The plain and simple truth about fires is that they won’t just get easier to fight on their own. So many measures have been made to prevent fires before they start, but there will always be a way. Although fire will always be fire, it does seem to change behaviors so the training in how to fight fires has definitely been modified and will continue to evolve into the distant future. We cannot possibly cover every jot and tittle of this evolution, but some beneficial information will be provided here for those who are interested in how fire-fighter training has changed over the last twenty years and how it may continue to change.
The first reason why fire-fighter training had to change is because the number of fire-fighter deaths has unquestionably increased over the past twenty years. Although fire-fighters put their lives at risk every single day in their line of work, the goal in fire-fighting is to save as many lives and property as can be salvaged. Fire behavior has changed gradually over time and it is estimated that only 1% of a fire-fighter’s training is based upon this. New ways are being developed to fight changing fire patterns through using realistic scenarios. There is no better way to learn about fire than actually fighting it, whether the fire is simulated or not.
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Now more than ever it’s important to make sure as firefighters your safety is watched out not only by the firefighters you are working with, but by yourself as well. Proper training is extremely important, especially in urban firefighting training and we will cover what urban firefighting training is in depth here below.
The Importance of Urban Firefighter Training:
Being a fire-fighter despite its dangers and risks is actually quite a wonderful thing to be. Imagine loving others enough to serve them and put your life on the line for them each and every day. It doesn’t matter how much glory and honor one fire-fighter may attain over their career because the fact still remains, they were unselfish enough to give their all just for you and I.
Throughout the next paragraphs we shall take a brief look at urban fire-fighting and why its training is so vital to each and every fire-fighter around the globe. City fire-fighting not unlike wildland fire-fighting exhibits very extreme and distinctive challenges for all involved. Close calls such as entrapments result in on-duty fire-fighter deaths each and every year. In all areas of fire-fighting, safety always falls in as the first priority. This is why training is very important for all fire-fighters both on the job and off.
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EMS Emergency Protocols for pre-Hospital Treatment of Gunshot Wounds Vary from every State in the United States, this is a general description of priority actions as designated by the NAEMS team. All EMS professionals must be Certified and Licensed to be eligible to serve patients in their state.
EMT Basic Treatments Protocols – “The purpose of these protocols is to provide a uniform treatment standard through-out a designated E.M.S. Region of the U.S., for certified pre-hospital care providers and first responders.”
While this is the typical overview of what to expect from your EMS response team, proper gun safety should always be practiced and many gun related incidents would be prevented if more individuals were responsible enough to lock up their firearms securely.
First on the scene pre-hospital care providers or EMT’s provide on-the-scene recognition and treatment of life conditions that risk mortality or morbidity should treatment be delayed. Enter the patient into the E.M.S. system and begin immediate meaningful interventions.
For patients not immediately in life or limb threatening conditions, provide entry into the E.M.S. System, provide initial stabilization, safely transport to an emergency facility.
A third goal of protocol, for patients requiring immediate hospital stabilization, using only minimal on-site delay: examples like gunshot wounds, pre-mature infant, chest or stab wounds, deteriorating neurological status, or severe pulmonary edema.
In the case of multiple casualty incidents (MCI), the fourth goal protocol is on-scene triage. To achieve goal protocols of pre-hospital care, the EMT must quickly recognize the need for on-scene intervention using rapid patient assessment. At primary survey identifying needed interventions needed to be acted on immediately will interrupt the survey procedure then upon stabilization, survey is continued.
Examples of survey interruption:
- deal immediately with airway problems
- treat sucking chest wounds
- provide oxygen and immediate treatment if patient is having a MI
Once life and limb threat is stabilized continue primary and secondary surveys.
A base hospital physician will give medical direction to Not Give C.P.R. to a pulseless, apneic patient.
- Red – immediate (first transport and treat)
- Respiration over 30
- Pulse – no radial pulse
- Mental status – unable to follow simple commands
- Yellow – Delayed transport and treat
- Other more seriously wounded cannot walk on their own
- Green – Minor (Transport for treatment)
- Patients can walk without assistance
- Black – Dead or Dying – no respiration after head tilt and OPA
Priorities: ABC’s, Scene Safety, Get needed Assistance en-route to Scene. If there are 5 or more critically injured patients needing immediate treatment, contact base hospital to call an MCI. Some agency approved assistance upon an MCI call:
- Aircraft Assistance
- Special Needs such as Haz-Mat, Buses, etc.
- Mutual Aid
- Constant updates to Base Hospital
Additional resources will assign: Triage, Staging, Scene Safety and Security
The most obvious trauma may not be the worst risk of death, some trauma victims have died of mechanical airway obstruction while more dramatic injuries were being treated. EMT’s should continue primary and secondary surveys as soon as they are able during treatment.
In the event of a firearm wound, first responders perform the initial rapid assessment, then time permitting do the detailed head-to-toe assessment, visually then hands on. Check the following signs of trauma: Head, Neck-including major blood vessels, Chest, Abdomen, Pelvis, Extremities, watch for wounds, hemorrhage, crepitus, deformity and mobility. Note any potential circulatory compromise or hypotension from hemorrhagic shock.
Symptoms of gunshot wounds are influenced by many factors, including type of firearm, type of bullet, location of wounds, organs involved, patient health and condition. As preparation for transport, apply cardiac monitoring and pulse oximetry. Keep contact with base hospital regarding administering bolus fluids and any changes in vital signs.
When immediate interventions are indicated, such as chest wound with interval thoracic injuries, EMS may be required to perform chest decompression with needle thoracostomy before transport. All protocol regarding blood pressure in a gunshot wound victim is subject to local protocols, EMT level and base hospital physicians’ orders.
Depending on locations of wounds, treatments will vary from bandaging, application of pressure, immobilization, intravenous lines, blood and fluid replacement, pre-warmed blankets to avoid shock. Once the patient has been stabilized for transport, some of these procedures can be provided en route.
Monitoring in Transit:
- Score the following:
- Eye opening
- Verbal Response
- Motor Response
- Abdominal rigidity
- External Bleeding
- Deformity of head or extremities
- Fluid secretions, eyes, ears, etc.
- Decreased Breath Sounds
- Pulse Deficits
- Reduced or Absent Sensation
- Skin Color
Accompany Patient into emergency room to update physician in charge.
While this has been a good overview, please remember that the #1 thing you can do to prevent firearms accidents is to ensure that you are proactive in your approach to firearms. There is nothing worse than having one of these situations as a result of recklessness and carelessness when it comes to how someone handles a gun. Make sure you find a way to keep your firearms secure at all times, and dial 911 immediately in the event of an emergency.
If you have just graduated senior high school, college or university and went through to become a fire-fighter and are looking for financial information, then this article is just for you. We will be taking a simplified look at the first year average salaries in fire administrations throughout some 10 selected States. A brief summary on being a first year fire-fighter will follow after that.
We shall begin with the highest average salary offered for a first year fire-fighter which can be found in New York. For a rookie hired on an administration there they will be looking at a starting salary of about $29,000 annually.
Surprisingly, the State of Georgia holds the next highest salary with an average of about $28,000 per year for a rookie fire-fighter.
Illinois as possibly expected pays a competitive average starting wage to their beginning fire-fighters where they are offering approximately $27,000 annually.
California and New Jersey rank fourth on our list where a first timer there can expect to pull in an average income of roughly $26,000 in their first year of service.
Texas and Florida come next in line with an average income of about $23,000 annually for any fire-fighters looking to begin their careers in the American south.
Our dry States of Nevada and Arizona unfortunately don’t seem to be as competitive as other State administrations where they are only offering an average beginning salary of $20,000 in one year.
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