Category Archives: HazMat

Overheard on the radio

“Control to Engine 40…”

“Engine 40 go.”

“Engine 40 be advised there is a reported blockage, we’re upgrading this to a haz mat, stand by…”

“Units dispatched, Engine 36 on Haz Mat 1, Rescue Squad 1, Rescue Squad 2, Engine 19, Engine 40, Truck 19, Battalion 8, RC2, Medic 99, Medic 77, Medic 54 for the Haz Mat…units stand by…”

“Control, this is Engine 40, we’re on scene you can cancel that haz mat response.”

“Units responding to the haz mat, cancel…”

“Control, Engine 40, we have a woman reporting a long line at the checkout stand at the grocery store.  That’s your blockage.  Cancel this and send me PD please.”

“Copy Engine 40, do you need them code 3?”

I’m guessing not.

It’s burning my retinas!

We have all trained, at one time or another, to respond to a chemical release at a local swimming pool.  They keep enough chemicals on hand to cause quite the trouble, but how can I explain that to a mother who feels wronged?  By writing…a lot.

 

THE EMERGENCY

Dispatchers have hit the panic button on a full HazMat response to the local indoor pool.

 

THE ACTION

My ambulance is the first of 3 responding as well as a complete first alarm assignment, HazMat, etc etc.  We arrive first and are met in the street by a number of lifeguards waving their arms.  In their little red shorts they look almost like valet parking attendants having a really slow night.

As I roll down the window ever so slightly we are given the initial report of the situation:

“It’s only a couple of kids, there is no chemical release, their eyes sting after a swim lesson is all, the mom wants them to…”

and then he said it.  He said the line that gets my blood boiling.  The line I hear from the bulk of my clients and patients alike.  A line so innocent, but when taken to it’s logical conclusion is never followed through with.  The line I hope to actually act on in the near future.

“…get checked out.”

grrrrrrrr…

I cancel the bulk of the alarm, keeping the HazMat Battalion coming, just in case, and enter the pool where close to 100 people are still swimming and playing without problem.  In the back office a mother is sitting with her 2 children and their friends.

“They got out of the pool and were screaming and rubbing their eyes, I want it documented that this facility is using dangerous chemicals in the pool water.”

I introduced myself and went about my assessments while casually mentioning to the Manager to bring me the MSDS.  For those not in the know, anywhere there are chemicals known to possibly cause harm, there are Material Safety Data Sheets (MSDS) which describe the chemicals, how to treat a person exposed to them and who to call for more information.  It’s that giant binder crammed onto the top shelf in the janitor’s closet.

As he returns with the binder we flip to the chemicals used in the pool.  I have Mom read, partially as a distraction, while I talk more with the assorted children who are more interested with my partner’s phone than their “burning eyes.”

I already knew, as you do, why their eyes sting.  We all learn that lesson early on.

As Mom refused to accept the reality that the chlorine in the pool actually belongs there, she reminded me I am not a Doctor and that she wanted her children…

and this is where the encounter should end.  Me informing the Mom of exactly what is happening, her digesting the information and making an informed decision, based on my professional medical opinion and diagnosis.  But, who am I kidding…

“…checked out.”

My reminders that I had just completed the exam she had requested and that if further evaluation is requested a private vehicle would be more than appropriate went unheard, even unlooked at. She has turned her face away from me like one of her children would do. Then she reminded me I am there for her.  She never mentioned the kids.

We loaded up all 6 in seatbelts with Mom on the cot holding the youngest.  Then I documented all 6 patient encounters since she was convinced her lawsuit against the pool was a winner.

Good luck with that.  I’d love the get called to the stand on that one.  Too bad no lawyer will stop laughing long enough to file it.

 

Alert for the Haz Mat Incident

Our engine boss is cramming for the Captain’s exam when the bells ring for a call at the golf course.  A HazMat at the golf course.  This could be interesting…

THE EMERGENCY

Multiple calls for multiple sick persons, unknown cause.

 

THE ACTION

There are a few things we look for on the way to these types of calls, right?  There was no smoke, or cloud, and we approach from upwind, despite the requests from local law enforcement to pull up to the main entrance with him.  However, his skin remained intact and he was conscious, so our trusty litmus officer was helping in an odd way.

There were, however, 2 things that had me curious on our approach.  First, the ambulance had arrived before us and was staged across the street.  Second, there was a line of cars exiting the parking lot in a hurry.

Something was up.

 

We parked upwind at a hydrant so we could hook in and mass decon if needed.  Airpacks went on and the triage kit came out of the side compartment.  I was having trouble resetting my mind from being the EMS supervisor the day before, to being part of the engine company today.  Part of me wanted to establish the warm zone and set up the decon corridor while also designing ambulance ingress and egress.

Instead I had to find out what on earth spooked an entire golf course to run like hell on a beautiful California afternoon.

The remaining people near the clubhouse are pointing and giggling at the firemen approaching taking full precautions as we’re shouting for them to remain still and tell us wha on earth is going on.

As with most emergencies of this nature, their first action was to come towards us.  Great.

“In the kitchen,” a man with a name tag tells us, “Pepper spray.”

Huh?

Around the side of the building is a person with a wet towel on their face and a group of white shirt, checkered pants clad folks, clearly the kitchen staff.

Someone thought it would be funny to release some pepper spray into the kitchen during the lunch rush.

When the entire staff ran out of the kitchen screaming and rubbing heir eyes, the patrons thought the worst and did the exact wrong thing.

They dispersed themselves across the City and the region before we had identified what had happened.  Perhaps they understood it was pepper spray, but none of the non-kitchen staffers were able to tell us what had happened, so I doubt that.

Now imagine it was somehow something more sinister and all 300 people escaped without being decontaminated.  There you are in your district running a general sick call.  She mentions being in San Francisco a few hours ago on a golf weekend that went sour.  Then the husband vomits and passes out.

Worst case scenario sure, but we deal in those sometimes.

Any ideas on how to stop those evacuating?  And don’t say PD, because remember, he’s already in the hot zone.

You Make the Call – Hotel Rooms – What Happened

This scenario was patched together from a few here at home and from around the community.  My service recently ran a call for nausea that included multiple persons in stacked rooms and handled it well.  But identifying the cause or possible causes of the illness can be difficult when multiple possibilities present themselves.

ICS focuses on being the first in and building from the cold zone forward.  This call would be so much easier if we were donning our Medical Group Supervisor vest and carrying the command kit into the lobby control.

Ah, if only life worked that way.  Most MCIs and Haz Mats evolve quickly and rarely come in reported as what we find.

I added the element of the unknown upstairs to make us think about what ELSE could be happening besides the seemingly straight forward CO poisoning call which, had this been contained to two adjacent rooms, is easy to include in our plan.

Medic 88 responded above us, called for a haz mat response and went off the air.  We got neither a status update on their condition or why they called for the haz mat activation so we must assume the worst: They are compromised.

On the 4th floor we have 3 or 4 patients directly needing our assistance with an unknown number possibly dead, dying or completely oblivious to the situation.  The first instinct is to evacuate the building, but scattering our unknown illness may prove more costly than not, so we need to evacuate to a place of safe refuge.

The enclosed nature of hotel rooms gives us the unique option of being able to stage our evacuation from the rooms to the hallway, establishing a warm zone.  Of course identifying those experiencing symptoms will be difficult so we need a way to identify them easily.  The MCI and triage kits are downstairs in the rig, so we’ll need to improvise.  Advise the persons you have already contacted to put on the hotel white robe (if they’re there) or drape a large white towel over their heads.  Asking them to also bring a clean washcloth to cover their coughs will help contain any airborne illness should it be present.  The 2 masks we carry are on us and we are considered contaminated until proven otherwise.

Now we have our original patients easily identifiable and a method to separate them based on signs and symptoms of illness.

This information now needs to be relayed to the other responding units.  Using clear text is key in this situation.  Identify your unit, establish command, list threats and give your status.  If Medic 88 is unreachable upstairs we must include them as victims until we hear otherwise.

For the time being we should stay on the 4th floor, triaging all the rooms who will answer the door.  Symptoms get a white towel/robe and washcloth, non symptomatic get moved the the other end of the hallway from our rooms.

This is no place to establish a command post or begin to orchestrate the response of additional units.  In most communities the first units on scene will be engine companies with basic gear and SCBA, and until we know what is going on upstairs, they should not enter the 4th or 5th floor.

Haz Mat Specialists can speak in more detail as to how they may approach this situation, but leaving what Medic 88 found unknown, I think makes us think in different ways, determining a solution for each possible situation.

Think about the following changes to the scenario:

Medic 88 reports a faulty pilot light on the water heater common to 403, 405, 503 and 505 and that symptoms clear in the hallway.

Medic 88 reports fumes of unknown origin seen coming from room 505, two patients are down inside that room.

Medic 88 calls a mayday and reports they are trapped on the 5th floor in heavy smoke, no SCBA.

Medic 88 stumbles from the stairway with blisters on their faces and arms, excessive snot from their noses and mouths, begging for help.

A hotel employee approaches you stating the hotel has received a bomb threat.

These are all exotic situations we may never see in out careers, but could actually happen when we are already set up for a different event.  Responding to any of these situations allows us to think ahead, set perimeters and stay back from the nasty stuff, but with dispatch systems keen on getting us out the door ASAP, most times without finishing the coding of the call, a simple code 2 sick call can become a dangerous unknown situation.

Think on your feet, use what is around you to your advantage and don’t forget that in this situation, YOU’RE a victim too.  At least until the heroes in the yellow suits say otherwise.

If you said “Slow down and think this through” you made the right call.

Seat at the Table Ep15 – San Bruno Cont’d

Our discussion with Dan Gerrard, Bobby Halton and Jow Telles continues in our special look at building relationships in Emergency Response.

Whether a Chief Officer or Probationary Member, all can learn from this discussion, have a look.

Seat at the Table Success

We had a great day of filming yesterday in San Jose with disaster experts gathered to attend the Tak-Response conference which ends today.

Even though we have not yet found a sponsor to cover the expenses, this opportunity was too important to let pass.

The conference has been a lot of fun, with Thaddeus, Natalie, Jeremiah and Sam Bradley begin_of_the_skype_highlighting     end_of_the_skype_highlighting, the extended Chronicles family, all except Mark.
For a new conference in a new place with a new concept I think it did very well.

I think Kelly Greyson would have enjoyed the shooting simulator side by side with some of the SWAT folks on hand at the show.
And the law enforcement members we did meet were interested not only in what we were doing, but marveling at the wide array of equipment EMS carries, not just a bag and a cot.

Just the show floor was working to break down barriers and let disciplines mingle, imagine what the speakers are inspiring.

The audio difficulties in the filming of the Seat at the Table are well known, but finding a solution we can afford on a negative budget is difficult. We’re trying, I promise.

Today it’s back to the conference with the meetup tonight at Gordon Beirsch Brewery. See you there?

Gearing up for Tak Response

Over the next few weeks you’ll be hearing from me about the Tak Response Conference in San Jose coming up September 14th-16th.

Chronicles of EMS was invited to be a part of this collaborative training opportunity that will bring the best of all fields together to network and learn from each other.

This conference combines nursing, Fire, Haz-Mat, law enforcement, SWAT, EMS, public works and a number of other disciplines together, since when we all arrive on scene we have to work together.

Let’s start to train together.

Tak Response is not only a chance to learn from other disciplines where you fit in at “their” scene, but to network socially with your fellow providers before the you know what hits you know where.

Imagine a scene where the Battalion Chief, Patrol Officer and EMT all already know each other and what each agency expects from the others.  That’s a smooth running scene.

Here’s the episode of Seat at the Table where we meet the organizers of the Tak Response Conference and run the concept by paramedics, firefighters and even a cop.

You Make the Call…Man Hole Fire…My Call

You Make the CallWell, shoot. When I first got hired our training Captain put up a shot of the Tokyo gas attacks and asked us the two best ways to handle such an incident.  People were running everywhere, others lying in the street.

He let us think about it for a few minutes, then let us in on the secrets to dealing with large incidents.

Option #1 is to reach over the center console while pulling out of the station, grab the steering wheel and pull.  The rig hits the door and you’re out of service in quarters, send someone else.

Option #2, if you forgot #1 and found yourself on the scene, was to calmly remove your coat and helmet and blend in with the crowd.

All kidding aside, this is a situation many firefighters will not encounter.  In my area we have large underground electrical vaults that serve as relay points for the City’s electrical systems.  More than once these have failed, caught fire, exploded etc.  hey, it’s electricity, a thousand different things could happen.

The important question, and the reason I shared this photo of an actual vault fire, was to get us all thinking about that first radio report and request for resources that can establish the tone and response over the next 30 minutes.  they say the first 3 minutes of a large incident can dictate the next 3 hours and I believe it.

My Department also has resources specifically designed and staffed to handle these incidents so I simply have to relay to the Battalion Chief that I have a vault fire and the system does what it has to do.

But, here would be my initial actions if that was not the case:

“Control, this is Engine 99, we are on the scene of what appears to be an underground fire, smoke showing.  We are staging upwind at 5th and Main, establishing 5th Street Command.  Strike a full first alarm and have them respond from the south to 5th and Main.”

You get the idea.  The point is to convey what you can without getting too wordy, but get resources rolling, including higher ranks to co-ordinate further response.

I would use the PA to get bystanders away and set up a perimeter, stretching a line part way there to protect persons who wander in if something happens.

That’s my call.