In the fire service, we know the value of pre-fire planning and the positive influence it has on the outcome for emergency incidents. And that same proactive behavior by the company officer can greatly aid your department in the event of a serious firefighter line of duty injury (LODI).
Firefighters, particularly our younger members, tend to have an aura of invincibility. They also believe they will live forever. Both are fantasies.
Figuring out who can or can’t make medical and legal decisions for an injured firefighter should not be something that needs to happen following a LODI.
Preparation starts with the individual firefighters and officers.
Every member of the organization, regardless of age, should have these four legal documents properly executed, in place and readily available to their family. According to Care Diary, the four main documents are health care proxy, living wills, power of attorney and last will and testament.
Health care proxy and medical power of attorney are used interchangeably and is a legal document that allows a designated individual to make health care decisions on your behalf in the event that you are unable to.
Health care proxies are permitted in 49 states as well as the District of Columbia. In most states, the document must be witnessed or notarized.
Emergency information
A living will is a legal document that instructs health care providers about your wishes regarding medical procedures should you become incapacitated. Those instructions include medical interventions such as resuscitation, mechanical ventilation, nutritional assistance and hydration, dialysis and other life-support measures.
A power of attorney allows another person the right to make certain critical financial (including insurance) and legal decisions for a person whose capacity to make such decisions has been impaired.
A last will and testament allows you to control how your estate will be distributed should you die. It also enables you to appoint a guardian for your minor children as well as provide instructions and set aside funds for pets.
At my former organization, the Chesterfield County (Va.) Fire and EMS Department, every member in operations carries a personal information card inside the crown of their helmet. The card lists the following information for the member.
- Name and address.
- Name and phone number for their emergency contact.
- Blood type.
- Religion.
- Known medical history.
- Known allergies and medications being taken.
- Preferred hospital.
The company officer is responsible for ensuring that each member’s contact card is current or updated every six months. The company officer also must ensure that the member’s driver’s license is current as they may be required to drive fire apparatus and ambulances.
Post-incident actions
The company officer must maintain their supervisory role for their injured firefighter throughout their transfer from the scene to the medical care facility. It’s your firefighter who’s on the way to the hospital and you should make every effort to be aboard that ambulance.
The fire service is a tight-knit community, and the company officer is the best person to notify the injured firefighter’s emergency contact person by telephone. It will also benefit the spouse or significant other to know exactly where to go at the hospital and to see a familiar face when they arrive.
I previously wrote of our need to be properly prepared to provide emergency medical care for the rescued and injured firefighter. I encourage you to read that piece if you have not.
That’s because in addition to a firefighter who may need lifesaving medical intervention, such an event is also a workplace injury site if the firefighter survives, or the site of a line-of-duty death if the firefighter succumbs to his or her injuries.
Firefighters and EMS providers alike must be trained and prepared to manage the scene for both medical intervention and evidence preservation.
Scene security
Every fire and EMS department should have a Standard Operating Guide in place for the aftermath of a firefighter LODI. It must detail the actions that are taken, or not taken, immediately after the injured firefighter is en route to the hospital.
Those actions can have a positive or negative impact on workers’ compensation claims, insurance claims or later litigation. Company and command officers on scene must also do these six things.
- Secure the scene to make sure nothing is unnecessarily disturbed and remove all nonessential personnel.
- Impound all safety equipment that was used by the injured firefighter, including SCBA, PASS device, radio, turnout gear, helmet and gloves. These items may need to be sent for testing.
- Document how and where all of the firefighter’s equipment was found, the condition of the equipment and any damages.
- Record video and still pictures for the site of the LODI.
- Complete a detailed drawing of the scene to include vehicle locations, equipment and hose line placement, and the position and location of the injured firefighter.
- Document the weather conditions at the time of the incident.
These are the absolute minimum actions that need to take place.
The department’s SOG should include further actions to be taken including getting recorded and written statements from all personnel on the scene; getting audio recordings and written transcripts for all radio traffic for the incident, getting records of the medical care provided to the injured firefighter by EMS personnel and getting records of the medical care provided at the hospital.
A great resource for more information on investigating a firefighter LODI is the Fire Fighter Line-of-Duty Death and Injury Investigations Manual published by the International Association of Fire Fighters.
Try as we might, fire officers cannot prevent every line-of-duty death or injury. Yet with thorough, well thought-out planning they can minimize the problems after the incident.
