Every day this month there is a new issue, concern or development related to the pandemic that impacts fire and ems responders. As I edit this Sunday night the President has extended social distancing guidelines through April 30. Here are 5 tips that may help the company commander during this time of great hazard and uncertainty
It is a marathon – manage your energies
We are hard-wired to work until a problem is solved. That is what makes us great as an emergency responder. Unfortunately, this situation will be impacting us for weeks, so we should consider lessons learned from wildfires, USAR deployments, and other calamities
1. Critically Evaluate Clinical and Operational “Facts”
At the start of this pandemic, medical, public health and first responders were like a test pilot in an out-of-control experimental airplane. Transmitting a non-stop detailed radio commentary of what the pilot is observing, what the pilot is doing and what are the results. Often factoids will pop-up out of context or be incompletely reported.
One of the sharpest paramedics I know, Tracey Loscar, describes the process she used in exploring the statement “… don’t use Advil for fever because it turns COVID-19 into pneumonia.”
Without context, it implies a warning with substance. It promotes fear and can even create dangerous conditions for people who may misread it and then apply that information without legitimate guidance. … in seconds you can see that this recommendation currently has absolutely no basis in science. All you would have to do is type, “Advil in COVID” into Google.
If you dug into it at all, like, less than ten minutes of your time, you would see that it’s based off a combination of a single letter, published in a French journal two weeks ago (The Lancet, March 11), and a Tweet from one French doctor in the Health Ministry suggesting Advil could aggravate the infection, make it spread faster. It’s not an actual study, it’s a theory. Tracey Loscar (March 28)
A 2001 RAND conference on protecting first responders after terrorist attacks looked at the difficulties in managing information during the anthrax incidents – issues that ring familiar today:
Especially in the case of anthrax, keeping up with changing information being provided by numerous agencies was a serious challenge for front-line responder organizations.
The desire to have accurate information was of particular concern to commanders, who were making decisions about what level of risk their personnel would face.
Finally, an EMS panel member observed that post-event information can be just as important: Sometimes responders were not told whether the test on the suspicious substance they responded to turned out to be positive for anthrax or not. The responder assumed that they would have been informed if it was positive, but the lack of certainty caused stress anyway. RAND
Providing prompt and accurate feedback on the results of the patient (and caregiver) COVID-19 testing is vital to the caregiver’s sense of well-being.
2. Help every member of your crew to avoid contaminating their family and loved ones
A Dublin Firefighter/Paramedic describes a ritual he worked out with his wife on the times he responded to a chemical incident, water rescue, or fire with asbestos. He would call ahead to have her prepare the home. With the pandemic, this coming-home ritual occurs every night:
When we return our crew have finished and it’s back to the showers and the scrubbing , the uniform is kept at work and washed and I head home. I have two children, boys, who crave their fathers attention and after the day I have had I crave theirs, but before that happens I walk down the side of my house and take off my clothes at the back door and I pick up the towel my wife has left me and I head straight to the shower. SIPTU – Dublin Fire Brigade (March 27)
3. Create time and space to decompress and rest
Some practices a company commander can perform while on-duty include:
- Informational briefings at the start of every shift.
- Maybe some time periods with the TV talking heads turned off – interrupt the constant drone of crisis, fear, and controversy.
- The daily broadcast from the White House provides national updates (and political theatre).
- When possible, rotate members from high-stress to lower-stress activity during the work shift.
- Make sure your team hydrates, take breaks and safely maintain energy levels.
- Discourage the use of caffeinated energy drinks as they are linked to cardiac problems and dehydration. Click on the link below to Dan Bodin’s evaluation of caffeinated energy drinks on firefighters.
- Establish a “quiet” area, like the bunkroom, for decompression.
4. Be a reliable source of information and administrative support
Every emergency service agency is struggling with worker compensation, sick leave, and related workforce questions when it comes to self-quarantine, defining what an “exposure” is and how caregivers will be handled. This remains a work-in-progress with a different pathway taken by every state.
- Make sure you have the forms and procedure in place when a caregiver is exposed, injured or needs to leave work for a family emergency.
- Be assertive in resolving the “I do not know” responses from Human Resources, Worker Compensation or your bosses.
- Keep a journal of what the people under your command are doing (ambulance, fire company, battalion or division) – especially the battlefield workarounds. Document the situation, what was done, what was said and who said it.
- The journal will also be important for the after-action report.
- The journal also provides the work-hour documentation needed when applying for federal reimbursement through the Stafford Act. Find a colleague that worked on a USAR deployment for guidance.
- Memorialize every accommodation and deviation from the published procedures and protocols in an email from your agency’s email system to the person that made the decision. Include a carbon copy (cc) or blind cc back to you. In the rapidly changing conditions, what was agreed to do about health coverage, injury compensation or quarantine arrangements on March 30th will be forgotten when the issue comes up for resolution months later.
5. Use multiple media to get the administrator’s message out.
Even during a crisis period, some emergency service members do not check their departmental emails or website. A short video is an excellent method to send updates and share your concerns with your team members that learn visually.
This 3:14 video from Virginia Beach EMS Chief Ed Brazle provided an excellent example:
This remains an unprecedented time in the world, possibly more disruptive than World War II in a much shorter timeline.
Be safe
Stay clean
Work smart
+++++++++++++
Jackson, B.A., Peterson, D.J., Bartis, J.T., LaTourette, T., Brahmakulam, I., Houser, A. & Sollinger, J. (2002) Protecting Emergency Responders: Lessons Learned from Terrorist Attacks (Conference Proceedings December 9-11, 2001, New York City). Santa Monica, CA: RAND Science and Technology Policy Institute. Accessed 3/29/2020: https://www.rand.org/content/dam/rand/pubs/conf_proceedings/2006/CF176.pdf
U.S. Department of Health and Human Services. (2005) A Guide to Managing Stress in Crisis Response Professions. DHHS Pub. No. SMA 4113. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Accessed 3/29/2020: https://store.samhsa.gov/product/guide-managing-stress-crisis-response-professions-2/sma05-4113
Bodin, Dan. (2018 August) The Effect of Energy Drinks in the Fire Service. Ann Arbor, MI: Fire Department Safety Officers Association. Accessed 3/29/2020: https://www.fdsoa.org/wp-content/uploads/2018/08/The-Effects-of-Energy-Drinks-1.pdf
Fire Department Safety Officers Association website: https://www.fdsoa.org/
Featured image: An FDNY medical worker wears personal protective equipment outside a COVID-19 testing site at Elmhurst Hospital Center on March 25 in New York.(John Minchillo/AP) https://www.nydailynews.com/coronavirus/ny-coronavirus-911-calls-spiral-out-of-control-20200327-jaioo6lmnvdcfeeg6lkfxexnua-story.html