Situational AwarenessMatthew Sloan

Information about me • Owasco Fire Department 2003

• Asst. Chief St 1 2011• 2 stations located north east

tip of Owasco Lake • B EMT 2004• Deputy Sheriff With Cayuga

County 2008• Swat Team 2011• K9 handler 2014• Clandestine Lab investigator

2016

Training Objectives • Define: Situation Awareness • Discuss the ways first responders are exposed to

dangerous situations• Understand the effects of situation awareness on a

first responder • Review methods to help limit first responders exposer

to dangerous situations

What is situational awareness?

The ability to identify, process and comprehend the critical elements of information about what is happening to the team with regards to the mission. USCG

More simply knowing what is going on around you

Situation Awareness and the first responder

• First responders are constantly exposed to dynamic situations• Fluid environments that never remain constant

• Environments are unfamiliar to us• Most patients or suspects are comfortable and familiar with

the area where they are located

• We are constantly at a positional disadvantage • Responding to victims house, business or common place can

easily result in dangerous conditions

Situational Awareness Cont. It is important to maintain control of a scene to limit dangerous situations Initial scene safety The best way to limit exposure to an unsafe scene is stay away

in the first place “Power lines down”

Constant evaluations of the area where you are working help to prevent issues from arising Dynamic environments require constant re evaluation “Interior fire fighting and progress”

Quick assessment and decision making will help control a situation and address hazards “Progress reports”

Modern day hazards of EMS Scene parking Staging for law Mental transports MHL9.41 Illegal narcotics

Suicides First responder targeting and

Terrorist attacks

Staging Calls which require law response often require staging Is your staging area adequate and safe? How close are you to the scene If the caller can see you what's to stop them from walking or

running to you?What type of scene is it? Gun fire? Riffle ? Hazmat? Wind direction? Is suspect mobile?

Where are you parking when staged Well lit area with room for apparatus? Is your staging area making you a traffic hazard More then one egress

Domestic with injuries Issues with being told to stage by outside agencies 911 center and law may not be permitted to tell you where to

stage (fire arrival prior to Law)

Staging and Scene vehicle placement

Constant issue with Fire, EMS and Law Policy and Procedures for your department My fire department does not permit members to drive to scene

unless the scene is DIRECTLY between scene and fire house Sheriffs Policy states staging with be in a safe area in

coordination with traffic control Known your policy and follow it so your protected

Roadways always create hazards for first responders Staging vehicles incorrectly can cause havoc on scene control Keep staging and traffic control as simple as possible to maintain

safety “Don’t try to reinvent the wheel” Control the amount of warning lights used on scene to avoid

blinding or confusing oncoming drivers “ they are usually confused enough as it is”

Staging and Mobile post assignments

Staging at parking lot post is a part of the job. Placement of your rig will

provide added safety to you and your crewWell light areas in front of

businesses Stage with other rigs if

possible, safety in numbers Avoid over distraction by

mobile devices Take turns on look out https://www.youtube.com/watc

h?v=mZ7JxH4iu4w

Mental health transports and EMS Is this a medical issue Are you required to do this transport medically or is this a police

matter Its ok to ask those questions to law “even if law seems

disgruntled for asking” Patients behavior is always changing and needs to be re

evaluated There is no consistency with a mental transport, in fact its usually

one of the main issues with a patient Positioning in the ambulance Avoid placing yourself in a dangerous position. Legs arms and

mouth are your biggest threats Securing patient with all straps may buy you time in the event the

patient becomes aggressive. Most law policy is the subject needs to be under arrest of

accompanied by law to utilize hand cuffs and shackles

Illegal narcotics and EMS Most pressing and evolving

issue with EMS today Any calls involving drug over

dose or usage will require extra attention to your environment and the people within it Types of Narcotics causing

most issues Methamphetamines Synthetic marijuana Heroin Fentanyl Concentrated cannabis

Concerns after Heroin usage Personal safety is first Majority of users utilize syringe for administration All communities have some form of clean needle program I have searched a house and located 4 total boxes (100 count each) of

needles. With a 2 year old inside house (they called it a safe haven for friends who use)

Most users have more then one needle on them Most I have seen is 32 uncapped needles in a purse of a subject

transported by ambulance to hospital Pre Naloxone administration Is the Patient properly “Secured” Do you have enough help around Your safety is first Even if your obligated to maintain care of a patient, you can only due so

if your not at risk of injury. Naloxone administration https://www.youtube.com/watch?v=ySEHFK14phw

Fentanyl Safety Precautions Synthetic Fentanyl usage on the rise with most Heroin users Even more potent is Carfentanil (10,000) Currently there are no standardized procedures in place for

processing and handling of Fentanyl As of May 2016 DEA is still developing recommendations for

the handling, processing and testing of Fentanyl at there facilities Respirators are recommended when dealing with any substance

in particulate form to prevent exposer. Current recommendations from DEA are to preemptively

administer naloxone prior to processing Fentanyl labs http://www.courant.com/health/heroin/hc-hartford-swat-

sickened-0915-20160914-story.html DEA recommends utilizing Hazmat teams along with Clan

Lab technicians to handle scene.

Synthetic Narcotics Synthetic marijuana ,K2, Spice, bath salts Chemically produced to avoid being banned as controlled

substance Mixtures and amounts are always changed and very inconsistent

Designed to give similar euphoric high of other drugs Side effects seem to be much more dramatic then anticipated

by users Excited delirium, hallucinations and extreme strength

associated with rage Most subjects under the influence of these types of drugs are

only controlled by outnumbering and overpowering them. DO NOT ADDRESS THESE SUBJECTS without enough

manpower and law. Although they may require medical attention if they are still

walking, moving, breathing, or fighting you have time to wait for law.

Methamphetamine Production

• Growing issue in all types of communities• Several different methods of production • Very dangerous to responders as well as other

occupants

Methamphetamine and First Responders “Red P” Method Requires Phosphorus which is red in

color Popular in 1980-1990’s Very caustic and dangerous to

breath in DEA recommends all Red P labs be

handled in LEVEL A hazmat Causes Phosphine gas during

production Smells like garlic or decaying fish Colorless Can ignite spontaneously when in

contact with room air

Methamphetamine and first responders Nazi, Birch Lab, Ammonia Method Requires Ammonia usually obtained

through Anhydrous Ammonia Popular in 1980-2000 Anhydrous Ammonia is very caustic DEA recommends minimal LEVEL C

hazmat protections This method has to major hazards Some form of pressured container of

Ammonia Materials react violently with water

Methamphetamine and First Responders One Pot method Most popular method today Can be used to produce both

small and large amounts Requires only house hold

chemicals Extremely flammable due to

reaction between water and lithium during shake processes Liquid in container is ether or

Coleman fuel Hospital meth lab explosion Glass container hazards Colt 45 bottle

https://www.youtube.com/watch?v=0kq7zj8Kd_Q

Methamphetamine and First Responders All methods have risk of

explosion and fire All methods use some

variation of flammable liquid to suspend the methamphetamine product All methods also require some

form of gas to extract the suspended methamphetamine from the solvent HCL gas by mixing sulfuric

acid and salt Picture from Cayuga County

09/19/16

Concentrated Cannabis Method of extracting THC from marijuana

and condensing it into a wax like substance Usually done by packing marijuana (bud

and leaf) in a pvc or glass tube and running butane through it collecting the product and boiling it off with Corn based alcohol. Boil off is usually where the problem starts https://www.youtube.com/watch?v=agZBq

KBDq_4 https://www.youtube.com/watch?v=xmqJR

17mMgM

Suicidal calls All suicidal calls should be

handled coordination with Law Enforcement Any suicidal subject should be

treated as potential aggressive and a threat to EMS/FIRE/LAW Personal acquaintances,

Friends and even family members who are suicidal should never be considered less of a threat to responders Chemical suicides present a

greater risk to all responders due to lethal chemicals gasses used in the process

First Responder Targeting and Domestic Terrorism

Proactive FIRE/EMS/LAW involvement in Terrorist response training should be a high priority for all responders Most recent events 9 people stabbed at Minnesota Mall Seaside NJ and Chelsea NY

bombings “Lone Wolf” or ISIS encouraged

terrorism on the rise Overall goal is to inflict

signification damage and death to increase media coverage of there beliefs. Oklahoma City Bombing 2nd largest attack on US Soil Timothy McVeigh From Lockport NY 5000# or Ammonium Nitrate and nitro

methane

First Responder Targeting and Domestic Terrorism

Training available through Center for Domestic Preparedness https://cdp.dhs.gov/find-training If you see something say something Campaign 1-866-safe-nys Neighbors of San Bernardino shooters saw suspicious activity but

did not report it in fear of being accused of racial profiling 14 killed 22 serious injured Reports can be made anonymously with local law enforcement tip

lines as well as federal tip lines http://www.cayugacounty.us/cayugacrime/Crime-Tips https://tips.fbi.gov/

Closing and Questions Training will play a large factor in

Situational Awareness and addressing threats to you and your crew All EMS and FIRE calls have the

potential to become dangerous or threatening to responders If you are prepared for the worse you

wont be surprised by it msloan@cayugacounty.us (315)294-8155 work voice mail Questions