ON FIRE ❘ by MICHAEL N. CIAMPO
When you have aspirations of being a firefighter, the only thing really clear in your mind is that you want to go to fires and tackle this job head-on. Many of us don’t realize in our initial thoughts that the odds of walking into the firehouse and going on numerous medical runs during a tour are more the mainstream of the career. Big cities that never provided emergency medical services calls are now jumping into the arena to respond and save lives. Gone are the days of the “war years” or the fires during the Civil Rights riots; but, have we just entered another war-torn period in history? Unlike the rescue and recovery efforts at Ground Zero, where we knew our hazardous work environment, today we find ourselves on the battlefront in our own response area’s buildings. Our tools and protective gear are very different from our firefighting tools and bunker gear, and we’re performing with other skills and tactics.
Compassion
One thing for sure is no matter who you are or what you believe in, we all have some thoughts on stereotypes; it’s part of human nature to see something and categorize it. When we see the “junkies” roaming the streets, we often think, “When will we see them again with pinpoint pupils, a needle in their arm, and unconscious?” It’s easy to recognize the “frequent fliers,” but what about encountering the 17-year-old kid in his bedroom or the 40-year-old executive in an office who has overdosed? One thing you had better get used to on this job is that our “clients” can’t be stereotyped; we treat them all equally with the same grace and compassion when we provide medical care. Sure, we might take extra precautions when we’re dealing with a known carrier with an infectious disease or call them by their first name when they come to, but we provide the same care to one that we would for another. Most likely, it’s because it’s who we are—compassionate human beings set out to do one thing: save lives no matter if it’s searching a smoke-filled dwelling for a victim or performing cardiopulmonary resuscitation (CPR) on an elderly person in a nursing home. We perform, and we must continue to do so on every run, not only because we took an oath and it’s part of our job but also because it’s part of what makes us who we are to those suffering their worst day.
Performance
Just like our firefighting equipment, we must check our medical supplies at the start of each tour and after a run on which we used them. We should restock any of the supplies used and ensure the O2 is full just like we would the air in our self-contained breathing apparatus. If our air is vital to us, shouldn’t the O2 be vital to our patient?
Recently, while operating at a CPR run and using two suction machines, filling them both up, and successfully resuscitating a victim, one of the members commented that he was happy the daily equipment checks included operating the machine. Our arrival on scene should always include a size-up of the patient and our surroundings; our safety must be a priority for us to operate. It may include just removing a person from a cluttered bedroom to an open area or shutting down a busy roadway we’re operating on. There will be times when one of us has to run interference to separate a distraught family member or a bystander gawking with a cell phone trying to get video while shouting obscenities. Removing the distraught person to another room, interviewing him, and having him account for the victim’s prescribed medications and paperwork keep him occupied and calm him down. When working on the patient, remember you’re one team; listen to those trained above your level as they inject medicines or seek advice from the doctor at the hospital. It’s also important to know that medics may want to enter a dangerous vehicle extrication without personal protective equipment and the officer has to step up and remind them of the dangers of sharp metal, glass, and plastics. Whether your department operates its own medical services or you’re running with an outside agency providing advanced care, when you work on a patient, you’re one team and your performance together often results in a positive outcome. However, we all know that despite working on a patient for an extended period or performing a miraculous extrication and the victim has a pulse, sometimes the victim will succumb despite our best efforts.
Respect
One of the hardest things to do as a first responder is to inform the family members that their relative has passed away. Sometimes we face inconceivable odds such as rigor mortis or lividity when we find a patient lying in bed and the family member doesn’t understand why we’re not working on their loved one. There’s no set way to tell family members that the victim has passed, and you’ll see a gambit of sorrowful reactions when you have to do so. Be sure to do it with respect and compassion; it’s a part of the job no one ever counseled us on. Maybe we learned by watching a partner or an officer do it as we prepared for when it’s our turn. If the body is left in the residence, be sure to remove all your equipment and clean up the area; leaving a discarded glove or bandage can create more agony for a family. If a body is covered on scene so a fatality investigation can be done, you may have to place some weighted materials on the covering so the wind doesn’t blow it up; this may cause distress for bystanders and family as well.
COVID-19 has put us in a war zone, where we are performing an unfathomable number of CPR runs a day; yet, we continue forward with compassion, performance, and respect.
MICHAEL N. CIAMPO is a 34-year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC International Truck Essentials H.O.T. program. He wrote the Ladders and Ventilation chapters for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and the Bread and Butter Portable Ladders DVD and is featured in “Training Minutes” truck company videos.
