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

Page 2

Defense Secretary Robert Gates implemented a Golden Hour policy in the Afghanistan War in 2009, tapping the Defense Department's huge budget to provide three new field hospitals, new helicopters and other equipment that soldiers and medics needed. So far, however, wildfire managers have not followed suit.

Every eight to 16 combat troops have an assigned EMT. For urban firefighters, the EMT/firefighter ratio is one-to-one. But on large wildfires, the national standard is only one EMT for every 499 firefighters. Rob Palmer wants wildland crews to have at least one EMT for every 10 firefighters -- a ratio found mostly in the top crews, such as smokejumpers.

For a wildfire Golden Hour zone to work, Palmer says that firelines would have to be no more than 30 road miles or 50-100 air miles (depending on helicopter type) from a medical facility. He estimates that 50 percent of wildland firefighter fatalities occur outside the zone. If the government or private contractors can't evacuate an injured firefighter within an hour, he says, they should refrain from engaging the wildfire. He believes his reforms could reduce the average annual firefighter casualties from 19 to nine. On top of that, he adds, they could reduce the total federal wildfire suppression budget by somewhere between $500 million and $900 million per year, because fewer wildfire fronts would be attacked.

Rob Palmer's suggestions are facing resistance from many in the wildfire establishment. Tom Harbour, the U.S. Forest Service's director of fire and aviation, says, "Implementing a Golden Hour response as Robert Palmer has framed it would require fundamental changes," and the benefits might not outweigh "the additional risks or the unintended consequences."

Harbour contends that a Golden Hour mandate would require greater use of aircraft. Because aircraft accidents are responsible for so many wildland firefighter deaths -- 50 percent since 2000 -- aircraft fatalities would likely increase. And millions of new homes have been built in recent years within wildfire-prone forests; if crews were prohibited from battling some wildfires around homes, that would put more lives at risk.

But Palmer also has allies. Chad Fisher, a National Park Service safety officer at the National Interagency Fire Center in Boise, Idaho, acknowledges that "implementing the Golden Hour proper (a strict policy) is very difficult. Risk management comes into play." Sometimes fires that threaten valuable resources -- such as habitat for rare native trout or historic buildings -- must be attacked even where evacuations can't be done in an hour. Yet Fisher has encouraged the multi-agency National Wildfire Coordinating Group to learn from the Dutch Creek tragedy and make its recommendations for improving the framework for emergency medical care. For instance, all morning briefings for every large fire now include specific evacuation routes and procedures.

Fisher is also pushing what he calls -- "for lack of a better term" -- the Golden Hour Engagement Strategy. The "comprehensive strategy" recommends providing more appropriate medical gear on firelines, and urges that the distance to medical facilities be taken into account when fire-management decisions are made. The strategy is taking hold, he says, noting that in the last year or so, many crews have bought backboards and litters. He believes that, in the future, fire managers will be more likely to deploy EMTs with fire crews going into especially risky situations.

Fisher created a webinar presentation partly based on Palmer's talk at the Safety Summit, and he's showed it to influential agency groups. He's also working with other Park Service leaders to find a national park where the Golden Hour strategy could best be fully tested.

The Forest Service also uses the "Dutch Creek Incident" in its leadership training courses, and agency firefighters use simulations of medical emergencies to develop better procedures. But even though the agencies have begun to emphasize the importance of fire crews carrying better medical gear such as backboards, so far there is still no formal requirement for anything more than a first-aid kit. Proposals for establishing mobile medical clinics have been shot down, because of the expense. And on some Western fires this summer, it took longer than an hour to transport injured firefighters to medical facilities. "We can always do better," Fisher says, "and the more attention this gets, the better we will do."

Neil LaRubbio earned a master's degree from the University of Montana School of Journalism, where he developed a website for wildfire science news.

High Country News Classifieds