The tragic collision between the American Airlines regional jet and a U.S. Army Blackhawk helicopter, sending both aircraft into the icy Potomac River in Washington, D.C., will surely cause many EMS responders to think about how they respond to events like this.
Some will consider the water operations aspect of the event, including the need for highly trained dive personnel, while others will work through MCI protocols that would be used had the crash occurred over the runway, resulting in casualties to treat and transport.
Especially in a large metropolitan area, an event like this will also require activation of many other emergency plans, including:
- Scene security
- Media relations
- Fatality management
- Hazardous materials containment
- Family reception
Imagining this tragedy occurring in your jurisdiction should also make you think about the environmental challenges your rescuers face throughout the year. In this particular case, responders had a cold, dark and wet winter scene to manage. Temperatures were about 50°F with gusty winds when the crash occurred, dipping down to 35°F overnight as the search for victims continued. The waters of the Potomac River were in the mid-thirties, with chunks of ice floating through the scene.
What steps do you and your service take to be prepared for winter scenes? What measures are in place for your teams to endure the elements during a prolonged incident?
Department weather safety plans
Each service should be planning to support its members when out for a prolonged time at a scene. Whether it is excessive heat or cold, providers must be able to take a break when needed, requiring shelter out of the elements. This could be as simple as hopping into your ambulance to warm up or cool off, or a larger specialty vehicle designated to provide shelter, such as a heavy rescue unit or a command vehicle.
More prolonged scenes may require temporary shelters to be set up. Collapsable tents or canopies are commonly used and carried by fire departments and emergency management. Fans, heat sources and air conditioning are available as well.
Whenever possible, department plans should also include provisions to allow EMS crews to be relieved from a prolonged scene to allow them to return to the station, change clothes, warm up and get a healthy meal.
On-scene cautions and rehab operations
The concept of keeping an eye on your partner is always sound advice, but it is especially important in cold weather operations. Lower temperatures bring a risk of hypothermia, especially when mixed with rain, snow and perspiration-soaked clothing. One of the dangers of hypothermia is that the victim does not realize they are slipping into it. As their body temperature drops, they slowly begin to lose motor skills and their central nervous system slows, creating mental fog and delayed reactions. Responders need to monitor each other and be alert to any signs of impaired functioning.
EMS personnel may be called upon to assist with rehabilitation efforts. During cold weather operations, the priority for rehab is getting workers out of the elements and into a warm, dry environment to rest. While they warm up, their vitals signs should be checked per department policy and they should drink some fluids and have some high-calorie snacks. If their clothes, turn-out gear or other PPE are wet, work to get them dry gear before releasing them back into the cold.
|More: Cold weather response tips for EMS
Come to work prepared
While on scene, whenever possible, stay in your rig or other warm environments until you are needed. It may be tempting to get up and close to the action to see what is going on, but stay out of the elements and don’t make your body waste energy keeping you warm. When you do get out of your rig, put your coat and hat on. This is not the time or place to try to be tough and brave the cold without the proper attire. Don’t look like the high school kid dressed in only short sleeves waiting on the corner for the school bus in the dead of winter.
Each night I work an EMS shift during the winter, I take a look at the weather forecast and decide how many layers I will be sporting.
Although I may be a little warm spending most of my hours in the EMS station or at one of our emergency department posts, I still dress for that potential call that could take me into the woods for a snowmobile crash or have me standing on a highway for an extended motor vehicle collision extrication.
I forgo the ease and comfort of lighter slip-on shoes or sneakers for more sturdy and warmer boots that are less likely to get soaked if I step in a puddle.
In the ambulance, I keep a good set of gloves and a warm hat. If I am starting the night with just a sweatshirt, my warmer shell jacket is stuffed in a compartment in the ambulance.
Back at the station, I usually keep an extra uniform, including spare socks. Anyone that has worked EMS for more than a week knows that there are more than a few reasons to keep an extra uniform handy. Getting wet during a rainy or snowy emergency scene is on the list, too. And don’t overlook the danger of wearing perspiration-soaked shirts or long underwear if you might have to go back out in the cold.
Whether it is a major incident, such as the tragic crash of an airliner, or a hiker injured a couple miles out in the woods, EMS responders must be prepared to be out in the cold weather and still provide professional and safe patient care. Take steps to be personally ready and help ensure your department has plans in place as well.
Stay safe out there.
