First on Scene: Managing traumatic injuries.

Emergency response and civil defence teams will sometimes find themselves at an incident where people have been injured and paramedic and similar care is not available.  When this occurs, it remains possible to respond effectively.  Essentially all responders will have first aid training; this note covers the systems which allow that training to be most effectively deployed.

In preparing this note I have drawn heavily from Wildernessand Remote First Aid (American Red Cross, n.p., 2010) and Ian Dunbar, VehicleExtrication Techniques (Holmatro, n.p., n.d.).

Scene Control

Confirm that the scene is safe (or is made safe) for your crew, the casualty and any bystanders.  Consider whether safety may be affected by daylight, environmental or weather factors.

Establish what happened, how many casualties there are and whether any of them are unconscious (ask bystanders and casualties).  If the incident was a high-impact event (for example, a road accident), it may be worth taking the time to work out the level of force which will have been exerted on a casualty using the formula E = ½M x velocity², or E (in joules) = ½ mass (in kilograms) x velocity² (in metres per second).  The greater the energy in joules, the higher the impact on the person, and the more severe their potential injuries.  By way of example, a person weighing 80 kgs who has been involved in a collision at 65 km/h (or 18 metres/second) will have a formula reading E = (½ x 80) x 18² = 12.96 kilojoules.

Consider what resources you have available to care for the casualties and whether further resources will be needed.

Casualty Management

Conduct a primary assessment of each casualty.  If required, also conduct a secondary assessment and take a SAMPLE history.  Document the information you obtain.

Primary Assessment

Assess for life threatening conditions with ABCDE questions –

A – Tilt the casualty’s head back and lift the chin to open the airway.  If the casualty can speak or breathe, their airway is open.

 

B – Spend ten seconds checking whether the casualty is breathing.  If not, commence cardiopulmonary resuscitation (CPR).

C - Check the casualty’s circulation.  If no pulse is found, commence CPR.  If the casualty is bleeding, expose the wound and apply firm direct pressure.

D – Check for any disability which may have been caused by a spinal injury.  If there appears to be a spinal injury, task a member of your team with ensuring the casualty’s back and neck are kept straight.  If the casualty is face down, use the log-roll technique to turn them face up.

E – Check for indications that the casualty has been exposed to severe environmental conditions, particularly extreme heat or cold.

 

Logrolling casualty from their chest to their back

Parts A, B and C of the above process are critical, and should be carried out first on unresponsive casualties who cannot communicate their distress.  Two of the greatest contributors to death in the first hour after an accident are loss of an airway and significant internal or external blood loss.

If you identify a life-threatening injury, treat the condition with the resources you have to hand and send for help.  The person sent to get help should be able to advise as to the location of the incident, the casualty’s injuries, any relevant environmental conditions and the resources available at the scene.

If no life-threatening condition is found, conduct a secondary assessment and gather a SAMPLE history.

Secondary Assessment.

A secondary assessment is significantly more detailed.

Hands-On physical assessment

With the casualty’s consent, conduct a hands-on physical assessment.  Look for deformities, open injuries, tenderness and swelling.  Check for circulation, sensation and motion of each limb.  Also check the colour, temperature and moisture of the casualty’s skin.

Responsiveness

Responsiveness can be assessed using the AVPU scale –

A – Is the patient alert and able to answer questions?

• A+Ox4 = Casualty knows who they are, where they are, what day it is and what happened.
• A+Ox3 = Casualty knows who they are, where they are and what day it is.
• A+Ox2 = Casualty knows who and where they are.
• A+Ox1 = Casualty only knows who they are.

V – Responds only to verbal stimuli (if you speak or shout at them)

P – Responds only to painful stimuli (e.g. a pinch)

U – Casualty is unresponsive to stimuli.

Vital signs

Does the casualty have normal vital signs?  For an adult, these signs will be –

• 12-20 regular and unlaboured breaths per minute.
• 50-100 strong and regular heartbeats per minute.
• Skin found to be warm and dry to touch and a colour appropriate for the person’s ethnic background.

Focussed Spinal Assessment

If you suspect that there is a spinal injury but cannot find any signs or symptoms, ask the following questions.  If the answer to each question is ‘yes’, spinal immobilization can be discontinued.

1. Does the casualty appear to be reliable?  That is, on the AVPU scale, is the casualty at least A+Ox3?  Are they sober and not distracted by injuries or other factors?
2. Can the casualty move their limbs and do they have normal sensation in them?
3. Does the casualty have a firm hand grip and can they lift their legs against resistance?
4. Does their spine have a normal range of motion, and do they deny pain or tenderness in the spine

SAMPLE History

Take a medical history from the casualty by asking the SAMPLE questions.

S – Signs and symptoms.  Ask the casualty what hurts?  Are they suffering pain, nausea, light-headedness or any other abnormal sensations?

A – Allergies.  Do they have any allergies?  Have they been exposed to anything which is likely to cause a reaction.

M – Medications.   Are they taking any medications?  If so, what for and when did they last take it?

P – Past medical history.  Ask if this sort of thing has happened before and whether they are currently seeing a doctor for any significant condition (for example, cardiac or respiratory).  Ask whether they have recently had surgery and (if female) whether they are pregnant.

L – Last intake and output.  Ask when they last ate or drank, and how much.  Are they currently hungry or thirsty, and when did they last relieve themselves?

E – Events leading up to the incident.  Ask how and when the incident happened.

Image from here

Evacuation

A decision will need to be made on whether to remain in place or to evacuate the casualties.  Before deciding, you should weigh up -

• How severe are the casualties' injuries, and do you have crew and equipment which will allow the casualty to be moved safely?
• How far will they need to travel, and over what terrain?
• How long will it be before outside help arrives?
• Are there particular hazards where you are? (eg rising flood water).  Will the weather be a problem if you do evacuate?

Swift evacuation

If you decide to evacuate, a swift evacuation is required for in cases of –

1. Worsening vital signs (including an increasing heart rate)
2. Hypothermia
3. Head injuries including skull fracture or suspected stroke; seizures which do not resolve within 10 minutes; and altered mental state caused by extreme heat.
4. Near-drowning causing loss of consciousness or respiratory problems.
5. Lightning strike.
6. Anaphylactic reaction (even if treated with an epipen or similar device).
7. Spinal injury
8. Heart attack, or chest injury followed by difficulty breathing
9. Serious infection or serious abdominal problems.
10. Open or angulated fractures, or fractures of the pelvis, hip or femur.
11. Injuries causing a loss of sensation, circulation or movement beyond the injury itself.
12. Any wound that was caused by crushing or impalement; involved ligaments, tendons or a joint space; is deep and affects the face; or was caused by an animal bite or is otherwise contaminated.

Slow Evacution

A slow evacuation is appropriate if the casualty has –

1. One or more broken ribs.
2. Persistent abdominal pain.
3. A first-time joint dislocation, or any injury that prevents use of a limb.
4. Unresolved heat exhaustion or mild hyponatremia.
5. A wound which cannot be closed, or an infection which does not improve within 12 hours of treatment.
6. Mild head injury.

Image from here

 

Handover

If you are in a position to hand over management of the casualty to a paramedic, advise them in the MIST pattern -

M – Mechanism of injury

I – Injuries (both suspected and confirmed)

S – Signs and symptoms

T – Treatment given.

Brexit: A Romantic View

Just about everyone is weighing in with an opinion on the vote of the United Kingdom to leave the European Union.  I can't think of a more down to earth topic to write about, so I may as well write about it.  Regular readers will understand that I try to avoid doing 'big ideas' posts too much.  I don't think they're a good form of writing.  Spouting opinions on the grand subjects of the day isn't (pace Philip Adams) something to be proud of when you never have the responsibility of implementing either them or their results.  Even if people listen to you, it's (well) no better than an evening on Chatroulette.

I have mixed feelings about the outcome of the vote.  On one hand, it doesn't really concern me.  I've never been to Europe and have no particular desire to go.  Bloviations on Lateline aside, I don't foresee the vote tipping the world into recession, causing mass migration, poor fuel mileage and ingrown toenails.  On the other, the European Union was perhaps the best surviving relic of the long weekend off from history between 26 December 1991 (the day on which the Soviet Union was disbanded) and 11 September 2001 (needs no introduction).  It was in that period that the dominance of liberal, commercial, more-or-less progressive and broadly Western ideals seemed to be assured.  It was only in that period that Francis Fukuyama's argument that we were approaching The End of History could be credibly made.  The EU (almost in spite of itself) tried to make that set of ideas a concrete reality -

Following Alexandre Kojève, the Russian-French philosopher who inspired my original argument, I believe that the European Union more accurately reflects what the world will look like at the end of history than the contemporary United States. The EU's attempt to transcend sovereignty and traditional power politics by establishing a transnational rule of law is much more in line with a "post-historical" world than the Americans' continuing belief in God, national sovereignty, and their military.

There was certainly plenty to like about the EU's ideals.  A continent brought together by law and culture and trade is a beautiful idea after centuries of bloodletting, even if it was accompanied by the sort of irresponsibility that prompted two German economists to say bitterly that “It would be much easier politically to renegotiate a compromise with Greece, albeit a lame one, and thus maintain the fiction that Greece will pay back its loans at some point in time” (emphasis mine).

 

Images from here and here

It's also not an unmixed blessing for Britain.  The people of Northern Ireland and Scotland may go their own ways, leaving England and Wales with their independence.  A strain of French nationalism seems to have been stirred up by this vote.

Du #Brexit au #Frexit : Il est désormais temps d'importer la démocratie dans notre pays. Les Français doivent avoir le droit de choisir !

— Marion Le Pen (@Marion_M_Le_Pen) June 24, 2016

But I ask myself if the future is really so bleak.  Despite having no known English or Welsh blood in my veins, I think  - romantically perhaps - that there's much to love about the 'idea' of England.  Its placenames lean towards quaint (Blandford Forum, anyone?).  English law, for all its lack of logic, works remarkably well.  And the refusal of its rural and village culture to be subsumed by the great cities of London and Birmingham and Manchester (consider their endless popularity as subjects for television) says that this is a place endlessly able to regenerate itself.  Something big has certainly happened, but I still think there's good reason to be hopeful for that green and pleasant land.

Life lately

Hi everyone,

Time to update you.  The biggest item is that my contract with the water corporation ran out yesterday.  I have a few applications for good jobs out there and an interview next Friday.  I'm not fretting about being out of work at present.  I don't know if that's because I'm confident of finding work.  Possibly  after a total of 12 months out of work in the last three years, unemployment has stopped being a source of terror or shame.

Farm work ahoy

The weather is leaning to colder and damp, with quite a bit of rain.  The seasonal creek in the middle of the farm is flowing stronger than I've seen in forever.  The other day there was a heavy mist that generated one of those photos I love: a bedewed cobweb on barbed wire. That combination of fragile and very tough.

Annoyingly I've been struggling to find time to run lately, what with the shorter days and SES and work.   Certainly eating more and drinking more wine of an evening.  I need to get back on the fitness wagon.  I knocked out 12kms at a respectable pace on Sunday but I can feel my body losing its edge.

Not much else to report just now.  I've started doing some videos for Facebook and this blog.  Ever wanted to know how to tie a bowline?  You're in luck!

A linkup: Show us your kits!

Hi everyone,

It struck me the other day that lots of the people I know would have 'kit' of some type that goes with their role.  Classically a doctor has a black bag.  Student athletes and gymrats have gymbags.  A dancer might have a shoulder bag, a mother a diaper bag and a police officer a heavily loaded belt.  I'm wondering: what's in your kitbag?

This is mine:

As you can see, its a standard black SES kitbag, reasonably well stuffed.  The first thing to come out of it are my overalls -

 

These are the standard workwear for an SES member.  They're fire retardant and difficult to tear, and acceptable for pretty well any task except boat rescue (of which more in a moment). They're mandatory if you're undertaking road crash rescue.  Their chief drawback is that they become a portable sauna in summer, although they're comfortably warm in winter.

Standard wear with the overalls are boots -

The boots are thick soled and made of padded leather, and go to a couple of inches above the ankle.  The zipper insert allows them to be done up quicker than laces do.  They're well suited to our work because they provide very good ankle support, largely prevent lower leg and foot injuries, and are comfortable to wear for hours at a stretch.

Next to come out of the bag is a lightweight two-piece uniform.  It's acceptable for a number of jobs (land searches, roof damage, flood control) and in summer it's more comfortable to wear than overalls.  It's also mandatory for people who may be called upon to serve as crew or coxswain on a rescue boat (which is when it'd be worn with light sneakers rather than heavy boots).

Finally (and bulkily), a wet weather jacket.  Most of our work takes place in bad weather and so this provides some degree of protection.  It includes a polar-fleece insert that makes it very warm to wear in cold conditions.

The bag has a separate section that takes up about 1/3 of its space.  I've found that this is the best place to keep my helmet. 

This is an unusual piece of gear in a way.  The crown is squared off at the front to allow a lamp to be fitted, and the helmet has a slight brim to provide some protection from rain.  Interestingly, because there's a space between the kevlar shell and one's head, it's insulated by air and cool to wear in summer.  Inside the helment there's also space to keep a P2 facemask (chiefly worn when working near broken glass).

Stored with the helmet are gloves and safety glasses (both clear and shaded). 

 

I carry a couple of pairs of gloves.  The orange ones are intended for road rescue and are a combination of synthetic material and leather, and very dextrous.  The grey ones are simple leather rigger's gloves which are used for most non-rescue jobs.  They protect your hands, but it's impossible to do any fine work while wearing them (even tying a knot is difficult).  Part of the reason they're our go-to gloves is price: rescue gloves are about $60/pair; riggers gloves about $10/pair.

 

In the same pocket is a Holmatro road rescue toolbelt, containing the tools one needs for that part of the job: marker pens (to mark where to cut the car), hooks and levers for prying away the interior trim of the car to expose hazards (like undeployed airbags), a seatbelt cutter and a glass punch (among others).

 

Finally, in the small end-pocket of the bag are the other odds and ends I carry around with me: an inflatable pillow (sometimes the places we sleep are a little insalubrious!), a small first aid kit, a compass, a whistle (for signalling), a competency log book and spare earplugs.

So there you have it: this is what an SES member carries as part of their kit.  What do you have as part of your kit? 

Orlando and Paris

I've been trying to think of something worth saying about the spate of jihadist killings in Florida and France.  It's harder than one would think.  People have taken predictable positions: progressives blame guns and conservatives blame Islam.  My feeling is very much what it was after the San Bernardino shootings: the cause isn't important, and the means even less so, but being able to do something about the consequence certainly is.

I struggle to make sense of these attacks on their own terms or any other.  In each case the offender couldn't really be called a madman.  Each one seems to have been aware that he was killing a nightclub full of human beings, or two police personnel, rather than (say) because he believed either was persecuting him particularly (I'm happy to be corrected on the point, of course).  Both men considered themselves to be acting for a cause larger than their own desires or grievances, which means one can't really say they were simply criminals like Martin Bryant or Al Capone.

Acts of war then?  This isn't a terribly satisfactory description either.  Certainly, indiscriminate killing has been used in warfare for millennia, but even when it was intended to spread terror, it was for reasons which were rational, at least in their own terms (barbaric and evil on anyone else's).  At the trial of Radovan Karadžić for crimes committed during the Bosnian War -

The Judges also found that between April 1992 and November 1995 Karadžić participated in a [Joint Criminal Enterprise (JCE)] to establish and carry out a campaign of sniping and shelling against the civilian population of Sarajevo, aimed to spread terror among the civilian citizens (Sarajevo JCE).

During this period the Army of Republika Srpska (VRS) deliberately sniped and shelled civilians in Sarajevo on an almost daily basis throughout the conflict. “Sarajevo civilians were sniped while fetching water, walking in the city, and when using public transport.  Children were sniped at while playing in front of their houses, walking with their parents or walking home from school” said the Presiding Judge Kwon.

The Chamber found that Karadžić significantly contributed to the Sarajevo JCE, both as the highest political authority in RS and Supreme Commander of the VRS. Having control over the VRS throughout the conflict, he was directly involved in military matters in Sarajevo and issued many orders at the strategic and at the operational level. Karadžić used the campaign of sniping and shelling, causing terror among the civilian population in Sarajevo, as a means of exerting pressure on the Bosnian Muslim leaders and the international community in pursuit of his political goals.

The judges concluded that Karadžić is guilty of unlawful attacks on civilians, murder and terror.

Even the Nazi obliteration of the village of Lidice at least had a discernible purpose - the punish the assassination of Reinhard Heydrich and and to deter further attacks (as an aside, forgetting that event rendered Quentin Tarantino's Inglourious Basterds an unforgivable lèse-histoire; in reality, the sequel to the film would have been about Albert Speer and Dietrich von Choltitz carrying out the Nero Decree).

But Orlando and Paris?  Even the most committed jihadist can't have imagined that even a double-digit bodycount carried enough terror to make gay people in America deny their sexuality?  That killing two police officers bring the French state to a grinding halt?  Ninety-four years have passed since the very early horror film Nosferatu.  I suspect our culture is no longer so easily terrified (as opposed to being shocked, startled, or stirred up to great whirling gusts of emotion).

I think the real explanation is in the dead bodies of the attackers: Like Herostratus burning down the Temple of Artemis, their crimes were a means of securing both their own death and their place in a pantheon of heroes.  Both conservatives and liberals, then, are wrong in their response.  Conservatives blaming Islam are at best blaming an accelerant for an already burning fire.  Liberals blaming guns concede that the killings must simply be lived with and that the only interesting issue is means.  And out here in the real world where real people turn up to face real weapons and tend real casualties, both sides are as irrelevant as shit.  Real problems crave real solutions: stop the person doing the killing if you can, and bind the wounds of the injured where you can't.  Nothing else matters.

Queen's Birthday Long Weekend

Hi everyone,

 

I’m typing this on the Monday evening of the Queen’s Birthday long weekend.  The weather has been good – the days are (kind of) warm and clear, but the nights are sharply frosty.  I took advantage of the weather on Sunday to go out for my first run in about 3 weeks.  It was a case of sweet relief: I only meant to go 8 kilometres, but I found that I was loving having some alone time – just me and my music – so I ignored my tired legs and pushed on, eventually knocking out 12 kilometres.  I’m still a little sore this evening, but it was so worth it.

 

Exercise notwithstanding, Saturday night continued my recent experience of not actually feeling rested even after a long sleep.  It didn’t help that my pager went off at 4am to advise of a tree on the road northwest of Tatura.  It’s probably just as well I wasn’t duty officer – I opened one bleary eye to see what it was but it still wasn’t easy to get back to sleep.  I’m blaming that for the headache I had for most of Sunday!

 

Second Oldest Sister and Bro-in-Law came up on Sunday for lunch and dinner and as usual it was great to see them (helpfully, it also reminded me that I need to rustle up a birthday present for her in a few weeks).  One of the other tasks I was attending to that day and since has been to take biscuits of hay and jerricans of water to a cow in the paddock below the house.  She was having trouble calving the other day and we had to pull her calf.  The calf didn’t survive (they rarely do) and the mother hasn’t been able to get up for a few days (also not unusual), which is why I’ve needed to carry feed and water to her by hand.  She’s very placid and will let you pat her while she’s eating.  She’s tried to get up a few times and my instinct is that she’ll be on her feet in a day or two.  To protect her from the cold we’ve cut down a bulker-bag and wrapped it around her with hayband – it’s the bovine equivalent of an overcoat!

 

Over the last two or three weeks we’ve had about 3 inches of rain which is a godsend.  It’s made the paddocks very soft – you wouldn’t want to move any sort of heavy vehicle over it if you could avoid it – but it’s put water in the dams again.  One of the smaller ones which was bone dry is now full to its banks and spilling into a seasonal watercourse.  The water is flowing into another dam – much larger and more reliable – which is also full to the brim.  This makes me happy.

 

 

Not long to go now at work – about 6 days I guess, although half of one of those days will be taken as leave to go to the doctor, dentist and blood bank.  I really hope I can find work.  I’ll go mental without having a job to go to.  Here’s hoping.

 

Cities where we belong

Yesterday took me out of my area.

 

A few days ago I had a call from a recruiter asking if I was looking for work.  As my contract at GMW has only about 10 days left, I certainly am and I said so.  We arranged to meet at his office in the city yesterday to discuss what he could put me forward for.

 

I spent the morning at work and then drove down to Seymour to get the train to the City.  I didn’t fancy slogging through city traffic to get to the interview.  I fancied driving back through Friday-before-Queens-Birthday-long-weekend traffic less.

I’ve always liked travelling by train.  It’s a lovely rhythmic form of transport.  It’s so easy to understand why it’s inspired music and poetry.

I got into Southern Cross Station about 30 minutes before the interview.  Southern Cross is the main interstate and regional rail hub for Melbourne (Flinders Street Station is the hub for metropolitan and suburban trains), so it’s a big, wide set of platforms and rail lines, with both electric and diesel trains coming and going.  I was pretty pleased to take a quick photo that had a tiny echo of Monet’s Gare St Lazare.  It seemed a good augury.

Claude Monet, La Gare Saint-Lazare

Image from here

 

The interview was a bit forced.  I have little desire to return to legal practice or to Melbourne.  That’s where the money is though.  I plastered on a smile and a reached into my bag of trumpery emotions and located some enthusiasm, and that got me through.  Pay me enough and I’ll run anyone’s cases for them.  Law, logic and Switzers may be hired to fight for anybody.

I had some time to spare after the interview before my return train (this wasn’t accidental).  I went for a walk through town in search of a Book Grocer.  Even though I worked in the city for years I was never sure if there were multiple Book Grocer shops, or if it was the same store leapfrogging from one shop to another.  I liked Book grocer because they have a flat pricing policy ($6.00 for any book, regardless of whether it’s a dinky paperback or a leatherbound Shakespeare on good paper) and because they only sell odds and ends: books that had been remaindered, or imported but never sold, or that had been self-published.  I’ve been able to buy some real gems there.

 

In the event I bought a copy of Alexander the Corrector, which looks like a nice historical cameo from the eighteenth century.  There was a little girl in the shed with (I suppose) her grandmother.  She was agonizing over whether she wanted to buy one book or another, which is a wonderful dilemma to see a kid wrestling with.  I would have loved to have given her a $50.00 note and told her “loving books is a great thing: go nuts!”.

 

One of the good bits about Southern Cross Station is that it houses one of Melbourne’s few remaining Starbucks.  People get sniffy about Starbucks, but they serve the best mocha I’ve had anywhere.  At the end of a chilly afternoon in Melbourne with a long trip back to the Goulburn Valley ahead of me it was about the most comforting thing I could imagine.

 

I wasn’t sorry to get to Platform 8 South and get on the train.  Albert Camus said that “they are often secret loves, those that we share with a town”*.  I suppose every love between two persons is really a relationship between three: the people, and the city or town or countryside they share.  When the relationship between the people goes kaput, what they share with the place changes too.  It might even be lost altogether (which is why I don’t think I could ever live in the town where The Ex and my daughters live).  Melbourne will always be a part of me: I’ll always understand what Paul Kelly means when he sings about going leaps and bounds “down past the river and across the playing fields, the fields all empty only for the burning leaves” in May (you really only understand that song after you’ve spent an autumn and a winter there).

 

 

I can’t shake the feeling of being a only sojourner in the Goulburn Valley, rather than a person who really lives here.  I’m actually kind of okay with that.  It means that there’s somewhere else in the world that I belong.

=============================

* “Ce sont souvent des amours secretes, celles qu’on partage avec une ville”: Albert Camus, ‘L’été à Alger’, Noces (1950).

 

 

 

 

 

 

 

Finding Fred.

Hi everyone,

Shorter post tonight, I suspect.  I had to scurry down to Melbourne and back this afternoon to meet with a recruiter (which will be the subject of tomorrow's post I expect and I'm a bit on the tired side.  I just spent an hour doing the Unit's weekly email - it must be said that it's a good way of organising my thoughts about that aspect of my life.

Last night at SES training covered land search for a missing child, near the Goulburn River in Shepparton.  The original plan was for it to be a mixed land and water search.  We took the boat, but none of us grabbed the bag with the lifejackets (which highlighted a gap in our processes which is now fixed).  So, the river search was converted into a straight land search.
 

We used the staggered-parallel-lines technique to conduct the initial brisk search along the path, and then a line search along the river bank.  I'm tending to think that a mobile phone is a great asset for pinpointing locations of finds - these were where the bike and a stuffed toy were located, if you're curious:

 

 

As you can see, the child's bike we were using for the purposes of this exercise had seen better days!

 

One the 'casualty' (a child-sized version of Fred, our rescue dummy) was located, we log rolled him onto a blanket stretcher improvised from a wet weather coat and took him back up to level ground.
 

I have to say, though, that it's been an A1 crappy week to be an emergency volunteer.  Some good units are being partly defunded as collateral damage in a dispute between State and Local government over revenue.  And the State government is siding with the firefighters' union in a deal that shows utter contempt for volunteer firefighters (which has an echo of the hostility that professional fire brigades apparently had for the Auxiliary Fire Service in London in World War Two).  Just at the moment, more than anything else, what's keeping my passion for volunteering alive is the great people I get to work with.

Extrication Techniques: Penwell (Texas) bus accident

Some incidents read like they come from a particularly challenging desktop exercise.  A multiple fatality near Penwell in Texas was such an accident.

 

The report of the National Transportation Safety Board (NTSB) states that on 14 January 2015 at about 0750, a westbound 2015 Blue Bird Vision prison bus operated by the Texas Department of Criminal Justice (TDCJ) struck a section of guardrail on a two-lane bridge.  The bus left the roadway and dropped about 20 feet (6 metres).  Its forward motion caused it to collide with the flatcar of a Union Pacific freight train which was passing on the rail line below the bridge. The bus then hit one of the bridge supports, finishing lying on its left side.  The front section of the bus was torn off altogether

 

Accident scene (Image courtesy of the Odessa American) 

The bus sustained massive damage and ten passengers (two prison officers and eight inmates) were killed.  The survivors (a prison officer and four inmates) were seriously injured.

 

 

Video Footage courtesy of News West 9 

Vehicle

The bus had been built by Blue Bird Corporation with a custom fitout by the TDCJ.  The interior was separated by metal partitions into a driver's area, a segregation area (apparently for inmates in protective custody), a general inmate area and a rear guard area.  The partitions separating the driver's and rear guard's area were reinforced with plexiglass.

 

Interior of similar bus to that involved in this accident (Image

from NTSB, Highway Accident Brief HAB-16/03, p.8)

 

The 13 windows along both sides of the bus were covered by perforated metal sheeting.  The bus was not required to have emergency roof hatches or emergency exit windows.  The inmates were handcuffed in pairs for transport.  None of the occupants (guards or inmates) were wearing seatbelts.

 

Collision bus post-accident (Image from

NTSB, Vehicle Factors Group - Vehicle Photos)

Emergency Response

Extrication

Emergency responders (principally the Odessa Fire Department) reported difficulty with extricating the prisoners due to their location in the bus, their handcuffs and their entanglement with each other.  In addition, they were partly also covered by the damaged metal partition which prevented most of them being extricated at all.

 

Emergency responders were best able to access the casualties by using a Husqvarna K-12 circular saw to cut an access point in the roof of the overturned bus (although there was some difficulty cutting through the roof because it was made of two layers).  Once cut, the roof was peeled back using "the jaws" (probably referring to spreaders).  One would infer that this was a variation on the 'side roof flap' technique.

K-12 circular saw (Image courtesy of Team Equipment Inc)

 

The circular saw was also used later to cut away part of the metal partition inside the bus.  The prisoners' handcuffs were variously unlocked or removed with boltcutters.  One inmate reported that rescuers were cutting up the bodies of the dead to get to the living, but this is not described by the responders.

Casualty Management

Some casualties were ejected from the bus in the accident and a search of the area was undertaken to attempt to locate any other casualties

 

There were difficulties handling the casualties carefully.  Many of the seats inside the bus were torn loose in the accident.  It was necessary to remove those which remained in order to reach the casualties.  The seats which had been detached became an additional factor making extrication difficult (one would infer that it was difficult to move them without also twisting or bending the casualties).  In addition it was difficult for responders to avoid slipping within the bus because of the liquid that had spilled from the onboard toilets.  The deceased (and presumably other casualties) were moved on spineboards with four responders per board.

A conference and a drive

Hi everyone,

I'm back up at the farm again this evening.  It's been a good weekend.

Saturday was taken up with the controllers' seminar.  It leaned heavily towards the high level management perspective on State Emergency Service, which was interesting but concerned matters well above my level of authority.  There were also a couple of very useful sessions on volunteer recruitment and training.

I don't think I should share all the details that were passed on from the upper echelons of the SES food chain.  However, I don't think I'm telling tales out of school by reporting these points -

• Last year the SES responded to 22,000 requests for assistance.
• Assisting police - including searches and crime scenes - is a growing part of our work.  Casualty handling is also a growing area.
• Communities need to be steered in the direction of understanding that in a major disaster, the emergency services may simply be too thinly stretched to help.  They need to be helped to consider how they can best protect themselves (my immediate thought is that this has echoes of the Cold War approach which assumed that there would never be enough responders to deal with the effects of a nuclear explosion; in that approach, the emergency services would instead be the hard professional core around which would give shape and guidance to the community's response)
• Communities need to be encouraged to believe that what they do will make a difference in the event of a disaster.
• Only 41% of Melburnians are confident their community would pull together in the event of a disaster (I found this a little alarming).
• Sometimes the key issue with obtaining funding from local councils is not active hostility from councillors, but instead a simple lack of awareness of what we do or why it matters.  So, taking positive steps to build council relationships is a very necessary development.

I can also say that the current stoush between the volunteer fire fighters and the United Firefighters Union was discussed informally quite a bit, as were the possible implications for the SES.  The most common view was that there seemed to be larger political drives on both sides that are escalating the dispute dramatically.  My own view is that both sides have been incredibly irresponsible by letting the dispute sprawl out into public: whatever side wins, it'll take a generation to rebuild trust between paid and volunteer firefighters.  An industrial dispute is a normal thing - maybe the contending sides both have a point - and a demarcation dispute is always uncomfortable (nobody likes losing jurisdiction or authority), but when it potentially poisons operational effectiveness, it becomes disgraceful.
 
One very useful part of the conference were the stands that were available for visiting during morning and afternoon tea breaks.  We were able to get a quick briefing plus some written material on the radio system which is currently in development, and also details about the updated doctrine on rescue boat operations.  One of the most useful stands, however, was one setting out the new rooftop safety system which will apparently be rolled out later this year.  It's radically different to what we're using now.  My instinct is that it'll take slightly
longer to set up but be fundamentally simpler to use and easier to get people proficient with.

 

 

 

Food was top notch (I may have come back quite a bit heavier), and very nicely the conference centre provided a complimentary bottle of wine in each room (happy my room-mate - a very nice fellow from the Wodonga Unit - isn't a wine drinker, so that mean I had free rein.  Score!)

At about midday a pager message came out asking for volunteers who have training in swiftwater rescue to put their hands up to deploy to East Gippsland in light of a severe weather system making its way down the east coast.  I know that Lismore in northern New South Wales has had a belting and it looks like its slowly making its way to Victoria.  My area should miss it entirely, but it's possible SES in that region ask for outside help if they get completely smashed.

Most of those of us who had travelled from regional units stayed for the dinner on Saturday night and began our return trips this morning.  I mentioned yesterday that driving through the Yarra Valley has a lot of memories for me, and I was thinking about driving across to pick up the Hume Freeway to come home and avoid the area entirely.  In the end I decided I didn't want to crawl across northern Melbourne to get to the Hume, so I said 'screw it' and went up the Yarra Valley.  I'm afraid to say there were no flashes of insight, or moments of liberation, or bursts of emotional pain: just tugging memories and familiar road signs.  What made it burdensome was being in the mountains and unable to pick up any radio stations.  When you're trying to keep your mind occupied, you need something more than the noise of the motor and the voices inside your head.

 

The town of Yea, where the ex and our girls and

I went for coffee and brownies on the Sunday

before I started work at H&W in 2011.

It was kind of a relief to get to Seymour and start driving in what is more or less 'my world' now.  They've had maybe an inch of rain since Sunday.  The dog was certainly happy to see me back (he had a nice long walk this evening), and little sister was still up here when I got back.
 

So there you have it: that's what my weekend has involved.  What have you out there in the wide world been doing?