can review the First Draft Report at www.nfpa. org/1970next.

If you read the proposed changes

review in the Fall of 2023. Throughout the process, the latest information on this standard can be found at nfpa. org/1970next, as noted above.

In addition, to stay apprised of updates to NFPA 1970 or any other

on the First Draft Report of NFPA 1970 and wish to submit a comment, you may do so by the January 4, 2023, deadline.

In the following months, the Technical and Correlating Committees will consider all the proposed changes received by the deadline and will develop a Second Draft of NFPA 1970. NFPA anticipates that the Second Draft Reports will be posted for public

standard, you can sign up for e-mail alerts at www.nfpa.org. This is the best way to be notified whenever information regarding a particular code or standard is updated, providing the latest information about any standard, including the document revision history and the development of the next edition. In addition to automatic alerts, you can access the public input submission

system, apply for membership on the Technical Committee, ask a technical question (for NFPA members and public sector officials only), find related news, or see any related products in NFPA’s catalog. Also related to firefighter PPE is a recent webinar that NFPA is making available from its website titled, “Female Firefighter Personal Protective Clothing: Investigation of Design, Comfort, and Mobility Issues” by Drs. Meredith McQuerry and Cassandra Kwon. Dr. McQuerry indicates that female firefighters have a 33% greater risk of injury than male firefighters and part of that could be due to ill-fitting gear. The study, with help from the Fire Protection Research Foundation (the research affiliate of NFPA), created the first ever database of female firefighter anthropometrics or physical measurements. This database can help manufacturers and the technical committees create better PPE for female firefighters. The webinar can be viewed for free at https://www.nfpa.org/Trainingand-Events/By-type/Webinars.

GET INVOLVED AND MAKE YOUR VOICE HEARD

Your firefighting PPE is an essential part of you being successful at what you do. It is with you for your entire journey through the fire service and

it is important to understand where the requirement for its design comes from. It is also important to know that you have a say in the very standard that helps to regulate the many aspects that go into it. Visit www.nfpa.org to learn more about the standards that affect you and other resources from NFPA that help firefighters do their job safely and effectively. Simply put, get involved and make your voice heard.

Curt Floyd is currently the Responder Technical Lead at NFPA where he works as a technical advisor on responder initiatives. Before his work at NFPA, Floyd spent 34 years in the fire service, teaching technical rescue and serving as a rescue specialist and instructor for the FEMA USAR system. He holds a bachelor’s degree in Fire Protection Engineering, graduated from the National Fire Academy’s EFO Program, and has presented on responder topics around the globe.

Chris Farrell came to NFPA more than 10 years ago, where he currently serves as the staff liaison for the NFPA PPE project. Previously, Farrell worked for the Chapel Hill Fire Department in Chapel Hill, NC and the New Hope Volunteer Fire Department in Orange County, NC.

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Your firefighting PPE is an essential part of you being successful at what you do. It is with you for your entire journey through the fire service and it is important to understand where the requirement for its design comes from.

THE COMPLICATED, EVOLVING ISSUE OF PFAS IN TURNOUT GEAR: Part 1

Firefighting these days feels like competing in the Hunger Games. In the Hunger Games, combatants knew they would face 23 other unlucky lottery losers, each fighting to the death to save their own lives.

So, fighters pre-planned and trained for those 23 known, obvious life threats.

But then, whoa, once in the Arena, the Head Gamemaker had some surprises in store. He unleashed a tsunami, or deadly hornets. Or rolled out toxic fog. Or hid landmines near supplies. Or enticed a starving participant to eat poisonous berries.

Hunger Games combatants pre-planned for 23 known perils but could not imagine what other dangers loomed.

For centuries, firefighters trained hard to survive the most obvious life threat – fire.

Fire (and the various ways it can trick, trap, and kill you) is the handto-hand combatant we know and train to face, so we can stay calm and safe in burning structures.

But for more than a decade now, firefighters have realized the most insidious life threat we face is cancer.

Maybe before awareness increased, cancer seemed to be in another “Zone” of the Arena – like those berries someone was dumb enough to eat but we would never.

But then more and more cancer studies could not be ignored, so firefighters did what they do –started pre-planning and training to prevent cancer with known.

STEPS TO FIGHT CANCER

Our worn gear stays contaminated and sheds carcinogens.

Departments prohibited bringing bunker gear into living areas and bought fancy extractors to launder the gear instead of our personal washing machines.

Contaminated or wet gear means fire crews have no PPE for the rest of a shift, which compromises protection of the district? Departments bought second sets of gear, and municipalities scrambled to fund their purchase.

Breathing products of combustion causes cancer? Departments mandated air quality monitoring and that firefighters stay on air during salvage, overhaul, and investigations.

Contaminants soak into our skin and cause cancer? Departments added on-scene decon and provided wipes in each apparatus. Firefighters know they now must shower within the hour, during which departments now allow

crews to stay out of service.

So, the fire service has some counterpunches, some solutions to fight occupational cancer. Various “solutions” were not perfect; they can involve very high cost or discouraging fireground logistical hurdles. The highest hurdle might be convincing a bunch of really strong folks to admit they are not invincible and need to embrace inconvenient extra work after a job.

A NEW ENEMY IN

OUR GEAR LOCKER

But most recently, a combination of toxic fog plus raging hornets plus poisonous berries has descended upon the fire service. And we do not yet have a counterpunch, in fact we are still trying to pin down the problem.

OUR TURNOUT GEAR CONTAINS PFAS.

Not our gear! It keeps us safe,

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allows us to survive unsurvivable environments. As rookies, we practice donning and doffing it a million times and I admit I had a friend take a ton of pictures of me in my very first set.

Our bunker gear – thrown on for everything from a fully-involved

advocate for safer turnout gear, we need to educate ourselves about what we have worn our whole careers.

According to the U.S. Food and Drug Administration: “Per- and polyfluoroalkyl substances (PFAS) are a diverse group of human-made

whether PFAS are really that unhealthy – government health agencies are conservative in their statements about the dangers of PFAS. Progressing from there, some question whether the PFAS in turnout gear really hurt firefighters.

We hope more scientists will urgently delve into this topic and not only address our concerns but provide us with reasonable alternatives.

As conservative as the federal government has been, the FDA website does say, “While the science surrounding potential health effects of bioaccumulation is developing, exposure to some types of PFAS have been associated with serious health effects.”2

The Utah Department of Environmental Quality states: “Some, but not all, studies in humans with exposure to PFAS have shown that certain PFAS may:

• Affect growth, learning, and behavior of infants and older children

working fire to a medical call that interrupted our workout – could possibly be harming our health.

A final verdict is still very much out on a causal link between PFAS and firefighting occupational cancer, but the news has rocked the profession and left millions of firefighters scrambling for answers on how to best protect themselves.

PFAS, THE NEW NEMESIS?

As a reformed hazmat technician nerd, I know most firefighters’ eyes glaze over when you toss around long words containing “-alkyl’ and multiple syllables. But hang in there, because if we are going to

chemicals used in a wide range of consumer and industrial products. PFAS do not easily breakdown and some types have been shown to accumulate in the environment and in our bodies. Exposure to some types PFAS have been linked to serious health effects.”1

You may also see references to PFOA (Perfluorooctanoic Acid) and PFOS (Perfluoro octane Sulfonate) which are types of PFAS.

It is crucial to point out this is a very new field – the first true research studies of gear seem to have been conducted in 2018, which is like a millisecond in terms of scientific research. Some doubt

• Lower a woman’s chance of getting pregnant

• Interfere with the body’s natural hormones

• Increase cholesterol levels

• Reduce the immune response

• Increase the risk of cancer

• Change liver function

• Increase the risk of pregnancyinduced hypertension/ preeclampsia

• Increase the risk of thyroid disease”3

THEY’VE GOT US SURROUNDED

PFAS have been around for almost a century now, used to increase resistance to stains and water, in everything from fabric to paint to personal care products. Water-resistance helps protect firefighters from steam burns while the oil-resistance protects against permeation by some chemicals.

Trying to avoid PFAS might feel useless, because of the sheer volume of them in thousands of consumer products including cookware, cosmetics, personal care products (shampoo/lotion), dishwasher and laundry detergent, and food packaging like fast food wrappers, pizza boxes and microwave popcorn bags.

However, you can avoid PFAS in consumer products with a bit of effort. Make popcorn with an air popper instead of the microwave. Cooking in cast-iron pans harkens back to the earliest days of firefighting (but rookies, dear sweet heaven please ask a vet how to wash one!). Googling “PFAS free” cosmetics and cleaning products –and just about anything you put on your body – yields many options.

But as we know, staying out of turnout gear is flat-out not an option for firefighters. Even at “retirement home” stations, gearfree days are not guaranteed.

So, what is a firefighter to do?

DON’T WEAR GEAR

IF YOU DON’T HAVE TO

Unnecessary donning of turnout gear falls into two categories: 1) “It’s so easy” and 2) “You never know.”

“It’s so easy” to jump into your gear when your workout gets interrupted, and you do not want some poor syncope patient waking up to your very short workout shorts.

“It’s so easy” to stay in jammies and throw turnout pants on in the middle of the night, rather than put your uniform back on, belt and tucked-in-shirt and all.

Coveralls, or “multi-response PPE” could be a good, low-cost alternative to the convenience of turnout gear in either case.

And then we have “You never know” if you may face a fully involved structure despite being dispatched on a fire alarm, right? “You never know” if an incomplete 911 dropped because residents fleeing a house ablaze abandoned their phones in their rush to escape.

“You never know” if an MVA might present you with a subjecttrapped who needs extrication.

Or at the very least, you have to navigate a ton of broken glass at almost every wreck so wear your gear to be safe.

Sound familiar? But now you know you could possibly increase your cancer risk every time your skin contacts that gear, maybe convenience is not worth it. And maybe there is a better system to assess whether conditions warrant wearing it at all.

One North Carolina safety officer

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Special Feature Section Personal Protective Equipment (PPE)
Your firefighting PPE is an essential part of you being successful at what you do. It is with you for your entire journey through the fire service and it is important to understand where the requirement for its design comes from.

told me, “I have started telling guys, the standard says you have one minute to put your gear on. It does not say you have to do that before you roll. Get there, see what you have got, and whether you need that gear or not.”

Now, realizing the fire service is based on planning for worst-case

CHECK INTO PFAS FREE ALTERNATIVES

Manufacturers are scrambling to catch up to the revelations about turnout gear. Right now, at least one company is making outer shells without PFAS, and while the Alliance does not endorse any brands, we applaud departments

years of his career on several studies to better protect firefighters such as the effect of UV rays on your hood’s durability and ways to check gear more thoroughly for contaminants after fire exposure.

Look to our social media pages in the coming weeks for links to the live stream so you and your crew

new issue in our occupation, with many complex factors, and will require vigilance just like every other cancer risk factor firefighters face. Know your normal, know your risks, and do what you can to protect yourself. Be safe.

Angie Bell is a retired Captain, serving 17 years in the Asheville (North Carolina) Fire Department. She loves to hike the Western North Carolina Mountains with her dog, Murray, and takes care of goats when not volunteering for the NCFCA and other organizations.

Instagram: @ncfirefightercanceralliance

Facebook: https://www.facebook.com/ ncfirefightercancer

Twitter: @ncffcancerally

REFERENCES

scenarios, “You never know” will be a tough mindset to overcome. When we get to that MVA subject trapped, it seems unthinkable to tell them to stay calm for just one more minute while we don our gear.

But if you have done this job for a minute, you know the ratio of fender-benders to true extrications is low, and at some point, you have to choose what you are willing to risk your life for.

In their statement in the fall of 2022, the International Association of Firefighters and the Metropolitan Fire Chiefs Association included the following on the Safety Advisory checklist:

“Do not wear turnout gear on responses where this level of protection is not necessary. (Wearing all PPE and SCBA during firefighting, overhaul,

who have brought together committees to research all options. We will certainly address innovations in turnout gear in coming articles, and welcome emails and messages from readers who learn of new products.

CONTINUE TO EDUCATE YOURSELF AND STAY TUNED FOR PROGRESS

The Alliance has scheduled a day-long workshop concerning “PFAS in Turnout Gear” at the Mid-Winter Chiefs’ Conference in Concord in February.

Dr. Bryan Ormond, Ph.D. in Fiber, and Polymer Science is an assistant professor at N.C. State University who will be leading a half-day workshop addressing the subject. Dr. Ormond is part of the Textile Protection

can catch Dr. Ormond’s expertise. We will also record it to allow for widespread viewing.

SUMMARY

PFAS in turnout gear is a relatively

1. “Per- and Polyfluoroalkyl Substances (PFAS),” USDA website, https://www.fda.gov/ food/chemical-contaminants-food/ and-polyfluoroalkyl-substances-pfas

2. ibid

3. State of Utah DEQ “Health Effects of PFAS,” https://deq.utah.gov/pollutants/ health-effects-of-pfas

4. https://www.iaff.org/pfas/

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Manufacturers are scrambling to catch up to the revelations about turnout gear. Right now, at least one company is making outer shells without PFAs, and while the Alliance does not endorse any brands, we applaud departments who have brought together committees to research all options.

A CLASSIC PIECE OF GEAR IN NEED OF A MODERN UPDATE

DHS S&T and Texas Tech Put Their Heads Together for Firefighter Safety

We expect a lot from firefighters.

Time and again, they rise to the challenge: meeting communities’ growing needs, expecting the unexpected, and adapting in real-time—often under extreme pressure. And if we expect them to adapt, we should expect their protective gear to evolve with them as well. Responders need effective, affordable equipment that they can rely on to support their increasingly demanding jobs.

Additionally, with a changing response landscape, the roles and responsibilities of firefighters have changed significantly in the past few decades. Firefighters are required to perform structure firefighting, search and rescue, hazardous materials mitigation, and disaster response—but it does not end there. The increased call for firefighters to respond to potentially violent emergency events (with or without law enforcement,) such as active shooters, terrorist incidents, or armed crowds, demands better physical protection.

Perhaps no other item is more classically associated with firefighters than their helmets. It is a highly valued piece of equipment that can even hold special emotional significance for a firefighter— providing a sense of not only safety but also confidence when donned. Paradoxically, though, according to the National Fire Protection Association (NFPA), roughly 40% of musculoskeletal injuries reported by firefighters can be attributed in part to the helmet — the very thing that is supposed to protect them. Though designed to shield the firefighter’s head from thermal and low-velocity direct impact, helmets often contribute to overexertion/sprain-related head and neck injuries because of the added bulk and weight. Helmetrelated injuries were also the subject of a 2015 lawsuit in St. Petersburg, Florida, where firefighters claimed the helmet design caused neck and head injuries.

An effective, modern firefighter helmet calls for thermal and ballistic protection combined with communication devices, face shields, visors, thermal imaging, and lighting. However, all of these elements

increase the total weight and potentially shift the helmet’s center of gravity. Thus, these changes can lead to injuries to the cervical spine and neck muscle fatigue.

Traditional structural firefighter helmets do not incorporate these enhanced capabilities, nor do they offer sufficient ballistic protection. As a result, firefighters currently either forego ballistic protection entirely, or they have two helmets, one for structure firefighting and one for violent situations. This

means twice the amount of gear to procure, transport, store, and maintain. It is simply not practical, and it could be dangerous during a rapidly evolving response in which the firefighter must remove one helmet and replace it with the other. That is why the Department of Homeland Security (DHS) Science and Technology Directorate (S&T) is developing an all-in-one solution that is both protective and light—providing

adequate functional mobility as well as positional stability, thereby reducing the risk of injury while also supporting ancillary accessories

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 11 Special Feature Section Personal Protective Equipment (PPE)
A traditional 6.1-mm composite helmet plaque shows damage after NIJ IIIA ballistic testing. (Photo courtesy of Texas Tech University.) A professional marksman conducts ballistic testing, firing 9 mm rounds at helmet shell plaques at the Lubbock Shooting Complex, Lubbock, Texas. (Photo courtesy of Texas Tech University.) A 3-mm thick composite helmet shell (sample plaque) is tested for mechanical (tensile) strength per ASTM standard.
Join us in the beautiful Blue Ridge Mountains for NC continuing education and innovative training. Learn more at abtech.edu/emergency-services or call 828-782-2355 . ASHEVILLE, NORTH CAROLINA • (828) 398-7900 • ABTECH.EDU Explore the Fire, EMS and Law Enforcement Training Center at A-B Tech Woodfin
(Photo courtesy of Texas Tech University.)

that expand firefighters’ capabilities. CREATING A HELMET THAT’S BOTH PROTECTIVE AND LIGHT

To meet this need, S&T is partnering with Texas Tech University (TTU) to develop the Next Generation (NextGen) Firefighter Helmet. This new, cutting-edge piece of technology will provide both fire and ballistic protection and mitigate the risk of blunt head trauma. It will incorporate both NFPA 1971:2018 fire protection and National Institute of Justice (NIJ) Level IIIA ballistic protection. As the research and development arm of DHS, S&T partners with private industry and academia to develop innovative solutions to the most pressing challenges faced by first responders. TTU is an internationally recognized research institution with an awardwinning faculty. According to S&T Program Manager Maua Karen H. Johnson, “Both S&T and TTU are anticipating an incredibly positive impact with this project.”

The new device will employ alternative materials and advanced ergonomic design solutions that eliminate the risks of the conventional helmet system. It will not only expand the range of protection for firefighters by delivering an injury-mitigating helmet; it will also promote new safety standards and advance the collective knowledge of material design.

The project is already well underway, with the ultimate goal of producing a prototype capable of performing with high fidelity in operational environments later this year. Initial critical design analyses examined the capabilities and limitations of existing helmets, including functional mobility, dynamic positional instability, skull area covered by the outer shell, head-helmet contact pressure, peripheral visibility range, and other factors and parts that can contribute to the risk of head and neck injuries.

The NextGen Firefighter Helmet will be designed with a shell that can absorb energy during impact and rapidly dissipates it without injuring the skull or brain. While the current materials used in both firefighter and military helmets are inadequate for the temperature and ballistic protection being sought, they provide a useful blueprint for future innovation. For example, Kevlar fiber has a melting point of 1040 °F and has proven highly effective in ballistic helmets and body armor. Similarly, polyester resins used in current firefighter headgear can have glass transition temperatures (the point at which it becomes hard and brittle) as high as 386.6°F. The idea is

that thermosetting resins can be reinforced with Kevlar fiber, creating a shell that meets both the thermal and ballistic protection requirements of the NextGen Firefighter Helmet.

Another important aspect of the design is the center of gravity and subsequent stability. The helmet must provide both static and

dynamic fits to protect from blunt impacts. While there has been significant research on assessing injury-mitigating design solutions for both military and motorcycle helmets, there is a lack of preexisting systematic research on designing a user-centric injurymitigating firefighting helmet, including ballistic protection, that

addresses firefighters’ concerns.

ENSURING END-USER NEEDS ARE CONSIDERED EVERY STEP OF THE WAY

The NextGen Firefighter Helmet project is seeking to address all of these concerns. Firefighters’ insights are being incorporated throughout the entire development process. To that end, researchers from TTU’s Industrial, Manufacturing, and Systems Engineering Department designed and distributed an online Firefighter Helmet and Safety Survey to collect feedback on various helmet features that support or hinder overall safety and functionality. The questionnaire helped assess the safety, functionality, and overall satisfaction of existing firefighter helmets. It included an additional supplementary portion (completed by over 100 responders) for those who have experienced a head injury

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A Fire Ops 101 event arranged by the Lubbock Fire Rescue Department, Lubbock, Texas provides Texas Tech engineering students with the first-hand experience of various firefighting activities. (Photo courtesy of Texas Tech University.) A local firefighter volunteers to perform various head and neck range-of-motion tasks while wearing a traditional firefighter helmet for the data gathering process. (Photo courtesy of Texas Tech University.)

or concussion in the past. All of the more than 1,700 responders to the survey were firefighters currently working or volunteering in a local fire department in the United States. In addition, the head and neck biomechanical data of 11 firefighters was recorded in a study conducted by TTU in September 2022. Researchers are using this information to help determine optimal ergonomic designs for a prototype that will both improve usability and reduce the risk of head and neck injuries. Participants in the study were also evaluated for endurance with and without wearing a helmet to gauge neck flexion and extension limits. Sustained exertion was calculated to determine the type of helmet shape that causes the smallest reduction in endurance and the least amount of fatigue. The goal is to achieve improved mobility, visibility, comfort, and fit while also reducing neck muscle fatigue, skull vulnerability, and cervical spinal load. Despite all of the innovations being sought for this new piece of gear, researchers are keeping in mind the end-user desire for ease of use. The NextGen Firefighter Helmet will be employed in nearly the same manner as current helmets. The firefighter will have the helmet on or near his or her person when responding to a call. Upon arriving at the call scene, the firefighter should be able to put on their helmet, mask, and hood in under one minute. Establishing communication and performing a communications check with an integrated communication module should be no more complicated or difficult than with current solutions. When entering a structure, activating integrated lighting should be simple, easy, and quick. The new helmet should require few if any, changes to current standard operating procedures.

EVALUATING PROTOTYPES UNDER STRENUOUS CONDITIONS

Researchers are hard at work on prototypes that put all of

this data and feedback into practice. They are engaging a combination of principles and methods from four key areas— reverse engineering, materials design, injury biomechanics, and human factors engineering. The testing environment contains state-of-the-art equipment such as a Delsys TrignoTM Wireless electromyography system, 10-camera Eagle optical digital motion capture system, and Pupil Core eye-tracker. The high-speed desktop computers have Abaqus finite-element modeling software to develop human head and neck models, HyperMesh to process helmet imaging data, and opensource OpenSim musculoskeletal modeling software to develop head and neck biomechanical models. Using all of these resources plus extensive expertise, they have developed a digital prototype of the NextGen Helmet for ballistic protection tests and biomechanical modeling. Frontal, lateral, and crown impacts have been successfully simulated to analyze potential brain trauma from various projectiles such as .44 Magnum bullets. Additional evaluation is ongoing to help further optimize the design.

The research team is also beginning to fabricate physical prototypes—approaching different vendors to identify cost-effective materials able to withstand impact and penetration resistance testing as well as thermal trials. Just recently, they successfully produced a 10.01 mm helmet shell using a vacuum bagging process, manually applying resin to the fabric to facilitate the infusion. To complete this work, the team has access to an Advanced Manufacturing and Materials Lab (AMML) equipped with additive manufacturing equipment capable of fabricating prototypes and applicable parts from plastic, metal, ceramic, and composite materials. The AMML has two general mechanical testers and one nanomechanical tester with testing

capabilities for tensile, compressive, bending, indentation, wear, and scratching tests. The team is also making use of additional laboratory space designed for polymer and soft matter physics and thermal analysis activities. These spaces are outfitted with rotary rheometers (measurement devices to evaluate how a dense fluid flows in response to applied forces), large ovens capable of accommodating vacuum bag molding equipment to manufacture composite panels and helmet shells, atomic force microscopes, and calorimeters (used to characterize glass transition temperature).

DELIVERING A WORTHY PRODUCT

The NextGen Firefighter Helmet will meet a variety of key performance parameters. In addition to NFPA 1971:2018 structural firefighting requirements and NIJ Level IIIA standard for ballistic protection, it will also meet the NFPA 1951:2013 protective standard for technical rescue incidents and the United States Occupational Safety and Health Administration 1910.156 fire brigade standard. It will integrate with a variety of self-contained breathing apparatus masks and communications systems and will not inhibit the user’s hearing or vision. Additional desirable characteristics include weight of 62oz or less for size large and 57oz or less for size medium, comfortable, adjustable, maximized range of motion, no snag points, and easy to don and doff.

Once the prototype is ready, likely in mid-2023, an operational field assessment will take place with coordination by S&T’s National Urban Security Technology Laboratory. Firefighters will

be brought in to evaluate every aspect of the helmet’s design and capabilities. The ultimate goal is, of course, commercialization. The NextGen Firefighter Helmet team also plans to apply for the device to be added to the DHS Federal Emergency Management Agency

Authorized Equipment List and seek Support Anti-Terrorism by Fostering Effective Technologies Act of 2002 certification as a final deliverable. TTU’s Office of Research Commercialization will assess the final product, file patents as appropriate, and help accelerate licensure to a commercial partner or University start-up who will bring the technology to market.

Paul McDonagh is currently the First Responder Portfolio Manager for the Department of Homeland Security Science and Technology Directorate and oversees the First Responder Resource Group (FRRG), a multidisciplined group of volunteers from the first responder community. The FRRG provides insight and support so DHS can increase the capabilities of responders to protect our communities. He is a former police commander with over 38 years of service. He was a patrol officer and SWAT member and managed the Police Operations Center working closely with fire, emergency managers, and federal partners during large-scale events and emergencies.

Morgan Noonan is a contractor working in the Communications and Outreach Division of the Department of Homeland Security Science and Technology Directorate as a Senior Communications Specialist. She has seven years of experience creating multimedia content promoting federal research and development efforts.

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A 3-mm thick composite helmet shell (sample plaque) is tested using the torsion rectangular fixture on an ARES rheometer. (Closeup) (Photo courtesy of Texas Tech University.) A 3-mm thick composite helmet shell (sample plaque) is tested using the torsion rectangular fixture on an ARES rheometer. (Photo courtesy of Texas Tech University.) A hemisphere-shaped helmet of 3 mm thickness is made by a vacuum infusion process. (Photo courtesy of Texas Tech University.)

3 WAYS TO EXTEND GEAR LIFE

Routine inspection + cleaning, + care keep turnouts and PPE in top shape so firefighters stay safe while departments save money.

Most firefighters understand that properly worn PPE is required to limit exposure to contaminants encountered on the fire scene. It’s important to also understand that studies have shown that protective clothing can pick up numerous highly toxic contaminants, putting firefighters at risk of developing long-term health disorders. And it’s not just clothing that picks up toxins; it’s also gloves, helmets, and hoods. These toxins are then shared in common areas in the apparatus, in the firehouse, and even in firefighters’ homes.

Both the longevity of turnout gear and its effectiveness against carcinogens and other harmful contaminants rely heavily on one factor: proper maintenance.

The popular image of a firefighter in dirty, grimy gear is a badge of honor to many, but it also depicts a serious health risk. Accumulated soot or substances on turnout gear can have

serious negative effects, including:

• Reducing the ability to repel water.

• Decreasing the ability to reflect radiant heat.

• Causing reflective trim to be less visible.

• Creating potential for PPE to ignite (due to oil, grease, and/ or hydrocarbon deposits—“the yuck”).

Keeping up with turnout gear maintenance provides three main advantages:

1. It reduces the risk of being exposed (and exposing others) to carcinogens.

2. It extends the usable life of protective garments significantly.

3. It saves fire departments money by prolonging the need to purchase new gear. Taking proper care of fire-

resistant and other specialty fabrics helps keep PPE in top shape and compliant with National Fire Protection Association (NFPA) standards. The following maintenance tips can help departments get the most out of their gear:

ALWAYS CHECK TWICE FOR WEAR AND TEAR

When is the best time to inspect gear for damages? The answer is before and after wearing it so that rips, snags, and openings are spotted as soon as possible. Even minor problems can compromise the integrity of a garment, causing it to become irreparable with repeated use.

Fire-Dex recommends that turnout gear be maintained by a third-party verified Independent Service Provider (ISP) of PPE that is well-versed in NFPA requirements. ISPs that specialize in cleaning and repairing PPE provide a higher level of care and expertise that is most critical for urgent-risk occupations

like firefighting. Correctly maintaining gear is also more costeffective than replacing damaged garments in nearly all cases. Be it a lost button, torn strap, or splitting seam, inspecting gear before and after it sees service helps to spot damages an ISP can launder or mend often in a matter of days or just a few weeks, depending on the need.

Whenever a routine inspection determines potential damage, an advanced inspection should then be performed by a verified ISP. At a minimum, an advanced inspection is recommended annually for garments, even those not showing obvious signs of wear.

KEEP GEAR CLEAN

Cleaning turnout gear on a regular basis helps to remove harmful particulates and residue. Not only will the advanced fabric of the gear be better protected, but the risk of secondary exposure to toxins and carcinogens will be reduced as well. Most fire departments do not

14 | CAROLINA FIRE RESCUE EMS JOURNAL | WINTER 2023 WWW.CAROLINAFIREJOURNAL.COM
Todd Herring, V.P. of Product Innovation and Strategy, Fire-Dex
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Scenes like this make a good movie, but in reality, contaminated bunker gear is a serious hazard to the wearer (and potentially others) for as long as the smoke lingers.

of cross-contamination or secondhand exposure.

KEEP TURNOUT

GEAR IN THE DARK

Sunlight is not kind to many types of protective garments that can be damaged by prolonged exposure to UV rays and fluorescent lighting. Thermal exposure conditions, UV radiation levels, and usage all impact the likelihood and extent of the damage; however, UV light generally contributes to the degradation of moisture barrier and flame-resistant fabrics.

Keep gear stored away from harsh lighting to better protect it, such as in a locker or on a rack away from direct light. Also, allocating proper storage for PPE makes inspections easier. This can even reduce the possibility of lost gear by making sure it’s returned to the correct spot each day.

WHEN TO REPLACE GEAR

All turnout gear will eventually need to be replaced. Once the protective properties of the turnout gear have diminished, it is no longer safe to use. Implementing a rotation of when to buy new turnout gear will allow everyone to have a primary and secondary set. It’s important to replace turnout gear:

ISPs use special deep cleaning detergents formulated to take proper care of fire-resistant and other specialty fabrics while removing the accumulation of daily grime from gear being used on the job. Gear Wash, a subsidiary of FireDex, uses detergents that are NFPAcompliant and environmentally safe.

enjoy the convenience of having a fully outfitted in-house laundering team to combat the constant onslaught of dirtied garments. Just like the clothes pile at home, grimy gear can pile up quickly, and cleaning often takes a backseat to other priorities.

Again, a verified ISP cleaning facility is the answer for maintaining gear on a schedule according to the manufacturer’s recommendation. These providers use laundry detergents formulated for the safe cleaning of turnout fabrics, reflective materials, and hardware used with PPE. Many ISP facilities also use special extractors and dryers built specifically for the task of laundering protective fabrics. After entering a structural fire, it is critical to decontaminate and wash turnout gear immediately. Gear wash operations may also use EPA-registered laundry sanitizer to soak garments in, which eliminates lingering viruses and bacteria. Helmets, boots, gloves, and hoods must also be thoroughly cleaned, sanitized, and disinfected to ensure their integrity and avoid the risk

• After ten years, as recommended by NFPA 1971.

• When cleaning can not properly remove contaminants.

• When it is beyond routine repair.

• When workplace requirements change.

Fire departments can contact their local PPE cleaning and repair service provider to learn more about maintaining turnout gear for longer use. This starts by giving gear a good look before and after it is worn in the line of duty. Doing so is the first step to keeping first responders safe and healthy.

Fire-Dex and Gear Wash offer video tutorials on proper cleaning and inspection techniques to help departments stay updated on the current standards.

Todd Herring began his journey at Fire-Dex in September 2015 as part of the acquisition of TECGEN. With over 20 years of experience in the protective textile industry, Todd was soon promoted to Director of Marketing and Product Development in August 2016. Gaining the title of Vice President of Product Innovation and Strategy in 2021, Todd currently leads the newly created Product Innovation and Strategy team. He holds a Bachelor of Science in Textile Engineering from NC State University.

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A NEW STANDARD IN FIREFIGHTER GEAR CLEANING

Over the last 20 years, an increasing body of scientific research has provided increasing evidence that firefighting causes an elevated risk of certain types of cancer. In 2021, one study supported by NIOSH showed significantly elevated levels in firefighters of Polycyclic Aromatic Hydrocarbons (PAHs), a highly carcinogenic product of combustion, when measured directly after structural fires (https://pubmed.ncbi.nlm.nih. gov/33654270/).

Products of combustion can become trapped inside the layers of turnout gear. Without timely and effective cleaning, smoke deposits, condensed residues and lingering hydrocarbons in grease, soot, and oil may not only reduce the protective properties of the clothing but put firefighters at risk of secondary exposure to carcinogenic products of combustion after firefighting operations are completed. While effective in removing a substantial amount of contaminants, infrequent, conventional waterbased cleaning of fire PPE cannot thoroughly penetrate & remove 100% of all contaminants from all layers of protective fabric. The residual PAHs embedded in the fabric create a risk of exposing firefighters to these contaminants through inhalation and/or dermal absorption (unlike some chemicals, PAHs in particular have a high rate of dermal absorption) if they become released from the clothing while wearing.

Laundry operations in the fire service have thus far been built upon an assumption that water-based cleaning is the most appropriate process for achieving cleanliness. The 2020 edition of the NFPA 1851 Standard was updated to include cleaning requirements for ISP verification. One of those requirements was a minimum of a 50% average reduction in PAHs, which are known carcinogenic chemicals found at typical structural fires. The average reduction of PAH contamination by standard water washing, following NFPA 1851

guidelines, is between 50%-55%. Until now, there has not been a solution for removing all but a small percentage of PAHs and volatile organic compounds (VOCs) while not using large amounts of water and energy.

WHAT IS CO2 CLEANING AND HOW DOES IT WORK?

Liquid carbon dioxide (LCO2) outperforms water on multiple fronts.

• Cleans more Thoroughly – LCO2 ensures a deeper clean without the use of harsh chemicals, allowing for garments to experience less agitation and fiber disruption for a longer-lasting product.

• Saves Natural Resources and Conserves Energy – By eliminating the use of water and heat, CO2 cleaning drastically reduces the consumption of natural resources and energy, allowing for a more sustainable process that prioritizes the environment

• Lowers Carbon Footprint – By utilizing liquid CO2 via a closedloop cleaning process, we can contribute to a circular economy that effectively reduces the carbon footprint associated with the creation and release of carbon emissions.

How does a CO2 washing machine work? The simple explanation is this: CO2 cleaning leverages CO2’s natural affinity for common contaminants found on and in turnout gear. The pressure in the machine is raised, first by injecting gaseous CO2, then liquid CO2. The pressurized CO2 molecules are significantly smaller than a water molecule, allowing them to easily penetrate all layers of turnout gear, lifting these contaminants up and out of the garment. These particulates are then transported to a sludge tank in the machine from where it’s removed and disposed of as a hazardous waste. Because the process does not use water, garments come out of the machine dry.

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CULTURE AND QUICKSAND

In an iconic scene from the 2000 sports comedy, The Replacements, the football coach, played by Gene Hackman, asks his team of unconventional players to discuss their fears. After a hilarious sequence of players professing their fear of different insects, the quarterback, played by Keanu Reeves, shares that his fear is “quicksand.” He explains: “You’re playing and you think everything is going fine. But then one thing goes wrong. And then another. And another. And you try to fight back, but the harder you fight, the deeper you sink. Till you can’t move, you can’t breathe, because you’re in over your head—like quicksand.”

Workplace culture, like a sports team’s experiences on the field, is built upon momentum. When your team is winning—scoring points and working cohesively—morale is high, and your success breeds more success. The inverse is also true. When your team experiences defeat, communication becomes difficult as people point fingers and lose confidence in each other, and errors occur more frequently. Morale suffers, the group loses cohesion, and the team sinks deeper.

Very few organizations have been insulated from the challenges of our time: a rapidly changing workforce, inflation, reductions in reimbursement, call volume increases, and a degradation of public trust toward public servants. Our organizations have struggled over the past two years. As we continue to struggle we only seem to experience more failures.

How does an organization fighting multiple challenges recover?

First, stop fighting against it. Just like rescuing yourself from actual quicksand, fighting frantically against a problem only makes it worse. A crisis requires specific, meaningful action: defining the problem, brainstorming solutions, and working towards a common goal. Determine what is actually causing the problem rather than just reacting to its superficial symptoms. Second, declare an emergency. Far too often, we fear admitting that our organizations need improvement. By not acknowledging the problems we face, we risk gaslighting the team and demonstrating that leadership is separated from the realities of what is occurring in the field. We must admit that the situation is not

normal or acceptable and work together to find a solution.

Third, take extreme ownership. As Navy Seal Jocko Willink argues in his books on the subject, everyone, and especially leaders, must take ownership of what

what is causing it.

Fourth, redefine your department’s priorities. Determine what is truly important to the department and ensure that those issues receive the amount of attention that they deserve. We

Their palpable frustration negatively affects the organization’s overall culture and results in an unwelcoming experience for new team members. The new members then seek work elsewhere, and the hiring spiral continues. Prisma Health Ambulance service provides 911 assistance for two counties. Additionally, as our agency took on additional volume, we hired other private vendors to reduce our overall volume. For fire departments, who traditionally have lower volume than EMS agencies, assess your minimum staffing levels. Utilize mutual aid as you rebuild your team. Straining your full-time members with forced overtime will only continue to worsen your culture and hiring woes.

happens in an organization. We can approach our work with humility and openly communicate our desire to do better. We can show others that we are committed to improving, and we can ask them to help us do so. There’s an old Chinese proverb, “The fish rots from the head down.” Accept that you own the situation, and ask for help from your team. View your organization issues as an iceberg. Only 10% of your issues are known by leadership while 100% of the issues are known by the field. Again, you cannot escape the quicksand without understanding

all have a policy and procedural handbook with hundreds of pages. How many of those policies are essential, especially during times of great strife? Some argue that not enforcing strict standards for uniforms, for example, reflects a lowering of standards. We should first insist that standards essential to the performance of our duties are met, and then we can focus on minutia.

Fifth, ask for help to reduce your volume. When employee turnover occurs, team members that stay on with the team feel the weight of their workload grow exponentially.

Lastly, find ways to limit turnover. Team members who embrace the core values of your department are invaluable. Staffing challenges cannot be a reason to retain problematic team members. Smaller, high-quality teams will do significantly better than larger, dysfunctional ones. Their success will create and attract more success.

Quicksand occurs when sandy soil is saturated with water and the individual particles loose friction. Similarly, a department can get saturated with issues, thus eroding the team’s cohesion and ability to solve problems. Recognizing the quicksand and taking deliberate meaningful action is the only way to pull the department out to safety.

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EMS
A crisis requires specific, meaningful action: defining the problem, brainstorming solutions, and working towards a common goal. Determine what is actually causing the problem rather than just reacting to its superficial symptoms.

The American College of Surgeons has published the 2021 National Guidelines for the Field Triage of Injured patients. This document is the basis for the Trauma Triage Destination Guidelines that all EMS systems in North Carolina are required to utilize. The purpose of the guidelines is to ensure that severely injured patients are transported to the most appropriate trauma center. Severely injured adult patients have a 20% lower hospital mortality and a 25% lower one-year mortality when initially taken to a level 1 trauma center. There are similar benefits with severely injured children.

The guidelines are meant to make sure that patients are taken to an appropriate trauma center with a minimum of under or over triage. Over triage is when patients with only minor to moderate injuries are taken to a high-level trauma center when they do not need that level of care. Under triage is when severely injured patients are not taken to a high-level trauma center. The goal of the trauma system is to keep the amount of undertriage to less than 5% and to keep overtriage to less than 35%. Using the trauma triage guidelines helps reduce the level of over and undertriage.

The American College of

Surgeons has a list of High-Risk Criteria for Serious Injury and a list for Moderate Risk of Serious Injury. The high-risk criteria are divided into injury patterns and mental status / vital signs. Any patient with high-risk criteria will likely need the care offered at a Level 1 trauma center. Patients who only meet the moderate risk criteria should be transported to any trauma center available to the EMS system. The moderate risk criteria are divided into Mechanism of Injury and EMS judgment.

The Trauma Triage Guidelines have a list of injury patterns that it classifies as high-risk injury patterns. These injury patterns are very specific for needing to go to a high-level trauma center. Changes have been made to the injury pattern criteria which predict severe injury and the need for a level 1 trauma center. Many of these changes were based on EMS feedback. One new highrisk criterion is active bleeding requiring a tourniquet or use of wound packing. The old criteria of “Penetrating injuries to the head, neck, torso, or other extremities” was changed to “proximal injuries.” Another old criterion of “paralysis” was changed to “suspected spinal injury with new motor or sensory loss.” The old criterion for chest wall injury were also changed. The

guidelines used to state “Chest wall instability or deformity (e.g., flail chest).” The new criterion for chest injury simply say, “Chest wall instability, deformity, or suspected flail chest.” There were also other changes made to the injury criteria for two or more long bone fractures and pelvic injuries.

Mental status changes and vital signs also make up a list of highrisk criteria indicating the need for high-level trauma center care. These criteria like the injury pattern

pedestrian/ bicycle injuries. No changes were made to the criteria dealing with ejection, death in passenger compartment, and vehicle telemetry data.

criteria are highly specific but not very sensitive for identifying patients who need a higher-level trauma center. A big change with this criterion is how the Glasgow Motor Score is used. In the past a GCS of less than or equal to 13 was used. Now it only matters if the patient has an abnormal motor exam. This means that a patient who cannot follow commands (GCS motor < 6) meets a high-risk criterion. A full GCS score does not need to be calculated to decide on where the patient should be taken. Another big change is the use of the shock index in adults. This means that if a patient’s heart rate is greater than their systolic blood pressure then they meet criteria for needing transport to a higher-level trauma center. A new criterion in the new document includes “Respiratory distress or need for respiratory support.” An additional new criterion is a room air pulse ox of less than 90%. This is for all ages.

Moderate risk criteria are divided into mechanism of injury and EMS Judgment. Patients meeting the moderate risk criteria should be taken to a trauma center, but not necessarily the highest-level trauma center. One new mechanism criterion is a child (0-9 years of age) unrestrained or in unsecured safety seat. The modified mechanism criteria include compartment intrusion, rider separated from vehicle (includes horse), fall from greater than ten feet, and

EMS Judgment includes a list of criteria which should prompt EMS personnel to consider transport to a trauma center. These include suspected child abuse, highresource care needs like chronic ventilator dependence or ventricular assist devices, and ground level falls in the elderly.

The NC College of Emergency Physicians has slightly modified the American College of Surgeons National Guidelines document to better match the needs of NC. The biggest change was that if a level 1 trauma center is not reasonably close then EMS can then take the patient to a level 2 or 3 center. Each EMS system can make changes to the NC College of Emergency Physicians Trauma Triage Guideline as they see fit.

Here is the link for more information on the American College of Surgeons National Guidelines for the Field Triage of Injured Patients: https://www. facs.org/quality-programs/trauma/ systems/field-triage-guidelines/

The article from where much of this column was written can be found at this link: https:// journals.lww.com/jtrauma/ Fulltext/2022/08000/National_ guideline_for_the_field_triage_of_ injured.19.aspx

Dr. Winslow has worked at Baptist Hospital in WinstonSalem for the past 11 years. He was appointed as the Medical Director of the North Carolina Office of EMS in 2011. This document contains all protocol, procedures and policies for all EMS agencies in North Carolina.

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2022 UPDATE from the NC Medical Director
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The Trauma Triage Guidelines have a list of injury patterns that it classifies as high-risk injury patterns. These injury patterns are very specific for needing to go to a high-level trauma center.

STRENGTH TO BODY WEIGHT RATIO AND METABOLIC EFFICIENCY

Please reference the previous edition of Carolina Fire Rescue EMS Journal – volume, issue, story Health Related Components of Physical Fitness, as a precursor to the current article.

Before we progress to SkillRelated Components of Physical Fitness, I would like to take a step back and discuss a few concepts prior to moving forward. Please note two variables I emphasize as a byproduct of training for Muscular Strength when working with athletes are: 1. Strength to Body Weight Ratio and 2. Metabolic Efficiency. These derivatives of Muscular Strength Development need to be mentioned because, in my opinion, they are the link between all other components and are significantly important in the development of sustainable athleticism while minimizing injury potential. Many years ago, I asked a question to no one in particular

but was interested in knowing more about training for Maximal Strength, given most of the strength programming, especially among our high school-aged athletes, centered around load-based training and 1RM testing. At the time, all I had ever seen from load-based strength programming was poor technique resulting in high injury rates both within the weight room and as accessory injuries during a bout of competition: practice or games. The thought that I kept coming back to was, “what is more important when training athletes increased Maximal or Repetition Strength”? Upon examination, strength training with an emphasis on developing Repetition Strength, also known as Muscular Endurance, was more advantageous when working with the majority of athletes in the weight room, regardless of sport. Of course, there are exceptions; however, the outliers are in the minority and given the nature of most sports and physical

occupations, the ability to produce sustainable force for an extended period of time is more desirable than producing an elevated 1RM or training for Maximal Strength given the nature of the business or sport(s) being played.

Upon exploration and many years of trial and tribulation, I discovered the percent difference between training for Maximal Strength and Repetition Strength when utilizing undulating strength programming is more closely related than different. It was during this timeframe of my career; that I discovered the two components: Muscle Strength and Muscle Endurance, were more interdependent than previously thought; therefore, my objectives started to shift towards helping athletes to become more resilient and less prone to injury, which in turn allowed the firefighter to refine their skill development. As a result, effort- versus load-based strength programming became the clear objective, with the minimum

number of repetitions programmed as five but subjected to change based on the experience and objective of the firefighter. It has been my experience that training loads of five or fewer repetitions tend to unnecessarily subject joint loads to the edge or beyond human tolerance and can result in compensatory movement patterns, which may increase the likelihood of chronic accessory injury.

A related concept I explored at the same time was the comparison of Strength versus Hypertrophy with the intention of understanding it is possible to increase muscular strength without developing hypertrophy. The reason for this line of thinking was because mass added to the body, in the form of muscle hypertrophy, is more likely to hinder athletic development until the developed strength is able to “catch up” to the added mass in the form of strength to body weight ratio. Furthermore, most strength training programs that I

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&WELLNESS Health

grew up with and were designed for our young athletes were what would be considered hypertrophy based. For these reasons, I started to explore concepts for Muscular Strength development for athletes with minimal or unnecessary hypertrophic effects. If my main objective is to improve athleticism and increase mass through hypertrophic-based strength programming has been shown to negatively affect strength-to-body weight ratio, I realized I needed to shift time in the weight room towards increased strength while monitoring strength-to-body weight as the desired variable when working with the service industry.

My goal became preparing firefighters for the call of duty and not building mass in the weight room to look good for the next calendar shoot… building mass has shown to not always transfer well to the on-the-job demand. Therefore, the question became how much volume is necessary when working with firefighters given this paradigm shift? Volume equates to the number of sets, reps, and loads an athlete is subjected to during a session in the weight room. No matter the time of year, my objective is to minimize time spent in the weight room to maximize the opportunity for skill development. Research and anecdotal evidence support a minimum of one, maybe two lifting sessions per week, based on the firefighter’s ability to properly recover – minimal dosage suggests as little as one programmed strength day every 1014 days is enough for maintenance of strength. Adding a third day of strength training per week is only encouraged for advanced lifters who have perfected the art of proper recovery. Often if the firefighter is interested in extra or additional time spent in the weight room, I will often throw a curveball in the form of a mobility session: yoga or Pilates. The lack of mobility, previously addressed, is a significant contributor to chronic injury. The duration of the strength sessions should not exceed 45 minutes at to start, and with time spent and efficiency, strength sessions can be reduced to 30-35 minutes. Each of the traditional major muscle groups needs to be addressed without excluding the following areas of the body: handgrip, forearms, cervical, and ankles - specifically the lateral compartment of the shank. The formula I follow in the weight room is: S-R-A – in other words, how much Stimulus (S) is necessary to put the working muscle(s) into Recovery (R) for the purposes of

the desired Adaptation (A)? The stimulus or demand on the working muscle must be great enough to force the working group of muscles into recovery… once this threshold is crossed, then additional volume leads to unnecessary muscle damage, additional recovery time is needed, and the result is more likely going to lead to hypertrophic muscle gains and possibly chronic injury.

The next question that needs to be addressed is how much volume is necessary to take an athlete through the S-R-A formula – the honest answer is it depends on the athlete and several variables. As a clinician, when I work with firefighters as athletes, I try to get a “feel” for their tolerance in the weight room and stress the importance of stimulus for the purposes of needing recovery and an understanding of the desired adaptation.

Today, I am no longer concerned with “how much load” an athlete can lift – 1RM testing has no place in my weight rooms. My sole focus when strength training firefighters has become how are you feeling right now, how much time do you have to properly recover before your next significant event, including are you in a position to be called into the field, etc., and how close to momentary volitional failure (MVF or muscular failure) – the inability to complete another repetition with “good” technique in concentric phase – can I take you today?

When programming strength for a firefighter, I peek at their calendar and ask loads of questions with an understanding of Maximal Recovery Volume (MRV) – in other words, how much stress can I add today in the weight room and still have the athlete prepared for their next event, workday, scheduled workout session, etc. I know that if I take an athlete to MVF with one set, no matter the number of repetitions, there is little doubt there is enough stimulus to put the targeted group of muscles into recovery. However, it is not always ideal for taking the firefighter to complete MVF given the nature of the occupation, and research suggests that getting within 3-5 repetitions of MVF is close enough to put the muscle(s) in recovery for the purposes of adaptation. The concept is widely accepted and has recently been termed stimulating reps, which have been shown to be the reason the working muscles are put into recovery mode, and the recovery time is minimized by not working on completing MVF. As a result, it is possible to get the biggest bang for your buck – increase strength through neurological adaptation, minimize

hypertrophy gains, and minimize recovery time for the purposes of skill development, chronic injury potential, and job preparedness.

In addition, with a strength program focused based on effort for the increase in Repetition

Strength, an immediate byproduct is metabolic efficiency at the local or muscular level, which pays dividends for improving total work capacity, allowing your athlete more time, repetitions, and opportunities for skill development. This improved metabolic byproduct is especially true once your athlete learns to push themselves to near or full MVF on a consistent basis when proper recovery time is available. The result is an increase in Lactate Threshold, an anaerobic measurement that measures the accumulation of lactate in the blood and is often associated with the onset of fatigue. If fatigue is delayed due to the shuttling of lactate out of the working muscle, keeping the muscle primed to perform, the result is an increase in VO2 max, which is one reason the aerobic and anaerobic bioenergetics are interactive and not on the opposite ends of a conditioning continuum. As a result, the response at the local level improves the work capacity of the exercising muscle due to improved metabolic efficiency, and the firefighter can sustain higher amounts of output for extended periods of time.

One final thought – Effort-based lifting and strength programming for Maximal and Repetition Strength is difficult to teach, but once installed and your occupational athletes gain an understanding of your intent and purpose, then it becomes a powerful tool. The firefighters show ownership and, as a result, increase their effort in

the weight due to the fact that they have a clearer understanding of the objectives. However, because I do not perform any 1RM testing, strength to body weight ratio is a best guess estimation, not an exact measurement, and can change from workout to workout. Therefore, if you choose to adopt effort-based strength programming for your athletes, there is more room for improvement; however, it takes more effort to establish the culture.

With an emphasis on Muscular and Repetition Strength development to near or full MVF for minimal sets (1-2), reps (5-15), and possibly load (based on the competency of your lifting athletes), strength to body weight ratio is increased through an improved neuromuscular relationship, hypertrophy is minimized due to a decrease in strength training volume, and improved metabolic efficiency is enhanced because of physiological changes at the local or muscular level.

Jeff Casebolt has been associated with the fitness industry since 1991, working as a personal trainer, strength and conditioning coach, and corporate fitness coordinator prior to going back to school to work on a Ph.D. in Biomechanics and as a professor. Jeff’s research interests include increasing function with strength training across all ages, occupations, and abilities, lower body power development, injury mechanisms among athletes and occupations, and fall prevention among the elderly. In addition, Casebolt is associated with Dynavec Resistance Systems and the Fire Fit Trainer, assisting with research, development, marketing, and sales.

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&WELLNESS Health

ARE YOUR INTERVIEWS HURTING YOUR ORGANIZATION?

The war for talent has finally reached the shores of the fire service. Lateral transfers. Sign-on bonuses. Educational pay incentives. The fire service is sounding more and more like other service sectors. Many departments across the

Soon lawyers will be involved and asking questions about the interview process. We all likely need to create a more legally defensible, fair, and just process than our current one. So, as we collectively throw things at the wall to see what sticks, have we considered that the interview process might be keeping the best

Job descriptions are also created based on a job analysis. It may have been some time since the last job analysis was performed on positions in your organization, so it does not hurt to reexamine those roles for needed changes in the job description or for building an interview.

country have seen a steady and rapid decline in applicants for open positions. Promotional processes are becoming less competitive in many departments too. All the while, we are also working as a fire service to become more inclusive and equitable. Despite how long we’ve been doing it, for many of us, our hiring processes are still plagued with issues. A recent headline out of Vermont says several firefighters resigned following the controversial hiring of a new chief.

candidates out of those positions?

SETTING A FOUNDATION

Like building a house, creating an interview requires a solid foundation, and that foundation must come first in the process. A job analysis must be performed for all positions to understand the associated tasks, skills, and responsibilities. This is essential in building a structured interview because it establishes what elements are needed in the interview itself.

A job analysis generally uses observations and interviews to gather data on a position. Although interviews are often used and very helpful in the process, it is important to focus on the role rather than the individual to collect the pertinent information. A job analysis should show the skills and abilities needed, activities performed, working conditions, demonstrated behaviors, equipment used, physical demands, and other interactions. We can build an accurate job description and a structured interview with this information in hand.

FRAMING YOUR STRUCTURED INTERVIEW

There are many considerations when creating an interview, including the structure of it, instructions provided to candidates, how scoring will be done, the actual questions asked, and more. The first thing to consider is the overall structure of the interview process. Research has repeatedly proven that structured interviews are the best

predictive measures of success in our toolbox despite seeming cold and heartless. What is a structured interview? A structured interview is an interview where all the questions are predetermined before the interview beings. The questions are all presented in the same way to each candidate and given in the same order. This approach ensures that every candidate is given a fair and equal interview, making this approach the most legally defensible. Unstructured and semi-structured interviews allow candidates and interviewers to have different experiences in each interview, creating a risk around the fairness and objectivity of the process.

Now comes the fun part, creating the interview questions that will largely determine who gets the job. Have you ever been asked what you would be if you were an animal? What does that question measure, and how does that apply to being a firefighter or an officer? What is the purpose of that question in an interview? When designing our interviews, we need to be critical of the questions we allow into the process. Often we are limited to less than 12 questions. Each question must have a purpose in the process and measure something related to the job analysis we performed. Usually, we ask about preparation for the job and associated traits and characteristics such as teamwork, problem-solving, communication, taking orders, and adherence to ethical standards. There are creative ways to let candidates express their ability to think critically and get creative, such as situational or scenario-based questions. But remember that these should have a specific purpose, such as measuring their conflict resolution abilities. With that said, think about removing the question about what type of animal they are and replacing it with something worth learning about your candidates.

Candidates, especially those we see today in Generation Z (Born after 1996), will be quick to question the authenticity and justice present in an organization that judges someone based on questions in the interview that have no business being there. Ensure your process is fair and just, and ask purposeful and relevant questions.

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&Recruiting RETENTION
There are many considerations when creating an interview, including the structure of it, instructions provided to candidates, how scoring will be done, the actual questions asked, and more.

&Recruiting RETENTION

SCORING THE INTERVIEW

Far too many errors are made in this part of the process. These errors could be costing candidates their opportunities. Unfortunately, the most at-risk candidates are those diverse candidates the fire service has long struggled to reach and recruit. So, what is the best method for scoring interviews? First, we need to start with a scoring rubric or rating scale. Creating a rubric or scale will help eliminate bias in the interview process and help keep the process as objective as possible. Typically, a scale of five is used to rate responses. Each rating corresponds to a specific criterion that is spelled out to achieve a particular score. For example, the candidate answered the question completely by providing a specific example demonstrating the desired attributes. Each response should be rated independently. One response might get a five, and the next a one, which will happen. It is important not to let a grand slam in the first inning make you miss the rest of the interview and vice versa. While all attempts should be made to make the process as objective as possible, it is common to allow the interviewer to score the intangible overall performance of the candidate. Just be sure to spell out what the interviewer is grading. So, the interview took place, and each question now has a corresponding score by each person on the interview panel. Now what? Spoiler alert. Please refrain from corrupting the process by deciding the overall score for that candidate as a group. Several departments in a class recently told me that this is what they are currently doing. A candidate leaves the interview, and immediately the group begins to discuss the performance in order to come to an agreement on a final overall score as a group. A whole new world of problems is introduced into the process by this type of consensus scoring or hiring. Suddenly that candidate’s performance can be decided by the loudest voice in the room or the most senior person. Think about the Olympics and picture the judges holding up those scorecards. They did not stop and talk about the scores amongst themselves, and together all decided on an eight. Instead, they all hold up numbers, having never shown the other judges. They are there for their expertise to judge the performance. Your interview panelists should be no different. Experts in the field are there to apply their perspectives through the objective lens of the scoring sheet or rubric. The most

accurate thing to do is to collect the interviewers’ scoring sheets and allow them to be tallied by an independent third party who was not present in the interview process. Once scores are totaled, your organization can decide how best to move forward with that data. A best practice is to use descriptive statistics to understand the distribution of scores which can be used to set rating parameters such as “highly recommended, recommended, not recommended .”These parameters can be based on standard deviations from the mean, a more objective approach than a predetermined cutoff score.

PUTTING IT ALTOGETHER

The last step that should happen before the interview is training the interview panelists. Some may have limited experience in interviewing, and it is a skill that must be taught. Potential legal pitfalls must be discussed, but

you must also ensure that these panelists understand the scoring sheet and interview questions. It is best to do the training as close to the interview as possible so the training is fresh in their minds. Panelists should be given the rubric and an opportunity to understand the traits and attributes being assessed by the questions. A guide with definitions is beneficial so that all panelists have the same understanding of each attribute. Look to resources outside of your department as well for training if needed. There may be a Chief Equity and Inclusion Officer, or you may consider reaching out to local colleges or your HR department for help learning about unconscious bias and things like the halo effect. A little awareness goes a long way in preventing harmful influences on the interview process. Your panelists will feel far more confident in their abilities to interview candidates following this process, which will

lead to more objective results that will provide the department with the best possible candidates for the job. It will also build a legally defensible interview process based on a foundational job analysis.

Dr. Andrew Holter is an organizational psychologist serving as the Administrative Services Manager of the Wilmington Fire Department. He has had an 18year career in emergency services, starting as a volunteer firefighter in rural Pennsylvania and rising to the rank of Chief Paramedic in a regional ambulance service. Dr. Holter has worked as a firefighter, lieutenant, captain, and fire inspector and has served as a staff liaison for NFPA. He holds a B.S. in Fire Science and an MPA from Anna Maria College in Paxton, MA, and this past year successfully defended his dissertation earning his Ph.D. in organizational psychology from Capella University.

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RETENTION ACROSS GENERATIONS: AN EVIDENCE-BASED PERSPECTIVE

Volunteer fire departments around the country continue to function at high levels despite having to routinely adapt to changing needs and circumstances. However, recruitment and retention of volunteer firefighters remain a constant challenge, with department leaders working tirelessly to attract and keep members engaged.

Reaching and retaining the younger generation can be especially

difficult. Often, leadership programs emphasize the importance of “adjusting to the times” to bridge the generational gap and understand the needs and interests of younger populations. Many departments focus on financial incentives for their volunteers, but with funding presenting its own challenges, department leadership must also look at alternatives.

What does evidence-based research say about generational differences? Aside from what

we see on social media, in our interactions with acquaintances and loved ones, and even with interviews with potential recruits – do we have an accurate idea of what causes a person to not only show up to volunteer but also to be inspired to come back? Monetarybased rewards are often viewed as a force for incentivizing a person to volunteer, but they are not what motivates retention.

What drives a person to remain at their job involves more than money.

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There are many other factors that reflect an organization’s turnover rate. If a person is not happy at their job, they will be less committed and more willing to seek a different position that provides them with more personal fulfillment.

With the volunteer fire service, where financial incentives are low, other retention factors take on even greater importance. When leadership fails to meet specific needs across generations, productivity diminishes, and staffing numbers decline. Without some of the other important elements, like a positive workplace environment, effective leadership, training opportunities, a sense of community, and professional growth, volunteers are likely to look elsewhere.

Research shows that values differ across generations. Older generations report that work benefits and status are of utmost importance, while younger generations tend to seek out opportunities that offer freedom, autonomy, and contributions to society. However, there is a common value found across all generations, and that is whether or not the organization satisfies an individual’s personal values.

With differing needs among individuals and across generations, the question leaders must ask is, how can the organization satisfy all volunteers’ interests to reduce turnover and increase recruitment?

Two methods to assist with addressing this are by meeting social and esteem needs. Create a culture that offers a sense of belonging to meet individual and social needs. Adults seek relationships that are positive and rewarding. Studies on individuals in late adulthood show that healthy relationships are the strongest indicators of living a long life. While exercise, diet, environmental toxins, and other risk factors all play a vital role in healthy living, positive human relationships

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 23 | National Volunteer Fire Council NVFC
Photo courtesy of NVFC Maggie Mojab Candice McDonald
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with others impact a person’s happiness the most. This means prioritizing activities and events that strengthen social bonds among your volunteers can have a big impact on their happiness, which affects recruitment and retention at a core level. Being a member of a volunteer fire service organization provides a social connection which enhances an individual’s mental and emotional health.

To meet the esteem needs of volunteers, offer professional development opportunities that are beneficial inside and outside of the fire department. The volunteer fire service is in a unique position to serve as an apprenticeship program for young volunteers. Data on younger generations show individuals are likely to experience workplace satisfaction later in life and choose to stay with an organization for long periods of time the earlier they’re exposed to training. Moreover, the value of positive relationships can be instilled in younger generations by modeling these behaviors. This also means that it is possible to retain younger volunteers long-term by ensuring that the training provided at your department is transferrable to other areas of their life. It’s important to get members to think about how they can take home the information they learn at your department and share it with the world. If a volunteer can find space in your department that allows them to grow professionally AND personally by learning something challenging and new, they can show up to the other agencies they are involved in with a sense of confidence, adequacy, and career satisfaction. These are feelings that are cultivated by engagement within your department.

Acknowledging generational differences doesn’t necessarily have to symbolize a challenge; rather, it can represent a simple need for a more inclusive environment that invites shifts in your department’s culture to create more space for retention and recruitment. Understanding the differences and similarities in personal values across generations and how engaging volunteers on a deeper level using existing resources can help with

recruitment and retention is a big step. As you work towards addressing generational needs and bolstering your department’s recruitment and retention, the National Volunteer Fire Council (NVFC)

has resources to help. There are a number of training courses in the Virtual Classroom, including a fourpart series on Training the Next Generation, a multi-course track for new department recruits, and training to help departments shift to a more inclusive environment. In addition, the NVFC offers tools and resources for recruitment and retention through the free Make Me A Firefighter campaign. Learn more at www.nvfc.org.

Maggie Mojab is a program coordinator at the National Volunteer Fire Council (NVFC), where she oversees all virtual education and training. She started her nonprofit career at the Society

of Fire Protection Engineers and has eight years of experience developing and executing programs, projects, and events. She is currently enrolled in a Master of Clinical Psychology program at Pepperdine University. Dr. Candice McDonald is the deputy CEO of the NVFC and has two decades of experience as a firefighter, EMT, inspector, and instructor. She holds an associate degree in health and human services, a bachelor’s degree in organizational management, a master’s degree in organizational leadership, and a doctorate in business administration with a specialty in homeland security.

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*RESTRICTIONS MAY APPLY | National Volunteer Fire Council NVFC

OPERATIONS PLUS — OFTEN OVERLOOKED BUT VERY IMPORTANT

As hazardous materials responders, we all receive training in the levels of certification stipulated by the National Fire Protection Association and the certifying entities in our state. Most hazardous materials responders are easily able to recall the certification levels of operations and technicians, and oftentimes, even specialists and the functions personnel at each level are able to perform. There is one level of certification existing solely within the State of North Carolina. However, that is often overlooked but is very important from both capability and legal liability standpoints.

Back in the 1990s, it was noted in the State of North Carolina that we were dispatching technician and specialist-level assets and personnel to fuel leaks from cars, light or heavy trucks; and even tractor-trailers on a regular basis. While those resources undoubtedly could easily handle such situations, the thought was posed as to whether both we and the citizens we serve could be best served in such situations by operations-level responders who have received additional specialized instruction in the control of hydrocarbon fuel leaks and are properly equipped to do so. Thus, the unique certification level of operations plus was developed. The concept of operations plus is delineated in the North Carolina Administrative Code at 13 NCAC 07F .0103, in which responders at the operations plus level are defined as “Individuals who respond to hydrocarbon fuel tank leaks where the leaking tanks contain a hydrocarbon fuel which is used to propel the vehicle on which the tank is located. Only those vehicles designed for highway use or those used for industrial, agricultural, or construction purposes are covered.” In short, personnel trailed to the operations plus level are able to plug, patch, or otherwise mitigate hydrocarbon fuel tank leaks on cars, light or heavy trucks, and tractor-trailers in situations where the fuel powers the vehicle. Some hazardous materials responders may also interpret the regulation to also allow operations plus responders to stop releases of LP Gas from a bobtail or straight

MC 331 delivery truck in which the LP Gas in the large tank powers the vehicle, however practically, that is usually exceeding the scope of operations for those personnel trained at the operations plus level. Our next point of discussion will be that of the specific training required at the operations plus level. Personnel are first required to be certified to the operations level of hazmat certification and then receive training or demonstrate competency in several topical

areas. The first topical area is that of the knowledge, and use of the personal protective equipment (PPE) utilized at the operations plus level, namely the structural firefighting PPE used for thermal protection in case of an ignition of the product and the chemical protective clothing (such as Tychem suits; and Viton or nitrile gloves used for chemical protection). I do remember approximately twenty-five years ago when we were provided with Tychem suits for just that purpose

and were told that “one size fits all.” I will say that I found out that was not the case the first time I tried to scoot under a small car to stop a fuel leak and proceeded to hear the Tychem suit rip. Potential operations plus level responders are also required to acquire a knowledge of the hazmat terminology that applies to hydrocarbon fuels, such as flash point, ignition temperature, vapor density, and specific gravity.

An additional topic covered during operations plus training

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is that of the hazard and risk assessment techniques used with hydrocarbon fuels. Personnel are required to be able to recognize the flammability and chemical hazards of hydrocarbon fuels, as well as the on-scene hazards in areas such as possible ignition sources (hot exhaust components, etc.). The core tenet of operations plus training that is also required to be addressed is that of control, containment, and confinement of hydrocarbon fuels. There are many options available to utilize in product control, including plugs or wedges, fabricated stoppers such as those found in Cromwell Kits, granular products that form a putty when mixed with water, and binary putties consisting of two components that are mixed together on scene. One of the simplest and easiest methods of product control is the use of a portion of a wax toilet gasket (the same as used to seal your toilet at home) to patch a leak. Other items discussed within product control consist of tightening fuel filler caps to help slow a leak, rotating ejected saddle tanks so that the hole or compromise is at the top of the tank, how to properly use a spill pool to catch leaking products, and the use of crossover valves on older heavy trucks to isolate leaking saddle tanks so that they do not draw fuel from an intact saddle tank on the other side of the vehicle. The final operations plus topical training area that is required to be addressed is that of the proper decontamination procedures used with hydrocarbon fuels. Personnel should be reminded that a detergent and water decontamination solution is usually the most appropriate choice and

a suitable decontamination setup should be developed and discussed that allows for a quick setup time with minimal equipment.

As we have discussed above, the operations plus level of certification is very unique in the hazmat world. An additional item regarding this level of certification is that personnel will not receive a certificate from the North Carolina Office of the State Fire Marshal (NCOSFM), nor will the training show up on an NCOSFM Transcript as the operations plus certification is granted by the employer. With the above having been stated, the next logical question is that of how to conduct the training at your own department. The best method that I have found is to use a qualified hazmat instructor to deliver the operations plus training program at the end of annual operations level hazmat refresher training sessions for those personnel that have completed hazmat operations certification in the preceding year. A short classroom session is followed by a practical evolution in which personnel stops a simulated release of a hydrocarbon fuel (a suitable vessel and water are used for the simulation). Personnel who successfully complete the training are then awarded certificates by the department.

Many responders will also question the need for operations plus training, especially since the very existence of the training is often not known by responders. One driving factor underscoring the need for such training centers on our departmental capabilities. As most fire departments respond to vehicle accidents, it behooves us as a department and for our

personnel individually to be able to competently plug, patch, or otherwise stop fuel tank leaks ad releases that often occur at accident scenes. As fire departments are also the “go-to” agency for many types of incidents, fire departments in the State of North Carolina are also likely to be dispatched to fuel leaks emanating from parked or stored vehicles. A second driving factor is that of liability. If personnel in your department may even possibly attempt to stop a leak or release from a vehicular fuel tank, that personnel should be trained to the operations plus level in order to reduce departmental liability and ensure the safety of personnel. The last thing any Fire Chief wants is to be in court after an incident involving a leak or release from a fuel tank head south and then be asked by an attorney why departmental personnel were not trained to an existing required level of certification to perform the actions that were undertaken.

In conclusion, the operations plus level of hazardous materials certification that exists solely within the State of North Carolina is an often overlooked but vitally

important area of hazardous materials training and certification. If your department does not provide the additional training that was discussed above, the department and its leadership may be facing unanticipated roadblocks in terms of departmental capabilities and the liabilities that may arise from personnel not meeting defined training requirements. It also is a great benefit that operations plus training is neither time-consuming nor overly complicated. As always, stay safe out there prior to, during, and after hazmat responses.

Glenn Clapp is a past president of the North Carolina Association of Hazardous Materials Responders and has over 24 years of fire service and emergency management experience. He is currently an Improvement Specialist with the Industry Expansion Solutions Division of North Carolina State University and is a volunteer firefighter with the Fairview Fire Department. He is also a Technician-Level Hazmat Instructor, an Executive Fire Officer, a Certified Hazardous Materials Manager and a Certified Fire Protection Specialist.

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UPDATE FROM THE NC STATE FIREFIGHTERS’ ASSOCIATION

Have you ever wondered about serving on your local Fire Association?

These boards are usually comprised of local members who are working to serve as a voice for the Firefighters of a particular area. These Board members could be either formal or informal leaders within a department. They usually have a common goal of moving the Fire Service forward.

You may have noticed that the North Carolina State Firefighters’ Association (NCSFA) has added a line to the iconic NCSFA block logo. This line reads, Every Firefighter, Every day. As a Fire Service Leader, have you ever thought about that as a personal motto? Are you working for every firefighter every day or just a select few?

When you think of moving the fire service forward, does that mean moving one section of the fire service forward or all of it?

I think we would all be working to move it all forward. Every Firefighter means that the NCSFA is looking for improvements for Every Firefighter. The boards of the regional associations are looking to make their areas better. In doing this, we are making it better for all of the 55,000-plus firefighters in North Carolina.

We need your help in doing this. We need younger members to help provide input on these boards. We need established members working alongside these boards to continue to provide input to establish growth and diversity for the future of the fire service. Did you know that you are already a member of the NCSFA?

Each year, when your Fire Chief certifies the department’s roster and pays the annual dues, become a member of the NCSFA. You also automatically become a member of the regional association. Being a member of these opens up several benefits for you and the members of your family. To keep these benefits for you and your family, we will continue to need to encourage the younger members to get involved with serving on these boards.

Theodore Roosevelt offered these words when talking about Citizenship in a Republic “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again because there is no effort without error and shortcoming.” Often we allow the critics to deter us from growing the Fire Service. We let those who are trying to keep things as they are, decide the future of the Fire Service. Those critics are hurting moving our beloved Fire Service forward.

We need more people in the arena, people who are committed to making changes. Those who are willing to get involved to make the needed changes as we continue to prepare the future of the Fire Service. Getting involved in moving the Fire Service forward can be done in multiple ways. Some of us enjoy the business side, while others look forward to teaching the next generation of Firefighters. Each side is equally important. To prepare the

Fire Service, we should research the issues that firefighters are facing. Whether you are an instructor or working with Fire Associations, those making decisions need to be informed on how things move forward. We need to be making resources available to newer members so that they will be better prepared. The Fire Service is everchanging, and as older members move towards a well-deserved retirement, we should have younger members prepared to fill their shoes. Involved Instructors who are taking their time to utilize trial and error to find ways to better prepare members to carry the same value as the Fire Association member who takes time to show why they need is there for more funding.

Understanding the Fire Associations in North Carolina can be slightly difficult. We have several different Associations that work for the betterment of the Fire Service in North Carolina. First, we have the North Carolina State Firefighters Association. Every firefighter in NC is a member of this Association, so long as they are on a certified roster. The NCSFA represents all of NC and is broken into three regional districts: Eastern, Piedmont, and Western. These three regional districts form their respective regional associations. If you are a member of the NCSFA, you automatically become a member of the Regional Association. Next, you have the NC Association of Fire Chiefs. The NCAFC members elect those from their regions to serve their board. Anyone who is a member of the NCAFC can apply to be considered for their elections. All five of these boards work together to collectively make changes within North Carolina.

Now, more than ever, is a great time to get involved. We need leaders to embrace the future. We need those who are visionaries and able to make positive changes happen. Getting involved can start at the local level. You can be engaged with your county fire association. You can attend classes and the South Atlantic Fire Rescue Conference or Mid-Winter Conference. Maybe you would like to make an impact on the regional level. Start attending those meetings. Do not be afraid to ask questions of the board members.

Get to know those board members and let them know that you are interested in helping. You can find out a lot of information by attending meetings and asking questions. Just because you are not on one of these boards does not mean that you cannot help. Being visible at related events is equally helpful. Once you begin working on the issues that Firefighters face, you will find out that many are looking to better prepare the firefighters of the future. Lastly, I am sure everyone knows someone that needs help. This may be on-the-job help, scholarships for education, health benefits, or classes to help prepare them for the future. Being involved in the Fire Service is how we continue to grow these programs. The NCSFA offers so many benefits to our Firefighters, and they all came from Board Members who were looking to make the Fire Service better. Do you see ways that we can make it better?

I am sure we all have thoughts on how to grow the fire service for the future, and to do so, we must be prepared to enter the arena. People are going to talk about the process of you doing good, and that is OK.

You have to keep pushing and know what the end goal is. You have to be ready to put in the work for other Firefighters. As a current board member, I can tell you that the work is worthwhile when you see the big wins, such as the Cancer Benefit. If you are interested in serving on a Regional Board, you can find the information for them here:

Eastern NC Firefighters’ Association: https://encfa.org/

Piedmont NC Firefighters’ Association: https://www.pncfa.org/ Western NC Association of Firefighters: https://wncaff.com/

I look forward to seeing you in the Arena.

Doug Bissette is currently Deputy Chief of Wilson Fire-Rescue, and an active volunteer at Pinetown Volunteer Fire Department and Pinetown Rescue-EMS. He is the Past President of the Eastern Carolina Firefighters Association. He enjoys conducting live fire training throughout Eastern North Carolina.

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North Carolina

FIRE STATION PROFILE

Type Department: Volunteer

Structure: Conventional

Organizational Chart

ISO: 5/9E

Number of Stations: 1

Number of Apparatus: 9

Pumpers: 4 Aerials: 0

Specialty: Rescue, Brush

Trucks, Boat and UTV

Do you provide EMS? Yes

EMT/First Responder

Annual Budget: $384,000

Area Covered Square miles: 28

Population: +/- 4,500

Chief: Chief Graham D. McManus

Chief Officers:

Assistant Chief Brandon Liles, Assistant Chief Derrick Carnes

Other Officers:

Captain Dedrick Brown

Captain Matt Morse

Number of Members: 34

Paid: 2 Volunteer: 32

Address: 8323 Lancaster Hwy Waxhaw, NC 28173

Phone: 704-843-2611

Community Outreach: We help at Cane Creek Park for there children’s summer camp. Updating and send-

Jackson Community Volunteer Fire and Rescue Inc. Union County, NC

for. We have a large furniture store beside our station, this is our largest hazard in our district.

What problems in your department that you would like feedback from others? Best practices for recruitment for qualified personnel to add to our part time staff.

List anything else you are proud of and would like the readers to know about, are you doing anything special in Recruitment, Retention or anything unique other departments could benefit from:

ing out info through social media platforms to keep the community up to date. Trunk or Treat for the kids, we discuss fire safety with all age groups at this event. With our department being all volunteer Facebook has been a great outreach for our department.

Top Two concerns in your community: Rapid growth in our county with lack of infrastructure water and sewer. Recruitment of volunteers and hiring part time staff members. Community awareness for the rapid growth.

What are you doing for fundraising? None, we have citizens make various

donations and use those funds to purchase supplies for our blue address sign program. We have a retired member that makes all our blue reflective signs for us.

What upgrades will you make in your department this year? Sprinkler system and working on adding bedrooms and offices as we move toward a combination department.

What special hazards or unique businesses in your community? Cane Creek Park which covers 1000 acres 350 of that being a lake. They have several triathlons and events we provide first responder coverage

For the past five years we have had a very good response from our stipend program for our pay per call incentive. This has been a huge benefit for participation on calls and training. In the Spring of 2022 with the help of Union County Management team, Union County Parks and Recreation, and Union County Fire Marshal’s office we were able to install a dry hydrant at Cane Creek Park. Our fire district has no fire hydrants, so we rely on tankers and static water sources. We were able to certify 3 lakes in our district which helped us lower from an ISO 9 to a 5/9E this in turn was a huge savings to our citizens and something for all our members to be proud of.

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SO YOU WANT TO BECOME A HAZMAT TECHNICIAN - NOW WHAT?

Imagine that you are an emergency responder that is considering becoming a Hazmat Technician. The first thought in your mind is probably, “Why in the world am I even thinking about doing that?” In all honesty, that is a question that you should answer prior to embarking on the greatest leap in the hazmat world - That of progressing from a responder certified at the Operations Level to a Hazmat Technician. Making the aforementioned move can be one of the most rewarding (and challenging) progressions in your emergency services career as you transition from a defensive action-based response model to an offensive action-based model (e.g., being able to enter the Hot Zone to plug, patch, or otherwise mitigate leaks, spills, and releases). As such, the decision to become a Technician should not be taken lightly.

Simple logic lets us determine that there are generally two means

by which an emergency responder begins their journey to becoming a Technician. Either the responder expresses a desire to make the leap, or they are assigned to a hazmat team by administration or other supervisors. No matter which method of selection to the ranks of the Technician community occurs, the prospective Technician should spend some time in introspective thought as to their physical and mental readiness to take on the challenge. Prospective Hazmat Technicians usually concentrate on the mental aspect of the leap; however, the physical aspects of functioning as a Technician should not be overlooked. In an effort to be realistic while not sounding pessimistic, wearing hazmat chemical protective clothing and respiratory protection on a hot day can be taxing even to those who are in great shape. Your peripheral vision is often limited, your face shield in vapor protective suits will fog over, and your mobility and dexterity will be limited. In terms

of mental readiness, the prospective Technician should ensure that they are not claustrophobic, as when personnel are zipped into a fully encapsulated vapor protective suit, they are just that—fully encapsulated—and are not averse to the “academic” portion of Hazmat Technician training and on-scene operations. You are probably now wondering why anyone would become a Hazmat Technician after the preceding “pep talk.” The truth is those personnel that can rise to the occasion to meet the physical and mental challenges presented as a Hazmat Technician will be able to save lives and property by entering into an unforgiving environment that few emergency response personnel can safely and competently enter.

Now that you have ensured yourself that you are up to the challenges of becoming a Hazmat Technician, it is time to get to work. The examples that follow are representative of the process in North Carolina; therefore,

if you are in another state, the details may differ somewhat. Since you are already certified in the Hazmat Operations Level as a prerequisite to becoming certified as a Firefighter, you will next need to register for and attend the Chemistry of Hazardous Materials (Chemistry of Hazmat) class. The class is either completed in a twoweek session lasting eighty hours or over a college semester at a community college. During this period of time, participants will cover the salient points of organic and inorganic chemistry relevant to hazardous materials response, such as chemical naming conventions, chemical reactivity, and the physical and chemical properties of hazardous materials. Sometimes comments arise as to why prospective Technicians should complete the Chemistry of Hazmat class. The rationale is that in the field, Hazmat Technicians may be required to interface with chemists, chemical engineers, and process managers that have an extensive

Training At Its Best!

In an increasingly flood-prone world, swift water rescue training is critically important for first responders. Specialized training can often be difficult and dangerous to arrange in natural outdoor settings.

In Spring 2023, Fayetteville Technical Community College will open the only indoor swift water rescue training facility on the East Coast of the United States!

The facility will be equipped with an 88,000-gallon indoor tank that will allow for a variety of training scenarios, including different weather, water temperatures, obstacles, and rescue challenges, including simulated rescues at night.

The Swift Water Rescue Training facility will be located on FTCC’s 30-acre state-of-the-art Fire & Rescue Training complex that FTCC is building on Tom Starling Road in Fayetteville, NC.

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chemistry background. Without having completed the Chemistry of Hazmat class, responders would not be able to “speak their language” and would lose the credibility that is so difficult to earn and so easy to lose. All-in-all, the Chemistry of Hazmat class is not something to dread but rather is a valuable learning experience that builds a

teaching the Technician class in past years, we would place a looseleaf binder textbook on the desk of each participant that was approximately three inches thick and would promptly inform them that we would cover the entire textbook in the two-week timeframe. For those that did not run out of the room screaming (just kidding), we would

get interesting as hands-on practical evolutions are interspersed with the classroom sessions. The practical evolutions range from air monitoring exercises to hazmat chemical protective ensemble dressouts to product control techniques such as applying Chlorine C Kits to mitigate rail car releases. All of the academic and practical studies then culminate at the end of the second week with realistic response exercises that pull everything from the class together. A final written exam then rounds out the class. One important point for participants to remember at the conclusion of the process is that you are then just beginning your learning process as a Hazmat Technician. Your knowledge base is there; however, only experience in the field and continual training will continue your learning process.

to arranging for some companylevel hazmat training to seeking nationally recognized training opportunities such as applying for Highway or Railcar Transportation Specialist training at the Security and Emergency Response Training Center in Pueblo, Colorado. As is oftentimes stated, if you ever stop learning in the hazmat world, it is probably the time to “hang it up.” Just like our fire service career, our hazmat career should be a process of continual learning and growth.

basic foundation for the aspiring Technician to build upon.

The next step in the process of becoming a Hazmat Technician is the successful completion of the eighty-eight-hour Hazmat Technician course offered through the North Carolina Office of the State Fire Marshal. Unlike in the past, when prospective technicians could complete the Chemistry of Hazmat and Technician courses in any order, prospective Technicians must now complete the Chemistry of Hazmat course first as a prerequisite that is required to even start the Technician class. The Technician class is an intense two-week journey

do just that. We would also inform them, however, that although the class material would often seem overwhelming at first, it would all come together and “click” in their heads approximately halfway through the second week of the class. In all my years of teaching, I have never had anyone disagree with that statement at the end of the class.

The first two to three days of the Technician class are in-classroom building blocks that may be highly reminiscent of the Chemistry of Hazmat class for participants. Topics such as hazmat regulations, the HAZWOPER Standard, and recognition and identification

introductory topics, things really

Once new Technicians return home to their departments and hazmat teams, the learning of teamspecific procedures and equipment begins. We also have to carefully guard against complacency. It is easy to sit back at that time and only do a minimal amount of training at the Hazmat Technician level. Let’s face reality - even busy hazmat teams are not bombarded with significant hazmat incidents every day. If we do not use the hard-earned knowledge and skills learned in the process of becoming a Hazmat Technician through appropriate training, we are sure to lose them. New Technicians should not only participate in regularly scheduled training opportunities but should also actively seek out training opportunities. These opportunities can range from simply speaking with your company officer

In summation, becoming a Hazmat Technician is a rewarding and fulfilling experience that enables us to make a difference in an environment few people dare to venture into. Although the effort required to get there is considerable, the rewards inherent to entering into a tight-knit community of motivated individuals that possess very specialized skills make it very much worthwhile. As always, stay safe out there, and be sure to visit the North Carolina Association of Hazardous Materials Responders website at www.nchazmat.com.

Glenn Clapp is a past president of the North Carolina Association of Hazardous Materials Responders and has over 24 years of fire service and emergency management experience. He is currently an Improvement Specialist with the Industry Expansion Solutions Division of North Carolina State University and is a volunteer firefighter with the Fairview Fire Department. He is also a Technician-Level Hazmat Instructor, an Executive Fire Officer, a Certified Hazardous Materials Manager and a Certified Fire Protection Specialist.

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 31
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YOGA 101

s the fire service focuses more on mental wellness, practices like breathwork, meditation, and yoga are being promoted to reduce stress and build resilience. Still, despite this rise in prevalence, many firefighters are reluctant to explore these techniques – especially yoga. There is no doubt a variety of reasons for this reluctance. Some firefighters are satisfied with the things they are already doing. Others may find the whole “yoga thing” a little too “crunchy granola” for their tastes. Still, others may have some fear or concerns about injury if they push too hard. Finally, there are firefighters who are simply afraid of looking silly if they step onto a yoga mat and can’t perform at the level they think they should.

This article seeks to dispel these concerns and to show firefighters that the benefits of yoga far outweigh any perceived risks. In fact, yoga can help your body and mind while also making you a better firefighter. The bottom line is that

the benefits derived from a regular yoga practice extend far beyond the four corners of the yoga mat.

Let’s start with the basic question: What is yoga? While the question is basic, there are a lot of answers. Here, we will explore “What is yoga?” through the Yoga Sutras of Patanjali1, which is the highest regarded description of yoga among yoga teachers. Sutra 1.2 states that yoga is the stilling of the fluctuations of the mind2. We can see from the outset that yoga is designed to allow our minds to calm and settle. But that’s not all. To understand yoga from our Western perspective, we need to refine things a bit. From a traditional yogic mindset, Patanjali describes eight parts (or limbs) of yoga3. These limbs apply to all aspects of one’s life, not just the time you spend on a yoga mat. When Westerners think of yoga, however, they have a more limited perspective on what yoga is. Nevertheless, while all eight limbs of yoga may not seem relevant to an American, several of them will make sense to Westerners when they think about their own

perceptions of yoga. Specifically, when Westerners think of yoga, they envision activities associated with posture, breathing, sense withdrawal, focused concentration, and meditative absorption. To simplify things a bit, these five aspects can reasonably be grouped into three categories: body, breath, and mind.

BODY

When most of us think about yoga, it is really asana that we are envisioning. Asana refers to the posture and movement of a yoga practice. Or, as many of us would describe it: The stretching. While this description of asana is limited from a traditional perspective4, it is sufficient for our purposes. Is asana really about stretching, though?

In short, no, it isn’t. It is easy to see how one could consider the point of asana to be increasing your flexibility, but in reality, asana is designed to prepare you for the focused breathwork that follows it5. Now, in the western world, many yoga classes have asana but skip the breathing and mind-

related aspects of yoga. This is unfortunate, and it skews our vision of what yoga is supposed to be. This stretching-only mindset probably scares many people away from yoga because they feel they aren’t limber enough, and they don’t want to hurt themselves or feel embarrassed if they don’t measure up. They may also feel that, if they want a stretching routine, they can easily find one from other sources. When we look into the actual roots of asana, however, we can see that it is designed to warm the body and get it used to being held in postures. Ultimately, this allows the practitioner to be able to sit in meditation for longer periods. It also allows us to learn about our breathing patterns and to see what happens within our minds when we are challenged. While these postures may sometimes involve stretching, trying to reach some “full expression” of a stretch is never the goal. Dr. Judith Lasater says it beautifully when she notes that “yoga is not about touching your toes; it’s about what you learn on the way down.6”

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A good yoga class for firefighters will be designed not to focus on how far you can bend. Instead, it will recognize and articulate that many of us come to our mats with stiffness, chronic pain, and a decade’s worth of joint injuries. A yoga class that offers multiple modifications and the use of props like bolsters and blocks is essential to firefighters who want to learn how to move their bodies in a way that allows them to quiet the mind and discover their breathing. This type of practice is welcoming and allows us to check our ego at the door easier than if we feel we are competing. Yoga asana should center around how your body feels as you move it. The term for this interoception is at the heart of asana practice. Being able to feel what is happening within your own body as you move it and to determine what those feelings mean allows you to learn from the real expert in the room: Yourself.

BREATH

We all know how important breath is. Breath is life. But in addition to the physiological function of delivering oxygen to our bodies and removing carbon dioxide, our breath holds broader implications for our overall health. As Buddhist monk and Zen master, Thich Nhat Hanh put it, “breath is the bridge which connects life to consciousness, which unites your body to your thoughts. Whenever your mind becomes scattered, use your breath as the means to take hold of your mind again.” As medical professionals, we already understand this connection. When we respond to a call in which the patient is in crisis or emotionally overwhelmed, many of us instinctively counsel our patients to take a deep breath. When we start to become angry, we are sometimes advised to stop, take a deep breath and count to ten. So, one can see that the function of our breath goes well beyond simply being a gas supply and removal mechanism.

What is it about the deep breath and/or focused breathing that calms the mind? Without turning this into an anatomy and physiology lesson, it boils down to the autonomic nervous system. Within the autonomic nervous system lies the parasympathetic nervous system. There are ways for us to deliberately activate the parasympathetic nervous system that allows us to calm ourselves. In polyvagal theory, the part of the parasympathetic nervous system that allows us to connect with our true selves is the ventral vagal system. While the polyvagal theory is a controversial concept, it is still clear that we can tap into the parasympathetic system

in a way that allows us to capitalize on a “sweet spot” wherein we can calm the mind, lower respirations, lower heart rate, and lower blood pressure. This type of deliberate activity is a natural de-stressor, and it is a great way to proactively empty our internal “stress bucket.”

The idea of using the breath to calm our minds and connect with ourselves is an ancient concept. Yoga has promoted breathing practices for thousands of years through what is known as pranayama. Directly translated, pranayama means “drawing out the life force.7” The contemporary translation is “breath control.” Traditional pranayama uses several different techniques for this breathing control, and the techniques vary between the styles of yoga and the person teaching them.8 To avoid overcomplication, we can consider just a few techniques that you may already be doing. Have you ever done box breathing (aka, tactical breathing)? If so, you have engaged in pranayama. With box breathing, you inhale for a fourcount, hold for a four-count, exhale for a four-count, and pause for a four-count before inhaling and starting the process over again. This process is repeated five times (or more) if possible. If you have a wearable heart rate device, try out box breathing on your own

and see if it lowers your heart rate. Another common technique is 4-7-8 breathing. You inhale for a four-count, hold for a seven-count, and exhale for an eight-count. Then the process is repeated five or more times. This technique is great at bedtime. Even something like the skip breathing we are taught in the fire academy is a type of pranayama. While skip breathing is designed to lower air consumption, it does so by requiring us to calm down and focus on our in-breath and our out-breath. While not all pranayama is designed to slow the heart rate and lower blood pressure, the things we can do (and may already be doing) that can activate the parasympathetic nervous system and lower stress are invaluable. And again, while this may be the first you’ve read the word pranayama, you have almost certainly already been practicing without knowing it. No discussion of breathing is complete without discussing some mechanics. In public safety, we are taught to be authoritative and confident, which often leads to us standing with our chests puffed out. A puffed chest normally also means that we use our chest muscles to breathe. That is exactly the wrong approach to breathing if it is used as a calming mechanism. Instead of chest breathing, we need to focus on belly breathing. With

allowed to relax and expand as you inhale. This technique requires us to check our egos and our vanity at the door, which can be difficult. Still, allowing our belly to relax and expand as we breathe in activates the parasympathetic nervous system, thereby relaxing us. It also allows us to take deeper breaths. Speaking of mechanics, it is also helpful to breathe in through the nose and out through the nose. The nose is designed to handle calm breathing. When we breathe through our mouths, the air isn’t properly filtered, warmed, or humidified. The mouth is useful for breathing when we simply can get enough air through the nose; in all other circumstances, nasal breathing is preferred.9 Nasal breathing signals the body and the mind that everything is okay, which has a naturally calming effect. So how does pranayama, belly breathing, and nasal breathing impact a yoga practice?

When I teach a yoga class to firefighters, I focus on the breath at four distinct times. The first time we focus on the breath is during our warmup. During the warmup, we sit as a group and try to shake off the stress of the world that we are currently feeling. Part of that process is to really focus on the breath and how it feels entering and leaving the body. I also ask students to note how their body feels as they focus

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 33
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students can calm their minds and body and use interoception to gauge their emotions. The next time we focus on the breath is during asana. Regardless of the style of the class, breathing is directly tied to the movements and postures engaged during the class. Tying the movement of the body to the breath and the mind is truly at the heart of yoga. In fact, the word yoga is derived from the Sanskrit word Yuj, which in English means “to yoke” and is an expression of uniting the mind, the body, and the senses.10 The third time that the breath becomes a focus is immediately after asana. After asana, the students are invited to sit upright, and they are guided through focused breathing (pranayama) exercise. It may be something as simple as box breathing or something more complex like alternate nostril breathing. The point of this part of the practice is to recenter our focus on slowing things down and calming the mind through focused breathing. This focused breathing also sets the stage for the final breath practice as it relates to meditation. The mind and meditation are discussed in the next section, so for now, just recognize that focused breathing plays a larger role in one’s yoga practice than anything else, including “the stretching.” A firefighter-friendly

class will recognize how important the breath is and will provide several opportunities to hone the skill of focused breathing. The ability to capitalize on focused breathing helps firefighters not only on their yoga mat but also under the stressors associated with firefighting and EMS work. If for no other reason, firefighters are encouraged to develop a yoga practice simply for the wide-reaching benefits they can derive (personally and professionally) from better breathing,

MIND

The culmination of a yoga class is, ideally, some type of meditation practice. Many Western yoga classes, however, focus more on the body than they do on the mind. The result is a class that revolves around movement, stretching, and possibly exercise without much focus on the mind.11 As mentioned above, the traditional intent behind asana practice was to prepare the practitioner for breathwork and meditation. Without a deliberate meditation practice during class, one of the key components of yoga is missed. Recall from the introduction of this article that “the mind” aspect of a yoga practice is actually the combination of three different limbs of yoga. Omitting it from a class leaves out

a considerable basis for getting on a mat in the first place. What is meditation? For our purposes, meditation involves sitting or lying down and focusing on the breath or some other object. Often, meditations are guided by the teacher, and students are asked to focus on particular sensations, thoughts, mantras, or just observing the mind. A vital point here is that meditation is not designed to quiet the mind; meditation is focused on observing the mind. Your mind will wander. Period. When it wanders, you simply return to the object of focus. Even if you have to do it 100 times a minute, you are still meditating. In fact, the whole point of meditating is observing the mind as it starts to think, catching it, and returning to the focal point. Every time you follow that process, you improve your concentration. This cannot be stated emphatically enough: Do not view your wandering mind as an obstacle to meditation; it is an opportunity to develop concentration for which you should be thankful. Grateful that your mind wanders? Yes! It is going to wander anyway. Adding the ability to catch it as it wanders makes your mind stronger. While meditation can and should be practiced independently of a yoga class, having it as part of a yoga class is part of the natural progression of yoga as described in the Yoga Sutras. My classes have a five-to-ten-minute meditation, and even that short meditation has a powerful impact on the mind. Meditation which focuses on the breath, interoception, and a focal point, activates the same parts of the parasympathetic nervous

system as focused breathing, and they have the same stress-reducing impact. To omit or neglect this part of a yoga practice turns the practice on its head and means that firefighters don’t receive the full benefits of yoga. Finding a class that incorporates meditation is essential for firefighters.

TRAUMA-INFORMED PRACTICE

An internet search for yoga classes will find a plethora of practices from which to choose. Many of these classes will be for a particular ailment or situation. “Yoga for this” and “yoga for that” can range from classes for anxiety to classes for runners to classes for sleep and everything imaginable in between. This article isn’t intended to critique any of those classes. If they are right for you, then that settles the matter. But one thing that all firefighters should keep an eye out for is “trauma-informed yoga.” This type of yoga is particularly helpful for first responders, especially if traumatic stress has been a part of their lives. When it comes to traumatic stress, there are some aspects of a regular yoga practice that can exacerbate or cause a reexperiencing of the trauma. For example, holding postures for a long time, touching a student without permission, certain pranayama practices, hot yoga rooms, turning off the lights during Savasana, directed cues rather than inviting cues, and postures that aggressively open the hips and spine can trigger a traumatic response.12

To understand the relevance of this to firefighters, it is important to discuss how the brain responds to trauma. There is a network of

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structures in the brain called the “default mode network” (DMN), which “processes sensations that you feel in your body, coordinates emotions and thinking, and allows you to reflect on your own emotional and physical state.”13

The brains of people who suffer from traumatic stress learn to shut down the DMN so that they can avoid the fear and terror associated with past events.14 The unfortunate result of this emotional processing shutdown is that it also turns off the ability to sense one’s body. In addition to losing the ability to sense one’s body, trauma can make a person hyperreactive to stimuli such that a slight increase in one’s heart rate or respiratory can cause a panic attack. If a yoga class is led in a way that ignores the lowered DMN responsiveness and the overactive emotional and physical responses to stimuli, then it can lead to an aggravation of the traumatic response – a response that may be considerably out of proportion to the stimuli. A couple of other structural changes in the brain that can occur with traumatic stress are the enlargement of the amygdala and decreased hippocampal volume. These physiological changes cause the person to feel threatened more easily, which results in an enhanced fight-or-flight response. In short, the person may never feel safe. Yoga classes that anticipate and respect these potential issues among students are best suited for first

responders who may have concerns about being triggered during class. A trauma-informed class will be led by a teacher who understands not to touch students without their permission. Trauma-informed teachers also lead classes in a way that students never feel obligated to perform a pose. Instead, students are empowered to choose what parts of the class feel right for them. One of the deleterious effects of trauma is the lost sense of control one feels over their person and decisions. Something as simple as telling students they are free to take a break or to refuse to engage in a posture anytime they want is remarkably empowering. Returning for a moment to the autonomic nervous system, regular yoga practice also appears to train the autonomic nervous system to be more adaptive, which lowers the heightened response seen in those who are more easily triggered. Additionally, the practice of mindful meditation as part of yoga “can lead to positive changes in neural functioning, including the reduction in the size of the amygdala and increased hippocampal volume.”15 When these areas of the brain are returned to their normal sizes, the fight-or-flight response is less easily triggered. To demonstrate the power of trauma-informed yoga practice, a “2013 study of 64 women with chronic, treatment-unresponsive PTSD found that after a ten-week trauma-informed yoga program, 52% of participants no longer met

criteria for PTSD.”16 While not all firefighters need a trauma-informed practice, it never hurts to start there and see how it goes.

CONCLUSION

Yoga helps us sleep better, reduces stress, and reduces anxiety. If firefighters can get past their preconceived notions of what yoga is and their fear of “doing it wrong,” then they stand on the threshold of an opportunity to destress, build resilience, and even recover from trauma. Any practice that helps us face physical challenges, remain calm, and use our breath to get through things is a perfect vehicle to develop some life-saving skills that firefighters can use on the fireground and EMS scene. These skills also create a healthier overall life. If I can offer one piece of advice as a yoga teacher, it would be this: Find a yoga class that sounds interesting and get started now.

Brandon Dreiman is a Captain and 21-year veteran of the Indianapolis Fire Department, where he serves as the Coordinator of Firefighter Wellness & Support. He is also an International Association of Fire Fighters (IAFF) Peer Support & Resilience Master Instructor. He is a Certified Addiction Peer Recovery Coach and a Certified Recovery Specialist in the State of Indiana. He believes in a holistic approach to mental wellness, is a Registered Yoga Teacher, and is the founder of Naptown Yogawalla.

REFERENCES

1. Patañjali., Sastri, G. D., & Ballantyne, J. R. (1971). Yoga-sutra of Patanjali. [2d ed.] Delhi: Indological Book House.

2. The Sanskrit translation is Yogas Chitta Vritti Nirodha.

3. The eight limbs of yoga are Yama (moral disciplines), Niyama (positive duties), Asana (posture), Pranayama (breathing), Pratyahara (sense withdrawal), Dharana (focused concentration), Dhyana (meditative absorptions), and Samadhi (enlightenment). See Newlyn, E. (2022) The eight limbs of yoga explained. Ekhart Yoga. https://www.ekhartyoga.com/articles/ philosophy/the-8-limbs-of-yoga-explained.

4. Desikachar, TKV (1995) The heart of yoga. Rochester, VT: Inner Traditions International.

5. Kabel, O. (3 April 2015). How to prepare the body and mind for meditation. Sequence Wiz. https://sequencewiz.org/2015/04/03/preparefor-meditation/.

6. Laseter, J. (2020). Yoga myths. Boulder, CO: Shambhala Publications.

7. No author. (14 March 2019). The eight limbs of yoga. Vagabond Temple. https:// vagabondtemple.com/what-is-pranayama/.

8. Warren, S. (11 February 2020). Why bodycentered therapies help heal post-traumatic stress. Somatic Movement Center. https:// somaticmovementcenter.com/ptsd/

9. For a nice discussion of several pranayama techniques, see Julian. (25 January 2022). 15 types of pranayama (Indian breath) breathing techniques and their benefits. The Yoga Nomads. https://www.theyoganomads.com/pranayamabreathing/.

10. In some yogic and meditative breathing, practitioners are encouraged to exhale through the mouth. As a general non-guided approach, however, breathing through the nose is ideal.

11. Carerra, J. (2006). Inside the Yoga Sutras. Buckingham, VA: Integral Yoga Publications.

12. Many Western yoga classes will engage in 45-50 minutes of asana (or flow) and then end the class by having everyone lay in corpse pose (Savasana) before ending the class. The corpse pose is incredibly valuable and often difficult, but it is not a replacement for meditation practice.

13. Rice, A. (3 January 2022). Traumainformed yoga: A guide. PsychCentral. https:// psychcentral.com/health/what-is-traumainformed-yoga.

14 Warren, S. (11 February 2020). Why bodycentered therapies help heal post-traumatic stress. Somatic Movement Center. https:// somaticmovementcenter.com/ptsd/.

15 Streeter, C., Gerbarg, P., Saper, R., Ciraulo, D., & Brown, R. (24 February 2012). Effects of yoga on the autonomic nervous system, gammaaminobutyric acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012 May;78(5):571-9. DOI: 10.1016/j.mehy.2012.01.021. Epub 2012 Feb 24. PMID: 22365651.

16 Hölzel BK, Carmody J, Vangel M, Congleton C, Yerramsetti SM, Gard T, Lazar SW. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011 Jan 30;191(1):36-43. DOI: 10.1016/j. pscychresns.2010.08.006. Epub 2010 Nov 10. PMID: 21071182; PMCID: PMC3004979.

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&WELLNESS Health

DR. NEWT T. ENLOE AND HIS “PIG TROUGH” OF AN AMBULANCE

Ihad seen this photo of my great-grandmother and her brother on a log flume boat growing up but hadn’t realized the significance of this photo until the National EMS History Museum told me he was the inventor of the first lumber flume ambulance. I guess it was time to go digging around in that steamer trunk they used in 1901 to retrieve the rest of the story. Fortunately, Grammy Knorr kept journals during this time and although there was plenty to go through, the stories were fascinating.

for loggers to be struck by donkey engine cables or get crushed between massive logs as they dealt with derailed log cars.

LUMBER FLUME AMBULANCE

TWENTY-PENNY NAIL FIXES FRACTURED HIP

RIDE OF THEIR LIVES

FROM JEFFERSON CITY TO CHICO

In 1901, my great uncle, Dr. Newton Thomas Enloe, left his practice in Jefferson City, MO and took his infant son and 16-yr. old sister (my Grammy Knorr) to northern California to serve as the Sierra Lumber Company’s Chief Surgeon outside of Chico. With the $15.00 he made from pawning off his watch, he started his practice in this logging community, an industry known for horrific accidents and serious injury. It wasn’t uncommon

Dr. Enloe utilized the flume boat to rush between injured parties as well as transport patients from the West Branch camp to Chico for further treatment, a 25 mi. trip that often rose upwards of 100’ across the trestle bridge. Ensuring his patient was as comfortable as possible, he would either choose someone to ride along on this dangerous journey or accompany the patient himself. Yet sometimes, the patient had to go alone.

The flume also came in handy while fighting fires. In 1904, a crippling fire overtook one of the mill warehouses that contained two thousand pounds of dynamite used to split logs while everyone waited for the explosion. Fortunately, it didn’t. But the flume was put to good use. A sump hole was dug and filled with water from the waterway, which was able to supply three streams of water for dousing the lumber piles.1

Within the first year, Dr. Enloe built a small six bed hospital from scrap mill lumber and worked with a local blacksmith to create essential surgical tools that were needed. During his first emergency surgery, he used a twenty-penny nail from a Chico hardware store to

One story I found in that old trunk talked about two millionaire adventurers in the 1870’s who embarked on the ride of their lives. Reporter H.J. Ramsdell, millionaires James Flood and James Fair, construction boss Mr. Hereford and an unidentified carpenter. A narrow, water-filled flume built on

set a fractured hip, which was later judged to be a complete success. He also implemented California’s first medical plan for the lumber jacks and their families to the tune of $1/ mo. per family (incl. childbirths).

trestlework would carry them 15 miles down in a “pig trough with one end knocked out”. The flume boats were 16’ long and open at the bow. The New Golden Argosy magazine tells of their ride:

Occupants were to sit in the stern -

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Dr. Newton Thomas Enloe with son and sister Emma towards the back of the lumber flume ambulance Dr. Newton T. Enloe (on right)
HISTORY Preserving
A narrow, water-filled flume built on trestlework would carry them 15 miles down in a “pig trough with one end knocked out”. The flume boats were 16’ long and open at the bow. The New Golden Argosy magazine tells of their ride.

their weight would lift the bow clear of the water. The stern of each boat was enclosed and decked over for thirty inches to prevent the wake spilling in over the rear. In cross section, the boats were V-shaped like the flume, the downward flow of water, pushing against the flat transom, would propel the craft.

At the launching point near the sawmill, the downgrade of the trestlework was relatively steep and the two boats, Ramsdell reported, were off like the wind. Ramsdell rode with Fair and the carpenter in the lead boat, with Flood and Hereford following closely. No one stopped to think that the second boat, not so heavy-laden, would tend to overtake the first.

As soon as the two boats began their hurtling journey, the flume sailors had misgivings, but the point of no return had been passed when they first shoved off. Picking up speed to match the rapid flow of water through the flume, the boats rocked and pitched, bumped, and careened as they flew high over rock-strewn gullies and whirled madly around sections where the curving trestle hugged a sheer cliff. Ramsdell later reported the experience to the Tribune: “I cannot give a better idea of the ride than to compare it with riding down an old-fashioned eave trough at an angle of forty-five degrees, hanging in mid-air without support of roof or house and thus shooting a distance of fifteen miles. You cannot stop and you cannot lesson your speed; you have nothing to hold on to; you have only to sit still, take all the water that comes – drenching you

like a plunge through the surf – and wait for eternity.”

The three riders in the front boat shipped water through the front whenever the craft swept down a grade, while on the relatively level stretches, sheets of water came in at the rear. Too heavily loaded, the boat rode low in the flume and at one point, hit a submersed object that hurled the carpenter completely out of the boat, but fortunately inside the flume ahead of it. The boat momentarily crashed to a stop, and Ramsdell landed on top of Fair. The second boat meanwhile was bearing down and a collision that would spill all five men off the flume to the rocks at the base of the trestle seemed likely.

Relieved of the carpenter’s weight, however, the craft broke free. At the same instant, Fair shrugged off Ramsdell and, reaching far forward, seized the carpenter by the collar and yanked him back into the boat. The rescue cost Fair a handful of crushed fingers.

The two boats raced on, the distance between them narrowing rapidly. No mishap had yet marred the journey of Flood and Hereford, but they huddled, soaked, miserable and wishing to Heaven that they had never started the insane ride. Their boat was better balanced and rode the stream at terrific speed. The trees whizzed by and the canyons loomed, but eventually the end of the trip was near. With safety in sight, the second boat suddenly crashed into the lead craft with a force that flattened the occupants of both craft. Riders in the first boat evidently were better braced than when they had hit the

underwater object, but Flood and Hereford were hurling headlong. Fortunately, they remained inside the boat, but water rushed in at both bow and stern. In a slack water section of the flume, near the bottom, all the men jumped clear.

“Fair said that he would never again place himself on an equality with timber and wood,” Ramsdell wrote, “and Hereford said he was sorry he had ever built the flume. Fair said we had traveled down the flume at a mile a minute… My belief is that we annihilated both time and space.”2

My great-grandfather, Daniel Knorr (Grammy Knorr’s husband), had a few brushes with death as well.

The accident occurred while a car of logs was being unloaded at the mill pond. The logs were above the average in size. Knorr was working about the logs when one of the hooks, attached to a cable and set into the log, became loose. In some manner, Knorr got between the two logs which were about four feet apart and they started rolling down the log-way to the pond. He could not get out and could only run with them. Those who witnessed the accident expected momentarily that the second log would overtake him and crush him to a pulp. Just before the first log rolled over the log-way into the pond, Knorr caught onto it and it threw him ahead of it into the water. The second log had gained a greater speed and struck the water beyond him.3

ENLOE MEDICAL CENTER

Dr. Enloe opened what is now known as the Enloe Medical Center in Chico in 1913 and prior to the Paradise Camp Fire in 2018, I was able to visit the hospital and spend time with Nancy Hodges, Dr. Enloe’s daughter. The two of us drove up to the old camp, looked

around Paradise and Sterling City and I was finally able to put pictures to the stories I had heard growing up. As a non-profit hospital, the Enloe Medical Center now has a Level II Trauma Center and the region’s only Level II neonatal intensive care unit.

A big thank you goes to Nancy Hodges, Andy Mark and Christina Chavira for filling in the gaps of a history I was unfamiliar with. What an honor to dive deep into family history and learn how closely tied to EMS I really was.

Beth Krah is founder and CEO of The Krah Corporation (dba Krah Health Solutions). She has served the healthcare community for over a decade providing non-toxic infection prevention measures with a special focus on EMS, Disaster Preparedness/ Response, Medical Care Facilities and the Military. Previously employed by Solvay Pharmaceuticals in their Quality Assurance/Quality Control group, her passion to serve is of utmost importance for her and her team’s role in serving their customers and keeping them healthy so they can focus on the pressing needs of saving the lives of others. She can be reached at beth@krahcorp.com.

REFERENCES:

1. Mark, Andy. (2012). The West Branch Mill of the Sierra Lumber Company. The History Press, p.55

2. Goldrath, Bert. “River In A Box.” The New Golden Argosy, Mar. 1961, pp. 35-39, 104-105.

3. Chico Daily Record (1904, October 17); Chico Daily Enterprise, (1904, October 17).

4. Mark, Andy. (2012).

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The West Branch Mill of the Sierra Lumber Company. The History Press, p.69 Loggers with donkey engine (family photo)
HISTORY Preserving
Enloe Hospital Tent or Booth

THE TRAINING OFFICER AND USING SCENARIOS IN RESCUE TRAINING

In our training as rescuers, we go through classes, such as contained in the Technical Rescue standards used in North Carolina. As part of the certification in such classes, rescuers are required to pass “practical skills” components of the subject matter. This, of course, is a good thing, as the intention of this process is to show proficiency in the application of the class skills. If the skills are remembered for future applications in the “real” rescue world, then all is well; we learned, we tested, passed, and became certified in a particular area of rescue.

But what happens if we rarely train on the learned skills, or if we rarely get the chance to use this knowledge in real rescues? It is a well-documented fact that knowledge and associated skills deteriorate over time if not refreshed, practiced, or utilized. But how do we need to refresh this knowledge to keep it current, or “fresh in our minds” should the need arise to perform rescues?

As a rope rescue instructor at the DuPont Rescue Experience, (a wonderful technical search and rescue school held annually at the DuPont State Recreational Forest) I have had the opportunity to set up training scenarios based upon actual rescues performed at DuPont State Forest. The rescuers participating in the classes we offered all possessed ropes, rigging and mountain rescue technical standards and skills. Each scenario presented its own unique challenges, based upon the surroundings and physical features at each rescue site.

It was rewarding to see that the class came up with various ways to perform the same rescues. All were safe; some methodologies were very simple; others were more complex… but each way to do the rescues was effective. This showed me that the technical skills previously taught in a variety of classes over the last few years at the students’ home departments, were not only remembered, but were utilized very effectively as the problem scenarios were presented to them. To me, this is very rewarding and gratifying, as this is what rescue is all about! As I have preached for years in my articles, this “tools in the rescue toolbox” approach is the only REAL way to perform

rescue. Knowledge, along with skills and the ability to apply them properly….IS rescue. (Photo 1 Img. 0844: “Rescuing victim off top of water tank”)

So, what should you as a training officer strive for in your rescue scenarios? You should try to challenge your team with problems with significant complexity so as to make them think HOW to apply their knowledge to perform a safe rescue. This means possibly limited anchors in which to attach lowering systems, or to have a very limited work area in which to rig for a rescue. Perhaps the “mindset” of the top rescuers performing all the rigging for the rescue when 10 members may be on the ground, with ample anchors, who could do the rigging for a raise or lower, but, due to “tunnel vision”, overlooks this obvious method of rescue. What I am saying here is this: just because rescuers ascend a tower or rock does not mean they have to do all the work. If all the natural or artificial anchors you need are on the ground, and a sufficient number of rescuers (on the ground) can rig a mechanical advantage hauling system or a braking system to perform the rescue, why make the top team do all the work? Yet many times, the obvious is often overlooked. (Photo , Img. 1352: “Utilizing ground-based lowering system on water tank rescue”)

A rescue scenario should, of course, be realistic, but it should

contain variables that require the team to think of the best and easiest way to do the rescue, and to be able to select a method that will

be safe and be performed within the standards the rescuers learned in class. Over time and through experience, rescuers learn many ways to rig rescues that are safe and efficient. The training officer’s challenge is to create scenarios that force the team to select from all their various knowledge, skills and equipment, the easiest, safest, and simplest method to perform any given rescue. The idea here is to avoid the “cookie cutter” mentality in applying rescue knowledge. It is to make them pull from many different skill sets the specific skills needed to perform the task presented to them. Make your team THINK! Make them have to analyze the situation, think about the gear they will need to do the rescue, what hazards are present and how to mitigate them, both for their safety and that of the victim(s)….and then just do it.

I have seen, both in training and in real rescues, teams analyze a situation so hard that they miss the obvious and “over rig” a rescue to

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&PREVENTION Safety
Rescuing victim off top of water tank

the point that the actual rescue took three or four times the amount of time really necessary to do the job. Part of this is tunnel vision, part is not thinking about how to keep the

rescue as simple as possible, some is from a lack of experience (which will only come with time and continuous training), and some is from thinking that the cookie cutter

approach must be used (after all, this is how we trained in the classes we took, right? etc.). (Photo3, Img. 1429: “Using a crane along with rescue standards to perform a rescue off of rock crusher”)

Do you see where I am going with all this? Rescue is a technical art. It is a blend of knowledge, skills, abilities, equipment, training, and experience. For the newer rescuer, and sometimes for the older, experienced rescuer, this can be a daunting task. Therefore, it is the Training Officer’s responsibility to present realistic training that will challenge your team yet allow them to use their learned skills in a common-sense approach. By this I mean teach rescuers all that you can, allow them to learn all the rescue skills that they can from as many schools as possible (over time), train often, have the team critique themselves constructively utilizing after-action reviews

(AAR’s) and gain their selfconfidence…and then take pride in your folks when you see them do the job professionally. Then…… when you can tell your team members “well done” after their rescues, then you can know you did your job right, too.

Bob Twomey has been in the volunteer rescue service for 46 years, having served on five Rescue Squads from the coast to the mountains. He is currently a member of Transylvania County Rescue Squad, past Chief and Training Chief, an EMT for 45 years, and is an IFSAC and OSFM certified Rescue Instructor. Bob has been active in SAR, Mountain Rescue, and teaches high-level rescue. He is the chief pilot of Wolf Tree Aviation, and flies helicopter searches and rescue support locally. He is a Crew Chief for the NC Forest Service. He can be reached at 828-8847174 or at btwomey@comporium.net.

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 39
&PREVENTION Safety
Utilizing ground-based lowering system on water tank rescue Using a crane along with rescue standards to perform a rescue off of rock crusher

GENERATIONS IN THE WORKFORCE: Culture and Values

In the current way of life as a first responder, firefighter, emergency medical provider, and emergency management person, we are always looking at station life as our family. How does the family of multiple generations really get along in the station? On emergency scenes we all know what to do and actually do a good job at the scene. We are battling the fires and saving property and lives but, how do we function back at the station?

Older generations would simply go back to the station and find the allotted area to have a cigarette or cigar and talk about the call that they just returned from. The newer generations that are prohibited from tobacco products on the job for various reasons are not privileged to that relief factor after the calls. So, what do we do in today’s world for relief when the culture for one of many things has changed? In the so-called old days, the remote part of their station was a center for teaching the newer firefighters and medics the lessons or establish the values of being a public servant.

Those values are still present and just as valuable today as they were thirty years ago. When we discuss values, we need to understand that values are what makes up the person or persons within the arena of public safety. Values are created from good and bad experiences and can be mentioned in multiple ways and definitions are going to be different among each individual. Older generations may tell you that the most important value is discipline whereas the newer generation may see discipline in a totally different capacity.

In training, we are taught to be disciplined in the manner in which we don and doff our bunker gear and that prior to entering a burning building we need to ensure that our partner as our self is fully donned and ready to fight fire. Firefighters in the United States are well qualified and do a great job. But station life is where we differ and occasionally experience a cultural shift. Often, we hear that the East Coast fights fire better than the West Coast, or that Volunteers are the backbone of the nation’s fire service. Well, in the culture of the fire service there will always be a conversation on who is the best. That is our culture! Looking at culture, what is really the one thing that stands out is the simplest thing

we all do as taught, young and old, and its discipline. Despite the political ideologies, what happens when the bells or tones go off? We become team members to get the task at hand complete and safely

we need to examine our personal life and actions to see if we have a balance of work and home life? What is interesting with generations in the workforce while at the station, the older personnel

have them introduce the new “stuff.” Once this is experienced, we go back and have that learning moment in which the rookie is now accepted, and the veteran is willing to see exactly what so intriguing about that handheld computer that also has a cell phone application on it. That my friends are one of many cultural changes that have value in our world.

return to our station.

The station is our home for a great period of our lives, 1/3 if working shifts sometimes more on the volunteer side. Our culture of station life extends to our culture of home life. This is where we ask ourselves, do we expect the same disciple at home as we do at work? How does the first responder act at home and also is it at work? Do

may experience some challenges of understanding the younger personnel simply because of the ability to utilize computers and technology.

In simple terms we, as the older generation, are intimidated by technology and how fast it changes. What needs to be done on the technological cultural shift is bring that kid into the cigar corner and

Mark Rivero worked for the City of Las Vegas, Nevada, Fire and Rescue until 2011, as firefighter, training officer and ultimately professional development officer, creating degree pathways for fire service personnel. He currently serves as a program advisor/site coordinator for Southern Illinois University and as chairperson for the doctoral degree path committee for professional development at the National Fire Academy. Rivero also works with the American Council on Education, reviewing fire service courses at various institutions across the United States. He received his doctorate from the University of Nevada, Las Vegas in 2004.

40 | CAROLINA FIRE RESCUE EMS JOURNAL | WINTER 2023 WWW.CAROLINAFIREJOURNAL.COM
Leadership
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Older generations may tell you that the most important value is discipline whereas the newer generation may see discipline in a totally different capacity.

Wesley Chapel Volunteer Fire Department

Pierce Enforcer 107’ Ascendant Aerial Ladder with Cummins X12, 500 HP engine; Oshkosh TAK-4

Front Suspension, Hale QMAX-200 2000 GPM

Single Stage Pump, 500 Gallon Poly Water Tank, 22” Extended Front Bumper. Delivered by Atlantic Emergency Solutions

South Iredell Fire Department

Pierce Enforcer Tanker/Pumper with DDC DD13 525HPengine; 45” Side Control Zone Pump House, Waterous CXC20 1500 GPM Single Stage Pump, 3000 Gallon Poly Water Tank, 19” Extended Bumper Delivered by Atlantic Emergency Solutions

Princess Anne Volunteer Fire Department

Pierce Enforcer Pumper Responder with Cummins L9 450 HP engine; Hale QMAX-200 2000 GPM Single Stage Pump, 750 Gallon Poly Water Tank, New York Style Aluminum Hose Bed, 19” Extended Bumper. Delivered by Atlantic Emergency Solutions

Hatteras Fire Protective Association

Pierce Enforcer Pumper with Cummins L9, 450 HP engine; New York Style Aluminum Hose Bed, 22”

Extended Front Bumper, Waterous CSU 1500 GPM

Single Stage Pump, 750 Gallon Poly Water Tank.

Delivered by Atlantic Emergency Solutions

Hanover Fire Department

Pierce Enforcer Pumper with Cummins L9 450 HP engine; Oshkosh TAK-4 Front Suspension, New York Style Aluminum Pumper, Waterous CSU 2000 GPM Single Stage Pump, 750 Gallon Poly Water Tank. Delivered by Atlantic Emergency Solutions

Roanoke Fire-EMS

Pierce Enforcer Pumper with Cummins X12, 455 hp engine; 50” Side Control Pump House, Hale QMAX-150 1500 GPM Single Stage Pump, 1000 Gallon Poly Water Tank, Allison 5th Gen 4500 EVS Transmission. Delivered by Atlantic Emergency Solutions

Merck Pharmaceuticals

Pierce Enforcer Pumper with Cummins L9, 450 HP Engine; New York Style Aluminum Hose Bed, Hale

QMAX-200 2000 GPM Single Stage Pump, 500 Gallon Poly Water Tank, Husky 12 Single Agent Foam System. Delivered by Atlantic Emergency Solutions

Midway Fire Department

Pierce Enforcer Pumper Heavy Duty Rescue with Cummins X12, 500 HP engine; 45” Side Control Pump House with Speedlay Module, Waterous CSU 2000 GPM Single Stage Pump, 1000 Gallon Poly Water Tank, 26” Extended Front Bumper. Delivered by Atlantic Emergency Solutions

Wilmington Fire Department

Pierce Freightliner M2-106 Encore Rescue with Cummins L9, 330 HP engine; 13” Extended Front Bumper, Allison 3000 EVS Transmission, Side Roll Protection, HiViz LED Lighting. Delivered by Atlantic Emergency Solutions

New Hanover County Fire Service

Pierce Enforcer Pumper with Cummins L9, 450 HP engine; Waterous CSU 1500 GPM Single Stage Pump, 1000 Gallon Poly Water Tank, Oshkosh TAK4 Front Suspension, HiViz LED Lighting. Delivered by Atlantic Emergency Solutions

West Yadkin Fire Department

Pierce Enforcer Tanker/Pumper with Cummins X12, 500 hp engine; 60” cab with 10” raised roof, Oshkosh TAK-4 Front Suspension, Waterous CSU 2000 GPM Single Stage Pump, 2900 Gallon Poly Water Tank. Delivered by Atlantic Emergency Solutions

Town of Edenton Fire Department

Pierce Enforcer Pumper PUC with Cummins L9, 450hp engine; Oshkosk TAK-4 front suspension, Pierce 1500 GPM Single Stage Pump, 1000 Gallon Poly Water Tank, Husky 3 Single Agent Foam System. Delivered by Atlantic Emergency Solutions

WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL | 41
DELIVERIES New
42 | CAROLINA FIRE RESCUE EMS JOURNAL | WINTER 2023 WWW.CAROLINAFIREJOURNAL.COM
Newland Fire Department 2022 Ford Transverse Flatbed Brush Truck with Diesel chassis engine; Hale HPX200-KBD24 Diesel pump Kubota Engine; Super Single Conversion Kit, Extendable Scene lights, Front Deluge Package, Custom Compartmentation Delivered by Anchor-Richey EVS
DELIVERIES New NEW DELIVERIES? Email advertising@carolinafirejournal.com for instructions on how to submit your new deliveries to be published in the Carolina Fire Rescue EMS Journal.
Propst Crossroads Fire Department 2022 Ford Transverse Flatbed Brush Truck with Diesel chassis engine; Hale HPX200KBD24 Diesel pump Kubota Engine; Extendable Scene lights, Front Deluge Package, Maximum Compartments, Rear slideout tray. Delivered by Anchor-Richey EVS

Big Marsh Fire Department

2021 E-One Typhoon Rescue Pumper with L450 Hp Engine; Hale 1500 GPM 1030 Gallon water tank. Triple Speedlay, Full Depth Compartments, Ladder Rack Even with Hosebed. Delivered by Fire Connections, Inc.

Dunn Fire Department

2021 E-One Typhoon eMax Pumper with L450 Hp Engine; Darley 1500GPM 780 Gallon water tank. Full Height Full Depth Compartments, Light Tower, Hi-Viz Scene Lights, Rolling Hosebed Cover. Delivered by Fire Connections, Inc.

Kitty Hawk Fire Department

2022 E-One Typhoon Custom Low Hose Bed Pumper with L9450 HP Engine; Hale 1500 GPM 750 Gallon Poly water tank, Low Hosebed, No Left Side Discharges, Hinged directional Light. Delivered by Fire Connections Inc.

Town of Matthews Fire Department

2022 E-One Typhoon 22’ Non-Walkin Rescue with L9450 HP Engine; Hydraulic tool carousel, Hi-Viz Scene Lights, extensive organization and cabinetry. Delivered by Fire Connections Inc.

Southern Shores Fire Department

2022 E-One Typhoon HP78 Ladder with Cummins X12525 HP Engine; Hale Qmax 1500 GPM 500 Gallon. 78’ Aluminum Ladder, 1000’ 5”, Laser on Aerial Tip, Remote Control Aerial. Delivered by Fire Connections Inc.

Wade Volunteer Fire Department

2022 E-One Typhoon eMax Pumper with L450 HP Engine Darley, 1500 GPM 780 Gallon water tank. Full Height Full Depth Compartments, Roto Ray, Mars Lights, Winch Receiver. Delivered by Fire Connections Inc.

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WINTER 2023 | CAROLINA FIRE RESCUE EMS JOURNAL |
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44 | CAROLINA FIRE RESCUE EMS JOURNAL | WINTER 2023 WWW.CAROLINAFIREJOURNAL.COM A-B TECH COMMUNITY COLLEGE 11 AIR CLEANING SPECIALIST 34 ANCHOR-RICHEY EVS, INC. 14, 42 ATLANTIC EMERGENCY SOLUTIONS INC. IFC, 24, 29, 41 BLANCHAT MANUFACTURING 19 BOBBITT DESIGN BUILD 12 BULLDOZER FIRE INC. 26 CITY OF CHARLOTTE - CCPA 20 CIVIC FEDERAL CREDIT UNION BC CODE 3 INSURANCE, INC. 26 COLUMBIA SOUTHERN UNIVERSITY 42 D.R. REYNOLDS COMPANY, INC. 40 DAVIDSON-DAVIE COMMUNITY COLLEGE 23 FAYETTEVILLE TECH COMMUNITY COLLEGE 30 FIRE CONNECTIONS, INC. 4 FIRE HOOKS UNLIMITED, INC. 39 FIRE SEMINAR (NAFI) 10 FIRE STATION OUTFITTERS 31 FIRST CHOICE FIRE & SAFETY, INC. 3 FOL-DA-TANK COMPANY 8 KEISER 35 KIMTEK 15 KRAH CORPORATION 9 LIBERTY ARTWORKS INC. 34 MARION BODY WORKS, INC. 22 MOUNTAIN TEK 7 NAFECO 6, 16 NEWTON’S FIRE & SAFETY EQUIPMENT, INC. 5 NORTH CAROLINA ASSOCIATION OF RESCUE & EMS 18 NORTH CAROLINA STATE FIREMANS ASSOCIATION 27 NORTH GREENVILLE FITNESS & CARDIAC REHAB 33 PEACEFUL ROADS 24 READS UNIFORMS 2 ROLL N RACK, LLC 28 ROWAN-CABARRUS COMMUNITY COLLEGE 38 SEAARK BOATS 17 STEWART COOPER NEWELL ARCHITECTS 21 SVI TRUCKS, INC. 32 SYNTEX INDUSTRIES 10 TECHNIMOUNT SYSTEMS, INC. 43 THIS END UP FURNITURE COMPANY 39 TLC TRI STATE LAUNDRY COMPANIES 7 ZIAMATIC CORPORATION 25 IFC= Inside Front Cover; IBC= Inside Back Cover; BC=Back Cover INDEX Advertiser
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