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Concussion and Head Injuries

 

Being struck in the head is unfortunately common in the wildland environment. Snags, equipment, loose scree, and UTV use all abound in our environment. Hard hats and helmets are a must and provide a degree of protection. But what if your co-worker gets a hit to the head (with helmet on!) and stumbles to the ground?

Image
Twelve symptoms that could indicated concussion.

Consider the scenario:

Your crew is walking along a trail when a large tree branch falls and hits the head of a team member. They are knocked to the ground but do not appear unconscious. No other injuries are identified and after a few minutes they seem to be OK. With relief, you hike onwards. A few minutes later they ask, “Where are we?” and you answer. Again, after a couple minutes the same question—same answer. This happens several more times and pretty clearly, they are not able to process or retain the information. What’s going on? What should you do? 

A blow to the head–with or without loss of consciousness–which results in some impaired cognition is a concussion. Concussed individuals sometimes repeatedly ask the same question and can’t seem to process the answers. They may complain of headache, dizziness, nausea. More severe concussions can result in being off balance, vomiting and some degree of panic as they cannot understand what has happened no matter how much you explain.

Fortunately, thanks to mainly the field of Sports Medicine there are now standard approaches to patients with concussions, as well as clear guidelines.

Follow the three 6 Rs: recognize, report, and recover.

Or even better are the 6 R’s:

  • Recognize. Learn the signs and symptoms of a concussion.
  • Remove. If an individual has a concussion or even a suspected concussion, they must be removed from duty immediately.
  • Refer. Seek medical attention.
  • Rest. A minimum of 24 hours for mild symptoms – 72 is better.
  • Recover. And then begin a gradual process of low levels of physical and mental activities over the next 7-14 days.
  • Return. If all symptoms have resolved and you are cleared to do so by a medical provider.

Allowing a person with a concussion to continue on duty is not only detrimental to their recovery but could put the entire crew in jeopardy if quick thinking or movement is required.

 

Category
Firefighter Health & First Aid
References
NWCG Emergency Medical Committee
AANS, Concussion – Symptoms, Diagnosis, and Safety Guidelines
IRPG, PMS 461 – Emergency Medical Care (red pages)


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2025 NWCG Incident Response Pocket Guide (IRPG), PMS 461, Now Available

Date: February 27, 2025
Contact: Incident Operations Subcommittee

NWCG is excited to announce that the 2025 NWCG Incident Response Pocket Guide (IRPG), PMS 461, is now available. Visit NWCG's website to learn about the major updates and changes in the 2025 version of the IRPG. The NWCG Guia de Respuesta de Incidente de Bolsillo (GRI), PMS 461-ES is available electronically and will be available from Great Basin Cache by early summer 2025.

All hard copy materials, including the IRPG, are ordered through the Great Basin Cache (GBK). Information on the ordering process can be found in the National Fire Equipment System (NFES) Catalog.

References:

2025 IRPG Information 

NWCG Incident Response Pocket Guide (IRPG), PMS 461 

NWCG Guia de Respuesta de Incidente de Bolsillo (GRI), PMS 461-ES 

NWCG NFES Catalog - Part 2: Publications, PMS 449-2 

2025 Professional Reading Program

Date: February 18, 2025
Contact: Wildland Fire Leadership Development Program (WFLDP)

The Wildland Fire Leadership Development Program is announcing the 2025 Professional Reading list! The goal of the annual reading list is to promote the reading and discussion of the books throughout the year.

The five books chosen for this year are: Surf When You Can by Brett Crozier, Man’s Search for Meaning by Viktor E. Frankl, Elephant Company by Vicki Constantine Croke, Simply Managing by Henry Mintzberg, and Chop Wood Carry Water by Joshua Metcalf.

References:

Professional Reading Program

Task Group Volunteers Needed to Update the Property Loss or Damage Report, OF 289

Date: February 5, 2025
Contact: Julie Bennett, Incident Business Committee Chair

The Incident Business Committee (IBC) is requesting volunteers for a new task group to revise the 1981 version of the Property Loss or Damage Report, OF 289 and create an incident replacement job aid. The volunteers may be recruited from within or outside the Geographic Area Incident Business Committees.

References:

IBC Memorandum 25-02

IBC Correspondence

2025 Updates to the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1

Date: February 4, 2025
Contact: Incident and Position Standards Committee

The NWCG Incident and Position Standards Committee has updated the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1. 

These updates address changes to incident position names and requirements for qualification, training, and experience. Updates related to the implementation of Complex Incident Management (CIM) are also included.  

The NWCG Wildland Fire Position Qualification Flowchart, PMS 308 has also been updated to reflect the recent changes.

References:

NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1

NWCG Wildland Fire Position Qualification Flowchart, PMS 308

NWCG Memo: 2025-01 January 2025 Updates to the NWCG Standards for Wildland Fire Positions Qualifications, PMS 310-1