LAUREL
HILL
VOLUNTEER
FIRE DEPARTMENT
PROCEDURES
ADOPTED FEBRUARY
13, 2003
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
INDEX
PAGE 1
LAUREL
HILL VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
01
For Accountability
It
is necessary to be able to account for all personnel that may be
assigned to or working at the scene of an emergency. Occasionally,
our members respond on a fire apparatus as does the mutual aid
personnel. Generally, our personnel will respond to the scene in
their private automobile and participate in the emergency operation.
We must ensure that all personnel, regardless of the method of
transportation, will be accounted for in case of a change in strategies
such as changing from an offensive position to a defensive position, a
building collapse, or other circumstance that would require an
accounting for all personnel at the scene.
A
nametag shall be issued to every active firefighter. This tag will
be attached to the rear of the helmet or the outside of the
firefighter’s turnout coat. Note that they were made
purposefully large to aid as a reminder to use them.
On arrival at the scene of every incident,
all firefighters will give their accountability tags to the incident
commander or safety officer.
Upon
returning to the apparatus just prior to returning to service, you
should retrieve you nametag form the incident commander or safety
officer.
Firefighters
should be working under the direction of the Incident Commander in teams
of two or more. Firefighters entering the structure should be
doing so in order to accomplish a tactical objective. If not
needed inside, they should be held together in readiness until the
incident commander assigns your team/crew an assignment. Once you
and/or your team/crew enters the structure, someone should be aware that
you are entering, the approximate area where you are going, the general
time when you are entering, and the number of personnel going inside.
It may be the incident commander, safety officer, pump operator, or
other person that you inform. The intent is if conditions should
deteriorate, someone would know your approximate location and number of
persons we are looking for.
The
incident commander should advise mutual aid officers and firefighters of
the procedure and establish a means of accounting for them.
It is
imperative that you inform someone prior to entering the structure so
that in the event of a deterioration of conditions, someone will be
aware of your position and be looking for you. A system of
communication must be maintained so that the firefighters may be
notified or that firefighters may inform persons outside of problems.
The tag system is intended to identify the number and names of persons
who may be in need of assistance and for your safety. Please help
make it work.
Each
team/crew entering a structure should have a portable radio, be given a
tactical objective and assigned a team/crew identification (i.e.
Interior 1, Search 1, etc.).
Each
team leader will stay in constant communications with the Incident
Commander.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
Apparatus
Placement
Apparatus
function should regulate placement. Poor apparatus placement can
reverse this rule, limiting the operations or eliminating functions to
which a unit could be assigned.
Firefighters
operate with a natural inclination to drive apparatus as close to the
fire as possible. This often results in positioning of apparatus
that is both dysfunctional and dangerous. The placement of all
apparatus on the fireground should be a reflection of the following:
· Standard
operational procedures for first arriving apparatus
· Staging
procedures
· A
direct order from Command
· A
conscious decision on the part of the apparatus driver based on existing
predictable conditions
Effective
apparatus placement must begin with the arrival of the first units.
The placement of the initial arriving engine should be based upon
initial scene size-up and general conditions upon arrival.
First
arriving apparatus should place themselves to a maximum advantage and go
to work. Later arriving units should be placed in a manner that
builds on the initial plan and allows for expansion of the operation.
Avoid
"belly to butt" placement on the fireground. Do not
drive all fire apparatus directly in front of the fire. Reserve
and mutual aid apparatus should stage a minimum of one block short of
the immediate fire area and remain uncommitted until ordered into action
by Command. Apparatus drivers should select staged position with a
maximum of tactical option and as assigned by S.O.P. if applicable.
In
large, complex, and lengthy fireground operations additional apparatus
should be staged consistent with Level II Staging procedure. Under
these procedures, Command communicates directly with the Staging Officer
for additional resource required on the fireground.
Command
must maintain an awareness that access provides tactical options and
that the immediate fire area can quickly become congested with
apparatus. The officer must regard apparatus on the fireground in
two categories:
Park
out of the way. Apparatus that is not working should be left in
the Staging Area or parked where it will not compromise access.
Maintain
access lane down the center of the streets wherever possible or down the
side of the street opposite that which the hydrants are located on.
Think
of apparatus as an expensive exposure: position working apparatus
in a manner that considers the extent and location of the fire and a
pessimistic evaluation of fire spread and building failure.
Anticipate the heat that may be released with structural collapse.
Apparatus should generally be positioned at least 30 feet away from
involved buildings, even with nothing showing. Greater distances
may be required in many situations. The driver will stay with the
apparatus at all times until relieved by the Fire Chief or Incident
Commander.
Beware
of putting fire apparatus in places where it cannot be repositioned
easily and quickly, particularly in operating positions with only one
way in or out (i.e. yards, alleys, driveways, etc.).
Beware
of overhead powerlines when positioning apparatus. Do Not Park
where lines may fall.
If
apparatus does become endangered, operate lines between it and the fire
while you reposition it. When you do move it, move it to a
position that is safe. It is dysfunctional to move apparatus
several times throughout the progress of a fire.
Take
maximum advantage of good operating positions and "build" the
capability of units assigned these effective positions.
These
positions should offer maximum fire attack access to the fire area and
supplied with large diameter supply lines as quickly as possible.
Subsequent arriving apparatus can be supplied from this apparatus.
Place these "key" apparatus first before access is blocked by
later arriving units.
Key
tactical positions should be identified and engines placed in those
locations with strong water supply.
When
high volume is indicated, a pumped supply line from a hydrant should be
provided. The forward engine can distribute this water supply to a
variety of hand lines, master streams, or devices.
Take
advantage of hydrants close to the fire before laying additional supply
lines to distant hydrants. An engine hooked up to a hydrant close
to the fire can usually supply two "forward" engines in attack
positions.
Secondary
hydrants should be used to obtain additional supply if the demand
exceeds the capability of the closest hydrants.
Take
advantage of the equipment on the apparatus already in the fire area
instead of bringing in more apparatus. Connect extra lines to
pumpers that already have a good supply line instead of making
""daisy chain"" supply line connections.
Do
not hook up to hydrants so close to the fire building that structural
failure of fire extension will jeopardize the apparatus or the supply
lines.
Fire
hoses soon limit the general access, as the fireground operation gets
older. Command and sectors must direct apparatus to important
positions as early as possible. Lines should be laid with
attention to these access problems they present. Try to lay lines
on the same side of street as the hydrant and cross over near fire.
Spot
the command vehicle in a manner that will allow maximum visibility of
the fire building and surrounding area and the general effect of the
apparatus operating on the fire. Command vehicle position should
be easy and logical to find and should not restrict the placement or
movement of other apparatus.
Ambulances
and rescue units should be spotted in a safe position that will provide
the most effective treatment of fire victims and firefighting personnel,
while not blocking movement of other apparatus or interfering with
firefighting operations. Consideration must also be given for
additional ambulances access to the Treatment Area in situations
involving patient transportation.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
FIRE ATTACK
Upon
arriving at any structure fire where flames or smoke are issuing from
the building, the smallest line that shall be used to attack the fire
shall be one and one half inch (1 ½ ). (Not Jumpline.)
Unless fully involved at the time of attack, the lines shall not be
operated to as to drive the flames back into the building. The
only exception shall be when flames would endanger people exiting the
area or when flames are exposing another building or area of the fire
building.
The
attack will be made with the number of persons needed to control the
handline and to perform search tactics. All other persons on scene
will be directed to perform certain other duties as needed.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
INCIDENT
COMMAND
The
effective functioning of Laurel Hill Volunteer Fire Department units and
personnel at incidents requires clear and decisive action on the part of
an Incident Commander. This procedure identifies the standard
operating procedures to be employed in establishing command and
operating a Command Post. It also fixes responsibility for the
command function and its associated duties on one individual at any time
during the operations.
The
Incident Commander is responsible for the command functions at all
times. As the identity of the Incident Commander changes, through
transfers of command, this responsibility shifts with the title.
The term "Command" in this procedure refers jointly to both
the person and the function. Identity of the Incident Commander
will be as per Chain of Command.
CHAIN OF COMMAND
7. Department Captains
and Lieutenants will be responsible for fireground authority as
assigned by the Incident Commander. (search, rescue, ventilation,
overhaul, water supply, etc.)
The following numbers will be
assigned to the Chief Officers:
60
– Fire Chief
61
– Deputy Chief
62
– Assistant Chief
Command Procedures are
designed to accomplish the following:
Command is responsible for the
following functions as required by the circumstances of the situation.
· Assume
and confirm Command and take an effective position.
· Rapidly
evaluate the situation (size-up).
· Initiate,
maintain, and control the communications process.
· Identify
the overall strategy, develop an attack plan, and assign units.
· Develop
an effective fireground organization.
· Provide
continuing Command within the framework of standard operating
procedures.
· Coordinate
the transfer of Command as required.
· Request
and assign additional resources as required.
· Return
companies to service and terminate Command
All
of these functions are responsibilities of Command, whether or not
Command is transferred from one individual to another. The first
five (5) functions must be addressed immediately from the initial
assumption of Command.
ESTABLISHING COMMAND
The
first Incident Commander (see Chain of Command) to arrive at the scene
SHALL assume Command and remain in command until relieved by a ranking
Incident Commander or until the incident is terminated or until command
is passed.
The person assuming Command
shall transmit a brief initial radio report including:
2. Building
description (occupancy, size, arrangement, construction, and
address).
Radio Designation
The
radio designation "COMMAND" will be used with a brief
description of the incident location (i.e. "Poverty Creek Road
COMMAND"). This designation will not change through the
duration of the incident.
COMMAND OPTIONS
In
cases when the initial arriving Incident Commander is an officer,
efforts should automatically be directed towards establishing a Command
Post and fulfilling the listed Command functions.
The
establishment of a Command Post is a priority at all working incidents.
The location of the Incident Commander in a vehicle which provides
lighting, communications, equipment, reference items, and limited
isolation from distractions will make Command more effective.
When
an Incident Commander initially assumes Command, that Incident commander
must decide on an appropriate commitment for responding resources that
will make Command more effective.
2. Fast Attack Mode:
Situations that require action to stabilize the situation, such as
interior fires in residences, apartments, or small commercial
occupancies, require that the Incident Commander quickly decide how
to commit resources. Where a fast interior attack is critical,
utilization of the portable radio will permit the necessary
involvement in the attack without neglecting Command
responsibilities. This mode should not last more than a few
moments and will end with one of the following:
1. Command Mode:
Situations that require a strong command by virtue of the size of
the fire, the complexity or type of occupancy, or the possibility of
extension require strong, direct, overall Command from the outset.
In such cases, the Incident Commander will initially assume a
Command position and maintain that position until relieved via the
Chain of Command. Tactical worksheet should be utilized to
assist in managing these situations.
The Incident Commander assuming
Command has a choice of modes and degrees of personal involvement in the
attack but continues to be fully responsible for the identified tasks
assigned to the command function. In all cases, the initiative and
judgment of the Incident Commander are of great importance. The
modes identified are not strict rules, but general guidelines to assist
the Incident Commander in planning appropriate actions.
PASSING COMMAND
In
certain situations, it may be advantageous for the first arriving
Incident Commander to "Pass Command" to the next arriving
driver or officer. This is indicted when the initial commitment of
the first arriving resources require their involvement in operations
(i.e. a high-riser building or an immediate rescue situation), and the
next arriving Incident Commander is on the scene or close behind.
The
initial arriving Incident Commander will give an initial on scene radio
report and advise that Command will be passed. The initial
arriving driver or officer retains responsibility for Command until the
next unit arrives and acknowledges the transfer. Dispatcher will
confirm that the next unit assumes Command.
TRANSFERS OF COMMAND
The
first driver or officer to arrive on the scene shall assume and retain
command until relieved within the following guidelines:
Within the chain of command
indicated above, the actual transfer of command will be regulated by the
following procedures:
2. The Incident
Commander assuming Command will communicate with the person being
relieved by radio or preferably face-to-face on arrival.
3. The person being
relieved will brief the Incident Commander assuming Command indicating
the following:
1. fire location,
extent, and conditions
1. The person being
relieved should review the Tactical Worksheet with the Command
Officer. This sheet provides the most effective framework for
Command transfer as it outlines the location and status of resources
in a standard form that should be well known to all members.
The
Incident Commander should eliminate all unnecessary radio traffic while
responding unless such communications are required to ensure that
Command functions are initiated and completed. This requires the
person initially in Command to give a clear on-scene report and continue
to give updated progress reports as needed.
The
arrival of a ranking Incident Commander on the fireground does not
necessarily mean Command has been transferred to that Officer.
Command is transferred only when the outlined communication functions
have been completed.
The
response and arrival of additional officers on the fireground
strengthens the overall command function. All officers will
exercise their Command prerogative in a supportive manner that will
ensure a smooth transition and the effective on-going function of
Command.
The
officer assuming Command will utilize the person relieved of Command
to best advantage.
In
cases where an individual is effectively commanding a tactical
situation and is completely aware of the location and function of
operating companies and the general status of the situation, it may be
desirable for that person to continue as Incident Commander. In
these cases, the arriving ranking Incident Commander may assume a
supportive role in the overall command function.
COMMAND FUNCTION
It
is the responsibility of the Incident Commander to develop an
organizational structure, using standard operation procedures to
effectively manage fireground operations. The development of the
organizational structure should begin with the implementation of the
initial tactical control measures and may continue through a number of
phases, depending on the size and complexity of the particular
situation. The objective must be to develop the command
organization at a pace, which stays ahead of, or even with the
tactical development of resources.
The basic configuration of a
Command structure includes three levels:
· STRATEGIC
LEVEL – overall incident command
· TACTICAL
LEVEL – direction of divisions and groups
· TASK
LEVEL – unit activities
The Strategic Level involves
the overall command of the incident and includes establishing major
objectives, setting priorities, allocating resources, predicting
outcomes, determining the appropriate mode of operations (offensive or
defensive) and assigning specific objectives to Tactical Level Units.
The
Tactical Level includes intermediate level officers directing activities
toward specific objectives. Tactical Level officers include
officers in charge of grouped resources operating in assigned areas or
providing special function at the scene of an incident. The
accumulated achievement of tactical objectives should accomplish
strategic level objectives.
The
Task Level refers to those activities normally accomplished by
individual units or specific personnel. Task Level activities are
routinely supervised by company officers. The accumulated
achievement of Task Level activities should accomplish tactical
objectives.
The
most basic structure for a routine incident involves only two levels.
The role of Command combines the Strategic and Tactical levels.
Units report directly to Command and operate at the Task Level.
In
more complex situations, Command should group units to wok in sectors.
The sector officers operate at the Tactical Levels, directing the work
of several groups and units or performing specialized functions as
requested by Command. Command continues to operate at the
Strategic Level, determining and directing the overall strategy to deal
with the incident.
The
responsibilities assigned to Command often require the involvement of
more than one individual to manage Command functions. The officer
in Command of a working incident routinely assisted by Field Incident
Technicians and other assigned personnel in managing information at the
Command Post, gathering information by reconnaissance, assisting with
communications and providing liaison. The Command Post
organization may be expanded through the involvement of other officers
and staff personnel to provide Incident Planning and/or Technical
Support at the Command Post. The roles of the individuals
performing these functions may vary, depending on the situation.
As
the fireground organization grows in complexity, the Incident Commander
may implement an additional intermediate level within the Command Post.
The Control Level involves Operations Officers who provide direct
supervision over Division/Group Officers and handle radio communications
for the Incident Commander. This allows the Incident Commander to
be removed from the immediate pressures of radio traffic and to focus on
the strategic aspects of the overall situation and management of the
organization.
STRATEGIC
LEVEL – Incident Commander
CONTROL
LEVEL – Operations Officers
TACTICAL
LEVEL – Groups/Crews
Operations
Officers function internally within the Command Post and assume
responsibility for major segments of the fireground organization.
Operations
Officers should be physically located at the Command Post and
communicate with the Incident Commander on a face-to-face basis.
The
function of Operations Officer is frequently initiated when a ranking
officer assumes responsibility for overall Incident Command and elects
to have the relieved officer continue to communicate to the
Division/Group Chiefs. The relieved officer becomes the Operations
officer.
OPERATIONS OFFICER ASSIGNMENTS
Each
Operations Officer is responsible for the direction of Divisions/Groups
and functions. These should normally be grouped according to their
similarities and related natures to provide the most effective
organization.
Examples:
Fire
Operations – All sectors involved in direct fire suppression.
Each Operations Officer is responsible for the direction of
Divisions/Groups and functions. These should normally be grouped
according to their similarities and related natures to provide the most
effective organization.
Fire Operations – All sectors
involved in direct fire suppression actions and/or working within
fireground perimeter.
Support Operations – Staging,
Rehab, Support, etc.
Hazmat Operations – Hazard,
Decontamination, etc.
All
firefighters at the scene of a fire or incident, when in close proximity
to the structure or vehicle, shall wear full firefighting gear,
including at a minimum, turnout coat, hip boots or bunker boots and
pants, helmet, and gloves. The intent of this is not to require
that protective gear be worn at the scene of an incident where no
immediate hazard exists.
All
firefighters shall don respiratory protective equipment for all interior
structural fires, fires in other confined spaces, areas where an oxygen
deficient or toxic atmosphere may exist, and at other incidents that
require respiratory protection. Masks may be removed after the
fire has been knocked down and the building and/or area has been
thoroughly ventilated.
Members
raising ladders, operating lines outside a fire building, performing
exterior ventilation (roofs, etc.) or other external activities are not
mandated to use respiratory protective equipment. However, it is
strongly suggested that SCBA be worn while performing these or similar
operations.
When
masks are removed, they shall not be dropped or left in a building or
other area where they may be subject to damage.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
For Hose Testing
1. Lay out hose to be
tested in lines of convenient length. Make sure that lines are
straight and without kinks or twists. Record identifying numbers
of length to be tested. Examine all gaskets. Worn or cracked
gaskets should be replaced.
2. Connect a fire
department engine or hose tester at a suitable location to provide the
source of water and pressure for testing.
3. Connect lines to be
tested to engine or hose tester. Attach nozzle to the far end of
the lines.
4. With the test gate
valve open and nozzle open, fill hose with water at a pressure not to
exceed 250 psi. After the line is charged and all air has been
exhausted, close the nozzle slowly.
5. Check all couplings for
leakage and tighten couplings with spanners where necessary. Mark
each end of the hose around coupling with pencil. This is to
determine if there is any coupling movement during test.
6. Hold the test
pressure for 5 minutes. During this time, walk down the line and
inspect for coupling leaks or pinholes in hose. Personnel should
keep a distance of at least 15 feet from hose except as necessary to
inspect couplings.
7. After 5 minutes, reduce
engine speed to idle, disengage pump, and open drain valve on engine to
reduce pressure. When pressure drops below 100 psi, open nozzle
slowly to finish relieving pressure, close gates, and disconnect lines.
8. Observe marks placed on
hose at back of couplings. If couplings have moved, leaks
observed, or hose burst, a tag should be affixed to it describing the
problem, and it should be noted on the Annual Hose Test Record Form.
9. Hose records should
also be marked to indicate the condition of each length tested.
10. After testing, hose
should be properly drained and dried.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
For Motor
Vehicle Accidents
It
has been established that this Fire Department will respond to all Motor
Vehicle accidents and related vehicle incidents.
Upon
page out of a motor vehicle incident, this fire company SHALL respond
with both engines. The first firefighter to go in service
responding to the incident will be responsible to go to the station and
get the engine. All other responding units shall continue to the
scene.
The
first unit on scene will be responsible for scene size up and report to
dispatch the disposition of the scene. The first unit on scene
will also establish Incident Command and will do so until relieved by a
higher-ranking officer or incident is terminated.
In
the case of Mutual Aid, units arriving on scene before Laurel Hill
units, Incident Command should already be established by first on scene.
All Laurel Hill responding non-officer units arriving on scene shall be
under the command of the Mutual Aid officer established. If mutual
aid units on scene have not established Incident Command, then the first
arriving Laurel Hill unit shall assume Incident Command.
All
responding units shall be fully bunkered upon arrival on the scene.
If the vehicle is fire involved, SCBA equipment will also be used.
Any personnel that is not bunkered, will not participate in any fire
suppression or extraction attempts. If an Incident Command Officer
deems it unnecessary to be bunkered, then bunker gear may be removed.
Bunker gear is worn for your personal protection. You may remain
bunkered out if you feel that the duties you are performing require
personal protection.
Upon
arrival on scene, all units responding will establish a SAFE scene, at
which time will determine fire hazards, injuries, potential hazards
(i.e. stable vehicle, traffic, hazardous debris). A scene
parameter should be established to allow all incoming units a safe and
unobstructed path to the scene. Fire personnel safeth is always
first. Unsafe scene can only hinder attempts to perform rescue
operations or fire suppression.
In
the case of an MVA with injury, be sure that all hazards are clear
before attempting to perform patient care. If the incident
involved a rollover, then the vehicle must be secured as to that all
activities can be performed without risk of the vehicle shifting or
moving. Any fuel spills should be contained and diluted with water
or foam, and any other fluids such as oil, transmission fluid or any
other fluids that may be present can be contained with dirt or Chem-Dry.
The vehicle’s battery should be disconnected, to prevent any
electrical devices from activating or creating spark during patient care
or removal. This will also ensure that undeployed airbags do not
activate.
A
First Responder or firefighter should, if possible, be inside the
vehicle with the patient holding C-Spine. A cervical collar should
be administered and a first responder should give immediate care until
EMS arrives.
In
the event of an MVA that requires extrication, only personnel trained in
the use of the JAWS of LIFE will participate in the extrication process.
All
participating members shall bunker out. There are no exceptions.
Extrication is a very dangerous activity and there will be strict
supervision during this process. It is not only the goal of this
fire company to safely remove the patient, but also not to create more
injuries by being careless. All previously stated procedures also
apply in the extrication process.
A
First Responder should, if possible, be inside the vehicle with the
patient holding C-Spine. A cervical collar should be
administered and the patient should be covered to protect the patient
from broken glass and other possible flying objects while extrication
is in progress.
While
extrication is in progress, there is often a lot of crunching and
noise of metal bending. Reassurance and detailed explanation of
what is happening or is about to happen is helpful to calm the
patient.
Once
access to the patient is accomplished, the scene should be cleared of
all debris. All vehicle parts should be brought to a safe
location away from the vehicle as not to create hazard to personnel
working the scene. At this point, EMS personnel will be the
governing body. They will give instructions on how the patient
should be removed.
Once
the patient has been removed and has been put into the ambulance, the
scene then becomes the jurisdiction of the Sheriff’s Department or
Highway Patrol. Take care not to move or disrupt anything.
Remember the scene could be a crime scene, especially if there is more
than one vehicle involved. It is the job of the police to secure
all personal belongings and items of value, not the fire
department’s. If you see items that have been thrown from the
vehicle that are not in the immediate area of the scene, then notify
the authority having jurisdiction.
In
the case that the police have not arrived on the scene and bystanders
are present, be sure that all personal belongings and other items are
secure until they arrive. Once again, these procedures apply to
all MVA scenes and not only to extrication scenes.
In
the case of an MVA with injuries, and Life Flight has been activated,
all Life Flight S.O.P. shall be followed.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
For Oxygen
Equipment
Gas
flow from an oxygen cylinder is controlled by regulators that reduce
the high pressure in the cylinder to a safe range (around 50 psi) and
control the flow from 1 to 15 liters per minute. These
regulators attach to the cylinder by a yoke; each yoke is designed so
that its pins will fit only the cylinders for one type of gas.
In addition, all gas cylinders are color-coded according to their
contents. Oxygen cylinders in the United States are generally
steel-green or aluminum gray.
SAFETY PRECAUTIONS
Never
allow combustible materials, such as oil or grease, to touch the
cylinder, regulator, fittings, valves, or hoses. Oil and oxygen
under pressure will explode if they come in contact. This
includes petroleum-based adhesive (adhesive tape) or lubricating a
delivering system with petroleum jelly.
Never
smoke or allow others to smoke in any area where oxygen is in use or
on standby.
Keep
all valves closed when the oxygen cylinder is not in use, even if the
tank is empty.
Never
stand an oxygen tank upright by the patient. If the tank is not
in a commercial pack, lay it on its side by the patient.
OXYGEN ADMINISTRATION
Place
the cylinder securely upright. "Crack" the tank with
the wrench supplied (i.e. slowly open and rapidly close the cylinder
valve to clean it of debris.) Inspect the regulator valve to be
certain that it is in the right position for an oxygen cylinder and
that it has a intact washer. Apply the regulator valve and
tighten securely.
Regulate the oxygen flow:
SIGNS OF RESPIRATORY DISTRESS
OXYGEN DELIVERY EQUIPMENT
Often,
the non-rebreathing mask is preferred in the field because it can
deliver high oxygen concentrations. Some patients, however,
tolerate the masks poorly and complain of feelings of suffocation.
Whatever
device you use, explain to the patient what it is and why you are using
it. Forewarning the patient that the mask may feel confining, but
that it is nonetheless providing the proper amount of oxygen, will help
considerably.
1. Select a mask
(individually wrapped) with the oxygen supply tube pre-attached, and
attach it to regulator. Turn and open the main cylinder valve,
adjust the liters per minute initially to 15 Lpm. If the mask
has a reservoir bag, make sure that the bag is filled before using
it. After the reservoir bag is filled completely, readjust
liter flow to 10 – 15 Lpm. Monitor patients respirations and
reservoir bag to prevent collapse of the reservoir bag. The
non-rebreathing mask will deliver 80-95% of oxygen.
A
complication you may encounter when administering oxygen is respiratory
depression in a chronic obstructive pulmonary disease (CPOD) patient.
The drive to breathe may come from the lack of oxygen (hypoxic drive).
Very high oxygen levels may eliminate the COPD patient’s hypoxic drive
in isolated cases. Monitor patient carefully.
The
control of the rate and depth of breathing rests primarily in the brain
stem. The brain stem measures carbon dioxide (CO2)and pH levels in
the blood. This is issued as an indicator for the correct
respiratory rate to blow off the proper amount of carbon dioxide and
provide the right amount of oxygen. Some COPD patients are unable
to eliminate carbon dioxide normally, so their respiratory centers
become accustomed to high carbon-dioxide levels and low oxygen levels.
These patients are stimulated to breathe by receptors located in the
aorta and carotid arteries, which are sensitive to decreases in oxygen
levels. Therefore, oxygen administration may supply high enough
oxygen levels to discontinue the body’s messages to breathe.
LAUREL HILL
VOLUNTEER FIRE DEPARTMENT
STANDARD
OPERATING PROCEDURES
For Emergency
Incident Rehabilitation
To
ensure that the physical and mental condition of members operating at
the scene of an emergency or a training exercise does not deteriorate
to a point that affects the safety of each member or that jeopardizes
the safety and integrity of the operation.
SCOPE
This
procedure shall apply to all emergency operations and training exercises
where strenuous physical activity or exposure to heat or cold exists.
RESPONSIBILITIES
Incident
Commander
The
Incident Commander shall consider the circumstances of each incident and
make adequate provisions early in the incident for the rest and
rehabilitation for all members operating at the scene. These
provisions shall include: medical evaluation, treatment and monitoring;
food and fluid replenishment; mental rest; and relief from extreme
climatic conditions and the other environmental parameters of the
incident. The rehabilitation shall include the provisions of
Emergency Medical Services (EMS) at the Basic Life Support (BLS) level
or higher.
Officers
All
officers shall maintain an awareness of the condition of each member
operating within their span of control and ensure that adequate steps
are taken to provide for each member’s safety and health. The
command structure shall be utilized to request relief and the
reassignment of fatigued crews.
Personnel
During
periods of hot weather, members shall be encouraged to drink water and
activity beverages throughout the workday. During any emergency
incident or training evolution, all members shall advise their
supervisor when they believe that their level of fatigue or exposure to
heat or cold is approaching a level that could affect themselves, their
crew, or the operation in which they are involved. Members shall
also remain aware of the health and safety of other members of their
crew.
ESTABLISHMENT OF REHABILITATION
SECTOR
Responsibility
The
Incident Commander will establish a Rehabilitation Sector or Group when
conditions indicate that rest and rehabilitation is needed for personnel
operating at an incident scene or training evolution. A member
will be placed in charge of the sector/group and shall be known as the
Rehab Officer. The Rehab Officer will typically report to the
Logistics Officer in the framework of the incident management system.
Location
The
location for the Rehabilitation Area will normally be designated by the
Incident Commander. If a specific location has not been
designated, the Rehab Officer shall select an appropriate location based
on the site characteristics and designations below.
Site
Characteristics
3. It should provide
suitable protection from the prevailing environmental conditions.
During hot weather, it should be in a cool, shaded area.
During cold weather, it should be in a warm, dry area.
3. Medical – blood
pressure cuffs, stethoscopes, oxygen administration devices, cardiac
monitors, intravenous solutions, and thermometers.
4. Other – awnings,
fans, tarps, smoke ejectors, heaters, dry clothing, extra equipment,
floodlights, blankets and towels, traffic cones and fireline tape
(to identify the entrance and exit of the Rehabilitation Area).
GUIDELINES
Rehabilitation
Sector/Group Establishment
Rehabilitation
should be considered by staff officers during the initial planning
stages of an emergency response. However, the climatic or
environmental conditions of the emergency scene should not be the sole
justification for establishing a Rehabilitation Area. Any
activity/incident that is large in size, long in duration, and/or labor
intensive will rapidly deplete the energy and strength of personnel and
therefore merits consideration for rehabilitation.
Climatic or environmental
conditions that indicate the need to establish a Rehabilitation Area are
a heat stress index above 90 F (see Table 1-1) or wind-chill index below
10 F (see Table 1-2).
Hydration
A
critical factor in the prevention of heat injury is the maintenance of
water and electrolytes. Water must be replaced during exercise
periods and at emergency incidents. During heat stress, the member
should consume at least one quart of water per hour. The
rehydration solution should be a 50/50 mixture of water and a
commercially prepared activity beverage and administered at about 40 F.
Rehydration is important even during cold weather operations where,
despite the outside temperature, heat stress may occur during
firefighting or other strenuous activity when protective equipment is
worn. Alcohol and caffeine beverages should be avoided before and
during heat stress because both interfere with the body’s water
conservation mechanisms. Carbonated beverages should also be
avoided.
Nourishment
The
department shall provide food at the scene of an extended incident when
units are engaged for three or more hours. A cup of soup, broth,
or stew is highly recommended because it is digested mush faster than
sandwiches and fast food products. In addition, foods such as
apples, oranges, and bananas provide supplemental forms of energy
replacement. Fatty and/or salty foods should be avoided.
Rest
The
"two air bottle rule", or 45 minutes of work time, is
recommended as an acceptable level prior to mandatory rehabilitation.
Members shall rehydrate (at least eight ounces) while SCBA cylinders are
being changed. Firefighters having worked for two full 30-minute
rated bottles, or 45 minutes, shall be immediately placed in the
Rehabilitation Area for rest and evaluation. In all cases, the
objective evaluation of a member’s fatigue level shall be the criteria
for rehab time. Rest shall not be less than ten minutes and may
exceed an hour as determined by the Rehab Officer. Fresh crews, or
crews released from the Rehabilitation Sector/Group, shall be available
in the Staging Area to ensure that fatigued members are not required to
return to duty before they are rested, evaluated, and released by the
Rehab Officer.
Recovery
Members
in the Rehabilitation Area should maintain a high level of hydration.
Members should not be moved from a hot environment directly into an air
conditioned area because the body’s cooling system can shut down in
response to the external cooling. An air conditioned environment
is acceptable after a cool-down period at ambient temperature with
sufficient air movement. Certain drugs impair the body’s ability
to sweat and extreme caution must be exercised if the member has taken
antihistamines, such as Actifed or Benadryl, or has taken diuretics or
stimulants.
Medical
Evaluation
1. Emergency Medical
Services (EMS) – EMS should be provided and staffed by the most
highly trained and qualified EMS personnel on the scene (at a
minimum of BLS level). They shall evaluate vital signs,
examine members, and make proper disposition (return to duty,
continued rehabilitation, or medical treatment and transport to
medical facility). Continued rehabilitation should consist of
additional monitoring of vital signs, providing rest, and providing
fluids for rehydration. Medical treatment for members whose
signs and/or symptoms indicate potential problems, should be
provided in accordance with local medical control procedures.
EMS personnel shall be assertive in an effort to find potential
medical problems early.
2. Heart Rate and
Temperature – The heart rate should be measured for 30 seconds as
early as possible in the rest period. If a member’s heart
rate exceeds 110 beats per minute, internal body temperature should
be taken. If member’s temperature exceeds 100.6 F, he/she
should not be permitted to wear protective equipment. If it is
below 100.6 F and the heart rate remains above 110 beats per minute,
rehabilitation time should be increased. If the heart rate is
less than 110 beats per minute, the chance of heat stress is
negligible.
The names of members and
times of entry to and exit from the Rehabilitation Area shall be
documented by the Rehab Officer or his/her designee on the Check
In/Our Sheet. Members shall not leave the Rehabilitation Area
until authorized to do so by the Rehab Officer.
The
decisions required to provide for adequate resources are an important
factor in effective fire ground management. Command must balance
the tactical problems with the resource required to control those
problems and stay ahead of the situation through effective
forecasting. Beware of "Crisis Management":
situation grows at a rate faster than the response rate to that
situation; Command ends up with an out of control situation and
inadequate resources to control it.
Many
times a point will be reached where Command begins to debate whether
to call for additional resources or not. In such cases, call for
it. If the extra resource is not needed, it can easily be put
back in service.
In
most cases, Command should utilize the mutual aid mechanism; it is the
quickest, provides for automatic move-ups, and indicates in a standard
manner that the fire problem is in an expanded mode.
It
is the continuing responsibility and function of Command to determine
the resources required to control the situation and to provide for the
timely call for any additional resources required. The early
call for additional resources will tend to consistently save the day.
Command
must be aware of both the capability and response time of additional
resources and effectively integrate these facts into calls for
additional resources.
Some
tactical situations move slowly, while some move very quickly.
Command must call for additional resources at a rate that stays ahead
of the fire.
Some
situations require the categorical call for mutual aid upon knowledge
of particular characteristics or conditions; in other situations,
Command will initiate some fire control activities, ask for reports,
and based upon receipt of bad news, will call for mutual aid.
When
calling for additional resources, Command must build a corresponding
command organization structure to manage those additional
Resources. Command
cannot encounter a big fire situation, call additional resources, and
then expect to effectively manage those additional resources in a
Level I command mode.
6. Forces are depleted
due to exhaustion, injury, trapped, or missing: Command must
forecast the effect the fire will have on personnel and provide for
the support of such personnel in advance.
7. Command runs out of
some resource (men, apparatus, water, equipment, command, etc.).
It
is the responsibility of the driver of each Fire Department vehicle to
drive safely and prudently at all times. Vehicles shall be
operated in compliance with the Florida State Motor Vehicle and Traffic
Law. This law provides specific legal exceptions to regular
traffic regulations that apply to the Fire Department Vehicles only when
responding to an emergency incident. Emergency response does not
absolve the friver of any responsibility to drive with due caution.
The driver of the emergency vehicle is responsible for its safe
operation at all times.
When
responding to an emergency, warning lights must be on and sirens must
be sounded to warn other drivers of other vehicles, as required by the
Florida State Vehicle and Traffic Law.
The
use of sirens and warning lights does not automatically give the
right-of-way to the emergency vehicle. These devices simply
request the right-of-way from other drivers, based on their awareness
of the emergency vehicle presence. Emergency vehicle drivers
must make every possible effort to make their presence and intended
actions known to other drivers, and must drive defensively to be
prepared for the unexpected inappropriate actions of others.
Fire
Department vehicles are authorized to exceed posted speed limits only
when responding to an emergency with lights and siren operating under
favorable conditions. This applies only with light traffic, good
roads, good visibility and dry pavement, as long as life and property
is not endangered.
Under
less than favorable conditions, the posted speed limit is the absolute
maximum permissible.
Intersections
present the greatest potential danger to emergency vehicles.
When approaching and crossing an intersection with the right-of-way,
drivers shall not exceed the posted speed limit.
When
emergency vehicles must use center or oncoming traffic lanes to
approach controlled intersections (traffic light or stop sign), they
must be prepared to come to a complete stop before proceeding through
the intersection, including occasions when the emergency vehicle has
green traffic lights.
When
approaching a negative right-of-way intersection (red light, stop
sign), the vehicle shall be prepared to come to a complete stop and
may proceed only when the driver can account for all oncoming traffic
in all lanes yielding the right-of-way.
Emergency
response with lights and siren is authorized only in conjunction with
emergency incidents. Unnecessary emergency response shall be
avoided. In order to avoid any unnecessary emergency response,
the following rules shall apply:
Drivers
shall avoid backing whenever possible: Where backing is unavoidable,
guides shall be used. If no guide is available, the driver shall
dismount and walk completely around apparatus to determine if
obstructions are present before backing.
When
stopped at the scene of an incident, vehicles should be placed to
protect personnel who may be working in the street and warning
lights shall be used to make approaching traffic aware of the
incident. At night, vehicle mounted floodlights and any other
lighting available shall be used to illuminate the scene. All
personnel working in or near traffic lanes shall wear high
visibility turnouts or vests.
If
it is not necessary to park vehicles in or near traffic lanes, the
vehicle should be pulled off the road to parking lots, curbs, etc.,
whenever possible.
Laurel
Hill Volunteer Fire Department vehicles shall be operated in a manner
that provides for the safety of all persons and property. Safe
arrival shall always have priority over unnecessary speed and reckless
driving enroute to an emergency incident.
Prompt, Safe Response Shall
Be Attained By:
1.
Leaving the station in a standard manner:
-
quickly mounting apparatus
-
station doors fully open
2.
Driving defensively and professionally at reasonable speeds.
3.
Knowing where we are going.
4.
Using warning devices to move around in traffic and to request the
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