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Understanding Crew Resource Management

Blog by Brian Ward
Officer with Gwinnett County Fire Department in Georgia

The International Association of Fire Chiefs describes Crew Resource Management (CRM) as the effective management of all available resources to mitigate a situation while minimizing errors, improving safety and increasing performance. Five factors have been identified as major components in dealing with accidents. These same five factors make up the core of CRM. They include situational awareness, communication, decision making skills, teamwork, and safety barriers.

Situational Awareness
The first and arguably the most important component is situational awareness. Everything on an emergency incident functions and revolves around situational awareness, including our decision making on the fireground. Situational awareness is commonly referred to as the Big Picture. It also encompasses more than just the Big Picture.

In Gary Klein and Caroline E. Zsamboks Naturalistic Decision Making, situational awareness is broken down into three levels:

Level 1: Perception of the Elements in the Environment

Level 2: Comprehension of the Situation

Level 3: Projection of Future Status

For the fire service this translates to how we perceive incidents, being able to understand incidents and how factors are interrelated in accomplishing our goals and forecasting future factors of an incident.

Communication
If situational awareness is not the most important key to handling an incident, then it most certainly is communication. Without effective communication, nothing will be accomplished. The IAFC describes communication as the cornerstone of CRM. There are six keys areas to communication: sender, receiver, message, medium, filters and feedback. Its best to use face-to-face communication when possible, but radio is the only option most of the time. Regardless of the method, the six key areas must be understood and used in order for communication to work and the job to be completed. Within these six key areas there are several other items that need to be addressed. The first is simply being clear and concise. Say what you mean and give enough detail, but don’t overload the individuals working memory space.

Below is a prime example from Gary Klein’s Sources of Power: How People Make Decisions on how even great leaders can make a communication mistake:

During World War II, Winston Churchill gave the order to not engage with warships that were larger and that could destroy their individual ships. What he meant was do not try and take on ships larger than theirs and lose. Consequently, one of his admirals had surrounded an enemy warship but let it go because it was larger and he did not want any trouble with his superiors. This was not the intent of Churchill’s letter to the admiral, but because of unclear communication, it happened. That same warship went on to destroy some of Britain’s ships, playing a significant role against the British during the war.

Decision Making
Situational awareness is vital to how we make decisions. One recent study examining military fighter pilots showed their decisions were directly based on how they perceived situations. They may have made the right call for their perception of the incident, but they didn’t perceive the situation correctly, so they failed.

In essence, having a strong background in situational awareness can help us make decisions within our limited scope of time. In conjunction with situational awareness, our incident commanders need accurate information relayed back to them to establish strategies and tactics. Once this has occurred, the leader can make a sound decision that will have a positive outcome on the incident.

In recent studies in the field of Naturalistic Decision Making, making decisions in a natural setting (real-life environment) has brought forward several considerations for training to be designed around, including mental simulation, pattern matching, story building and the power of intuition.

Each of these plays a part in how our brain relates to what is in front of us and how we make decisions. Nothing can replace on-scene experience, but that is not always something we can control. With this information, we have found the need for more training.

Using scenario-based or tactical decision games is a great way for a firefighter to begin to build patterns and stories of how to operate at an incident, without actually being on scene to learn. Mental simulation and intuition will only come once we show a complete understanding of how one factor relates to the next even when it’s not directly in front of us.

Teamwork
How often do we actually train or perform as a team? How often do we actually examine what we do as a team that makes us function effectively or fail? As firefighters we train constantly to function as part of a team; however, do we always carry that to the field?

When a team has worked together and has bonded, it functions smoothly. One key in reaching this goal is communicating suggestions and concerns to other team members. Mutual respect among team members is essential for it to excel.

Barriers or Safety Nets
Barriers or safety nets are put in place so that when we make a mistake, something is there to catch us. No matter who we are, how much training or education we have received, how much experience we’ve gained, or how many awards we have garnered, at some point we are going to make a mistake. The key is to understand our weaknesses and to avoid repeating the same mistake.

Barriers can come in the many different forms. Some of the obvious ones are SOPs/SOGs, effective training, core competency books, updated equipment and increased use of technology. Other barriers could include establishing Incident Safety Officers on all scenes, establishing RIC teams with proper resources and staffing, providing acting and company officers training, and offering drivers training programs.

One other area that can be of great benefit is the use of checklists and worksheets to help the officers on scene such as Incident Commander, Safety Officer, Rehab Group Supervisor and RIC Group Team Leader. Checklists can help remind the officers of the tasks to be completed, benchmarks, safety concerns and crew locations. However, with all great things there are downfalls.

We still have not found a way to checklist or talk a fire out. It’s important to remember that the checklist is only as effective as the expertise of the individual using it. We must still train and educate the same as before and still allow officers the discretion to change the plan of the checklist as they see fit. Each of these key areas has a place in every fire stations training schedule. The ability to understand how to correlate and implement these components into our training will translate to increased efficiency and safety on the fire ground.

About the Author
Brian Ward is an engineer/acting officer with Gwinnett County Fire Department in Georgia. He is a past training officer, chairman of the Metro Atlanta Training Officers and currently serves on the Honeywell Advisory Council. He is a State of Georgia Advocate for Everyone Goes Home and the Membership Task Force Co-Chair and Live Fire Instructor for ISFSI. Brian was recently awarded the National Seal of Excellence from the NFFF/EGH.

Is It Time to Arm Our EMTs

Story by Tim Holman
Chief, German Township Fire & EMS

According to the department of labor, 52 percent of EMTs in the field have been assaulted. This statistic is even more alarming when we see the increase of ambushes on first responders. In recent years we have seen EMTs shot and killed while trying to perform emergency care. These incidents are increasing each year.

Due to media bias toward guns, the idea of arming EMTs for self-defense and protection will receive much scrutiny. But times are changing and civil unrest is increasing. More people are becoming desperate and more people resent figures of authority.

Some argue we should just wait for law enforcement to clear the scene before entering. Unfortunately law enforcement is experiencing staffing issues just like others in public safety. How will waiting 30 or 40 minutes to enter a home to treat a patient stand up in court? Many systems, when dispatched to a drug overdose, rely on law enforcement to clear the scene before entering. This is a wise and proactive approach for keeping our EMTs safe. But suppose you are called to such a scene and the patient is not breathing. You stage your unit away from the scene and wait for your local police. Unfortunately all their units are tied up and the ETA is 20 to 30 minutes. You wait and the patient dies. The family sues you because you made no attempt to determine if the scene was safe. They argue the patient was unresponsive and of no danger to anyone. Do you really think that a jury would rule in the favor of the EMS?

What about routine calls that deteriorate into violent situations? Retreat? And what if you do not have time? Is that just the risk associated with the job? No, that is unacceptable. Our constitution states we have a right to bear arms for personal protection. That right should not end just because you are now at work.

Some may argue there are many EMTs who should not be allowed to carry a gun. The same can be said about some law enforcement officials I know. No one can convince me we cannot train EMTs in tactical skills. We teach them to start IVs, intubate, deliver medications, and many other difficult tasks.

Why can’t we train them to carry a gun for protection? Not to arrest people. Not to be a cop, but to be able to enter a scene and clear it for safety.

In 2009 the FBI estimates that more than 2 million crimes were stopped by law-abiding citizens with concealed handguns. Of these it is estimated that fewer than 100 shots were fired.

Before arming EMTs they must be trained in tactical techniques in clearing a scene, carrying a gun in deep concealment, de-escalating a violent encounter and various other skills. And yes some may not be allowed to carry if they cannot qualify appropriately. At the very least we should consider arming at least on individual on each EMS crew.

There are some negative consequences in arming EMTs. Our image may change. Some people think guns are evil. Public education would be needed to combat this. Some advocate using deep concealment and not publicizing that EMTs are armed. Another drawback may be the liability insurance. Training and qualifying may help reduce this challenge.

By the way, if you are still thinking this is a crazy concept, consider several cities have already passed ordinances to allow EMTs to carry handguns while on duty. Another city in the west has made it policy that no EMS crew leaves the station without someone on the crew being armed. This policy originated after several of their female crews were dispatched on false calls to lure them into homes.

Most people will have very strong feelings about this concept. Talk about it. Think about it. Consider other options. But we must stop the senseless killings of EMTs trying to serve their communities.

About the Author
Tim Holman is a seminar speaker who has conducted programs throughout the United States. Holman speaks and trains on a variety of business, fire and EMS management and leadership issues. Holman specializes in providing fire and EMS officer development programs. Holman was the Fire Chief magazine “Fire Chief of the Year” for 2002.

How to Motivate Your People More Effectively

Conventional wisdom says there are two ways to motivate employees. The carrot and the stick. But the truth is there is a third way, a better way. By showering employees with respect and appreciation, you can earn their loyalty and greater productivity.

Blog by Peter Dove
President of the Shared Values Association

Much has been written about how to motivate people. Some people think there is some type of magic that if they could only access, they could zap a new power into people.

Sorry, but no.

There are various kinds of motivation. Coercive motivation for example can be quite effective. Do you remember this quote?

“You can make a horse sit up and deal cards, it’s just a matter of voltage.”

Col. Nathan Jessep, played by Jack Nicholson in ‘A Few Good Men’

Later in the movie, Jessep famously exclaimed, “you can’t handle the truth!”

The truth is this: People are only motivated by what they value. Yes, that might be money, or saving their skin, but people remain motivated exclusively by what they value.

You can coerce people into doing what you want. Threats, punishment, and the rest of the stick methods are often used. Restrictive motivation is another stick method and somewhat of a cousin to coercive motivation. You can restrict liberty, freedom, access to information, things, people, or opportunity, as punishment unless people do what is demanded.

On the more positive side, one can motivate by way of incentive or quid pro quo, which is “do this and I’ll give you that.” It really is sort of based on a bribe paradigm and the carrot-end of the carrot vs. the stick approach.

Offering a carrot or brandishing a stick will indeed get people to do things, but it is something difficult to sustain; and as Alfie Kohn demonstrates in his book “Punished by Rewards,” it does not work very well. People resist the stick and carrots become carrot cake, then steak and carrots. Entitlement sets in and people expect steak, carrots, peas, potatoes and fine wine! And yes, fine wine gets expensive.

But there is a better way, a third way. You can work to understand your people’s motives and align your behavior in a way to deliver what they want. This is sustainable. Again, people are only motivated by what they value.

The typical manager thinks they have only two kinds of power (carrot and stick) available to them. But the carrot and the stick are accessible because of their position. Do this or that because I’m the boss and I have a certain amount of authority over you, they say. A good example is automobile dealerships, which use coercive, restrictive and incentive methods to persuade sales people to sell cars. This does not make these dealers good or bad, it just makes them typical of how business is done.

What Is Referent Power?

Referent power is based on a third idea and the greatest of things: Love. I will do for you, not because I feel a threat, either explicit or implied. I will not do for you because of some reward. I behave, work at my best and carry a certain winning attitude because I respect and want to serve you. I do what I do because I want you, my boss to be proud of me. I execute my duties with care because I like the people I work with and want to contribute and not let them down. I behave as I do because what we do together has meaning.

Can you see how referent power is the most powerful? The trick of course is how to deliberately create this values-based referent power in your workplace. There is not enough space here to describe all that goes into building a shared-values work environment, however, here are three things you can do now.

1. Make it safe: Create a workplace where it is safe to tell the boss and co-workers the uncompromising truth, without fear of repercussion.

2. Give credit where credit is due: This is the easiest thing to do and you can start now. Most people are not told they are appreciated and why they are appreciated.

3. Make expectations clear: Unclear expectations are enormously de-motivating. Tell your people what is expected, by when, what a finished job looks like, what the failure and success paths are, what the resources are and then coach them on their way.

There are a number of other values that must be shared in the workplace in order to arrive at a credible referent power base – or what we call a Heroic Environment. But focusing on these first three steps can accomplish much. I wish you all the best on your journey.

About the Author
Peter Dove is a management consultant with a background in corporate culture design. He serves as the president of Shared Values Associates, Inc. In this position, he travels the U.S. speaking to groups on the importance of shared values in the workplace.

Personal Protective Equipment: Back to the Basics

Blog by Brian Ward
Chief of Emergency Operations, Training Director for Georgia Pacific

How much do you know about your Personal Protective Equipment, specifically, your bunker gear? How well can you perform your job duties wearing the gear you have?

Understanding the basics of PPE and training in our gear are some key principles that will help us stay safe. The more information we know about how gear is properly put together, the safer we will be.

Several topics should be discussed when considering different types of gear. What may be good for one department in the northern part of the country may not be suitable for another department in the southern part or on the coast. It is important to point out that each of these topics is not mutually exclusive they all have an impact on each other:

>> Total Heat Loss is basically the breathability of gear. The higher the numerics, the better the firefighter’s body heat will dissipate. This could lead to cooling the core temperature of a firefighter and preventing such situations as heat stroke and over-exertion. According to NFPA 1971, a minimum of 205 watts per square meter must be met.

>> Thermal Protective Performance (TPP) represents how much conductive and radiant heat the gear will shield from a firefighter through all layers of the ensemble. At first thought, the higher the TPP rating, the better off a firefighter would be, however, this is not only false but also dangerous. As the TPP rating is increased, firefighters might be inclined to proceed further and envelop themselves in elevated temperatures where they should not be. In addition, the higher the TPP rating the lower the THL will be. It’s a trade-off.

>> CCHR was incorporated into the testing procedure as a method of examining the shoulder and knee areas of our PPE. This test is conducted with wet and dry gear at a starting temperature of 536 degrees, as a method of comparing the insulation provided by the PPE when it comes in contact with hot surfaces. According to NFPA 1971, it should take 25 seconds for the temperature of the opposite side of the gear to rise 43 degrees.

As you review gear, look at surrounding departments and examine the specifications they are using. Remember, there is no one perfect set of gear for every department. Choose the gear with the right combination for your department. In addition, no matter what gear you have, understand how it operates and know its limitations. Anyone can tie a knot, but can everyone tie a knot with gloves on, and correctly?

The only way to know these limits is to train and train often in a multitude of situations. Training for familiarization and in realistic environments will assist in developing these necessary skills.

Try this drill: Have a firefighter bunker out (pants and boots only) and blackout their SCBA mask. Take the remaining parts and spread them throughout the station in areas where they could obtain them by performing a primary search of the structure. Place the items so that the firefighters have to build their ensemble as they complete the search. This drill is simple, non-hazardous, and will assist in familiarization with their equipment. In the end the firefighter should be breathing air and dressed as if they were entering a burning building. Make sure that the gloves are the first item they come to and that everything is completed without the removal of their mask.

Train hard, take care and be safe.

About the Author
Brian Ward is chief of emergency operations and training director for Georgia Pacific in Madison (Ga.). He is a past training officer for Gwinnett County (Ga.), chairman of the Metro Atlanta Training Officers and currently serves on the Honeywell Advisory Council.

Dedication and Commitment: The Guts to Do More

Blog by Doug Cline
International Society of Fire Service Instructors, Vice President

As fire service instructors, we have a duty to provide the highest quality of service and instruction. We need to be our students’ inspiration, pushing them to strive for excellence.

But there’s a question we need to answer: Are we, ourselves, dedicated and committed enough?

Instructors need to stop and look in the mirror. The future of the fire service rests on our shoulders. That’s why it’s imperative that organizations, leaders and instructors take a hard look at how training is being delivered.

There are numerous ways to do this. Reaction questionnaires can be given to students. Subject-matter experts or senior trainers can audit training sessions. Test scores can be analyzed. Other instructors can perform peer assessments. These are just some of the methods.

The optimum time to evaluate the work of an instructor is while they are actually in the process of delivering a training session. Observation is recommended. However, observation is only effective if it is driven by standards that are objective, comprehensive, reliable and accurate.

Follow these steps to evaluate the delivery of training:

Step 1: Identify and define the objectives of the evaluation and determine how this process will work. Determine why the evaluation is being conducted. One reason may be to provide feedback on an instructor or a specific delivery issue. It also may be to evaluate the overall competence of an instructor.

Step 2: Consider how the information will be summarized and to whom it will be reported. Evaluation data can serve many purposes and can be interpreted different ways. It’s important that clear decisions define why, when and from whom data is being collected. It’s also important to evaluate what information is collected and its relation to the original objectives, which caused the need for the evaluation.

Step 3: Identify and define the specific competencies and performances to be measured. First, you must determine which competencies will serve as the basis of the evaluation. Typically, a detailed evaluation involves no more than three competencies where a more general evaluation may evaluate multiple competencies. Secondly, the objectives of the evaluation must be clearly specified. This is so the evaluator and the instructor understand what is being measured.

Step 4: Determine the sources of data. You can obtain evaluation data from a number of different sources. More common methods of data collection are evaluations by evaluators, co-instructors, and peer and self-evaluations. It’s important to remember that evaluators will have varying levels of skill that may influence data.

Step 5: Write the questions. For quality control, questions must be linked to a specific desired outcome for the evaluation. When the questions are written, we can control the specificity or generality of the individual item. These controls are essential to keep the evaluation instrument practical, manageable, reliable and valid.

Step 6: Design the format and layout of the instrument. Evaluation instruments must be written clearly and concisely for what is being measured. The evaluation must contain unambiguous directions for use and feature ordered questions or items to be evaluated. Instruments must be user friendly. This means easy to read and use and enough space for documentation.

Step 7: Pilot-test the instrument and obtain feedback. Prior to using a document for program evaluation, allow it to be pilot-tested. This will allow others to provide feedback on the instruments adequacy and usefulness. This pilot-test helps evaluators determine how well the instrument design and layout meets the objectives you are looking for. It also allows for the evaluation of the instrument to ensure its designed to provide what its intended to do. Since instrument development is time consuming and costly, it’s imperative to evaluate the tool to ensure it will provide the best information possible.

Step 8: Create the final instrument and implement the evaluation. The final instrument must provide the data needed to ensure training achieves its objectives or job performance requirements. Instruments may be used to assess a variety of aspects focused around training. The instrument may be used to assess the instructor’s performance and usefulness of instructional methods, course materials and content.

Effective fire service organizations must recognize their responsibilities to assist in the professional development of their instructors. Fire service instructors must also realize they have areas that need development.

As the leaders of the fire service, instructors need to have the guts to do more. We should be setting a precedent for the future. We start by looking at the man in the mirror.

About the Author
Douglas Cline is a student of the fire service serving as training commander with the City of High Point (N.C.) Fire Department and assistant chief of administration with the Ruffin Volunteer Fire Department. Cline is a North Carolina Level II Fire Instructor, National Fire Academy Instructor and an EMT-Paramedic instructor/coordinator for the North Carolina Office of Emergency Medical Services. Cline is a member of the North Carolina Society of Fire Service Instructors and the International Society of Fire Service Instructors where he serves on the Board of Directors as The First Vice President.

Learning to Be the Boss in the Fire Service

Blog by Alan Brunacini
Retired Phoenix Fire Chief and Author of “Functional Boss Behaviors”

I’ve studied bosses, and I’ve noticed that the best predictor of behavior in an organization is to look at the way the boss behaves. Often times, however, we lose sight of the fact that the relationships between bosses and workers have a direct impact on the level of service an organization provides.

If you ask anyone who has been a boss in the fire service, they’ll probably tell you a lot of stories about the road rash they experienced trying to get it right.

But I’d be willing to bet a lot of them would say, “I wish someone had told me this.”

After 50 years in the industry, making observations and learning by experience, I’ve put together some notes on what it takes to be a boss in the fire service. These notes, which I turned into my Functional Boss Behaviors book, which is available as a course through TargetSolutions, outline a set of 10 behaviors that effectively support and assist a worker in delivering standard service and added value:

1. Workers Must Take Good Care of Customers: A great deal of our focus is on customers. These are the people who receive services from us. When we are connected to the customer, we should deliver the best possible service to the customer.

2. Bosses Must Take Good Care of Workers: The relationships inside the organization are the launching pad for how we deliver services. The behavior of the boss is the most powerful thing in our everyday environment. If bosses don’t take care of workers, how can we expect the workers to take care of Mrs. Smith?

3. Build Trust or Go Home: Trust is a basic part of any relationship and is what connects the boss to the worker and to Mrs. Smith. Mrs. Smith trusts us because we respond quickly, solve her problem, and we’re nice. The workers trust Boss Smith because he responds quickly, solves the problem, and has a supportive relationship with them. Bosses must foster, develop, and then refine the trust relationship inside the system in order to provide the best service outside the organization.

4. Sweat the Big Stuff: The first priority for every boss is that “everyone goes home.” The routine stuff we do is important and ensures we are ready for the tough stuff; however, the boss’s focus should be on the critical stuff that allows us to deliver service and survive that service.

5. Set the Workers Free: When we become bosses, we gain authority and power that we use to create order, deliver adequate service, and take care of the workers. One of the best things a boss can do with that authority is to empower workers to be independent and self-directed.

6. Play Your Position: Organizations essentially consist of three levels strategic, tactical and task. For the organization to be effective, each level must be independently functional and capable, AND they must be interconnected. The challenge is to knit these three levels together in a way that connects the levels to each other, but points the organization toward the customer.

7. Keep Fixin’ the System: We are always operating within a model of continuous improvement. We follow procedures to deliver service and then constantly critique what worked and what went wrong. That model is necessarily boss driven. Bosses must continually look at SOPs, training, and, most importantly, themselves to improve organizational performance.

8. Create “Loyal Disobedience/Insubordination”: The firefighters the workers have the best set of perceptions, experiences, and connections to Mrs. Smith, and often they have ideas about how to improve service. A willingness to come forward with suggestions and bad news is a mature form of organizational commitment and respect. A good boss is accessible and will help solve the problem.

9. All You Got Is All You Get (Anatomy & Physiology): Every boss has different strengths and weaknesses. A boss’s personal effectiveness is dependent on how the boss uses his very personal skills and capabilities. Small improvements can produce big time results in the boss-worker relationship.

10. Don’t Do Dumb Stuff: This is pretty straight forward, but I bet we could talk all day about the dumb stuff we’ve done or seen others do. Workers can easily identify anything the boss does that is self-serving or stupid, which can be really destructive.

I’ve never figured out how to change somebody’s attitude, but I’ve noticed if you can change someone’s behavior, their attitude will change over time. And I don’t think you do that with leadership. You do that with an online, present, conscious, engaged boss.

About the Author
Retired Phoenix Fire Chief Alan Brunacini is one of the preeminent authors and pioneers of the fire service industry. Chief Brunacini is a 1960 graduate of the Fire Protection Technology program at Oklahoma State University and he earned a degree in political science from Arizona State University in 1970. He graduated from the Urban Executives Program at the Massachusetts Institute of Technology in 1973 and received a Master of Public Administration degree from Arizona State in 1975.

Boiling Point Avoiding the Hypertensive Fallout

Blog by Todd J. LeDuc
Deputy Chief, Broward Sheriff Fire Rescue (Fla.)

A published study by the Institute of Medicine calls attention to a national epidemic that is particularly threatening to firefighters across the globe untreated hypertension.

With cardiovascular events one of the leading causes of firefighter morbidity and mortality, unrecognized and untreated hypertension and pre-hypertension must be more aggressively diagnosed and confronted.

More than 70 million Americans suffer from hypertension while an additional 50 million more are close behind with pre-hypertension.

Hypertension contributes to nearly one-third of all cardiac events and is the leading cause of stroke and renal failure. According to the International Association of Firefighters website, 75 percent of firefighters with hypertension do not have it controlled.

The United States Fire Administration has reported in a meta-analysis of firefighter line-of-duty reports that the leading cause of fire service deaths is heart attacks, which accounts for 44 percent of all firefighter deaths.

Furthermore, a Harvard study concluded that while only 5 percent of firefighter’s time is actually spent combating fire, they are 100 times more likely to have a heart attack.

This may be attributed to the extremely psychically demanding rigors of the service and environment that firefighters operate within. This, coupled with risk factors such as high blood pressure, obesity, heightened cholesterol levels and a sedentary lifestyle, creates an axis of risk.

Several factors were noted that fire service members should realize. First, only 2 percent of adults receive adequate amounts of potassium. This places a higher propensity to elevated blood pressure levels. A concerted effort must be made to eat foods high in potassium.

The recommended daily intake of potassium is 3,500 milligrams. Excellent sources are fish, fruit (especially bananas, apricots, cantaloupe, and grapefruit), peas, beans, and potatoes, among other foods.

Additionally, compounding the propensity toward high-blood pressure is the over consumption of sodium. In fact, the average adult unknowingly takes in 3,400 milligrams of sodium per day when the daily recommended allowance is 2,300 mg.

This is often a byproduct of processed, canned and prepared food son top of additional table salt added to meals to enhance flavor in preparation or at the dinner table. The study also reviewed contributory factors of excess weight and its effect of hypertension. The researchers concluded that modest reductions of 10 pounds in overweight adults through diet and modest exercise would result in an 8 percent decrease in cases of hypertension.

Of course, the first step in combating hypertension or pre-hypertension is identifying it. This can only be done by routinely monitoring your own blood pressure and sharing the results with your healthcare provider.

The Institute of Medicines findings show we can’t rely on our health care professionals to solve this problem. As the commander of your own ship, it’s imperative you take an aggressive role in managing your blood pressure.

As fire service professionals, your cardiovascular risks are greater than those of the general population and as such your diligence should be greater. Hypertension is not named the silent killer without good reason ignorance is not a panacea for wellness and heath.

Make a pledge to learn your pressure, modify your risk and contributory factors, and embark on a path of prevention. Your proactive imitative can prevent you from reaching a boiling point.

About the Author
Todd J. LeDuc is the deputy chief of department for Broward Sheriff Fire Rescue in Florida. With more than 25 years in the service, he lecturers and publishes frequently on fire service leadership, safety and wellness topics. He has worked extensively with fire departments in more than a dozen states with master and strategic plans, accreditation, department evaluations and consolidation studies.

The Paradoxical Commandments of Fire Service Leadership

Blog by Doug Cline
International Society of Fire Service Instructors, Vice President

It’s always good to remember what we were taught by our mentors. Listed below are The Paradoxical Commandments of Leadership, which I was raised on during my early years in the fire service. These commandments of fire leadership are right on, not only for those of us in the fire service, but every profession and in all areas of life.

Here are The Paradoxical Commandments of Fire Leadership:

1. People are illogical, unreasonable, and self-centered. Love them anyway!

2. If you do well, people will accuse you of selfish, ulterior motives. Do well anyway!

3. If you are successful, you win false friends and true enemies. Succeed anyway!

4. The good you do today will be forgotten tomorrow. Do it anyway!

5. Honesty and frankness makes you vulnerable. Be honest and frank anyway!

6. The biggest men with the biggest ideas can be shot down by the smallest men with the smallest minds. Think big anyway!

7. People favor underdogs, but follow top dogs. Fight for the underdogs anyway!

8. What you spend years building may be destroyed overnight. Build anyway!

9. People really need help, but may attack you if you help them. Help people anyway!

10. Give the world the best you have and you’ll get kicked in the teeth. Give your best anyway!

Ironically, I was searching for something else in the office when I ran across an old text book that I utilized while going through the International Society of Fire Service Instructors Company of Development Series many years ago. One of the authors of the book, Fire Chief Dan Jones, wound up being my mentor. The book Managing People happened to fall to the floor during my search and randomly opened up to page 32 where these commandments were listed.

This just happened to be at an opportune time in my life when I was looking to clarify focus, create drive and provide sound direction for my future. These commandments were like a sign from above.

Over the past year, I’ve had many discussions with colleagues across the country about the issues and frustrations we encounter on a daily basis in the fire service. It can be depressing. And I’m sure it’s not just the fire service. The future holds so many uncertainties. I’ve watched friends with more than 25 years be laid off. We see fire stations closing, training centers shut down and good leaders cut at the knees by ram-rod political events.

I believe the book falling open to the exact page of The Paradoxical Commandments of Leadership is one of those events the kind that make you say, OK, I get it!

My frustration with the fire service is like riding a roller coaster. Many issues influence my feelings. I often find myself disheartened with current events that happen routinely in our business. Thankfully, The Paradoxical Commandments, which were written in 1968 by a 19-year-old Harvard student named Kent Keith, have given me, and will continue to give me guidance.

Keith’s commandments were part of The Silent Revolution: Dynamic Leadership in the Student Council, his first book for high school student leaders, which can be carried over to everyone in every profession.

I laid down the Paradoxical Commandments as a challenge, Keith is quoted saying. The challenge is to always do what is right and good and true, even if others don’t appreciate it. You have to keep striving, no matter what, because if you don’t, many of the things that need to be done in our world will never get done.

Thank you, Mr. Keith, for your wisdom. It’s as true today as it ever was.

About the Author
Douglas Cline is a student of the fire service serving as training commander with the City of High Point (N.C.) Fire Department and assistant chief of administration with the Ruffin Volunteer Fire Department. Cline is a North Carolina Level II Fire Instructor, National Fire Academy Instructor and an EMT-Paramedic instructor/coordinator for the North Carolina Office of Emergency Medical Services. Cline is a member of the North Carolina Society of Fire Service Instructors and the International Society of Fire Service Instructors where he serves on the Board of Directors as The First Vice President.

CDC Makes It Clear Vaccination Records are Your Responsibility

Blog by Katherine West
Author and consultant on infection control

In December of 2011, the Center for Disease Control published updated guidelines and recommendations regarding vaccine records. The document clearly stated that EMS personnel are indeed covered under these guidelines, stating Health-Care Personnel (HCP) might include (but not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students, trainees, contractual staff not employed by the healthcare facility.

It is very clear EMS is covered. It should also be noted that National Fire Protection Standard 1581 makes the very same statement and recommends following the CDCs recommendations.

Due to the outbreaks across the country for measles and Pertussis, it is essential that vaccination/immunization records be available to assist with prompt exposure follow up. Here are the CDCs statements:

– HICPAC and CDC have recommended that secure, preferably computerized, systems should be used to manage vaccination records for HCP so records can be retrieved easily as needed

– Each record should reflect immunity status for indicated vaccine-preventable diseases, as well as vaccinations administered during employment

Medical records belong to the individual, so it is your responsibility to request the information be sent to your department. A declination form should be signed if an individual fails to request records.

Every health-care worker should be aware of their immunity status and possible need for a preventive vaccine. Vaccination is critical to risk reduction and concern in an exposure situation.

For more information, please check online at www.ic-ec.com.

About the Author
Katherine West is an expert in the field of infection control. She’s worked in the industry since 1975 and has served as a consultant to the Center for Disease Control and the National Institute of Occupational Safety and Health. She authored Infectious Disease Handbook for Emergency Care Personnel and is a well-traveled lecturer and author.

A Case for Company Performance Standards

Blog by Bill Sturgeon
Retired Division Chief of Training for Orange County Fire Rescue Department in Florida

During the 1970s, the fire service became involved in Emergency Medical Services. Then, during the 80s, it was Hazmat. And in the 90s, it was technical rescue. After 9/11, Urban Search and Rescue (USAR) became the new service everyone wanted to provide.

We trained hard and became proficient at delivering these new services. But there may have been some unintended consequences.

I recently retired as the chief of training for a large metropolitan department in Florida. The department has its fair share of fires and I noticed numerous times that critical errors related to fundamental firefighting techniques were being made.

Pulling the wrong line (too short, too long), hooking up to an intake instead of a discharge, not properly using forcible entry tools, poor ground-ladder deployment. The list goes on and on.

If this sounds familiar, read on! This is how your department can develop a low-cost training program, set performance standards, improve basic skills and have some fun in the process.

To begin with, fire chiefs must use company performance standards to measure progress. These can be internally developed standards or you can refer to NFPA 1410 (Standard on Training for Initial Emergency Scene Operations, 2010 Edition) and use it as the standard.

The bottom line is that this training must be supported from the top. All officers must get up, get out, and participate with crews.

Find out who are your strongest players. Find out who are your weakest links. And determine who your top company is so they can mentor and teach others.

Company officers must train and challenge their crews to meet or exceed standards (measured in time and accuracy). Drivers can review basic hydraulic skills, or you can develop a scenario to solve that includes a basic pumping problem.

Finally, firefighters should strive to master each task. Why? Because it is their job. Because they are the future leaders of the fire service (drivers, officers, and instructors) and they need to be capable of passing down knowledge to the newest members.

It’s better to learn these skills in the beginning of your career. They will serve you well.

Developing the plan:
1. Identify special requirements for your jurisdiction. Are there special circumstances you must consider when developing your training outlines?

2. Determine what standard you are going to follow. Is it going to be the NFPA 1410, your own, or a combination of both?

3. Develop necessary drills and use your reference materials.

4. Break down each task into a separate drill. No more than one sheet.

5. Set a time limit to complete the task or refer to NFPA 1410. This will be your performance standard for initial training.

6. Enlist some of your senior people to test the drills out (chiefs, captains, and commanding officers). This is the alpha test. Get some photographs of them in action and post them prior to having the company perform the drills. This creates buy-in. Obtain their feedback on how the drills can be improved.

7. Identify facilitators (instructors and/or mentors) and have them master the drills while troubleshooting any problems. This is the beta test. Now they are ready to begin teaching!

8. Start the drills.

9. All drills should be performed in the appropriate PPE. You are trying to get crews comfortable in their gear when operating at the scene of an emergency. It also will assist in acclimatizing personnel for inclement weather. Do not forget rehab!

10. Have each company pair up with another company in an adjoining district to practice and master the drills. Your facilitator, company officer, or chief should set up these training sessions. If meeting on the line between districts, keep one unit in service for response or use a reserve apparatus.

11. Have your mentors and/or instructors meet during regular intervals to review the training and teaching points. This is continuous quality improvement.

12. Publish each company’s drill times in a public area (the TargetSolutions platform is a great tool for this). This builds pride and competitiveness.

13. Document and share lessons learned. Explore new ideas and techniques.

14. Once all of the training is completed, develop the department performance standard and demand each company meet it. Require monthly training on the standards then supervisors should quarterly spot-check and regulate annual performance standard testing.

You will see dramatic improvement in basic skills if you use this approach. I sure did!

About the Author
Bill Sturgeon is a retired division chief of training for the Orange County Fire Rescue Department in Florida. Sturgeon was a 30-year veteran of the United States Fire Service. During his career, he served as a volunteer, military, municipal, and county firefighter and held many positions, including paramedic, EMS supervisor, company officer (special operations), safety officer, battalion chief, assistant chief and division chief. He is a graduate of the Executive Fire Officer Program at the National Fire Academy.