Tuesday, April 21, 2009

Putting generic Strategic Priorities to work

One of the things I do with my all-too-rare spare time is that I read. My favorite genre is science fiction and sci-fi fantasy, because it often fuels my imagination. A lot of yesterday's science fiction ends up being tomorrow's science fact, too.

I recently finished a book regarding an unusual twist on a fairly standard plot - an uneasy intergalactic peace brokered by an advanced non-human society after two different human societies attempted mutual genocide.

The author could have been writing Strategic Priorities for fire and rescue. Her take on how to keep oriented to the proper Strategic Priorities, no matter what the situation involved four simple concepts and keeping them in sequence. The priorities...Life, Mission, Security, Operations. Fire and rescue services would be well-served to remember those same four priorities during both emergency situations and during our everyday routine.

Life - If we lose our lives, we can't accomplish the mission or any of our other priorities. At the scene, we need to focus on the most important things - discovering the things that can kill us and avoiding them. Those things can be buildings, forces of nature, evil people, or or our own egos. Or...it can be more insidious...smoking, lack of fitness, heat stress, cumulative stress, or a driver that's just a little sloppy with the accelerator.

Mission - If we don't accomplish the mission, we're wasting our time being there in the first place, plus our training time, plus our pre-planning time, plus our vehicle maintainence, plus the public's trust...

Security - If we don't secure our apparatus, our stations, and the rest of the public property with which we've been entrusted, then we may not be able to take care of our first two priorities. If we're missing tools, or if our station is wide open for anyone to steal from it or trash it while we're gone, then we might be missing the one tool that will save our lives or just the public's trust that we're going to be responsible with the expensive stations and equipment with which we're entrusted.

Operations - We have to keep on operating, no matter what challenges occur. Budget cuts, brownouts, station closures...the department keeps on operating. High call volume and unusual calls, check. Major terrorist attack, check. Long, boring shifts with few or no calls, check. A firefighter-arsonist that shames us all...the rest of us still keep on pulling on the gear and rolling out the doors.

If in doubt about what the priorties are, make sure that you and your crew can stay alive...the other priorities are important, but you can live without them. After all, imaginary intergalactic heros do it all the time, and they have it made compared to us. After all, their problems are imaginary.

Saturday, April 11, 2009

To evaluate progress, take a SEET

During simple call like a room and contents fire, it's usually fairly easy to evaluate progress.

The black smoke turns to white steam, the fire goes out, the building cools down, we go home, and the invetigators take over. The next morning, the local newspaper reports the wins and losses...hopefully with a box score that reads "Fire Department wins, 1 to 0". The local paper usually isn't shy about reporting the score when we're on the losing end, either.

Have you ever seen the morning paper report a tie score?

I've never seen a "Fire 1, Fire Department 1" front page box score. That means that eventually we figured out who won, but during the fight, it wasn't easy to tell. We can have a smoky fire that's difficult to find, even with thermal imagers. We can have a prolonged entrapment at a motor vehicle accident with so much wreckage that it's difficult to tell if we're making real progress or not. We can have a major incident where it takes days to find all of the problems and weeks to sort them out.

I've found a simple way to evaluate progress that works on almost any incident type...you just have a SEET. SEET is a simple set of four strategy considerations that you ask yourself Jeopardy style...in the form of a question.

Safety - Are we being safe? If we don't create additional patients, properly care for the people who were injured before we arrived, and operate using safety equipment, PPE, and while practicing safe behaviors, then we're being safe. If we're injuring responders, operating carelessly, or not wearing appropriate PPE, then we're not being safe.

Effectiveness - Are we being effective? Are we getting the job done? Can we tell? Task completion is the easiest way to measure effectiveness, but on a prolonged incident, task completion might have to be broken down into a subset of smaller tasks. "Cut through Beam A by 4 PM" or "Defensively confine the fire to the structure of origin if we can't extinguish the fire offensively in the next ten minutes" are pretty obvious measures of effectiveness.

Efficiency - Are we being efficient? Did we do an accurate size-up and take the right tools to the building or wrecked vehicle the first time, or did we have to send firefighters back to the rig for something that was forgotten or not anticipated? Did we split a four-firefighter crew so that they could accomplish two simultaneous tactical objectives? Are we operating in a manner that looks calm, smooth, and professional?

Timeliness - Are we doing things in a timely manner? Are we doing things at the right time and in the right sequence. Timeliness includes getting water on the room and contents before it extends, stabilizing the wrecked vehicle prior to applying tons of force to the it...and to the patient's cervical spine injury, and in performing tactical priorities in the correct sequence for the situation. RECEO-VS is a mneumonic invented by a Timeliness fan.

I don't know about you, but I'm having a SEET the next time I want the paper to report a win for the firefighters.

Sunday, April 5, 2009

Staging Prevents DIOs

"DIO" is a "Disfunctional Incident Outcome". A DIO can be something as mundane as two engines trying to lay in from opposite directions in the same street, or it can be something as severe as a LODD at hazmats, shootings, and other violent or escalating incidents.
Staging Prevents Funerals when you're responding to incidents with an expanding Hot Zone.

Saturday, April 4, 2009

Rolling the Window Down on Safety

Skip Kirkwood's Jems Connect blog had an excellent post about the recent multiple shootings at the nursing home in Carthage, NC, Binghamton, NY, and todays triple police officer murder in Pittsburgh, PA. Skip made some excellent points about how to approach dangerous scenes.

Skip's post triggered reminders of some old street safety habits that were daily occurrances in two high-volume cities where I previously worked. I have gotten a little slack on using these basic survival behaviors, due to the relatively peaceful nature of the town where I work now.
Skip's reminder that two of the three above multiple shootings occurred in similar "peaceful" towns to mine reminded me that there's no such thing as a really safe place to work fire-rescue or EMS.

My old habits - ones I dusted off today - are the following:

1) Roll the Window Down on Safety. If you roll the window down at least a block out from the scene, you can hear screams or gunfire that would otherwise not be heard over the death metal your new EMS partner or engine driver plays while responding. Rolling down the window also lets you smell the natural gas leak started by the car that creamed the meter when it hit the house or the unusual smoke smells from the landscaping company fire that was reported next door to the actual fire location. With the window up, you have disengaged four of your five senses - vision is the only one working. With the window down, you add the senses of hearing and smell, and triple the number of senses working to keep you alive and unhurt.

2) Stage on every call where a known violent event has occurred. Domestic violence, reported shootings/stabbings/assaults, robberies, hostage situations, or even unknown suspicious scenes or high-crime locations are good places to stay away from until law enforcement secures the scene. Stage a block away, out of line of sight, and it could save the lives of everyone riding your rig.

3) Don't run the lights and siren right up to the front door. Unless you work on crowded city streets where you can't get to the scene any other way, it won't make a real difference if you cut the lights and siren a block out. Being the center of attention is great...unless you're a shooter's bullseye. Reducing your "Bullseye Profile" might also save your life.
Roll the window down, stage, lower your Bullseye Profile, and remember that bad things happen in otherwise peaceful towns as well as in the big city.