firefight or by making many rescues. It didn’t
matter how the face piece was removed; the
end result was a near-fatal injury. I doubt that
he thought that he would be waking up at the
WHC for the next six weeks.
I visited this firefighter a few times early
in his stay. However, I would only step into
his hospital room to say hello to his family
members. I expressed my concerns for his
recovery and offered anything that our department could do to lessen their burden. The
burned firefighter was sedated and sleeping
during each early visit in preparation for several
upcoming skin graft surgeries. On my third
or fourth visit, the attending physician was in his hospital room.
Doctor Marion Jordan greeted me and indicated that he would
soon be extubating the young man so he would soon be able to
speak. Jordan allowed me to stick around and watch the process.
Always willing to learn, I made sure that I got a “front row”
seat to observe this procedure managed by one of the best burn
surgeons in our nation.
This routine procedure started off simple enough. Doctor Jordan
asked the attending nurse to wake the patient up to start the tube
removal process. She used a standard sternum rub followed by a few
soft blows to the cheek and a slightly raised voice calling his name.
In just 30 seconds or so, the firefighter was awake and starting to
get oriented. After a few minutes of Doctor Jordan chatting with
the man, giving him his medical status (likely he didn’t understand
much of it because of the deep sleep), the point was made that it
was time to remove the breathing tube. The doctor then described
the process and what actions the firefighter would need to take dur-
ing the procedure. One last bit of advice was provided to the injured
member. Paraphrasing Doctor Jordan’s words, “This will be difficult
at first. You will feel like you are in a fish bowl trying to breathe
underwater. It will take a little while for your body to start to
effectively get back to breathing on its own. Today we want you off
the ventilator. If you can’t get your breathing started back effectively,
With excited bright eyes and a thumbs up from the patient, we were
underway with the extubation procedure. As the tracheal tube was
withdrawn, a severe panic overwhelmed the firefighter. The confi-
dent thumbs up was replaced with arms waving to be reintubated. I
will never forget the pure fear and terror in the eyes
of this otherwise fearless warrior.
Looking back on what I will call a personal
significant emotional event, I wish that every fire-
fighter could have watched this procedure. How
horrifying to not be able to breathe on your own.
At about age 25, arguably in the best shape of his
life (minus the recent burn injury), but he could
not breathe without a vent machine. Once again,
if the face piece remained in place, this would have
been a much easier injury to manage. Although
painful, the skin graft surgery would have been only a few days in
the hospital with significant time for outpatient physical therapy.
Many weeks later, the firefighter was released to continue his
care from home. I watched the local news with great interest as
the media covered the story of him returning to duty about a year
later. Proper respiratory protection would have cut that time away
from the job by six to nine months. Wear your face piece!
FACE PIECE FAILURE
April 8, 2011, 1 was another one of the days that any fire chief
dreads. While operating at a house fire in northeast Washington,
DC, a burning room flashed over at about the same time the roof
started to collapse. The seasoned firefighters knew that they had to
evacuate the building. As the fire intensified, five members would
receive moderate to life threatening burn injuries. All members
were transported to The Burn Center at MedStar WHC. A few
would be treated and released from hospital care. A few were hospitalized for a short time for observation and treatment.
By far, the member who would need the most care was the
member who inhaled superheated smoke and gases. The burn
center professionals would once again be called on to save a firefighter’s life. This is a very interesting case study that would have
a significant impact in improving the requirements of an SCBA
face piece performance.
As the fire room began to flash over, it reached temperatures that
far exceeded the ability of the PPE ensemble and SCBA to protect
our member. After a few seconds of exposure to the extremely high
temperature, the injured member recalled his face piece started fog-
Chart 1: A sample training schedule that should be considered for adoption. (Table by author.)
Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1000 - 1200 Mayday Policy* Triage/MCI* Harassment Policies* Incident Command* Fire Apparatus* SCBA* Multi-Company
Lunch Time X X X X X X X
1330 - 1530 Training Division/ CO Training Division/ CO Training Division/ CO Training Division/ CO Training Division/ CO Training Division/ CO Free Afternoon
Night Drills As Required As Required As Required As Required As Required As Required As Required
of Daily Drills
policy and Mayday
along with tags
and other support
*Review all of the
functions of the
aerials, and sup-
while on com-
*Street drills with
at target hazard
Where possible, all company level drills need to be hands-on based on reaching baseline competency.
Drills prepared by the Training Division or company officer must focus on low-frequency/high-risk events as often as possible.
Other Duties Wash your hood
Always wear your face piece and your entire set
of PPE in the hazard zone. (Photo by DCFD staff.)