Editor's note: This article is from the International Public Safety Association’s Acts of Mass Violence: Public Safety Response and Recovery Initiative

By Dave Mulholland, Administrator, Arlington County Emergency Communications Center 

Each day, 9-1-1 telecommunicators handle stressful calls involving law enforcement, fire and medical incidents. Telecommunicators are trained to calm highly distressed callers and gather the appropriate information within structured protocols and processes. Their training and the protocols they use have been developed and refined over decades. Coupled with strong training and defensible protocols, telecommunicators have become experts in handling high-stress calls through repetitious use of both foundational elements. 

However, the 9-1-1 landscape has changed as acts of mass violence and other multi-caller/multi-victim high-threat incidents begin to increase. These acts have restructured in-the-field first response efforts.  Police officers now arrive and directly enter the area to engage the threat, no longer securing exterior perimeters and staging until sufficient resources exist for team entry into the incident. Trained fire personnel and medical personnel now enter hot zones rather than waiting for a scene to become secure before they enter to render aid.

Similarly, acts of mass violence impact traditional 9-1-1 response. Telecommunicators, as the first of the first responders, play a critical role in determining the nature and extent of the threat and supplying the in-field responders with information to end the threat. During an act of mass violence, it is likely that the 9-1-1 center will be quickly overcome with calls. Triaging these calls to gather the most pertinent information is paramount. To successfully do this, the telecommunicator may need to deviate from traditional practices such as gathering detailed information about injuries and providing emergency medical dispatch protocols.

Below are five tips to assist the 9-1-1 center in handling mass violence events.    

Tip 1: During an on-going act of mass violence, the highest priority is to gather information to stop the threat. Law enforcement first responders must be provided with as much information regarding the type of threat and information to help identify the attackers and their location. High-threat trained fire and rescue personnel need to understand the environment to make informed decisions on when and where to begin their response inside the incident. The dispatcher is informing these decisions.  Telecommunicators also help inform the response by identifying any additional information sources at the scene such as video feeds and determining if there are possible secondary threats at the scene.

Tip 2: It is essential that 9-1-1 lines be kept clear so that additional information may be obtained. This often requires truncating calls from victims and witnesses on the scene. It is hard to disengage with someone who is injured or next to someone who is seriously injured or dead. Calls must focus on stopping the threat, and until that happens, telecommunicators should not be triaging medical priorities or providing medical direction through emergency medical dispatch protocols. Jurisdictions could consider creating specially trained crisis personnel from other governmental departments (such as human services) who can be activated to communicate with callers during an active incident and provide direction and comfort to the callers. After the 9-1-1 telecommunicator obtains the necessary information from the initial call, the call be transferred to another phone bank staffed with these specialists. 

Tip 3:  As soon as it is clear that you have a mass casualty or significant active shooter event, mobilize Critical Incident Stress Management (CISM) or Traumatic Exposure Recovery Program (TERP) team members. When developing these teams, ensure that there are members not actively deployed as an event responder who can respond to on-going event to help begin help with stress management in the 9-1-1 center. Thus, the healing process can begin even as the incident is still ongoing. All 9-1-1 supervisors and managers must constantly communicate with and evaluate telecommunicators during the incident to gauge when they may be reaching breaking points. Be prepared to appropriately relieve an employee who may have reached maximum stress levels during the incident. A broken employee will not effectively contribute to incident resolution.

Tip 4: Train, train, train. As stress levels rise, thinking functionality begins to rely more on how the brain has been trained and conditioned to respond. The adage of you fight as you train is equally true in the 9-1-1 center. Telecommunicators must be trained on response to acts of mass violence, especially through repetitive simulation exercises. This will assist the telecommunicator in developing greater comfort to follow different protocols during a mass violence event. Time spent in continuous roll call and simulation trainings multiple times a year will reap large rewards should a mass violence incident occur.

Tip 5: Great efforts have been made to educate the public on responding to acts of mass violence, such as the “Run, Hide, Fight” educational campaigns. However, little has been done to educate the public on what information is important to relay when calling 9-1-1 during an act of mass violence or what to expect when calling. For example, the public should be prepared for the telecommunicator to quickly gather information regarding the active threat but not remain on the line to determine extent of injury or provide reassurance and medical direction. 9-1-1 centers should work collaboratively with their respective first responder agencies to expand education efforts to include communications with 9-1-1 during a mass violence incident.

The role of the telecommunicator is critical in responding to and resolving acts of mass violence. It is imperative to continually evaluate appropriate response to 9-1-1 calls during acts of mass violence through decomposition of prior events, adoption of best practices and lessons learned and development of new tactics and protocols in the 9-1-1 center. Telecommunicators prove their value in saving lives, providing hope to those in distress, and protecting first responders every day. Efficient handling of acts of mass violence amplify the telecommunicators critical role as part of the first responder team. 

About the Author

Dave Mulholland is currently the Administrator for the Arlington County, Virginia, Emergency Communications (9-1-1) Center. He retired as a Major from the United States Park Police after 27 years of service. He has also served as the Statewide Interoperability Coordinator for the District of Columbia. Mulholland will be presenting at the IPSA’s Mass Casualty Incidents Symposium this Fall in Washington D.C.

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By Natasha Lukasiewich, DNP candidate, MSN, HHP, LNC, RN, CCRN-K, CFRN, CEN, EMS-RN and IPSA Mental Health Committee Member, Critical Response Team and Peer Support Unit Member for Washoe County Sheriff’s Office

How many times has one said this to themselves or have heard others say this, I want to help, but I do not know what to say? Sometimes, it is not about saying anything, and it is about the ministry of presence. Active listening and knowing your resources available are key.

When I was seven years old, my dad died by suicide. He died from severe depression, lack of support and not knowing what resources were available for him. From the coroners’ viewpoint, he died of carbon monoxide poisoning, but he also died of shame, guilt and a lack of knowing how to better his situation. Ultimately, he died of reasons unknown to those left behind and, more importantly, he is not here today.

This article presents a tool that allows one to check in with oneself and your colleagues. This tool needs no specifics, but a self-awareness based on color identification.

Health care professionals and first responders

What is happening in our industry of health care professionals and first responders? Think about the calls for service you have been involved with:

• Colleague overdoses on narcotics they have been diverting.
  
• Physician overdoses.
• Death by suicide on duty.
• Suicide by cop.
• Another staff member takes their own life by suicide.

These stories are not unique, and everyone could sit here all-day recollecting about how they have all lost some amazing souls in their time. Again, the same responses that occur over and over is often, I just don’t know what to say or do.

Shift workers all have shift changes, pre-brief, debriefs and so on. Why is so much of the health care and first responder industry focused on the hard skills and not the soft skills? Those who serve must be resilient and must improve all skills – hard and soft. Research shows that individuals who health care professionals and first responders serve are only receiving the care and service as good as the providers that are serving them.

Changes to implement today

The challenge for each reader today is to implement what is called the mental health continuum model in your daily shift reports – adapted from the National Defense and the Canadian Armed Forces.

The Red Cross Crisis Response Teams worldwide also use what is called the Stress Continuum Model. This allows for the team leader to check in with those out in the field to see how they are coping with the horrific things they are being exposed to. See below.

Next steps

Now that the above tools have been shared and we have acknowledged that every health care professional and first responder must begin using them today, what are the next steps? Here’s an example about how to easily apply these tools in practice.

If you serve in an EMS agency, while doing crew change, the team lead can check with the crews and simply ask, “What color level is everyone today?” Without even knowing the details, a crew lead can assess mental readiness to the start of the shift. They have just triaged their team’s mental readiness.

The team lead can also check in after a bad incident – such as after a horrific pediatric call. Teams may have started off their shift in green or yellow, but after the call some of them are likely to be orange or red. If there is a significant shift in color after a bad call or shift, then there needs to be a tactical response to ensure the appropriate resources are dispatched or in contact with the health care professionals or first responders that need it, preferably, sooner than later.

Perhaps if my dad, or my colleagues had some sort of communication tool, they too could have been saved or at least been shown they were not alone.

The health care and public safety industries need to take mental health readiness seriously and regularly assess their personnel. These industries need to stop being reactive and be proactive with mental health readiness.

Try it, challenge yourself, challenge your organization. What color are your today?

About the Author

Natasha Lukasiewich started her journey in Health Care back in 2001, when she graduated from Grant MacEwan University, in Edmonton, Alberta, Canada with a diploma in Holistic Health. She later graduated from the same university, and completed her Nursing Diploma, venturing into Emergency Medicine. In 2006, she was recruited central coast California, to continue her ER nurse journey, later becoming  a flight nurse for Calstar. She then continued her flight nursing career in Lake Tahoe/Reno, NV areas with Care Flight.  In 2017, Lukasiewich completed her MSN and is currently completing her DNP (Doctorate in Nursing Practice). Her focus is primarily peer advocacy and raising mental health wellness in health care and first responders. She has been an invited speaker for many webinars, symposiums and national conferences on the effects of PTSD, depression and suicide for health care and first responders. For the last six years, she has served as a Volunteer Auxiliary Deputy Sheriff on the Washoe County search and rescue team, and also serves on their Critical Response Team and Peer Support Unit. You can connect with Natasha on LinkedIn or connect via her business website at www.legalnurse.solutions. Feel free to email her at natasha@legalnurse.solutions.

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By Anne Camaro, Assistant Director, Cambridge Emergency Communications, IPSA 911 Telecommunications Committee Member

Training is always needed in public safety, but its methodology, delivery and perceived success of the training is often a subject of controversy. Fiscal resources, staffing and time constraints are often impeding an agency’s ability to form a consistent and well-developed training program.

The private sector recognizes that developing meaningful, impactful and task-focused training will improve business performance, and of course, the bottom line. Private companies seem to have an easier time gauging the impact of talent development. Training effectiveness can be measured by looking at several indicators, including an employee’s cost-effectiveness.

But what is the public safety bottom line? Perhaps the bottom line in a 911 communications center can be defined as the ability of the dispatcher in managing incidents. But how is that quantified or measured? There are myriad possible bottom lines when it comes to public safety call taking and dispatching that the water gets muddied when trying to determine how to measure the effectiveness of training.

1. Should 911 communications centers measure how calls are handled?
   
2. Should 911 communications centers measure how field units are dispatched to determine effectiveness of the dispatch and time to scene arrival?
   
3. Should 911 communications centers measure whether call takers are gathering the necessary information from callers for an effective response?
   
4. Should 911 communications centers measure a successful shift by the number of field responders who arrive safely at home at the end of the shift?
   
5. All the above?
   

Agencies must go back to the basics of risk management and needs assessment, and have a continuous process to identify training needs, desired outcomes and measure whether the training model being used is addressing the needs.

Three training steps

In his book Work Rules, Laszlo Bock talks about the need to create a culture of learning within an organization. He highlights a few steps organizations can take to create this culture of learning.

Step one: Deliberate practice creates improvement. Organizations that focus their training in breaking down job duties into small practicable tasks encouraging employees to perform these tasks repeatedly have more success in improving performance with training. Bock cites the work done by K. Anders Ericsson, a professor of psychology at Florida State University, who studies the acquisition of expert level skills.

Ericsson found that individuals who attain expert level skills in any task, mostly learn by breaking down those tasks into smaller ones, and repeating them over and over after receiving feedback, or observing their results, making small adjustments to their tactics to improve. Ericsson refers to this as "deliberate practice: intentional repetitions of similar, small tasks with immediate feedback, correction, and experimentation.” Public safety agencies can maximize their budgets by utilizing downtime for these practice exercises.

Step two: Identify internal subject matter experts and invite them to teach. Many agencies when faced with training needs go to third parties (e.g. consultants) for classes, but they fail to consider that the consultant has never worked in their agency and do not have a true understanding of the agency’s organizational culture.

While the information received at these classes is often relevant, if not enforced or immediately applicable, it will likely be forgotten within a couple of days. Teaching from within the agency will allow for topics to be relevant to daily tasks, and employees will have easier access to the instructor for follow up questions.

Step three: Identify and measure the intended outcomes from the training. When implementing a new training program in a department, unit or division, agency leadership must be diligent in identifying and measuring the intended outcome from the training. Bock suggests implementing a controlled study in which employees are placed into two groups and only one group is exposed to a training course. Then, after a period time, compare the performance of the two groups. If the group that received the training is performing better, then the agency can reasonably infer that the training was effective.

Bock’s three steps in creating a culture of learning addresses many of the common complaints of public safety agencies. When agencies get creative and leverage internal talent and resources for training, they can address their training needs without having to constantly rely on budget approvals and balancing out staffing and time constraints.

About the Author

Anne Camaro is the Assistant Director of Administration and Training at the Cambridge Emergency Communications Department in Cambridge, MA. She has a Master’s Degree in Public Administration, and a Post Graduate Certificate in Local Government Management and Leadership. Anne is passionate about the 911 industry and has devoted a lot of her time to developing and implementing training programs.

By Heather R. Cotter, IPSA Executive Director and Founder

First responders experience extreme physical demands, often in hazardous environments. Many tragedies occur suddenly and without warning. Gunshot wounds, building collapses, vehicular accidents, assaults and other causal factors contribute to untimely deaths in our emergency response community. Further, first responders face several threats to occupational related diseases such as cancer and cardiorespiratory related maladies. Law enforcement, firefighting and rescue activities are inherently dangerous occupations.

Since June 2018, we have lost 48 first responders, according to data pulled from the Officer Down Memorial Page and the U.S. Fire Administration. These 48 fatalities include law enforcement officers, firefighters and K9 officers. The cause of death includes vehicle accidents, illnesses, gunfire and duty related injuries.

Download the Article

By Heather R. Cotter and Natasha Lukasiewich, DNP Candidate, MSN, HHP, LNC, RN, CCRN-K, CEN, CFRN, EMS-RN

This article highlights a valued member of the International Public Safety Association, Natasha Lukasiewich. Recently, Natasha went above and beyond and created a Facebook fundraiser on her birthday to support the IPSA. Her goal was to raise $500, and she surpassed it.

Q1: You recently created a fundraiser for the IPSA on Facebook. What prompted, you to do that and how can others replicate this?

Recently I got a year older and thought, you know, how great would it be to share my passion and belief in the mission that IPSA? Therefore, I decided to take a leap to honor and donate my birthday to IPSA on Facebook.

Facebook has a great feature in which you can choose a not-for-profit organization to raise funds for an organization you believe in. Any Facebook user can use this feature (instructions about how to easily do this are below).

Honestly, I had no idea if my friends, family and connections would support my fundraiser for the IPSA. To my gratefulness they did, and I beat my fundraising goal. I know the funds will be used wisely to support the IPSA mission.

Q2: Tell us about yourself. What is your professional background?

I started my journey in healthcare in 2001, when I graduated from Grant MacEwan University, in Edmonton, Alberta, Canada with a diploma in Holistic Health. I worked collaboratively in integrative medicine approaches with a Naturopathic Doctor and Chiropractor. I later realized my calling in nursing. Graduating from the same university, I completed my Nursing Diploma, venturing into Emergency Medicine.

In 2006, I moved to California to continue my ER nurse journey. I later found my calling as a flight nurse for Calstar. The rewards of flight nursing are never ending, but also the challenges mentally can tax even the most resilient. I continued my flight nursing career in Lake Tahoe/Reno, NV areas with Care Flight. Close to seven years in the skies, I stepped down due to a physical injury that would not allow me to fly anymore.

So being a nurse, I reinvented my career. I then completed my MSN and I am currently completing my DNP (Doctorate in Nursing Practice). My focus is peer advocacy and raising mental health wellness in health care and first responders. Being a voice for those that cannot, has been a true honor. I have spoken for many webinars, symposiums and national conferences on the effects of PTSD, depression and suicide for our heroes.

For the last six years, I have served as a Volunteer Auxiliary Deputy Sheriff on the Washoe County search and rescue team, and I also serve on their Critical Response Team and Peer Support Unit.

Aside from having professional experiences in dealing with those that suffer with mental illness and wellness balance, I am also a survivor of my dad’s suicide when I was younger. I try to share how others can become more resilient and embrace post traumatic growth that can occur in our industries.

Q3: Since you have been a member, what have you done to advance the IPSA mission?

Joining the IPSA was one of those steps that I do not regret. I’d like to personally thank Todd Kerfoot, an IPSA Board Member, for introducing me to this fantastic association.

Since I have joined the IPSA’s mental health committee, I have been part of the team that helped produce the mental health awareness posters, that have been shared for free and distributed across the nation. Just recently, I have taken on the support role of Vice Chair, hoping not to disappoint the committee members. We have some great talent, and I look forward to our next projects coming out. Some of us, and myself have been presenters on the IPSA webinars. I have also had the opportunity to attend one of our IPSA conferences in Arizona. It was so nice to put faces to familiar names.

Q4: Why should others get involved with the IPSA?

I have my own consulting and education specialist company. I know the importance of having support in one’s mission. I am constantly training with pre-hospital providers and hospital personnel to improve patient outcomes. The IPSA is an organization for those who serve. We truly cannot forget about ourselves, and the IPSA definitely helps bring those like-minded together. After all, together we are stronger.

Closing remarks  

I have served on many committees in the past and felt the frustration of never really accomplishing a lot. I can attest that joining IPSA and their committees, you are surrounded by the most motivated individuals. If you truly want to see change, then join us in the mission to improve our industries.

Facebook Donation Instructions

Step 1: Start by writing a post, and then click on the … to open up the menu you see below. Then click on Support Nonprofit.

Step 2: Select International Public Safety Association and the write a story in your Post about why you’re doing the fundraiser and how much you’d like to raise. Press Post and you’re done.

By Lori Pina, Lead Telecommunicator, Charlotte Mecklenburg Police Department, Communications and IPSA 911 Telecommunications Committee Member

Have you ever tried to find a watch? If not, it is very time consuming. Dispatching these calls isn’t what delays customer service, it is the process of calling back every smart watch-wearing citizen. Although policy varies between 911 call centers, it has the same impact overall, which is a call taker is temporarily unable to take an inbound emergency call due to calling a 911 hang-up back from a watch.

Apple

iWatch and its technology is becoming quite the experience for 911 call centers across the country. If you hold down the side button on the iWatch, it will call 911 with a Wireless Phase 2 location (approximate location of the watch-wearer). For this feature to work, the watch-wearer must be within a Bluetooth connection range to their cell phone or connected to a stronger Wi-Fi.

As the call comes into the 911 call center, it sounds something like this: several voices can be heard in the background, and the call taker is unable to advise if there was a disturbance. However, they have an approximate location (Phase 2).

The call taker will then call back the number associated with the iWatch, and, if lucky, the subscriber will answer and advise their watch called 911 accidentally. If there is no answer, then the call will be forwarded to voicemail. If voicemail is reached, the next step a call taker will implement varies based on call center policy.

Samsung

Samsung technology is entirely different. The smart watch has an SOS feature that will contact up to four people. If the watch-wearer intentionally or unintentionally pushes the side button three times in a row, it will notify up to four people of their approximate location via text message and also provide audio coming from the smart watch. However, no audio will return to the watch (in case the watch-wearer is in an emergency situation). It will continue to update your SOS contacts for up to one hour after with location.

While this is a great function in theory, the functionality has limitations in practice. In theory, the SOS contact would notify law enforcement, fire or medical of the victim’s location and advise what is occurring.

However, the 911 call center will receive up to four 911 calls for the same incident, with minimal information. Often, the caller can only advise that their friend pushed an SOS button and give an approximate location.

If the 911 call taker is fortunate enough to find the watch-wearer, they usually discover one of the following:

1. The individual accidentally sent an SOS call.
   
2. The individual was trying to reach a family member that wasn’t answering their phone.
   
3. A child was playing with the watch.
   

Unfortunately, most of the time, 911 call takers are unable to find the watch-wearer due to them being in a large crowd, or because the individual just moved on and continued whatever it was they were doing.

Other smart watches

In a 911 call center, we often deal with the Apple or Samsung smart watches but there are other watches that impact the 911 world.

Watches designed for children: The other smart watches use a service such as an alarm company or GPS technology that gets relayed through a parent or guardian. These smart watches tend to be targeted for children and usually have a geofencing technology, which is simply a geographic boundary set up specifically for the watch by the guardian. These smart watches are usually set up around a school, home or park where the child is known to frequent. In a situation involving a missing child or a person with special needs, although a 911 call taker would have to go through a parent or guardian on the account, they could get a decently accurate location for the subject.

Watches designed for the elderly: Smart watches designed primarily for the elderly are usually monitored by an alarm company. When this is the design, the alarm company usually has minimal information, such as the subscriber’s address, known medical information and key location. While the alarm company may not be able to give a 911 call taker an accurate phase 2 (approximate location), they may be able to provide medical information that can be relayed to first responders.

Although there are other brands and different types of smart watches on the market, the best practice out there is to be knowledgeable of what your smart watch can do and who you’re reaching when utilizing a SOS feature. If it is a third party monitoring the smart watch, such as an alarm company, make sure they know what information you are willing to have released to authorities ahead of time in case of an emergency. In an emergency, seconds make all the difference.

To all smart watch-wearers, figure out what your smart watch can do, so when the seconds matter, 911 call takers aren’t wasting minutes to help.

About the Author

Lori Pina is a Lead Telecommunicator with the Charlotte Mecklenburg Police Department and a member of the IPSA’s 911 Telecommunications Committee. She has been an Emergency Telecommunicator for the last decade. She began her career with a smaller consolidated agency that dispatched for police, fire and medical and completed all DCI functions. She relocated to Charlotte, NC in 2014 and subsequently got hired to join CMPD. Pina has been a Communications Training Officer for six years and has I recently become a Lead Telecommunicator. She loves her job in the communications center and enjoys the challenges that are thrown her way.

By Ahrar “Sid” Siddiqui, Supervisor, Arlington County (VA) Emergency Communications Center, IPSA Fitness/Wellness Committee Member

Wellness is defined as the state of being in good health, and strength training is a critical component of getting in good health. Whether you work in law enforcement, the fire service, 911 telecommunications or other public safety related discipline, there is a clear need to be in good health. There are obvious physical benefits to reap from a balanced program, such as increased strength and flexibility, but also many overlooked advantages that can make a bigger difference in your overall health.

Getting started and sticking to a plan can be difficult but setting attainable goals and pre-planning workouts can help you achieve your goals. Like many other things in life, your level of commitment to a strength training routine will determine what kind of results you get and how close you are to your wellness objective.

Benefits

Everyone who works in public safety, wants to be stronger or leaner, maybe weigh a little less; strength training can get you there. Beyond that there are many other ways strength training can impact your health in a positive way. It is an invaluable tool in relaxation, blow off some steam after a long day at work with a lifting session and you’ll be surprised how good you feel when you leave the gym. An added benefit, muscle burns more calories than fat even at rest, so if you are trying to lose weight you’ll be pleasantly surprised at how much easier that becomes even if you keep your caloric intake the same.

Your bones will thank you, as resistance training is one of the best ways to improve bone density and stave off or mitigate the effects of conditions like osteoporosis. It can help fight and slow down several major metabolic diseases like diabetes, by teaching your body how to use insulin more efficiently and lower your risk for heart disease by better regulating your blood pressure and boosting your good cholesterol. All of these are little pieces in the overall wellness picture, with the result being a healthier you.

Getting started

Beginning a strength training regimen can be quite difficult, especially if you have never really been into exercising before. Searching for plans on from authoritative sources (e.g. the American Council on Exercise), will give you literally thousands of options. But before you begin searching for a workout plan, set some goals. Simply ask yourself these three simple questions:

1. What kind of physique do I want, do I want to be a mass monster like a bodybuilder or do I want a trimmer more athletic body?
2. What’s my timetable to achieve these goals, do I just want to get in shape for the summer beach season, or am I trying to create life time habits?
3. How much time and money do I have to invest in this process, depending on my work and personal schedules?

If this sounds kind of daunting, it is. The answers to the above questions will help determine what kind of plan you should develop and where to begin. Here are two invaluable tips, keep it simple and just start doing it. 

You can join a gym or work out at home but pick a few exercises that you feel comfortable with and focus on those in the beginning, there will be plenty of time later to add variation and complexity. And start, as you gain experience over time you will be able to better understand where you want to be and how to get there.

Strength training is an important component in any plan to improve your health. Its benefits can vary from the immediate to subtler and long-lasting improvements in the form and function of your body and mind. Starting can be hard, with lots of choices to confuse you, but if you never begin you will never see the results that you want, so, keep it simple and just start doing.

 At the end of the day you want to look and feel good to be well, and this along with a few other pieces like a good diet and rest, will get you there.

About the Author

Ahrar ‘Sid’ Siddiqui serves as a Supervisor in an emergency communication center, with 11 years of experience in Emergency Management and dispatching Police, Fire and EMS resources. During his career he has served on Arlington County’s Diversity Workgroup, EOC, Vesta/Nextgen 911 committee and is currently a member of the IPSA Fitness and Wellness Committee.

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By Robert Mitchell, Retired Chief and Member of the IPSA's Memorial Committee

“Rescue 22 respond to 2615 Kingfisher Dr. for a two-year old having seizures. Timeout 0345, Unit responding select Tac 6.”

It’s 0345 in the morning. You’re on duty having just laid down for the first time this shift about 30 minutes ago. You’ve decided not to eat anything to try and get some sleep. You’re on the back side of a 48-hour shift which wasn’t much slower. As you stagger to the truck, you try to remember where Kingfisher Drive is. When you do arrive at the address, a mom comes running out the front door carrying her two-year old daughter in her arms. As you take the toddler you notice she’s kind of stiff and her colors a bit greyish. 

In the back of the truck you assess the little one and determine that she is indeed having a seizure and she is posturing. Mom tells you she has no known history, no allergies, doesn’t take any medicine and she’s been like this for at least 10 minutes. As you have done a thousand times, you continue her assessment, treatment and transport. 

The hospital is 10 minutes away and your partner makes it in five. There’s been no significant change in your tiny patient’s status the entire time she’s been in your care. You turn her over to the Emergency Room staff and get your unit back in service and write your report. You’ve done everything possible for this little one and you’ve done it right. You return to the station. Your shift finally ends. You go home.

After the shift ends

As you stagger into the house, your greeted by your two-year old who wants to do nothing more than play with you. Tears well up in your eyes and you can hardly keep it together. This is an all too often sequence of events for most of us in EMS, and sometimes it’s hard to let go.

• Does this happen to you regularly?
• What else is causing you stress? 
• Do you have a healthy way to deal with stress?

These are just a few questions you need to ask yourself to self-assess. Everyone knows the importance of diet, exercise, sleeping and staying hydrated. But is there more? The answer is yes.

Recognition of PTSD in public safety is at the forefront of the media and in many states, their legislatures. The International Public Safety Association has done several webinars on the topic and even created a series of posters for agencies and individuals to download and post in their departments. This is fantastic news, but how is this going to help the EMS responder in the field?

Collectively we have seen an increase in Critical Incident Stress Teams, Peer Support Teams, Chaplains and family training classes for spouses, significant others, and children that help to prepare them for what their responder maybe facing. Most responders don’t want to open to someone who has no operational experience in EMS or at the very least public safety. Having leaders who at least know how to recognize the signs of stress is a critical first step in getting help. As individuals we need to learn and understand that we may need help as well.

• Talk with your family about your feelings.
  
• Talk with a trusted professional.
• Remember your spiritual needs.
• Talk to your peers. 
• Seek positive ways to release your stress like exercising, reading a book and even playing video games.

Do yourself and your loved ones a favor, if you’re stressed, look for healthy ways to de-stress. Don’t be afraid to reach out, you are not alone.

About the Author

Chief Mitchell retired after 38 years of public safety service in fire, EMS, law enforcement and Emergency Management. He currently holds his Chief Fire Officer, Chief Emergency Medical Service Officer and Professional Emergency Manager designations.  He hold a degree in Professional Management from Nova Southeastern University and currently consults for a variety of different organizations.  Chief Mitchell is a member of the IPSA Memorial Committee.

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The IPSA created this new K9 Officer Safety Infographic for free download, printing and sharing.

By Jerry Steckmeister, Police Lieutenant, Westchester County Department of Public Safety, IPSA Fitness and Wellness Committee Member

Anywhere that you find public safety professionals, you are sure to find hand sanitizer. It’s in their buildings, personal bags and vehicles. It’s always nearby as if it were a magical potion that can cure all ills. Sinks are often bypassed to get to the hand sanitizer dispenser.

The main benefit to hand sanitizer is speed. It is quicker than washing hands and it is portable. When used properly, hand sanitizer can be an effective tool in protecting public safety personnel. But is public safety’s reliance on hand sanitizer sound? According to science, the answer is no.

Most hand sanitizers contain alcohol, generally 60 percent or more. This is sufficient to kill most, but not all, germs. For instance, it is not effective at eliminating norovirus or Clostridium difficile spores. It is an essential tool in healthcare settings, where the primary threat comes from germs.

What the CDC says

Problems arise when individuals overestimate the power of hand sanitizer. As noted above, it is ineffective at killing certain germs. It also may not have an effect on chemicals, and does not remove dirt or grease. In fact, it may cause your skin to be more absorbent to certain chemicals, such as fentanyl.

For this reason, the Center for Disease Control recommends hand washing over hand sanitizer in a non-healthcare setting. When soap and water isn’t immediately available, hand sanitizer is generally a good substitute, but the CDC still recommends that you wash your hands as soon as you are able.

None of this means that you should throw out all of your hand sanitizer. Used correctly, it can be a valuable tool for hand hygiene. In a health care setting, when your hands aren’t excessively dirty, hand sanitizer can provide a quick reduction in bacteria. Outside of a health care setting, if you have access to soap and water, you should wash your hands instead of using hand sanitizer. If you might be exposed to germs, but do not have access to a sink, hand sanitizer might help reduce bacteria, but you should still wash your hands as soon as possible.

Do not use hand sanitizer if you have been exposed to chemicals such as pesticides or fentanyl. Wipe excess chemicals off with a clean cloth and wash your hands. If you have a large exposure or do not have access to a sink, follow your agency’s protocol for decontamination.

Public safety professionals have a wide range of tools at our disposal. Each tool is effective when used properly, but can be dangerous when used improperly. Hand sanitizer is no exception. When it is used appropriately, it can help us to stay healthy and prevent us from bringing unwanted germs back to our family. However, it is important to understand its strengths and limitations.

About the Author

Jerry Steckmeister is a Police Lieutenant with 19 years of law enforcement experience. He is also a Major in the NY Army National Guard. In addition, he is a Director on the board of the Westchester B.L.U.E. Foundation and serves as member of the IPSA Fitness and Wellness Committee.

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