Life in the balance

Life in the balance

Emergency response is abound with risk, we can see this, we know this and our ultimate goal is to avoid risk. Opting for lesser solutions to training will only increase risk and should be proactively avoided writes Ashley Price, Vice President of the Fire Science Academy in the Kingdom of Saudi Arabia. 

News travels fast today and technology has without question changed how we see and perceive global events. In a click or a swipe, news streams in real time and social media provides us with raw, constant exposure to the severity of a disaster or an incident.

One would expect that with the abundance of clear and present (all be it indirect) witnessing of what can happen if we are not prepared, would be a lesson we have learnt well.

However, time and again, there are always instances of short falls in training that ultimately lead to greater risk when a response is required, not only reducing the prospects of success, but putting lives at risk across the board.

This may be uncomfortable for some, however, when we know someone is alive but incapacitated, that life is in the balance during an extended emergency situation (more than 2 days) and we can watch the outcome (life or death), human attention and interest to the event – be it motivated from concern, horror, sympathy or some other reason, is intensively heightened. Little is left to the imagination and we almost live it through imagined immersion. This is human nature and how we perceive and process these indirect experiences is subject to psychology. However, do we really learn from it.

Italy – 1981

The rescue attempt of Alfredo Rampi, the 6 year old boy trapped in a 30cm wide well, nearly 80 metres in depth. Broadcast live to millions on television, Alfredo tragically lost his life after 3 days of entrapment and the volunteer rescuer Angelo Licheri (a member of the public, slim enough to gain well access) being inverted for over 45 minutes during the attempt never fully recovered from his sustained injuries.

USA – 1987

Millions worldwide watched as emergency response teams worked 56 hours straight to successfully extricate 18 month old baby Jessica McClure (trapped in a 20 cm wide well 7 m deep), Post Traumatic Stress Disorder (PTSD) was cited as the reason for rescuer Robert O’Donnell’s later suicide.

Chile – 2010

An estimated 1 billion people watched the Copiapo Mining Incident as it evolved (33 miners successfully extricated from a depth of 700 m and 5 km from the mine entrance after 69 days).

Thailand – 2018

Billions worldwide watched the Tham Luange Cave Rescue as it evolved (12 junior football team members and their coach successfully extricated through 4 km of flooded cave), with the cost of rescue in life for Lieutenant Commander Saman Gunan. All of these very well publicised events were extended and complex incidents with life, death or life altering injury outcomes not only for those being rescued, but the also rescuers themselves.

If seeing is believing 

Anyone aware of these highlighted responses most likely understands that trained personnel were critical to the efforts. Not so many may appreciate the complexities of incident command and other situational related challenges, however, at the very least, understand risks were high, physically demanding and that only professional personnel would or should be involved.

Not everyone has access to professional emergency response services that can respond to everything. This is particularly the case for industrial facilities and other types of high risk sites that may require self emergency response capability. Often referred to as the Authority Having Jurisdiction (AHJ), these entities have the responsibility for the organisation and operations of there own Emergency Response Plans (ERP’s).

From observation, it is evident some entities are very well organised and prepared and some entities are not. Those not well prepared will often state a lack of trained personnel as the root cause, typically related to budget or manpower constraints and in some instances risk awareness of the organisations in question being flawed. Fundamentally however, this means an adoption of the gamble of ‘it will never happen to me’ or that they are simply taking a excessive risk to save money. Whatever the reason, to not train personnel appropriately will only further risk exposure.

The risk iceberg

When we observe and analyse risk, let’s not forget that what we can obviously see as being high risk (i.e. Visible & Known – like an iceberg above the sea surface), is not necessarily where most danger is going to come from (i.e. Unseen & Unknown – the majority of an iceberg is submerged). We know situations can complicate and complications should be expected.

An AHJ is usually self-regulated, sometimes externally regulated and probably audited for insurance. Most AHJ’s in our region adopt the National Fire Protection Association (NFPA) standards for emergency response. The NFPA Professional Qualification standards specify the required knowledge and skills in the form of job performance requirements (JPR’s) for various responder fields, including, but not limited to Hazardous Materials, Firefighting, Rescue and Command. Any incident if it complicates could need response capability in all these fields.

However, NFPA does not specify how the delivery of training is to be conducted, it is the standard to which we train. Quoting NFPA is one thing, ensuring that personnel are actually trained properly to NFPA is another. It is here that major mistakes are often made with implementation of sub standard or inappropriate training which in turn becomes a ‘deposit to hidden risk’ (just like the iceberg), meaning lack of preparedness won’t be exposed until a situation requires response. Organisations typically can’t see this if they think they have documented compliance (i.e. ‘the box was checked’) against training. Quality counts and is just as applicable to training as it is to everything else.

Fact or fiction

It is a scientific fact, we as humans learn very effectively through experience and practical application. The environment in which we train and learn within is therefore, crucial for meaningful outcome.

Emergency response training is a physical and mental balance between ensuring trainee retention of knowledge (cognitive), trainee development of skills (psychomotor) and, the effective application of knowledge and skills in a safe controlled manner that provide trainees with realistic challenges (immersive constructive stress) is essential.

Emergency response training can become a very dangerous work of fiction when we succumb to believing that; theoretical training is all that is needed; that skills only need be demonstrated to trainees; that the training environment need not be realistic; that a course can be shortened excessively; that we can state standards but not teach to them; that we need only partially train individuals or that just a certificate is needed.

During response, command decisions have to be made to deploy personnel in to incredibly dangerous situations. In Thailand, the unfortunate death of the highly trained diver, Lieutenant Commander Saman Gunan (participating in the Tham Luange cave rescue) underscores the risk responders take. The risk is a given fact, but to deploy untrained or unqualified personnel only increases risk and should be avoided.

Collision avoidance

The avoidance of poor training is best managed through selection of ideally an internationally accredited training agency. For NFPA programmes, either The Pro-Board or International Fire Service Accreditation Congress (IFSAC) organisations accredit training agencies or academies to provide internationally recognised certification to trainees.

The agencies or academies are audited by these organisations for their ability to certify training. To attain accreditation, they must have detailed knowledge and understanding of the NFPA standards, how to deliver them as courses and how to certify trainees as meeting a standard of professional qualification. This certification methodology is the backbone to NFPA standards based emergency response.

Certification for trainees is only gained if strict cognitive examinations are passed and that skills are successfully evaluated. As a baseline for specification and adherence to training standards, this is the best level of protection that can be invested in.