Training

CPR and Zoll Auto Pulse

CPR 

CPR is a vital operation in the fire service.  Rapid quality CPR can literally mean the difference between life and death.  With that being said, once learned, CPR in itself is a simple task.  Often the most challenging part of CPR is moving the patient from where the arrest occurred to a location that quality CPR can be performed.  It is not unusual to find patient in the tight confines of a restroom, garage or workshop.  It is vitally important that the crew of 1st responders be able to quickly formulate a plan and efficiently move the patient to a location that quality CPR can take place.  In an operation where time is of the essence, every member of the responding crew should have a task, that when working in conjunction with the other members of the crew increases the speed and efficiency of the operation.  This task may include moving the patient, moving the furniture or clutter out of the way to make a path, or setting up the medical equipment so that CPR can be initiated as soon as the patient reaches the new location.

Zoll Auto Pulse

The Zoll Auto Pulse as with all equipment is only as good as the person operating it.  Every firefighter should be proficient with it's set-up and operation including changing bands and being able to trouble shoot minor problems.

The Zoll AutoPulse is an automated, portable, battery powered chest compressor which provides compressions as an adjunct to performing manual CPR.  Use of the AutoPulse is intended to reduce the impact of rescuer fatigue and will enable the rescuer to address additional patient needs.  

The AutoPulse provides thoracic compressions that distributes the compressive force throughout the thoracic cavity.  This results in a higher cardiac output than can be produced by manual compressions alone.  Higher cardiac output means more efficient oxygenation of tissues and thus higher survivability potential.

Emotionally a full arrest can be the most stressful call you will go on. Being comfortable operating all required equipment will reduce your stress level and increase pt survivability.

Auto Pulse Considerations

• Intended for adults 18 and over

• Chest circumference  range:  29.9”-51.2”

• Not intended for patients with traumatic injuries

• Start CPR IMMEDIATELY  when indicated

• Ensure that patient remains properly aligned while en route to the hospital

• Only place patient face up on the Auto Pulse Platform

• If system error occurs, immediately revert to manual CPR

MSA Altair 5X 4 Gas Monitor

The value of 4 Gas Monitor that we carry on our apparatus, like most tools, is directly related to the proficiency of the person operating it.  This week we will be developing a deeper understanding of the capabilities of the MSA Altair 5X 4 gas monitor that we use and equally important understanding what its limitations are.

The start up on the Altair 5X provides information about the devices settings and ensures that the all components are functioning properly.  Below we will be reviewing each of the start up screens and and develop an understanding of the information of the information they provide.

Start Up Screen

When the pump test screen comes up, pump must be blocked  to ensure that the pump is functioning properly.  Hold your finger over the pump until the pump test pass screen appears.

The monitor measures the concentration of 4 separate gas types.  It is important to understand how each of these measurements relate to the safety of the atmosphere in which we are working.

Combustable Gas is measured in percentage of LEL (lower explosive limit) it is important to remember this number does NOT represent the percentage of combustable gas in the ambient air but rather the percentage of the lower explosive limit of the combustable gas.

The percent of oxygen measures the total percent of Oxygen in the ambient air.

Carbon monoxide and Hydrogen Sulfide are both measured in parts per million

During the startup process the monitor displays the low alarm settings

*** It is important to remember that the normal percentage of oxygen in the ambient air is 20.8%.  If the percentage of O2 begins to drop, it means that the oxygen is being displace by another unknown gas.

As well as the high alarm settings

If the gas concentrations meet of exceeds the alarm set point the device will:

-Alarm message displays and flashes in combination with the corresponding gas concentration

-Back light turns on

-Alarm Sounds

-LED lights flash red

***If combustable gas exposure exceeds 100% of LEL the monitor enters a lock alarm and XXX will be displayed in the combustable gas category 

STEL (short term exposure limits) setting-displays the average exposure over a 15 minute period

Example:  If you are exposed to 35 ppm for 10 minutes and 5ppm for 5 minutes your short term exposure would equal 

25 ppm

TWA (Time Weighted Average)  The average exposure to a substance over an 8 hour period.  Generally speaking this function will be reserved for occupations that work in hazardous environments for long periods of time.  

The Fresh air set up screen provides the monitor with a baseline from which to compare the potentially hazardous environment which we have been called to monitor.  If you are not in a truly fresh air environment hit NO.  Hitting NO will revert the the monitor to it's previous fresh air set up and thus provide a true baseline.  

The sensors in the monitor are sensitive to changes in pressure, temperature, and humidity.  Going from a cold dry exterior environment to a warm and humid interior environment may effect the accuracy of the monitor readings.  Give the device time to adjust to the new environment before taking readings.  In addition, when monitoring an area move slowly.  It takes time for the air sample to move through the pump and reach the sensors.  If you are moving too quickly and the monitor alarms, you may be well past the problem area   Finally, remember the monitor is designed to warn us of a hazard before it becomes life threatening.  If the device alarms always error on the side of caution.  We carry a supply of air with us everywhere we go.  Use it.  

Masking Up

Masking up is a vital component of any fireground operation.  As such, EVERY firefighter should be an expert on doning their SCBA mask regardless of the environment that they are in.  Each individual should strive for a 10-20 sec mask-up time at the front door.  The only way to reach this level of proficiency is practice, practice and you guessed it...PRACTICE.  Each movement should be so engrained in your muscles that you don't even have to think about it, and every square centimeter of skin should be covered EVERY time with no loose straps.  This allows you to focus on the scene and able to observe any changing conditions that may alter your IAP.

Linked below is a short video of some considerations for masking-up.  Remember this is not the only way to mask up, when you are practicing, find the method that works best for you so that you get it right EVERY time.

Link: Mask Up Drill

The Why

When was the last time you sat down and asked yourself why you do this job?  What motivates you to get up in the middle of the night or jump up in the middle of dinner to fix someone else problem?  What burns inside you to make the sacrifices that most would not?

Over the last few weeks I have had the opportunity to sit down with a number of our firefighters and discuss their perspective on the fire service, their personal motivation, and leadership traits they value.  What I observed is that there was one common reoccurring theme that was universal across all ranks and experience levels.  People want to know “WHY?”  Just as it is vital for each of us to understand why we do this job so that we can keep the motivation inside of us burning, it is vital that every firefighter in this department understand the “WHY” for each task that they may be asked to accomplish on the fire ground. It is easy to teach people “what’ we do and “how” we do it but but simply teaching someone to go through the motions with no understanding of the objective is setting them up for failure if thing go sideways.  By having a full understanding of why we are doing our assigned task, each individual will feel that they are a crucial part of a bigger picture.  We are beginning each task with a sense of purpose and the end goal in mind.  If things don't go as planned this will allow us to adapt our technique and have a better chance of accomplishing the goal.  

Link:  "Why" We Train

For the new year we are starting off with a review of the basics

Link:  Hose Management #1

Link:  Hose Management #2

The expectation is that you get the nozzle and the first coupling to the door. Why? 50' is often what you will need inside the door to reach the seat of the fire. Also, if there is a step or a threshold at the door it will likely catch the coupling...with the coupling at the door you can make sure it passes that threshold as you enter. So whether you stretch a flat load, triple layer or minute man keep the end in mind...Nozzle and coupling at the door.

Link:  SCBA Drill

The Objective is to address and remedy several problems that may occur on an SCBA.  Firefighter should be  Proficient with recognizing and fixing each of the given problems before attempting this drill blacked out.

1. PASS device activated
2. Tangled straps
3. Bypass activated
4. Loose connection on bottle
5. Donning air pack