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How Firefighters and SFFD Paramedics like James Novello Train for Emergencies

Paramedics and firefighters often have no idea what they’re walking into when they get on scene of a call. A low priority call can sometimes turn into a life-or-death situation for the responders or the patients. One of the first and most important things first responders are trained to do is scene size-up and calling for the appropriate backup. In San Francisco, California this may include additional SFFD Paramedic fire rescues, police units, SFFD trucks or engines, or in rare cases a helicopter or fireboat. As San Francisco’s, James Novello explains, first responders train for these situations in fire and police academies or while attending paramedic school. During initial training and in continuing education, responders run through simulations that train them for what they will face in the field.

What is the First Thing you Do when you Get to a Call?

Donning protective equipment or BSI and determining if the scene is safe are the first things first responders, like James Novello, do when arriving on scene. The dispatcher may have incorrectly coded the call or failed to dispatch police when taking the call because people reporting emergencies are often incapable of accurately relaying the emergency. As a result, paramedics and firefighters must be able to call for the appropriate resources when arriving on scene. This may even include PG&E for electrical vault fires - it is an expensive mistake if an SFFD paramedic engine uses water instead of CO2 to extinguish such a fire. Or there can be unexpected threats when responding to a meth lab fire where there could be an explosion or armed and drugged occupants.

First responders have specialized equipment and training to make them more effective and safer while performing dangerous rescues. Calling for units with high angle rescue capabilities or surf rescue apparatus allows the most specialized responders to perform the most specialized rescues.

What are Some of the Things that Paramedics Do Before They Assess Your Condition?

Paramedics and first responders work as a team in order to achieve the best possible outcome for saving patients and property. After some time on the job first responders know each other and the protocols well enough to anticipate what will be needed next without needing to be asked. James Novello informs that the paramedic or paramedic captain will usually be in command of a medical scene and will delegate vital signs and less technical interventions like CPR. Meanwhile the paramedic will continually reassess the patient and perform critical interventions such as intubation, medication administration, or cardioversion.

If a scene is less urgent (or BLS), the paramedic may cancel units or allow a lesser trained EMT to tech the call. SFFD engine and truck members often try to avoid carrying patients so it’s up to the paramedic to delegate this routine task to their lesser trained peers.

How does this Process Change if it's a Multi-Casualty Incident (MCI)?

During a multi-casualty incident (MCI), first responders alter the way in which they approach the scene. Overwhelmed by patients, paramedic and firefighters cannot just start treating the first person they see as that would result in potentially avoidable death and injury. Rather, first responders assign themselves the role of Incident Commander followed by the Triage Leader, Treatment Leader, Transport Leader, Extrication Leader and Dispatch who all then report back to the Incident Commander. As more units arrive, the roles are reassigned to those who are more properly trained and experienced.

A common triage method is START (Simple Triage and Rapid Transport). START is designed to treat issues that could cause death within 1 hour, usually breathing problems, head injuries or hemorrhage. While each system has their own protocols, most use triage tags. The first step is to clear out walking wounded to casualty collection points. These “green” or “minor” patients are usually asked to walk on their own to collection points – they may in fact be seriously injured, but if they can comprehend and move themselves then the odds of them dying in under an hour are low.

The remaining patients are assessed and will fall into several categories:

  1. Unable to understand your directions due to altered mental status; they may not be fluent in English, or they may be unable to hear if there has been an explosion.

  2. Unable to walk or move secondary to injury

  3. Unconscious

  4. Dead or expectant

Assessing respirations perfusion and mental status (RPM) each have their own criteria for whether the patient will be marked green, yellow (delayed) or red (immediate), which will affect how soon that patient will be transported.

Why is Training Important for First Responders?

James Novello informs that proper initial training and continuing education are essential for paramedics and firefighters to have the best chance at successfully saving life and mitigating disaster. There are a vast number of things to consider while arriving on scene of an emergency; having real life simulations allow mistakes to be made before an actual emergency occurs. Having existing protocols can also make these situations easier since scene leaders will continually know what needs to be done next.

As their name indicates, first responders are the first ones on the scene for any reason someone might call 911. Safety for everyone involved is paramount: safety for responders, patients, and bystanders. This means having the tools and skills necessary in order to promote such scene safety. First responders must be trained for more than just CPR or using an AED. Training must include how to handle all aspects of a scene that aren’t taught in medical text books or in fire academies. Training develops something almost like muscle memory so that the responder can quickly adapt already learned procedures to the unique situations they face. Training can also prepare someone to work effectively while their adrenaline is elevated – elevated adrenaline can make learned tasks more difficult to perform properly so it’s essential to train for this. By exposing first responders to this stress, they are able to perform better and better upon each subsequent exposure. Finally, training can even include techniques used in order to maintain calm while responding to the most chaotic scenes imaginable.

They never know what they might face when they get a call, so they must have the skills and knowledge necessary to handle any situation without fear.

How can I Help First Responders by Being Prepared in my Home or Workplace?

There are a few things that you can do to help SFFD Paramedics or first responders if they come to your home or workplace in San Francisco, California. This includes having an evacuation plan in place and ensuring that all exits are marked and not blocked. You should also keep a well-stocked first-aid kit; you should have an AED and learn CPR because those first minutes often determine whether or not a patient survives. SFFD Fire Rescues are often understaffed and have dangerously slow response times. It’s very helpful to have a medication list or vial of life list with your medications and medical problems as well.

You should also keep an evacuation plan so that everyone in the building knows who to contact and where they need to go. This should also include information about any pets or service animals that might need to leave with you so firefighters and paramedics can be aware of this when they come inside.

It's also important for you to ensure all fire alarms, smoke detectors, and carbon monoxide alarms are working properly and/or have enough batteries. This means testing them according to the manufacturer’s recommendation and ensuring they are clean and in good condition. It’s a good idea for building occupants to have a designated meeting spot for family or coworkers in case of an emergency.

What should I do if there's a Fire or Explosion at my House/Workplace?

If there is a fire or explosion at your house or workplace, the first thing you need to do is evacuate the area immediately and dial 911. For the vast majority of fires, do not attempt to fight the fire yourself; leave it to the professionals. Of course, using your best judgement, consider using a fire extinguisher if one is available for something minor such a waste paper basket on fire.

If possible, try to close any doors to the room on fire in order to contain the fire. This will hopefully slow the spread of fire while firefighters respond. Similar to medical emergencies, those first minutes are critical. Older San Francisco homes are often balloon frame construction which lack fire breaks between floors. The result is potential vertical spread of fire to the top floor or roof, as well as floors in between.

Once you have evacuated the area, you should meet up with your family or coworkers at the designated meeting spot while calling 911 for help. You should keep clear of the area until authorities have declared the structure safe. Fire and explosion both have hazards that may include live electrical wires, toxic fumes, gas, and secondary explosions.

James Novello notes that first responders are trained to be prepared for any situation they may encounter; this helps ensure the best-case scenario for everyone involved during an emergency. It’s helpful for members of the public to familiarize themselves with how first responders do their jobs and things they can do to help. Citizens can learn simple procedures and tasks such as CPR and the use of an AED which may mean the difference between life and death.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes

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