Battalion Chief Keith Long Fairmount Fire Protection District Golden, Colorado.

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Battalion Chief Keith LongBattalion Chief Keith LongFairmount Fire Protection DistrictFairmount Fire Protection District

Golden, Colorado Golden, Colorado

Who is this Guy?Who is this Guy?

Our JourneyOur Journey

• Perception vs. Reality• Our Mission has

Changed• Situational

Awareness• Infectious Disease• MRSA• Where do we go from

Perception vs. RealityPerception vs. Reality

• Finished files are the result of years of scientific study combined with years of experience.

How many letter “F”s in previous How many letter “F”s in previous slideslide

• 3?

• 4?

• 5?

• 6?

CharacterCharacter

“The ultimate measure of a person is not where they stand in moments of conflict and convenience, but where they stand in times of challenge and controversy”

Copyright Silva, Sweden, all rights Copyright Silva, Sweden, all rights reservedreserved

ThenThen

• Wildfire

Our Mission is ChangedOur Mission is Changed

• Wildfires• Hurricanes• Tornados• Earthquakes• WMD• 911• Snow Storms• Pandemics and Epidemics• Etc

Infectious DiseaseInfectious Disease

• Foodborne

• Waterborne

• Airborne

• Bloodborne

• Zoonotic/Vectorborne

Pathogens Transmitted in CampPathogens Transmitted in Camp

• We will be specifically talking about strategies for containing pathogen potential spread person to person.

Transmission Modes Transmission Modes

• Respiratory – e.g. influenza

• Direct Contact – e.g. Staph Infections

• Contaminated Environments - e.g. Norovirus

Questions?Questions?

• How many of you folks are on Teams?

• How many of your teams have Emergency Response Plans?

• When did you last practice the Plan?

• How many of your Teams have Infectious Response Plans?

• Have you ever practiced the Plan?

IDRP/ERP for IAPIDRP/ERP for IAP

• Position Checklist – Field Organization

• Division/ Group Supervisor

• Medical Group Supervisor

• Triage Unit Leader

• Treatment Unit Leader

• Transportation Unit Leader

Four Routes of EntryFour Routes of Entry

• Inhalation

• Ingestion

• Absorption

• injection

Its too late to duck!Its too late to duck!

PreparationPreparation

• N95 Masks for all members

*Must be fit tested*

• Safety Glasses

• Exam Gloves

• Hand Sanitizer

Masks and RespiratorsMasks and Respirators

• N95 Mask or Respirator (goes on you)

Surgical Mask (goes on them)

ResourcesResources

• Local Health Department

• Local clinic or Hospital

• State Health Department

• Center for Disease Control

SpecificSpecific

• MRSA – Methicillin – Resistant Staphylococcus Aureus

MRSAMRSA

• Background

• Signs and Symptoms

• Incubation Period

• Treatments

MRSA and FirefightersMRSA and Firefighters

• Methicillin Resistant Staph Aureus is a Staff infection that is resistant to normal antibiotic treatments.

• It exists on the skin and in nasal passages and is “colonized” in 20 to 30% of all people with no symptoms

• The Centers for disease control estimates that by 2015, all of us will carry some form of MRSA.

• It used to be solely a hospital problem but is now found in the community.

• MRSA can survive on some surfaces for up to 2 months.

• Why Fire Fighters?• FF’s move through the community, hospitals and patient environs

more that the general public.• Combined living/working environment• High potential for skin irritation/lacerations• Do not regard small injuries as a threat.• Why be concerned?• If MRSA enters the bloodstream it can cause death or damage that

makes you disabled.• Most MRSA treatments average cost to treat is between $15000.00

and $20000.00.

THIS IS NOT A NEW PROBLEM

FOR FIRE FIGHTERS

It is a problem in many fire stations, fire crews and at least one case of MRSA has

been found in every state across the nation.

• It starts as a pimple with red tender edges.

• What does it look like?

• Progresses into an abscessed infection quickly.

• If it enters the bloodstream it is hard to treat. – Only two antibiotics can cure it then.

• Can result in Fever, Malaise, Hospitalization and lost work time.

• Almost all MRSA can be treated by drainage of pus with or without antibiotics.

• If antibiotics are used, a sample must be analyzed first to determine the strain and type of antibiotics to use.

• Open skin wounds must be covered and dry. Do not use ointments for treatment of MRSA.

• Regard breaks in skin as potentially serious issues

• What can we do?• MRSA cannot live if there is not moisture. Dry PPE,

shirts and pants after use.• Make new bleach solutions everyday… Needs a ten

minute contact time to be 100% effective.• Use alcohol cleaners with at least 70% alcohol.• Cover any skin irritations or lesions with a dry bandaid.• Don’t wear the same clothes consecutive days when

sweating a lot.

• What can we do cont. What can we do cont. • WASH YOUR HANDS, FACE and WASH YOUR HANDS, FACE and

ARMSARMS» Wear Gloves and PPE Wear Gloves and PPE

• CLEAN! CLEAN ! CLEAN!CLEAN! CLEAN ! CLEAN!

Alcohol Based Hand SanitizersAlcohol Based Hand Sanitizers

• What about alcohol based hand sanitizers!

A Gift from the NLWA Gift from the NLW

• Myclyns – immediately after contact with – Blood– Saliva– Vomit– Coughing– Feces– Open wounds

Myclyns Myclyns

• Kills 50 pathogenic bacteria upon contact99.99%• MRSA• TB• Hep A, B, and C• H1N1• Hepatitus

ExtendaClynsExtendaClyns

• Hand Sanitizer

• Non Alcohol based

• Broad Spectrum

• Last up to 4 hours

• Kills 99.99% of germs

Leadership Development In High Leadership Development In High Risk EnvironmentsRisk Environments

• Training

• Field Experience

• Self Development

• Exercises

Fireline Leadership Challenge Fireline Leadership Challenge

• Time Pressure

• High Stakes

• Inadequate Information

• Ambiguous Objectives

• Poorly Defined Procedures

• Rapidly Changing Conditions

• Requirement of Team Coordination

Train as you fight, fight as you trainTrain as you fight, fight as you train

Cognitive Memory SystemCognitive Memory System• Complex and connects memories togetherComplex and connects memories together• Well integratedWell integrated• Treats information neutrallyTreats information neutrally• Subject to control and filteringSubject to control and filtering

Emotion & Fear Memory Emotion & Fear Memory SystemSystem

• Responsible for special emphasisResponsible for special emphasis• Stimulus-drivenStimulus-driven• Direct and quickDirect and quick• Highly emotional, inflexible, and fragmentaryHighly emotional, inflexible, and fragmentary• Connected directly to fear responsesConnected directly to fear responses

Are we setting ourselves up for Are we setting ourselves up for failure?failure?

• Wildland vs. Structure vs. All Risk

• Emergency Response Plans Incident within an incident

• Infectious Disease Response Plans

Lessons LearnedLessons Learned

• 95% of illness comes from inadequate washing of Hands, Sleeping in Dirty Clothes

• Incident Emergency Medical Task Group

Ideas and SuggestionsIdeas and Suggestions

• Medical Unit Leaders utilize Isuite Injury/ Illness section.

• Brief your folks, Give Expectations

• Have your people do evaluations on you

6 Priorities in Fire Camp6 Priorities in Fire Camp

1. Case Isolation or cohorting

2. Personal Hygiene

3. Environmental Sanitation

4. Crowding

5. Education and Awareness

6. Pre-deployment Interventions

Final ThoughtsFinal Thoughts

• I don’t have all the answers, Hopefully I never will. When I do it’s time for me to leave. Empower your people. Mentor your people. Utilize SME (subject matter experts)

• Thank you for all you do!

Battalion Chief Keith Long Fairmount Fire Protection District Golden, Colorado.

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