Wounds Occurring When Not Following SOPs

Last week we discussed wounds occurring when not wearing gloves.  Not wearing gloves, and other PPE for that matter, is often a violation of departmental Standard Operating Procedures (SOPs).  Many reported injuries could have been avoided had the injured party followed their department’s SOPs.   This week we’ll focus our blog post on the importance of SOPs and how you can decrease injuries by making sure you and your team follow them on every call.

SOP Issues

The commission requires every regulated entity to adopt several SOPs. These SOPs are required to ensure the safety of all fire fighters. Unfortunately, we have seen a few areas where firefighters were not following these SOPs.  Incorporating SOPs into training is a good way to build habits leading to safer behavior on the fire ground.

In 2011, among the injuries reported, you reported 27 documented SOP violations. The majority of them involve the injured parties not wearing Personal Protective Equipment (PPE) – often missing gloves. 

Check out some examples of Wounds occurring when the injured party was not following departmental SOPs:

“Individual got burned due to not wearing PPE during grass fire.  The department has SOP's regarding wildland fires and PPE that should be used.  The department is addressing this internally.”

“He has PPE's but was not wearing the coat. He was the driver of the pumper and was rolling up the red line and was pulling it over the wire fence.  He does not have wildland PPE's.  He failed to comply as he should have had his coat on.   The department will address internal SOP issues.”

Fight like you train

Do what you can to make sure your department provides quality training experiences, by incorporating department SOPs.  These should realistically reflect situations your team will face.  Similarly, when you are on scene, react the way you were trained to react.  Don’t cut corners in training, or on the scene.  Make sure proper PPE are worn and SOPs are followed during and after training – ALWAYS.  Make it habit, so that when the time comes no one gets injured or finds themselves in a near-miss situation. 

Write effective SOPs for your department
Learn to write applicable and realistic SOPs and you’ll get higher adherence rates.  Additionally, you’ll have safer firefighters who develop better work habits.  Check out these tips and contact the TCFP Library for other departments’ examples of our required SOPs.

• Firefighter Close Calls Policy & SOP Program
• Developing Effective Standard Operating Procedures (USFA)
• The Simple Approach to Writing Effective SOPs (Fire Engineering)

Follow up from last month:  Last month we discussed a near-miss that occurred in Hutto, TX.  Firehouse Magazine’s continued coverage of that incident is in their January issue.  They address the issue of having quality SOPs, and training to them.  If you need a copy of the articles, contact the TCFP Library.

Are your department’s SOPs realistic? 

Do your department’s SOPs play an important part in training?

Wounds Due to Not Wearing Gloves

Image courtesy of jasonEscapist via flickr - click to enlarge

Last week we discussed the wounds that fire departments are reporting to us. It seems that many of these wounds could have been avoided had the department’s standard operating procedures (SOPs) for PPE been followed.  This week we’ll focus on injuries incurred when not wearing gloves.

 

“No Gloves” Injuries

Quite a few injuries result when personnel don’t wear gloves when they should. When this occurs in your department, you’ll want to ask yourself, “Why are you taking off or not wearing the gloves?” Is it because gloves interfere with your dexterity, making it difficult to perform the task at hand? Is it habit (and not a good one) that you need to correct? Should the department look into the brand or type of glove the department is using and evaluate them for their effectiveness?

Check out some examples of Wounds occurring when the injured party is not wearing gloves:

“Fire fighter was part of a three-man team that had responded to a private residence for a water flow alarm and smoke investigation. Sprinkler system had extinguished fire in main room. While doing a secondary search for extension, fire fighters discover flame and called for water supply. While refitting equipment, adjacent room flashed causing burns to fire fighter's hands before he could complete putting his gloves back on.”

“Employee was at scene of MVA and attempted to pry tail pipe on muffler away from tire. Hand slipped and received laceration to index, middle and ringer of right hand. Went to hospital ER and received stitches to 2 fingers. He was not wearing fire fighting gloves at the time of injury.”

“During overhaul operations, the firefighter was standing on the base of a "pull-down" attic ladder. He began to climb the ladder to hand tools to a firefighter working in the attic when the ladder broke. As the firefighter was falling, he grabbed the side of the ladder and lacerated his finger. The firefighter was not wearing gloves at the time of injury. The laceration required five stitches.”

“At a structure fire, fire fighter was working in an attic space checking fire conditions. He removed his gloves to use the thermal imaging camera when the attic flashed over causing second degree burns to the back of his hands. He was wearing all of his PPE and SCBA except for his gloves. He was transported to the hospital.”

“Firefighter was loading hose tray back on engine and was not wearing gloves. A burr on the metal sliced his right thumb open.”

What is the problem & how can it be fixed?

You often find yourselves in urgent situations.  These situations can cause you to cut corners.  This is understandable, but doing so puts you in harm’s way.  Additionally, some gloves keep you from being able to perform your duties by limiting dexterity.  Having high-quality gloves and a variety of gloves readily available will ensure that you wear the right gloves for the job and keep yourself safe.  Taking the time to stop, pick the right gloves, and then get on with your job is worthwhile; at least when compared to missing work!

Wear high quality, appropriate, gloves that meet national standards

Care for your gloves properly

Inspect gloves properly (video)

Choosing, fitting, and buying the right gloves on Firerescue1

NFPA 1971 Standard for Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting – paying attention to upcoming revisions

Does your department provide a variety of gloves to you for a variety of types of jobs?  What’s your favorite type of glove for specific duties?

Is it realistic for you to pick the right gloves, at the right time, to do the job right?

Wounds

A wound, as defined by Webster’s New World Stedman’s Concise Medical Dictionary,

is “a trauma to any of the tissues of the body especially that caused by physical means and with interruption of continuity.”

Take a look at the wound injuries your departments have been reporting. 

The majority of these have occurred during the following four activities: Fire Suppression; Station Duties; Rescue Non-Fire Activities; and Skills Training. 

Wounds by Activity - click to enlarge

 

Within those categories, the most frequent injury types are cuts/lacerations and minor trauma contusions/bruises.  These types of wounds make up 80 percent of the wounds reported.

Wounds by Type - click to enlarge

The hands and fingers far outnumber any other body part with wound injuries - with 229 injuries. 

Wounds by Body Part - click to enlarge

Wounds occurring during Station Duties

The commission has defined Station Duties, for injury reporting purposes, as “Any activity done around the station, not an emergency response activity.”   Examples include checking apparatus, moving apparatus, checking hydrants, or maintaining the station (mowing, cleaning bays, house-keeping, etc.).

Station Duties - Wounds - click to enlarg

Check out some examples of Wounds occurring during Station Duties:

“Blade hit leg while attempting to start vent saw. The saw was not running at the time.”

“Employee reports that while at the fire station he lacerated his right hand while sharpening a kitchen knife used for preparing meals.”

Wounds occurring during Fire Suppression

Fire Suppression - Wounds - click to enlarge

Check out some examples of wounds occurring during Fire Suppression:

“Employee stated that while on location right hand was punctured pulling a wall down - a nail went through a glove sustaining injury.” 

“Firefighter was dragging a charged hose line through a burning structure and tripped over contents - bruising his shins on both legs.” 

“While cutting a fire break line, using hand tools, firefighter struck self with pulaski - not breaking the skin - causing localized swelling the size of a gold ball.  Firefighter didn't have a current tetanus shot and was transported to local hospital.”

Wounds occurring during other activities

Check out some examples of wounds occurring during Rescue – Non-Fire Activities:

“Firefighter lacerated left middle finger while working at a motor vehicle accident.”

“Employee was providing medical treatment when he was punctured by needle stick on left thumb.”

“Firefighter received injury while removing patient who was covered in broken glass at a MVA.”

Check out some examples of wounds occurring during Skills Training:

“Employee was doing extrication training.  Another employee swung an axe & it made contact with the halligan that the first employee was holding, hitting his left index finger.”

“Firefighter was doing training with a metal snap tank when a loose piece of metal sliced through his finger causing an approximately 1.5 inch cut.”

 Wounds can be avoided

On the fire ground, things are hectic and can easily go wrong.  If your team trains with department safety SOPs in mind, you’ll be safer on scene.  Using proper PPE for various situations will also help protect you from wound injuries.  In the station, and in non-emergency situations, take the time to do things right and use the proper tools for the job.  You can avoid wound injuries on the job, in any situation.

Quick tips for avoiding wound injuries:

•  Wear the proper PPE for the proper job. 
•  Follow the instructions on any equipment. 
•  Take your time, when not in an emergency situation. 
•  Train safely, so that it becomes habit in the field.

In the coming weeks, we’ll be discussing two types of wound injuries reported to us – wounds that could have been avoided had the injured party been wearing the proper (or any!) gloves, and wounds that likely occurred because department SOPs were not followed at the time of injury.