Letters to the Editor
DEPARTMENTS
Hand washing is most effective way to help prevent spread of hepatitis virus
“Hepatitis-B: Preventive Medicine for Emergency Responders” by Tom Richardson in the May issue was, on the whole, very well constructed and written. But Capt. Richardson failed to mention the most basic preventive medicine available to all emergency responders to prevent the spread of any communicable disease. This is simple hand washing.
The hepatitis viruses can live outside of the human host on an inanimate object for up to six months and cause infection when taken into the body. The hepatitis-A virus is passed through feces and is commonly contracted by fecal oral contamination. It can be contracted indirectly, such as by handling food without washing, or it can be transmitted directly from an infected person to a noninfected person.
I assume the hepatitis-D virus isn’t mentioned in the article because this virus can’t initiate an infection by itself. But when it occurs in conjunction with the hepatitis-B virus, the resulting disease is usually more potent than the disease caused by the B virus alone. I lepatitis-D virus is spread by the same means as the hepatitis-B virus, but it occurs mainly in the population that frequently receives blood products, such as dialysis patients or hemophiliacs, and intravenous drug abusers.
The article states there’s no vaccine or cure for hepatitis-A, but it can be prevented by taking globulin before exposure. I bis is impractical. The globulin specific to this virus is called gamma globulin, and its’ a very viscous, injectable solution. Gamma globulin contains antibodies that can reduce the risk of infection to the hepatitis-A virus, but the antibodies live only for about two weeks and should be given only after a possible exposure to the A virus has occurred.
After a person who wasn’t previously immune is exposed to the hepatitis-B virus, the specific antibody, hepatitis-B immune globulin (HB1G), may and should be given. The follow-up therapy at this point would be the hepatitis vaccine lor long-term prevention. The article says the vaccine begins to confer immunity only after the third injection. Since this is a true statement, it’s necessary to confer immediate immunity and then go for the long-term immunity, not the other way around.
My main point is to stress the importance of hand washing. This simple technique, so often overlooked, willslow down the spread of all communicable diseases.
Basement renovations inspire fire safety precautions
I read with interest Paul McFadden’s fine article, “Residence Fires: Starting in the Ce!lar”[see Volunteers Corner in the May issue]. Part of my responsibility at the huge Northwood Pulp complex in Prince George is firefighting. I’m aware of the danger of fires occurring in confined areas and especially in confined underground areas.
Like some of the people on the street where Lt. McFadden lives, I also renovated my basement. I added an extra bathroom and a bedroom where my 4and 6-year-old sons would be sleeping. During the renovation process, we encountered some fire-hazard problems. There was only one way into the basement, and that was through the kitchen. There was no window in the kids’ bedroom. If a fire broke out, they’d be trapped there unless they could somehow get back up the stairs. So we knocked out a hole in the 20-year-old cement and installed a window.
I also took some other steps to increase my kids’ chances for survival should a fire break out in the basement. I placed a sign on the door leading to the basement to tell firefighters there are two kids sleeping below. I stuck illuminating tape along the stairway wall to show the way in case of a power failure. I put an identifying sign on the bathroom door. 1 also put a sign on each bedroom door with each kid’s name on it. Then 1 bought two smoke detectors. I installed one on the bathroom ceiling, and the other one—with a flickering light—I put on the bedroom ceiling. I also put a sign in the window to indicate there are kids sleeping in the room.
Then 1 took things one step further by having drills. On fire alert, one boy wakes up the other one. They both climb onto their dresser, open the window, and climb out. Once outside, they yell “Fire” like crazy, and that alerts the neighbors. My wife thought 1 was going too far until I showed her Paul McFadden’s article. That swung her around to my way of thinking. I haven’t yet had the time or the nerve to do a 3 a.m. alert, but I’m working on it. Brendan Gillen Protection Officer Northwood Pulp and Timber Prince George, British Columbia Canada
Mark A. Koenig, R.N.
Engineer
Merced County Fire Department Los Banos, Calif.
“Command Presence” praised
I’ve always read Vincent Dunn’s articles because they’re based on much experience and a lot of common sense. They’re just what the fire service needs.
I’ve just finished reading Chief Dunn’s article “Command Presence” in the May issue, and I want to commend him.
I’ve met both types of leaders he describes so well. I’d definitely hire that guy who was always ready to go to work and assume immediate command. He sounds like the epitome of leadership and command presence. You can keep the other guy and the one from the other city who didn’t think he was in charge. I wouldn’t want either of them in charge if my house was burning.
Chief Dunn’s eight rules for executing command presence should be learned by anyone who wants to do this job properly.
Leo D. Stapleton Fire Commissioner Boston Fire Department Boston, Mass.
Another idea on asking “Why?”
After reading your June editorial, “Why?,” I must respond to your idea (as I see it) that it’s fine for a “proby” firefighter to question an officer at the scene of a fire.
The “aged leader” you spoke of in your editorial got to where he is because he did his job when he was told to and how he was told to, not by asking “Why?” You may not really mean what it sounds like you’re saying in this editorial. But I feel that many new firefighters are going to think it’s acceptable to question their superiors while they’re actually at the scene.
You should explain to your readers that back at the station is the place to ask, “Why did we pull the ceiling there, sir?” We must remember the fire service is a semimilitary organization. There must be orders given and soldiers to follow them.
T.J. Silvia
Dri ver/Engineer
Ft. Lauderdale Fire Department
Ft. Lauderdale, Fla.
Editor’s reply: The anecdote in the June editorial was meant to convey the idea of a repetitive action—and therefore a training situation. The place to inquire about the reasons behind orders may not be in the heat of battle, but understanding the reasoning behind procedures is crucial both to learning and to making sure procedures make sense. This process takes place when firefighters actively engage their brains during training and education, and not only in the accumulation of the months they spend on the job. For that reason, the question “Why?” will always be an important one for firefighters to ask.—Tom Brennan
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