Fairfax County Fire and Rescue Department

Nutrition and Cooking

Strength and Conditioning

Back to Basics Training

Day 1: Firefighter Cancer Risks

Firefighting is a profession that comes with significant health risks. One of the most serious risks faced by firefighters is cancer. Studies have shown that firefighters are at a higher risk of developing certain types of cancer compared to the general population. This content outlines the importance of cancer prevention, provides key statistics on firefighter cancer, and recommends strategies to reduce exposure to carcinogens.

Statistics on Firefighter Cancer

• Increased Cancer Risk: Firefighters have a 9% higher risk of being diagnosed with cancer and a 14% higher risk of dying from cancer compared to the general U.S. population.
  

• Common Types of Cancer: The most common cancers among firefighters include testicular cancer, multiple myeloma, non-Hodgkin's lymphoma, skin cancer, and malignant mesothelioma.
  

• Age Factor: Younger firefighters (under 45) are at a particularly higher risk for certain types of cancer, highlighting the need for early and ongoing preventive measures.
  

Strategies to Reduce Exposure

• Personal Protective Equipment (PPE) Decontamination
  
• On-Scene Gross Decon: Immediately after firefighting operations, use decontamination methods to clean PPE. Brush off larger debris, then rinse gear with water.
  
• Annual Gear Cleaning: Ensure that all PPE, including helmets, gloves, hoods, and boots, are sent in for annual cleaning, and after every training and working fire.
  

• Hygiene Practices
• Shower Within the Hour: After returning from working fire, food on the stove, and all other incidents where you were exposed, shower as soon as possible to remove contaminants from the skin. Use Fire Wipes if possible beforehand.
  
• Clean Uniforms: Change out of contaminated gear and clothing immediately. Keep a second set of clean uniforms available.
  

• Equipment Maintenance
• Respiratory Protection: Always use SCBA during overhaul operations to prevent inhaling carcinogenic particles. Comply with the No Drop Rule.
  
• Proper Storage: Store PPE in a clean, dry environment away from living quarters to prevent cross-contamination.
  
• Hood Cleaning: Participate in the Wash Your Hood Sunday initiative.
  

• Health Monitoring
• Annual Physicals: Participate in annual health screenings and cancer screenings. Early detection is crucial for effective treatment.
  
• Ultrasound Early Detection Health Screening: Sign up for ultrasound screenings for continuous health monitoring.
  
• 
  

Cancer prevention is an essential aspect of firefighter safety. By adhering to the recommended practices and staying informed about the latest research, you can significantly reduce your risk of cancer. Let’s commit to protecting ourselves and our colleagues through vigilant and consistent application of these preventive measures. Please review these two short videos:

FIREFIGHTER CANCER PREVENTION: Decon

Cancer in the Boston Fire Department

Back to Basics Training

Day 2: Outside-To-In-Fires

Exterior fires that extend from the outside to the interior of structures present unique challenges for firefighters, often originating from sources such as attached rear decks, mulch beds, or basement fires that extend upward. In Northern Virginia, these are known as Outside-To-In-Fires, and many of our working fires originate as this type. A defining characteristic of these fires is their ability to run along the siding, penetrating upper floors and ultimately the attic through the eaves. To effectively combat these fires and prevent further extension, a critical initial tactic necessitates fighting them from the outside before engaging in interior operations. This approach requires the rapid placement of at least two hose lines to address both the exterior fire and the upward fire extension within the structure.

Let’s explore the essential tactics, techniques, and case studies to better understand the necessary skills to mitigate outside-to-in fires and protect lives and property.

Tactical Approach: As noted in the Single-Family Dwelling Manual, to effectively combat outside-to-in-fires and prevent their migration into buildings, it is imperative to initiate firefighting from the exterior. This approach serves to control the fire's spread to adjacent structures and mitigate its penetration into upper floors and the attic space.

Sweeping the Eaves and Soffit Attacks: Eaves, common features of single-family dwellings, are vulnerable points where exterior fires can extend into attics. Enclosed eaves, particularly those with lightweight materials such as vinyl or sheet metal soffits, accelerate fire extension. However, exterior fire-stream application directed at the underside of the soffit can prevent fire from penetrating into the attic.

Utilizing UL's Study Findings: UL's study emphasizes the critical role of rapid water application in controlling outside-to-in-fires. Firefighters can prevent or slow upward fire extension by sweeping the eaves with hose streams parallel to the exterior wall. Additionally, directing water into the attic through the soffit upon arrival can rapidly knock down attic fires from the exterior.

Effective Techniques: To conduct a soffit attack, firefighters may need to remove sections of the soffit to ensure unimpeded water flow. Using a 2 ½” smooth-bore nozzle matched with the roof's pitch allows for effective reach and penetration from the structure's exterior.

Case Studies: The following incidents, all within proximity to Fairfax County, illustrate instances where failure to address exterior fires resulted in injury or death to firefighters operating inside structures.

Learning from these cases underscores the importance of proactive exterior fire mitigation tactics before entering the structure to complete extinguishment.

• Loudoun County Meadowood Court Fire After Action Video
  
• Four DCFEMS Firefighters Injured While Providing Interior Exposure Protection
  
• Kyle Wilson LODD Report
  

By recognizing outside-to-in-fires and implementing appropriate initial tactics, such as first attacking the exterior fire while sweeping the eaves with a soffit attack, and directing subsequent lines to the interior, firefighters can enhance their effectiveness in controlling these fires while protecting lives and property.

Please review this hour-long discussion

about Outside-to-in-fires.

“Outside-In” Fires

Back to Basics Training

Day 3: Patient Assessment

Proficiency in patient assessment is paramount to ensuring high quality patient care. This document outlines essential principles and techniques to ensure FRD personnel can conduct thorough and efficient assessments, optimizing patient care, regardless of one’s EMS certification level. Prioritizing scene safety is foundational, safeguarding both our personnel and patients in hazardous environments. As defined within the 2023 EMS Manual, the initial assessment, employing the ABC approach (Airway, Breathing, Circulation) starts each patient assessment. Rapidly assessing life-threatening conditions then guides immediate interventions and helps to identify Load & Go patients. Next, vital signs provide insights into a patient's physiological status and guide ongoing treatment decisions. Obtaining a comprehensive SAMPLE history (Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading up to the incident) explains pertinent details to inform further care.

The physical exam is vital, which assesses the head, neck, chest, abdomen, and extremities to identify injuries or abnormalities. Effective communication, both with the patient and personnel, ensures coordinated care and accurate information exchange. Thorough documentation of assessment findings and interventions supports continuity of care and informs subsequent medical personnel. Continuous reassessment is imperative, enabling the identification of evolving conditions or complications.

By adhering to these principles and techniques, FRD personnel can enhance their ability to deliver prompt, effective, and compassionate care, ultimately improving outcomes for those they serve.

This video reviews the parts of the National Registry medical assessment:

MEDICAL ASSESSMENT Taught in Only 19 MInutes

Back to Basics Training

Day 4: Gas Leaks

The NOVA Utility Emergencies Manual provides detailed guidance in response to inside and outside gas leaks. To further enhance this response, the FRD has requested First Due Size Up (FDSU) to build a 330-foot radius as a “RECON ZONE” identification tool in the FDSU application. Please note that this photo is a mock-up requested by the FRD for FDSU to develop. This feature will soon allow users to select a button that places a 330-foot radius

over the structure. Currently, this functionality is still in production and is not available on the iPads. An Informational Bulletin will be published once this functionality is live. This feature will enhance responder safety and provides a visual investigation starting point for all responding units to reports of gas leaks or hazardous materials (HazMat) emergency event types. This added feature supports the expected practices of initial arriving units, as outlined in the NOVA Utility Emergencies Manual (pp. 12 and 16). FDSU will display a 330-foot radius, consistent with initial action guidance for any HazMat event outlined in the United States Department of Transportation Emergency Response Guidebook and shall be utilized to establish the action zone where personnel will begin to recon and investigate.

The purpose of this training bulletin is to inform personnel of an upcoming general order and video that will guide personnel to the following:

RESPONSE ACTIONS

• All initial suppression unit responders shall dress and don full personal protective equipment (PPE), including self-contained breathing apparatus (SCBA).
  

• The first due/first arriving unit should identify a RECON ZONE by approximating a 330-foot area centered on a reported incident address. Until this functionality is available on the FDSU app, the first due/first arriving unit shall verbalize the RECON ZONE over the radio. “All units responding from E410, the RECON ZONE will begin at the intersection of Columbia Pike and Lakeview Drive.”
  

• Exterior recon and assessment considerations conducted while approaching the dispatched building entry point should include dispatch information, reported hazard type, wind direction, and lowest levels of impact, including assessing storm sewers and manhole covers upon approach to an incident scene.

• Until the RECON ZONE is cleared, all other responding apparatus should use judgment based on dispatch and supplemental information (i.e., structure type) along with the investigation findings of the first arriving suppression unit operating in the RECON ZONE before proceeding any closer.

• When the exterior of the RECON ZONE is cleared by the first arriving unit, apparatus should position a minimum of 100 feet from the entry point of the structure (NOVA Utility Emergencies Manual, p. 10). This location could vary based on type of structure (e.g., single-family dwelling, townhome, apartment, commercial building, high-rise, etc.)
  

• As part of the water supply plan for these event types, officers and apparatus operators should consider not utilizing the hydrants immediately adjacent to a structure or those within 100 feet due to the potential risk of damage should an unexpected explosive event occur.
  

• Once the interview is complete, occupants should be directed to seek a safe location outside of the 330-foot RECON ZONE if readings outside of normal ranges are discovered.
  

• Size up/situation report should be delivered at the doorway/entry to a structure, ensuring metering occurs both low and high prior to entry. Consider the meters' reflex time and allow sufficient time for the meter to sample the environment. Report initial readings, any odors, and occupant status to the Incident Commander (IC). “Battalion 406 from Engine 409, lap completed, two front, three rear single-family, walkout basement Side Charlie, gas meter Side Delta. Label floors basement, one and two. The occupant reports an odor of gas in the basement, confirms natural gas service to residence. All occupants are accounted for and located at/a safe distance. Normal readings at the front door, LEL reading at basement door is three percent.”
  

• If no hazard (e.g., all meter readings normal, no presence of odors, etc.) is met within the exterior RECON ZONE, up to the front door, the officer should communicate by radio to IC or, if the initial unit officer has not transferred Command, communicate the RECON ZONE is clear.
  

• Typical tasks to be accomplished on incident scene:
  
• Recon – RECON ZONE investigation, approach metering and size up.
  
• Water supply – safe distance, consider risk of explosion and/or potential of damage/water loss when selectin hydrants immediately adjacent to the building address.
  
• Metering – All units should operate with active meters. Fairfax County rescue squad or HazMat Unit (HMU) should conduct comprehensive interior metering, when all other meters may read normal, to further assist in investigation of suspected gas leak due to the sensitivity of their meters. Roof recon should also include metering.
  
• Ventilation – Ventilation actions should only occur with adjacent/concurrent metering and only upon direction of Command.
  
• Handline Deployment – Handlines should generally be deployed once a hazardous reading or situation is confirmed, and needs are identified. It is important to identify rich or lean environments to properly place protective lines.
  
• Utility Control – Building utilities commonly can be rapidly identified, exterior units should look for buried or in-ground exterior shut off valves.
  
• Medical group – Should be established for FRD personnel or occupants, outside of RECON ZONE.
  
• Incident Command.
  

The FRD has added a Fairfax County rescue squad or the HMU to all Inside Gas Leak (GASIN) responses. These units were added for the availability of gas meters that offer enhanced detection and monitoring capability than meters on frontline engines and truck companies. These meters can detect the potential presence of gas inside a structure that may not alert or alarm action levels for FRD personnel.

A general order will be published later this month further defining this information.

Back to Basics Training

Day 5: Violent Incidents

The Joint Action Guide for Active Violent Incidents provides guidance for how to respond to a violent incident. This guide identifies benchmarks for these incidents developed by leveraging medical and forensic data, which strongly indicate that patient survivability greatly increases when injured individuals are provided the quickest possible on-scene care followed by the most rapidly achievable transfer to the appropriate definitive care facility. The time associated with each benchmark begins upon the arrival of first responders. The benchmarks do not involve any component before arrival to include call taking, dispatching and response times. Upon arrival on scene, responders should seek to achieve these five benchmarks. The purpose of this document is to review the Rescue Task Force concept.

Rescue Task Force

A Rescue Task Force (RTF) is a team(s) of fire/EMS and law enforcement personnel who assemble for the purpose of rapid patient treatment within a warm zone. Teams are identified by numbers, for example, RTF 1, RTF 2, and their primary purpose is the rapid treatment of patients. This model requires the highest level of coordination and integration. An RTF is a minimum of two law enforcement officers, but four officers is the preferred composition, along with:

FRD personnel wearing ballistic gear will be assigned for warm zone care of patients utilizing rapid trauma kits.

Law enforcement will be assigned for protection.

Personnel can review the following:

Police Standby – 3245 Rio Drive, Falls Church

Rescue Task Force Awareness

Rescue Task Force: Airway Management

Rescue Task Force: Bleeding Control Options