Seven Oak Fire burnover report released

A fire whirl, during the final run of the fire onto the burnover site. The blurry image of an air tanker coming in to assist can barely be seen.

On February 3, 2009 CalFire released the report about a burnover that occurred July 6, 2007 on the Seven Oak Fire which was part of the Inyo Complex on the Inyo National Forest in California. Nine firefighters from two engines suffered injuries and were treated at a burn center in Fresno, California.

Photo taken during the burnover.

The report is very well constructed, and highlights a lot of good decisions, as well as some that contributed to the burnover.

You should read the entire document, but here are some of the report's findings and contributory factors:

• The two engines were defending a structure that had been identified as undefendable.
• The burnover occurred during a transition to an Incident Management Team.
• Providing medical treatment and air transportation for the injured to the Burn Center was much delayed.
• Two fire fighters experienced difficulties removing their fire shelters from the PVC bag.
• Fire suppression personnel resorted to their core training, which saved their lives. Per statements taken, the pond had been identified as a safety zone, if needed, by Engineer 4480. When things did not work as planned, each employee resorted to their core training and gathered at their identified safety zone. They communicated with, and supported one other. Working as a team, they survived this incident.

Engine 4452

The photos are from the report.


Thanks, Dick.

Wildfire news, November 11

Large fire in Brazil

Illegally set fires have burned about half of Chapada Diamantina National Park in Brazil. Over 75,000 acres of forest have burned so far in the park. Nearly 500 firefighters are working on the fires which began in July, probably caused by ranchers clearing land for grazing. The region was once a rich source of diamonds, but now depends on ecotourism.

Update on pilot who survived helicopter crash

Wildfire today covered the August 5 helicopter crash that killed nine firefighters here. There were four survivors, including co-pilot Bill Coultas of Cave Junction, Oregon. OregonLive.com has an update on his struggle to recover from his serious burns. You should be warned that reading the article can be difficult, as it describes in some detail the burn treatment that Mr. Coultas went through and is still enduring.

Firefighters should visit a burn unit

The EMT training I went through in San Diego included 24 hours of practical experience observing patient treatment in emergency rooms. While at University Hospital I became familiar with their burn unit and for the first time learned about the treatment and recovery process for victims of extensive third degree burns. The hospital personnel have to treat and debride, or clean, the burned areas on a regular basis. The process can be so painful that patients may be given morphine, or sometimes even a general anesthetic while it is done. This can go on for weeks or months.

This was early in my firefighting career. After seeing the suffering that burn victims experience, I made a pledge to myself that I would do whatever it took to prevent myself and firefighters under my supervision from ever ending up in a burn unit. Thankfully, I met this objective. After fighting wildfires for 20 years in southern California, and 13 years in other parts of the country, the most serious injury anyone working for me ever had was an ACL, a knee injury, when a very small female firefighter was carrying a heavy hose pack up a steep hill.

Every firefighter should take a tour through a burn unit or visit a firefighter undergoing treatment for burns. It may lengthen their career.

A little known fact

According to the diary of a passenger on the Mayflower, the ship landed at Plymouth Rock rather than continuing to their planned destination, Virginia, because of a lack of beer.

Engine burnover near Lincoln, California

Another engine burnover--this time it was two Placer County Fire Department brush engines on the Nicolaus fire near Lincoln, CA on June 11. Here is an excerpt from CalFire's "24-hour report" recently released:

On June 11, 2008 at 0949 hours, Placer County Fire units were dispatched to a vegetation fire at Nicolaus Road near Dowd Road, west of the City of Lincoln in Placer County. The fire occurred during a north wind event under a Red Flag Warning. BR 75, staffed with one Placer County Volunteer Firefighter, arrived first at scene reporting a wind driven five acre fire.

BR 75 drove down a dirt road paralleling the left flank of the fire. Engine 70 (E70) arrived and reported 7-10 acres with no structures threatened and assumed incident command (IC). BR 73 arrived next, staffed with one CAL FIRE Fire Apparatus Engineer and one Firefighter I. BR 73 followed BR 75 down the dirt road on the left flank. The right flank was inaccessible at this time.

Approximately seven minutes into the fire, E70 (IC) reported that units were being burned over. Appropriate EMS was requested.

The volunteer firefighter from BR 75 sought refuge on the leeward side of the apparatus. The fire intensity continued to increase and he retreated to safety, crossing a barbed wire fence, into a stubble field immediately to the east of the dirt road. He was met by apparatus and personnel from Lincoln Fire Department and escorted to ambulance personnel.

The CAL FIRE Firefighters from BR 73 tried to seek refuge in the cab, but were quickly overrun. They retreated through the flame front to the west, into the burn. Both of the firefighters walked north through the burn and exited where E70 was parked on Nicolaus Road.

All firefighters were treated and transported to UC Davis Medical Center. The volunteer firefighter from BR 75 received burns to the nose, was treated and released. The firefighters from BR 73 remain in the Burn Unit in stable condition with burns to the face and hands. They are expected to remain at UC Davis Medical Center for 7 to 10 days.

The Nicolaus Fire was contained at 1140 hours to 65 acres on June 11, 2008.

2008 Annual Wildland Fire Refresher Training

Having returned from Roatan Island, today I had a chance to review this year's Annual Wildland Refresher Training. As usual, it is well done and of high quality. The sections about the fire behavior, the Alabaugh Fire entrapment, and treatment for burn injuries are very interesting. Several interviews contributed a great deal to the DVD, including those of Dr. Bret Butler, Kelly Close, Dr. Ted Putnam, and Tom Boatner. The DVD even includes a copy of the piece that "60 Minutes" did on "Mega Fires" last summer.

Alabaugh Fire

There are quite a few issues related to the entrapment that could be opportunities for learning related to this fire which burned 10,324 acres and 27 homes. One homeowner died when he went back to try to save his belongings. The fire started from a lightning strike on July 7, 2007.

Some of the issues are mentioned only briefly in passing, perhaps to avoid criticizing the personnel who were involved. Some of the firefighters assigned to the fire were kind enough to step forward and discuss on camera their ordeal. They deserve our thanks for helping others to avoid a similar situation down the road. I hope the facilitators putting on the training this spring can allow enough time for some of these issues to be expanded upon.

Treatment for Burn Injuries

One of the units in the video describes the horrific situation that two federal employees faced after being burned on wildland fires.... and unfortunately I am not only referring to their burn injuries. The injuries are of course terrible to have to experience, but what could have made them even worse were the delays in being able to obtain adequate medical care.

Burn injuries are very complex and can't be properly treated by a primary care physician, a trauma center, or an emergency room, even if they have access to a plastic surgeon. Burn injuries require immediate treatment by trained specialists who deal with burns every day. Every day. In many cases, burn injuries will not heal properly or the healing will take much longer if the injuries are not treated quickly by the staff at a "verified burn center". Waiting days or weeks is not acceptable. The American Burn Association has more information about the verification process and also has a list of burn centers that qualify for this status.

In both cases on the video, the federal firefighters received treatment locally at emergency rooms soon after their injuries. After being discharged from the ER, they then, rightfully, tried to get proper treatment in a burn unit, but encountered administrative roadblocks in trying to deal with their agency and the Office of Workers Compensation (OWCP).

Eventually both victims, federal firefighters, received treatment at burn centers, but in one case it was three weeks after the injury.

Some of the following information came from the refresher video, some from my research, and some is just common sense.

What a firefighter should do if they are burned

• Obtain immediate treatment at an emergency room to stabilize the injuries.
• Before being discharged from the ER, if the injuries qualify under the criteria below, get a doctor to refer you immediately to a verified burn center. For federal employees, if this is done, the expenses for this further treatment by the burn center will be covered by the initial CA-16 form all the way through to recovery.
  
• If this is not done, you will have to then go to a primary care physician and convince them to give you a referral. This will take time.... time that you don't have.
• If you are having trouble obtaining adequate treatment and your agency will not help, contact the non-profit Wildland Firefighter Foundation at 208-336-2996. They are experienced in these issues and have access to attorneys who can help sort through the roadblocks. They can also provide money for the firefighter and their families if needed for travel or other purposes.
  

What employers of firefighters need to do

In advance, before anyone is injured, establish these policies

• Every person with a burn injury that qualifies under the guidelines as one that should be referred to a verified burn center (see below) will be referred to a burn center before they leave the ER. The agency will facilitate this process.
• Designate a compensation coordinator who knows the agency and OWCP policies, to be the liaison and advocate for the injured firefighter. This person should be in frequent proactive contact with the injured person or their family, especially during the first 2 to 36 hours.
  

What every firefighter should do

• If your agency does not have a written policy to ensure that burned firefighters receive proper treatment, ask that they establish one.
• Donate to the Wildland Firefighter Foundation. Their only goal as an organization is to help firefighters and their families, and they do a great job.
• Become familiar with the burn center referral criteria (below).
  

Burn center referral criteria

The American Burn Association has a link to these criteria developed by the American College of Surgeons' Committee on Trauma, to describe under what conditions a burned person should be referred to a verified burn center:

1. Partial thickness burns greater than 10% total body surface area (TBSA)

2. Burns that involve the face, hands, feet, genitalia, perineum, or major joints

3. Third-degree burns in any age group

4. Electrical burns, including lightning injury

5. Chemical burns

6. Inhalation injury

7. Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality

8. Any patients with burns and concomitant trauma (such as fractures) in which the burn injury poses the greatest risk of morbidity or mortality. In such cases, if the trauma poses the greater immediate risk, the patient may be initially stabilized in a trauma center before being transferred to a burn unit. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols.

9. Burned children in hospitals without qualified personnel or equipment for the care of children

10. Burn injury in patients who will require special social, emotional, or long-term rehabilitative intervention.

Lastly

Firefighters who are burned on the job deserve the best medical treatment available. Their employers should proactively see that this happens, both by having policies in place, and by having a compensation coordinator work very closely, immediately, with the injured firefighter all the way through to recovery. To do any less, is irresponsible.

And finally, the group that included the segment about burn injuries on the refresher training package should receive a lot of credit. This is important information for firefighters to have.


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