Lack of medical care on the firelines endangers firefighters

  • Andy Palmer, was struck by a chunk of a toppled tree during a 2008 California fire.

    palmer family photos courtesy robert palmer
  • When wildland firefighters are injured, medical evacuations -- such as the one pictured, right, during last summer's Las Conchas Fire in New Mexico -- can be difficult.

    Kari Greer
 

When the three young firefighters first appeared at the Dutch Creek trailhead in California's Shasta-Trinity National Forest, veteran crew boss Tim Bailey felt uneasy. Their green protective chaps were a little too clean, and their chainsaws looked practically unused.

But despite their apparent inexperience, the tree-felling crew from Washington's Olympic National Park was gung-ho, recalls Bailey -- eager to help battle the Eagle Fire, a finger of the Iron Complex, which was started by a 24-hour lightning storm that lit more than 1,000 blazes. "If you've ever dumped a tree, you know what the high is," Bailey says. "When someone gives you an opportunity to go dump trees ... you're all hyped up and ready to go."

The tallest crewmember was Andy Palmer, 6 foot 5 and 240 pounds, just 18 years old with a cherubic face. Palmer and his crewmates were assigned to cut down hazardous trees along a bulldozer path. It was his first time on the fireline. He had grown up in Washington and planned to start college in Montana in the fall. He was looking forward to a summer of good money and great adventure. But before the sun set behind the smoky ridges of the Klamath Mountains, all that would end.

A few hours after Bailey saw the crew head down the path, one of Andy Palmer's crewmates felled a large ponderosa pine. It struck a cat-faced sugar pine, and the top of that tree -- 120 feet long and two feet wide -- broke off, hit the ground and shattered. One hurtling chunk struck Palmer, who was standing 35 feet from the ponderosa's stump, breaking his ribs, fracturing three bones in his left leg and severing his femoral artery. Blood poured from his leg like water from a broken spigot.

Palmer's crewmates quickly applied tourniquets, but the radio communications from the scene lacked urgency and clarity, hampering the effort to get emergency medical care out to the rugged location.

It took at least 45 minutes for the first EMT paramedics to reach the site; they had to take an ambulance on a forest road and then hike the rest of the way. Two helicopter crews refused flight requests, saying the heavy smoke obscured visibility. After more delay, a U.S. Coast Guard helicopter crew accepted the mission, but two hours and 40 minutes had passed before they loaded Palmer into the helicopter basket. En route to the trauma center, three hours and 20 minutes after the accident, the young man died of severe blood loss; his life vanished like a puff of smoke.

Controversy still surrounds the July 25, 2008, accident, including allegations that the crew was "sport-felling" -- cutting trees that didn't need to be cut. But the most disheartening aspect for Andy Palmer's older brother, Robert Palmer, is that -- as he puts it -- "I lost faith in the fire world's ability to help one of their own." Now, Rob Palmer is fighting to reform emergency medical care on the firelines. His proposals could even affect decisions on how, and when, to battle wildfires.

Rob Palmer, 30, is a veteran wildland firefighter; he worked 10 seasons in fire operations for Olympic National Park, becoming a crew boss, a skilled tree faller and an EMT. He also managed the ski patrol at Snoqualmie Pass, east of Seattle, rescuing avalanche and trauma victims for five years. After his brother's death, he sank into a period of reflection.

"Andy was in the magic transition between growing up and being a grownup when he died," Rob Palmer says. "It was a huge, huge hole that was left for me and my entire family."

Rob Palmer researched his brother's accident and found that the nearest hospital was only 10 and a half miles away by road; the trauma center in Redding was less than 60 miles away. He talked with fire experts around the West and issued an eight-page report titled The Palmer Perspective in January 2009. He bluntly described how he'd lost faith in the firefighting agencies, and pointed out that crews on many firelines still lacked  evacuation plans and medical gear beyond basic first-aid kits.

His charges echoed through the top levels of every wildfire agency in the nation. Last April, he gave the keynoteaddress to the hundreds of experts  gathered at the Wildland Fire Safety Summit in Missoula, Mont. He recommended better wildfire training for EMTs, and called for more medical staff and equipment on the firelines, including backboards and neck collars. He also urged the adoption of a "Golden Hour Response" policy, which would require that any severely injured firefighter be delivered to a hospital or trauma center within one hour.

Mike Welch
Mike Welch Subscriber
Oct 19, 2011 11:53 AM
Tough situation. Wildland settings make for terrible places to get injured, unfortunatley these settings often lead to one's death more so than the injury itself as time becomes the killer. Nobody is to blame for this and changing a pretty damn good system (that of which is currently used by the USFS) will do no good and possibly (as mentioned in the story) could lead to greater harm. Could there be some more EMTs out there, sure. But who is going to train them, and more importantly who is going to pay for it? In a perfect world wildland firefighting managers could send all their employees (including the heart and soul of this line of works workforce--seasonal employees)to all the top-notch training programs, including EMT training and even some Wilderness First Responder trainings. Unfortunatly this just isnt possible, especially given todays anemic budgets. Aside from this fact, the ultimate battle is a race with time. A race that starts (in most scenarios)in some remote backcountry setting, where the only way out for an injured man or woman is via helicopter or plane. Now, as mentioned in the story a huge percentage of wildland firefighting deaths are a result of aircraft incidents. Is the USFS and other agencies going to be expected to ignore this fact and risk other lives while attempting to successfully complete the "golden hour"? Seems unreasonable and illogical, not to mention at times impossible. I dont want to sound harsh or insensitive as this tragedy is just that--a tragedy--but lets stop the blame game and pull the reigns back on whats become a litigation nation before we become a society totaly void of personal responsibility and ownership. Wildland firefighting (particularly while felling trees) is a dangerous job. People die on this job every year, does this suck, absolutly. Will it ever change, no. Is there anyone to blame for this fact,no. Again, this is a tragedy and it should have never happened, but I dont beleive there is any fault to be distributed and I dont believe changes in the current system need to be implemented or are even possible.
Bill Gore
Bill Gore Subscriber
Oct 25, 2011 04:49 PM
My heart goes out to you, Rob Palmer, for the loss of your brother Andy. While I certainly cannot speak for either of you, I can, at age 50, look back on my youthful seasons fighting wildfires and say that that is indeed a strong and noble place and way to die. And make no doubt about it, Andy was working some of the toughest country in North America. The Olympics feature very steep terrain and huge gnarly trees that are technically challenging for the most experienced sawyers and their crews. In my humble opinion the 2 most cost-effective deterrents to accidents of this nature are 1) training, training, training and 2) mixing green crews with seasoned workers. Especially in this case. Andy was 35 feet from the Ponderosa, which was diagonal to a widow maker type sugar pine. In terms of real safety zones, 35 feet is nothing. The crew should have been WAY back and shielded behind larger trees. Very tricky,as I said, for the most experienced. Situational awareness really is the difference between life and death out there, and often the young and inexperienced simply don't have this. As far as the delay evacuating him a mere 10 miles, there is no excuse for this. In the southwest the worst incidents I'm aware of in the last 30 years have been burn-overs, including one especially tragic incident in Arizona involving a prison crew. Sometimes the victims in burn overs have attempted to utilize their training, and run into the black, deploy shelters, etc. And sometimes they simply panicked and ran ahead of the flame front and simply died. Incidents like this are a management failure and there should be accountability. Unfortunately the cost of deploying EMT's on all fires would prove prohibitive. I think we have to come to grips with risk in jobs like these and the possibility of injury or death. They go hand in hand.
Isabel Cole
Isabel Cole Subscriber
Nov 06, 2011 11:17 AM
I am not a part of the firefighting service and I have no expertise in the area...however, I cringe every time I read that making something safer is not economically feasible. I completely disagree. If young Andy had been struck by a tree and killed instantly then I would say that there was possibly nothing that could have been done differently, although even this is not necessarily true because the second commenter suggests that he should not have been that close to the tree in the first place. But the fact that Andy remained alive for hours before finally succumbing means that there was the potential to save his life. I don't think we should ever approach that with the attitude of, "sometimes bad things happen." Every time someone is hurt or killed it is an opportunity to look at what went wrong and see how it could be fixed. I'm an air traffic controller. Every time we have an incident, whether people are injured or not, we look at what went wrong and what we could have done differently. I don't always agree with the solutions either. However if there is something that can obviously help to keep these things from happening again, they deserve a long hard look. To me the cost of providing enough EMT's in such a dangerous occupation should be the cost of doing business, period. The young men and women who put their lives on the line to protect others deserve no less.
Larry Ward
Larry Ward
Nov 06, 2011 12:03 PM
This tragedy was avoidable. It represents a breakdown of the protocols established by the agencies providing crews to fight the Iron Complex fire. Review the NPS incident reports to see how communication failures and a lack of trained support led to Palmer's death. http://www.nps.gov/[…]/fir_wil_fatality_investigation_dc.cfm
Nana Lynn
Nana Lynn
Nov 13, 2011 08:32 AM
I also have no experience with firelines, but I became engrossed in this well written and heart breaking story. In fact, the closest I have come to seeing the mountains and wilderness out West is when my plane flies low enough over several states enroute to San Fran or LA in California. There is one exception; the time I attended my Nephew's wedding in Montana, in a clearing, by a creek, at the base of a mountainside full of bears and 100 yards from a herd of about 200 bison! While I realize this in no way qualifies me to offer any advice on the safety of fireline workers fighting wildfires, I am compelled to at least ask questions that may cause enough people familiar with the issues to begin brain-storming ideas. I am hopeful that if enough people brainstorm a problem that can cause horrific and deadly consequences, a new idea can be arrived at that will at least address the goal of reducing danger and saving lives. As I read the story, I thought of the old TV series, M.A.S.H., that revolved around a make-shift hospital. As these brave firefighters hike from a safe point to a wildfire, why can't a make-shift hospital be established at the safe point with a transport vehicle capable of travel between the safe point and the area where firefighters are working? Would a volunteer doctor, nurse, and trained medical assistants be willing to man the make-shift hospital while firefighters are working? Would the agencies established to provide fireline workers to wildfires be willing to supply the make-shift hospitals with medical equipment and supplies? What would it take to ensure that the ratio of experienced fireline workers to 'green' workers is more safe and why aren't these agencies required to have answers for questions like these? My guess is that the comment by Mike, ..'anemic budgets', has alot to do with the reasons why my questions have no answers. Believe me, anemic budgets and the causes are within my realm of understanding. Taxpayer dollars funding these agencies must not be high on the list of priorities, but how many line items in a budget address life and death issues and shouldn't it be these issues that demand a sufficient funding source? Want to find a source of funds, how about this idea? According to endoftheamericandream.com, more than half of all members of congress are millionaires; in a large part due to the fact that insider trading is legal for them, and only them! Since January of 2009, hundreds of thousands were hired as federal workers and, with benefits, they earned an average of close to $130,000.00 per year last year! I believe enough of us need to stand together and demand that these politicians stop lining their pockets at the expense of the lives of those who take personal responsibility only to have the fruits of their labor stuffed into the pockets of politicians and those who do not take personal responsibility! Enough of us standing together demanding that these agencies be properly funded is the first step in assuring we stop any avoidable loss of life. Increasing awareness of the issues will ensure enough of us get involved. I, for one, will subscibe to High Country News and share it with many friends and neighbors asking that each write a letter to their representatives demanding answers and directives that can lead to more funding. I won't forget Andy Palmer and I'll make sure many, many others get to know his story. Imagine if one determined person can get ten others into action and then imagine if that one determined person becomes 50 people; and on and on we go. So, for Andy, can we all commit to DO something?
Ruth Hand
Ruth Hand Subscriber
Jul 16, 2013 03:55 PM
Let 'em burn. Put the lives of firefighters first.