Holmatro's single-line rescue system proves faster & easier than two-line systems
By Travis Kidd
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CORE Technology Lines
Pros
+ Faster tool deployment;
+ Safer for firefighters in the action circle; and
+ Lightweight.
Cons
- Slightly more expensive than two-line systems.
Holmatro Inc.
505 McCormick Dr.
Glen Burnie, MD 21061
Tel: 410/768-9662
Web: www.holmatro-usa.com |
The golden hour is one standard by which we gauge our success on the extrication scene. If we can get patients to the operating room in under an hour, their chances of survival greatly increase. But, as one great lieutenant once put it, "Sometimes the golden hour is 10 minutes."
The point: Time is critical to extrication. Anything we do to decrease time spent on scene provides a more positive outcome for the patient. There are several things we can do to accomplish this, one of which involves utilizing the right equipment. Our equipment must be powerful, fast and, above all, safe. The new CORE technology package from Holmatro Rescue Equipment accomplishes all three.
CORE stands for "co-axial rescue equipment," which refers to the system's complete design, from the pump to the end of the tool. The system features hoses and couplings with a high-pressure line surrounded by a low-pressure return line. According to Holmatro, this configuration makes using the equipment faster, easier and safer than before because it decreases the equipment's weight.
Safety seems to be the buzzword in the fire service today, so any tool that keeps us safer is worth taking a hard look at. With the CORE technology lines, it all comes down to the hoses and the power unit. The high-pressure line is contained within the outer hose, which prevents the high-pressure fluid from reaching us should a tear develop in any part of the line. A switch inside the power unit converts the high-pressure mode to low-pressure (first-stage) mode, allowing a maximum of only 363 psi to ever come in contact with a rescue worker.
PHOTO COURTESY HOLMATRO
The CORE system features a power unit, hoses and couplings with a high-pressure line surrounded by a low-pressure return line, which makes using the equipment faster, easier and safer than before. |
Due to the couplings attached to the hose, the power unit itself doesn't feature any dump valves. This eliminates any confusion as to which tool is operating on the extrication scene. Once the power unit is running, all lines attached to it are in operation. The hoses themselves feature an incorporated safety ratio of 4:1. Constructed of Kevlar, they are reinforced, but not with steel wires, as seen in two-line systems. The hoses are also highly flexible due to their construction, and they're 40 percent lighter than their steel-reinforced counterparts.
My test of this product turned into a showdown between the current technology of a two-line system versus the new one-line CORE technology system. Because time is critical on the extrication scene, I wanted to find out just how much faster the CORE system really was compared to a two-line system. Starting at the pump, I plugged the male end into the power unit and the female end into the spreaders. (Indicators on the hoses dictate which end goes where so there's no confusion.) Once connected, I picked up the spreaders and simply walked away. As soon as I began walking, the couplers on either end began to spin freely due to their 360-degree free-spin design, which allowed the hose to unravel itself. So is the CORE faster? You bet. Simple math dictates that you only have to connect one hose on each end instead of two, and with the 360-degree free-spinning couplings, I didn't have to stretch the line out to the tool to unravel it as I would with a traditional two-line system.
PHOTOS STEVE KIDD
Indicators dictate which direction to push the coupler for release. |
Universal connections allow one hose to power every tool. |
Not only was the CORE system faster, it was also easier to deploy and utilize compared with a two-line system, because, as mentioned above, I made only half the connections and simply walked away with the tool.
After this first test, I put a tool into operation, disconnected it and then reapplied the CORE line back into the tool. The task was a breeze, confirming my assumption that it's easy to use the CORE lines on different tools while on the extrication scene.
Holmatro offers several power unit models compatible with the CORE technology. The latest power unit is the DPU31, which comes standard with the CORE couplings and hoses. Older models featuring traditional two-line couplings will be phased out as newer units come standard with the new technology. Certain models can also be retrofitted with the CORE technology if a department wishes to upgrade its power unit. Fixed systems on apparatus aren't available yet, but the company is in the process of developing one.
Cost for the CORE hoses is roughly $100 more for a 32' section of hose, making it a good deal for the money spent.
Travis Kidd has been a firefighter/EMT with the Orange County (Fla.) Fire Department for the past six years, and is currently assigned to Rescue 40.
Quick Thinking
Fire department's ingenuity leads to successful trampoline extrication
By Jerry Varnes and Paul Messner
In August 2005, Hudson (Ohio) Emergency Medical Service responded to a call at about 1803 HRS involving an adult male injured on a trampoline at a private residence. The victim had attempted to perform a flip while using the trampoline, landed awkwardly on his neck and subsequently became unable to move.
PHOTOS BRUCE GRAHAM
A backyard trampoline requires creative problem solving when extricating the patient. |
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Rescuers log-rolled the patient onto a backboard where he was immobilized, reassessed and packaged for transport.
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Size-Up & Patient Assessment
Upon arrival, Hudson EMS paramedic Dave Enzman assumed EMS control. The crew quickly conducted a scene size-up and patient assessment.
Personnel found the patient on a 15' diameter trampoline located on a flat grass surface. The trampoline's mat was elevated approximately three feet off the ground. The victim was lying prone from the waist down and partially on his left side from the waist up. His neck was flexed forward and rotated to the right. The patient's head rested approximately 3 feet from the trampoline's outer edge, and his feet were near the center. The patient was conscious and breathing, complaining only of a sore neck.
Upon examination, responders discovered the patient had no movement or sensation in any of his extremities. Paramedics suspected the victim had sustained a traumatic spinal injury; therefore, they initiated manual C-spine control and immediately called a medical transport helicopter to the scene. Personnel also called the Hudson (Ohio) Fire Department (HFD) to the scene to set up a landing zone. HFD Duty Officer Lt. Paul Messner arrived and assumed command of the scene at 1811 HRS. He then requested an engine to set up the landing zone and called a heavy-rescue unit to the scene for extrication.
The patient's weight deflected the trampoline's surface downward approximately 18 inches. Any pressure applied by rescuers to the surface would cause unwanted patient movement. The challenge became clear: How would rescuers access, immobilize and extricate the patient without moving the trampoline's surface?
Going Up?
HFD Assistant Chief Jerry Varnes arrived on scene at 1815 HRS and met with Command. Fire and EMS personnel then developed a plan to create an "improvised patient elevator." The plan called for rescuers to place a backboard under the trampoline to elevate the patient to the level position using rescue air bags atop two box cribs. This would create a stable, level surface under the patient. Assistant Chief Varnes was assigned to execute the plan while Lt. Messner retained command.
The HFD's heavy-rescue unit arrived at 1821 HRS staffed by four firefighters. Equipment was quickly staged, and construction of the "patient elevator" began. Firefighters built two 18" square box cribs roughly 3 feet apart under the trampoline using 4 x 4 and 2 x 4 cribbing. The tops of the box cribs sat 21 inches off the ground. On top of each box crib, firefighters placed a 24" x 24" air bag typically used for auto extrication and then placed a backboard across the tops of the air bags.
Two cribbing towers, air bags and a backboard are placed beneath the markedly sagging trampoline canvas to elevate and stabilize the patient prior to further immobilization. |
Post air bag inflation, the patient is elevated to a non-sagging, horizontal position, with the canvas stabilized to minimize bouncing and motion. |
At 1833
HRS, after coordinating with EMS, Assistant Chief Varnes simultaneously inflated the air bags using a standard SCBA bottle attached to a regulator control unit, slowly lifting the backboard and the patient to a stable, level position. Rescuers then log-rolled the patient onto a backboard where he was immobilized, reassessed and packaged for transport. The Life Flight medical transport crew arrived on scene moments later, flying the patient to the Level 1 Trauma Center at Akron General Medical Center.
The initial injury caused a cervical fracture with quadriplegia. The efforts of the HFD and Hudson EMS resulted in successful immobilization of the patient without worsening the patient's condition or injury. After a difficult hospital stay, complicated by pneumonia, blood clots and cardiac arrest, the patient is now residing at a spinal cord rehabilitation unit in Cleveland, Ohio.
Teamwork Illustrated
The good news: The HFD accomplished extrication within 14 minutes of the heavy-rescue unit's arrival on scene. Everyone involved in this unique rescue felt it was an excellent example of teamwork, creative thinking and safe execution of training.
Both Hudson EMS and the HFD also discussed lessons learned from this incident, acknowledging the need for early recognition of a potential cervical spine injury, as well as the need to think outside the box and adapt existing rescue techniques and equipment for non-traditional applications.
The HFD is a 38-member combination department staffed predominately by volunteers. Hudson EMS is a separate 72-member combination department also staffed predominately by volunteers. Both departments serve Hudson's 22,439 residents located within a 25-square-mile suburban area.
Assistant Chief Jerry Varnes is a 28-year veteran of the Hudson Fire Department. He also is a 10-year fire medic with the Twinsburg Fire Department.
Lt. Paul Messner is a 15-year volunteer member of the Hudson Fire Department. He is employed as a special agent with the FBI.
SharedConcerns
IAFC survey concludes most departments share the same challenges
By Jane Jerrard
What are the major challenges your department faces these days? If your answer includes staffing, funding and/or increased demands for service, take some comfort in knowing you're not alone. Fire chiefs across the country named these the top three issues in the International Association of Fire Chiefs' (IAFC) 2005 Challenges Survey.
The IAFC e-mailed the survey to a large section of its members in November 2005. "We sent the survey to over 10,000 members we had e-mail addresses for," explains IAFC President Bill Killen, "and we got just under 1,300 responses." Of those responses, 61 percent said staffing was a concern, 55 percent said funding was an issue, and 23 percent said increased demands for service were a problem. These results confirm what the IAFC has been hearing anecdotally. "[These three issues] continue to plague fire departments of all types and sizes," Killen says.
ILLUSTRATION COURTESY IAFC |
Ask, Then Act
After the IAFC compiled the Challenge Survey results, it began working to address the three challenges through education and lobbying, as it did with the previous survey. "We asked for the same information in 2004, and we used the responses to help members address their biggest challenges," Killen says.
"One of the first things we're looking at is the issue of recruiting and maintaining qualified staff," Killen continues. "The IAFC's human resources committee just met in Washington, D.C., to discuss this, and its program will be reviewed by the board of directors. It includes a strong focus on minorities, [regarding] both gender and ethnicity."
In addition to the human resources program in the works, the IAFC has constructed what Killen calls "a very aggressive program" for the year ahead. The organization is sending speakers to various fire shows to present sessions and workshops that address the issues identified in the survey. "We've planned ‘Challenge Roundtables' at Fire-Rescue International, Sept. 14–16, in Dallas," Killen says, "where attendees can join discussions at a roundtable that specifically address the challenges raised in the survey. They can share ideas on what's worked in their department and get solutions they can implement at home."
Killen and the IAFC are also planning a series of articles on challenge subjects for the IAFC newsletter and soon-to-be-released books on fire leadership. "And as always, we're very heavily involved in working with Congress and the federal government on these issues," Killen says. "We've been talking about support of the FIRE Act and the SAFER Act." Grants provided by the FIRE Act help departments acquire tools and resources; funds from the SAFER Act help departments hire firefighters and recruit and retain volunteers. "Both are very valuable to what we're doing," Killen adds.
What the Future Holds
With two member surveys under its belt in the past two years, the IAFC has enough information to take it through 2006. "It's too soon to say if we'll repeat the survey every year, but we'll continue to do surveys as often as we need to in order to see what the problems are," Killen says. "We will be comparing responses to the [first] two surveys."
You can download a report containing the results of the 2005 Challenges Survey by visiting the IAFC's Web site at www.iafc.org/associations/4685/files/2005_ChallengesSurvey_Results.pdf.
Catch Some Zs
An in-depth look at one solution to snoring
By Jane Jerrard
Getting enough sleep is crucial to overall health. For firefighters, sleep doesn't just provide health benefits, it ensures a level of alertness essential to the profession. The right amount of sleep can mean the difference between life and death at a fire scene, which is why snoring in the bunkroom can be a big problem not just for the snorer, but for an entire shift of firefighters.
The Pillar System
To combat loud snoring or sleep apnea, firefighters might consider a controversial new outpatient surgical procedure that involves inserting three small (18 mm in length) polyester braids, called the pillar palatal implant system, into the back of the throat. The braids reduce the flapping of the soft palate, which is responsible for the chainsaw-like sound of snoring. The braids also reduce sleep apnea by keeping the airway open.
As of November 2005, the pillar procedure had been performed on roughly 9,000 Americans and 1,000 patients in Europe and Hong Kong. Restore Medical, the company that patented the treatment, reports that as many as 75 percent of patients and 90 percent of their bed partners reported decreased snoring after the surgery.
Surgery Under Suspicion
The Food and Drug Administration (FDA) approved the pillar procedure for snoring in 2003 and again in 2004 for mild to moderate sleep apnea. According to the FDA, "The system has been clinically evaluated in support of expanding the current snoring indication to include the treatment of patients with OSA [obstructive sleep apnea]. The clinical results were compared to the clinical results of other products which have an indication for the treatment of OSA."
However, the American Academy of Sleep Medicine (AASM) believes the FDA acted prematurely, saying the clinical trials weren't comprehensive enough. "The studies done on this procedure were funded by the manufacturer — a common thing among pharmaceutical companies," says Alex Chediak, MD, of the AASM. "And the number of patients in these studies [is small] compared to studies of other procedures for snoring. I think the science is weak, and I don't feel comfortable recommending the procedure to my patients."
Dr. Chediak's main concern: treating obstructive sleep apnea. "[The procedure] may turn a noisy, potentially dangerous condition — snoring — into a silent but still dangerous condition," he says.
Food for Thought
If you or someone on your shift is a loud snorer, the pillar procedure might be worth looking into, but others might prefer more proven methods, such as changing sleep position. "When I sleep on my back, I test at 36 [the highest end of the scale] for sleep apnea," says Dr. Chediak. "When I sleep on my side or my stomach, my score drops to zero."
Clean Sweep
Washington department fights fire, litterbugs
By Lynn Johnson
PHOTOS LYNN JOHNSON
These eight SKFR firefighters took part in the trash collection. Bonnie Shamion is in the front row, left. Standing on the far left is Kitsap County representative Kevin Bevelhimer. |
SKFR Lieutenant Ron Powers leads part of the pickup crew. |
For about 1 1⁄ 2 years, firefighter/paramedic Bonnie Shamion had been searching for a new type of community involvement for South Kitsap (Wash.) Fire and Rescue (SKFR). "I wanted something that would make a very visible improvement in a neighborhood," she explains. She then noticed some unsightly rubbish along the streets in a residential area around SKFR's headquarters, so she called the county road department to inquire about the possibility of involving SKFR in a clean-up program.
Coincidentally, Dave Peters, the county recycling coordinator, was also planning a program to partner the county with area residents and businesses to keep streets free of litter. The result: SKFR adopted a two-mile long road that loops through the headquarters' neighborhood.
SKFR is a combination urban/rural fire department with 16 stations covering 83,000 residents spread over 150 square miles. With a resource like this, Bonnie had no trouble convincing seven other firefighters to donate their time to help with the clean up. On Dec. 5, county representative Kevin Bevelhimer supplied the crew with equipment and gave some safety instructions. The gang, many of whom had just come off shift, split into two groups, each going the opposite way around the two-mile loop while facing traffic.
Both groups had great success. The refuse they collected filled 17 large trash bags. Included in this haul: a syringe, a crack pipe and some pornography. Collecting these items was especially important because the region contains two schools. Any sharps, broken glass, chemicals, etc., were flagged for pick-up by Bevelhimer, who later disposed of the sharps and chemicals at a local hazardous waste disposal center; he disposed of the glass personally, for safety reasons.
"It was a great idea to have the community see members of the fire department take such an interest in keeping the neighborhood looking nice," Shamion says. Peters was also pleased to see the location get a good cleaning. "The group seemed to be very happy with what they were accomplishing," he says.
The firefighters who performed this clean up look forward to repeating it about every 6 months.
Lynn Johnson is a volunteer photographer for South Kitsap Fire and Rescue. He previously worked as a volunteer firefighter for several years in both Washington and Oregon.
Company Officers Speak Out
When you were promoted to company officer, did others in your company perceive or treat you differently?
I think some guys might be a little jealous [of your promotion] if they have the same amount of years in as you do. In fact, when I made lieutenant, I was working with two guys who probably had 20 years more than me, so I had to walk softly. I've also worked with some older guys who were resentful of my position, and they'd do little things to make my job more difficult. You can't just come in and start barking out orders. You have to earn their respect; respect isn't just given. Hopefully others respect you before you get promoted. But it takes a couple of months for everyone to get used to everyone else.
Don't come out like gangbusters. Be fair, but remember, you're the boss. Some guys may be older than you, but you have to get along. You can't let someone walk over you once, because if you let them get away with it, they'll do it all the time. I say, "Hey, these are the rules; they are what we have to go by." Some guys bluff you to see how far they can get. Just be fair, have a meeting with them. Sit down and explain responsibilities, and make some kind of game plan from there.
Pittsfield, Mass.
There are a lot of different ways to answer this. We get moved to a different shift, a different world, and work with people we might have dealt with at one level or another in our past. Basically, you gain respect from the standpoint that you can function and do well. In my experience, the people I was responsible for worked in a double company — an engine and a ladder company. The guys tried to figure out how I would handle them in different situations. And one actually approached me and made the comment, "If you work with me, I'll work with you." And of course, my comment to that was, "I'm actually in charge; I have a responsibility to you people to see we do our jobs safely and efficiently." This guy had more time on the job than I, he had never been promoted, and he had a bit of self-imposed bitterness, because the system didn't work in his favor, in his perception. That was a challenge.
But my personality isn't to become hardnosed. I say, "We work together; we're a team. If we don't develop that team strategy between ourselves and the group, then we're not going to function appropriately." We need to ensure we identify what our real mission is here, talk about it and work as a team. We can't have disharmony or these feelings that I'm less [of a] senior [member] but in a promoted position. There are always some challenges when you reach a position of authority. I respect people who have time on me, but there are things I'm responsible for, people I hold accountable for certain things, and I make that very clear.
Madison, Wis.
No question, things change once you're promoted, especially if you're younger than others with more time on the job. But not everyone is ready or willing to be promoted, so that's just the way things go. You have to walk cautiously and watch each step until the guys know you. There are individuals who were jerks when they were firefighters, and they'll be jerks as lieutenants. Don't be a jerk. You have to be careful and show the team why you're worthy of their respect. Most guys [handled my promotion] pretty well.
But I don't think there's any question people had trouble with my actions or what I did, but after each event, I'd sit with my crew and talk it over. That's part of the management, part of what you should do as a lieutenant. You need to have good communications with your crew. Once you establish that, things become comfortable, and then you develop things from there.
Evansville, Ind.
In the 11 years I was a firefighter before I got promoted, the guys all called me by my first name. After becoming an officer, you don't want to be called by your first name, especially in public; you want to be called Lieutenant or Chief, or whatever. If you're working with someone of equal rank, or someone you've worked with for 20 years, that's different. Asking guys who have known you for a while to change this seemingly small, but ultimately important thing can be painful. But it's got to be done. If your guys respect you and respect what you do, they'll make the change, and they'll pretty much do whatever you ask of them.
Saginaw, Mich.
NIOSH: Line-of-Duty Death Report
Forest ranger/firefighter drowns after tire blows out
PHOTO COURTESY NIOSH
The vehicle left the road, struck a culvert and overturned, coming to rest on its roof in a ditch filled with approximately 2 feet of water. |
SUMMARY
On March 3, 2004, a 40-year-old male forest ranger died after he lost control of the brush truck he was driving to a controlled burn. The truck experienced a catastrophic blowout of the right front tire. The vehicle then left the road, struck a culvert and overturned, coming to rest on its roof in a ditch filled with approximately 2 feet of water. The victim was pronounced dead at the scene.
CAUSE OF DEATH
The medical examiner listed the cause of death as drowning with no evidence of trauma-related injuries. The victim had no known pre-existing medical conditions, and his post-crash blood alcohol content and drug screening tests were negative.
RECOMMENDATIONS
- Fire departments should provide driver training as often as necessary to meet the requirements of NFPA 1451. Training should incorporate specifics on maintaining vehicle control when a rapid loss of tire pressure (blowout) occurs.
- Fire departments should, as part of the apparatus maintenance program, ascertain the age of tires, and impose time restrictions for usage according to manufacturers' specifications and guidelines.
- Although it's unclear if the following contributed to this incident, fire management agencies and fire departments should consider implementing the recommendation listed below based on prudent safety considerations.
- Ensure that vehicles meet the requirements of NFPA 1901 and NFPA 1906 and do not exceed their load-carrying capacity.
