Uncategorized

Handling a Crewmember Injury or LODD

Issue 5 and Volume 3.

On July 19, 2007, I was awakened at home around 0500 hrs by a phone call from a fellow captain. It was the kind of call that all of us dread and none of us are ever fully prepared to receive. The captain informed me that three firefighters from my company had just been involved in a mayday at a working fire.

I immediately jumped out of bed and rushed to the scene. At that time of day, I was able to turn a 35-minute drive into a record-breaking 20-minute scramble, but during my trip, a number of thoughts came to mind:

  • Are they alive? If so, how serious are their injuries?
  • Have the families been notified?
  • I should’ve been there. That’s my crew. I shouldn’t have taken the night off.
  • It could’ve been me.

The Mayday

After arriving on scene, I met with the incident commander (IC) who gave me a quick recap of the incident and relevant information regarding the status and location of my crewmembers. There had been a mattress fire on the second floor of a single-family dwelling with one person reportedly trapped inside. As crews entered and attempted to ascend to the second floor, they were met with fire on the stairs. The stairs gave way, sending three firefighters into the basement. A mayday was called, and all three firefighters were evacuated from the structure by the rapid intervention group. Although the three sustained burns and injuries, they were alive.

From the incident scene, I went directly to the Washington Hospital Center Burn Unit where my guys were awaiting treatment. (A number of fire department chief officers were already present when I arrived.) The scope of the firefighters’ injuries ranged from second- and third-degree burns to torn ligaments. The good news: Two of the firefighters were released that same day; all three would live to see another day.

As I visited them at the hospital, their concern was more for each other than anything else. Although my presence was acknowledged and warranted as their captain, it didn’t matter to them who was there; they had formed a bond and a level of compassion for each other that only people who’ve survived a battle together can understand.

The Recovery

Over the next several weeks, my department allowed units to travel to Washington, D.C., daily to visit the third member, who was still recovering from the injuries sustained in the incident. With the support of my department and all of its available resources, as well as the support of my remaining shift members, I acted as a family liaison to my three firefighters, addressing any request for assistance so they could focus on recovery.

Assistance also came from neighboring jurisdictions and agencies. The D.C. Burn Foundation, in conjunction with the DCFD, funded dinner for the third firefighter during his first week’s stay in the hospital. The meals were prepared and delivered by DCFD companies in the area. The following week, dinner was provided and delivered on a rotating schedule by various stations within the Montgomery County Department of Fire and Rescue Service (MCFRS).

At press time, two of my firefighters are back to work while one is still on disability leave recovering from his injuries. None of their actions on the day of the mayday contributed to their injuries. Their only “mistake”: being on the scene of a fire started by an arsonist. To date, the culprit has not been captured.

None of us are ever truly prepared to deal with the injury or death of one of our own. Some of us have “dealt with it” by adopting an attitude of indifference, and some choose to ignore what is ever-present within our chosen vocation: the menace of injury or fatality.

The 2007 Report

In January, the U.S. Fire Administration (USFA) announced there were 115 on-duty firefighter fatalities in 2007. Firefighters were lost in 33 states, including Washington, D.C. South Carolina suffered the highest number of fatalities (due to the 9 lost in the Charleston tragedy), while Pennsylvania, New York, North Carolina and California each suffered more than five on-duty losses. The report does not include the countless near misses and career-ending injuries (traumatic or cardiac related) that also occur within our departments.

Although a large number of reported LODDs and injuries are preventable, we’re all still susceptible to critical injury simply due to the nature of our occupation. When these incidents occur, how do we conduct ourselves as company officers? How do we juggle our daily responsibilities as officers while providing aid to our shift members? Are our departments ready to support the needs of its members and their families?

Notification

Before an incident of a critical nature occurs, all departments must have a system of notification in place that involves three crucial steps:

  • The IC must immediately notify communications of the relevant circumstances involving the injury.
  • The communications supervisor must make an effort to notify, by phone or the alpha paging system, the chain of command, including the fire chief, division or deputy chiefs, the duty chief, the safety officer, the EMS officer, the battalion chief (if not already on the scene), the public information officer, the president of the local firefighters union (if applicable), the fire department chaplain and the volunteer chief or designee.
  • The duty chief or designee should then make every effort to contact the injured employee’s next of kin. To reduce family members’ stress and anxiety, the injured firefighter should be permitted to make the call, if possible.

The Family Liaison

Once the next of kin has been contacted, designate a family liaison who will do everything they can to meet family members’ needs. Although it’s strongly recommended that the family liaison be a command officer (because they will have the authority to make immediate decisions), this may be loosely interpreted based on individual circumstances. There may be a relative of the injured working in the department who has direct contact with the family, a senior member who has a close relationship with the injured’s family members or you, the company officer, who may be better suited to fill this role. Why? Because you are the shift leader, the first point of contact for both the injured firefighter and their family. As such, you should be able to provide tactful information, empathy and needed support.

Once a family liaison is established, their responsibilities should include coordination of the following:

• Transportation for the next of kin to and from the medical facility;

• Meals for the family and injured as needed;

• Babysitters for dependent children;

• Pet care;

• Household maintenance (lawn care, snow removal, leaf removal, mail pick-up, etc.)

• Completion of insurance claims, workers’ compensation claims and timesheets; and

• Dissemination of weekly reports through the chain of command regarding the condition of the injured firefighter.

Remember: Be careful not to publicize detailed health information about the injured firefighter. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has a Privacy Rule that takes patient confidentiality to a new level by giving patients the right to choose who sees their medical information. Patients may designate certain family members, friends or clergy members to be informed (or not) of their hospitalization.

In my role as family liaison, some of the tasks stated above were less essential than others. The two members who were released the day of the incident recovered at home. In their cases, administrative support was more of a concern than meals or transportation. For the member who faced the extended recovery period in and out of the hospital, comfort, transportation and household support were more immediate needs. Endless support from friends and fellow firefighters also sustained him during this difficult period.

System of Support

A far-reaching system of support must also be in place to provide assistance to family members and department members alike. The MCFRS has in place a behavioral health component of the wellness and fitness initiative established under the joint labor and management project, which was completed by the International Association of Fire Chiefs and the International Association of Fire Fighters.

One primary feature of this component is critical incident stress management, which provides stress management education, debriefings, defusings and demobilizations to departments facing an injury or death. The team provides one-on-one support for department personnel and their families at no cost in response to incidents of a critical nature or during other stressful periods.

Another component in the framework of our support system is Family Support Services. The purpose of this network is to acknowledge families and/or significant others in their role as the primary emotional support provider for their firefighter. It also provides peer support to MCFRS families through educational experiences that focus on the skills needed to cope with fire rescue work.

Conclusion

As company officers, the death or injury of a shift member is one of the worst experiences any of us can encounter. Even when following definitive safety practices during sound tactical procedures, the ultimate tragedy can sometimes occur. As officers we must remain strong for the rest of our shift members and for the families of the members involved. To do this, we must have the support and guidance of our department and its leadership, as well as reliable systems to help us cope with incidents of a traumatic nature.

Captain Derrick Anthony is a 19-year veteran of the Montgomery County Department of Fire and Rescue Services in Montgomery County, Md. He is currently assigned to Fire Station 18 in Kensington, Md. He has been a Maryland state certified Level II instructor through the Maryland Instructor Certification Review Board since 1997. He was previously assigned to the Montgomery County Public Safety Training Academy where he served for two years as the In Service Training Coordinator for the department.