In wrestling with ideas for this blog, I false-started on a number of ideas but then it hit me like our recent two-week-long -30 (if not colder) windchill: mission preparedness and safety. There is plenty of information out there, including Heavy Lies the Helmet’s own Nick Zuber’s recent blog on All-Hazards EMS & Patient Access or Chris Sharpe’s blogs and videos continually reiterating “dress to egress”, so this is not going to be about re-hashing those topics ad nauseam. Call it more of an emphasis on materials already written. On that very note, if you haven’t checked out any of Chris or Nick’s publications, I highly encourage that you do so.
For those of you that live and work in a climate that rarely ever drops below 60 degrees, this information may (emphasis) not be as applicable as it is to those that live and work in climates that regularly fall below freezing. Either way, at the end of the day, one needs to, as Chris says, be dressed to egress. Those words have continually echoed through my head over the past two weeks with wind chills routinely falling well below -20 F (our cutoff for flights to occur). As CCT and HEMS crew members our job is to, quoting the motto of the Boy Scouts, be prepared for and anticipate a call to go wrong with a patient. Why else do we carry the wide array of equipment and medications that we do? Hope for the best yet prepare for the worst. The requirement to be prepared for a call does not stop at medical care however. The fact remains that this requirement is all-inclusive. Think back to when you were a baby firefighter, EMT, police officer or whatever. If your FTO was worth even half of their salt, they told you that you cannot help anyone if you do not get there, i.e. stop driving like a crazy person just because you can and get to your call safely. It also means do not be a cowboy by putting yourself in danger unnecessarily. The same applies to CCT and HEMS…you cannot help anyone if you do not get there or have to be rescued yourself. Furthermore, at least in the medical transport world, three lives are not worth one.
While I digress, my goal is to emphasize that everyone personally prepares for a mission to go wrong. While I can be just as guilty of it from time to time, there is a tendency for us to take for granted that our vehicles, be them winged or wheel based, will work and not fail. News flash, if it’s mechanical, it can break. Before going on a run, ask those important questions: What happens if we have to set down at a rural airport because of a chip light that the pilot could not remedy with the fuzz-buster? What if we have a failure that requires us to land immediately? Do we have the gear to keep everyone warm should our ambulance slide into the ditch on some rural highway? How long can we drive this ambulance before the box cools off so much that the heat is no longer effective and it turns into a literal cooler? Is our vehicle even designed to operate in inclement weather to begin with? You get my point.
Dress to egress. Make sure you have, and wear, the proper PPE to keep you warm. While winter coats tend to be a bit bulky by nature (yeah…..they are basically a pain in the butt to work in while in cramped quarters). If it is jammed in a cubby hole, can you guarantee you’ll have that coat when you reach the ground should you experience an in-flight emergency? While the presence of your aircraft or ambulance survival bag may make you feel all warm and fuzzy inside, will you have it, or even remember to grab it, upon exiting your vehicle? Should you consider carrying a small personal survival kit on your person? Yes is the right answer, by the way.
Just as important as your survival gear, another thing to consider during frigid temperatures is your route of travel. While we may fly at temperatures above -20, that does not eliminate the immediacy and hazards of a situation should something go wrong. In that regard, consider alternate routes of travel. While you may drive on some no-name county roads to save you twenty minutes of travel time, how well maintained are those roads in the winter, and how easy will it be for you to be located and accessed should you end up in the ditch? While one of the attractions to an aircraft are their lack of requirements to follow roads, and thus save time, would you be safer flying IFR (I follow roads, not instrument flight regs.) as opposed to more cross-country routes? This slight modification in flight planning would put you closer to civilization in the event you have a malfunction that requires an immediate landing. Setting down in a field, even a short distance from potential help, in cold temperatures turns the emergency landing you survived without a scratch into an emergency survival situation, for both you and your potential patient, fairly quickly. Depending on the wind chill, it can take as little as five minutes to experience frostbite on exposed skin. That is, of course, not even taking into account potential hypothermia should you not be dressed for such weather.
Organization budgets being what they are, sadly some people find themselves having to spend some of their own hard earned money and invest in gear. That’s definitely a personal decision, by the way. In my past life as a police officer, while we were provided with both a three-season jacket and a leather jacket, there was no way those coats would keep you warm for an extended period of time. During frigid times, I frequently brought out the ’ole N-3B parka, because all bets were off at that point, and it became about me staying warm.
At the end of the day, it is all about survival, especially during this time of year. The phrase “everyone comes home” applies to those operating on the ground just as much as those in the air. While we are all in the emergency business, that does not mean we should be the ones creating the emergency. Furthermore, there is an unwritten expectation that emergency responders are trained to a higher level of common sense, if you will, when it comes to evaluating situations. Just because you can take a call does not necessarily mean you should.
Stay safe and stay warm out there.