Under attack: Fire victim fights, rips at SCBA masks during rescue

We crawled through heavy smoke and fire to find him and were not leaving without him

By Chad Everhart

On March 8, the Tiffin Fire and Rescue (Ohio) Division was dispatched for a two-story duplex on fire with a handicapped person trapped inside.

The first engine on scene reported smoke showing and commanded a fast attack mode. A handicapped person was found outside the structure, but a second occupant was reportedly trapped on the second floor.

Police on scene attempted to make entry prior to arrival, but were forced to retreat due to heavy fire conditions. Operating with only eight on duty, an officer and firefighter advanced to the second floor without the protection of a hose line and searched a front bedroom under heavy smoke conditions. 

Another officer in command struck a first-alarm and two firefighters advanced 1¾-inch cross lay to the second floor and called for water.

They met up with the other officer and firefighter in the structure and waited for water. As soon as the hose line was charged, crews began to advance and found heavy fire in the kitchen with a ceiling down and fire in the attic. While crews battled the blaze, melted and burning roofing material rained down through the kitchen.

Soon after, a second alarm was struck.

More than just a fire attack
Under protection of the hose line, the officer and firefighter located an unconscious male in a bathroom. The door had been closed and protected the victim. We later saw that a 4-inch diameter hole had burned through into the bathroom.

As they began to move the victim, he became combative and remained so throughout the rescue and transport to the hospital. The victim began to strike the firefighter and grabbed his high pressure hose – dislodging his mask.

With the fire still pushing down on the crew, an officer elected to close the bathroom door for protection and a firefighter continued to attack it in the attic and kitchen.

As the victim continued to struggle with firefighters, he fell to the ground and became wedged between the toilet and a dryer. Firefighters were able to free him as the victim became unresponsive. The officer and firefighter grabbed the victim’s upper body and opened the bathroom door.

As the crew reached the top of the stairs, they were met by another firefighter and the victim became combative again and attempted to kick the officer.

During the struggle, the firefighter was knocked down the stairs and injured his arm. The victim was removed down the stairs and transferred to the hospital by medics.

The initial attack crew proceeded back inside to continue with the fire attack.

How to deal with a combative victim
This was our first time encountering a combative fire victim. Our crew has dealt with many combative EMS patients over the years, which helped in this incident.

As far as dealing with the combative victim, striking a patient or victim should never be an option unless your life or your crew’s lives are in obvious danger.

We tried to just gain control of him and carry him out. With him striking me and grabbing at my equipment, this was no easy task.

At one point during the struggle, I did knock the victim to the ground, which only made things worse because my mask was still not on right and he became wedged between the toilet and the dryer.

On an EMS scene, if we encounter a combative patient we are taught to retreat and wait for the police to handle the situation and proceed only when the scene is safe.

This was obviously not an option. We crawled through heavy smoke and fire to find him and we were not leaving without him.

Lessons learned
There was a handicap ramp with high railings that led to the front door and stairs. Our engines are outfitted with a 200-foot minute man load preconnected. The first 100-feet of this preconnect was dropped in a pile at the front door between the railing.

We always stress flaking out the hose prior to charging it and entering a structure, but we also make mistakes.

It seemed like we were waiting on water forever while two firefighters were untangling the mess outside.

If the preconnect had been flaked out in the street or front yard first, the other two firefighters could have went about their designated tasks sooner.

We also later found a fire escape and exterior door leading right into the dining room — just past the kitchen. Basically, it was a straight shot across the dining room from the bathroom we were in.

If we had known this door existed at the time, we would have been able to remove the victim from the IDLH environment without dragging him through the fire area.

A 360-degree size up of the structure is important and features such as the fire escape and exterior door should be communicated with crews inside as an option to execute the rescue.

Also, no ground ladders were thrown at this incident.  

We did have a window above the washer in the bathroom that we could have removed the victim via ground ladder had we needed to. However, we had no one available to throw ground ladders. 

As far as changing the way we attacked the fire, some questioned why we didn’t put the fire out before crawling through the kitchen.

We were only working with eight guys on duty that day. It would have been ideal to have an attack crew, back-up line crew, truck and rescue crew, but we only had a crew of eight. It was imperative that the firefighters farther back on the line kept a good watch on what was going on around and above the crew as they helped advance the hose.

The firefighter that was knocked down the stairs injured his arms as he fell backwards. But he was evaluated on scene and remained on the job.

I suffered some smoke inhalation, but recovered before the start of my next tour.

The fire investigation determined that the fire started in a pot left on the burner of a stove.

Although the outcome of this fire was positive, do not overlook the impact a rescue can have on your crew. Pay attention and remember to always communicate.

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