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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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NWCG Latest Announcements

Updated NWCG Standards for Course Delivery, PMS 901-1 and NWCG Training Course Completion Certificate, PMS 921-1

Date: July 17, 2024
Contact: Training Delivery Committee 

The Training Delivery Committee (TDC) has updated the NWCG Standards for Course Delivery, PMS 901-1 to reflect changes in the standards for course management and delivery. These changes have been reviewed and approved by the members of TDC over the past year. Significant updates include additional delivery methods, updated definitions, and instructions for the use of digital signatures on training certificates. The NWCG Training Course Completion Certificate, PMS 921-1 has been updated to lock after an electronic signature has been applied.

References:

NWCG Standards for Course Delivery, PMS 901-1

NWCG Training Course Completion Certificate, PMS 921-1

IBC Memo 24-01: OF 297 Signature Order and 2024 Fire Season Use IBC Memo 24-02: Summary of Changes for SIIBM, PMS 902

Date: July 15, 2024
Contact: Incident Business Committee 

The NWCG Incident Business Committee (IBC) has recently released two memorandums. The first provides direction on the use of the Emergency Equipment Shift Ticket, OF 297 for the 2024 fire season. Due to delays in hard copy printing, both the 2024 revision and the older version of the Emergency Equipment Shift Ticket, OF 297 are acceptable for use during the 2024 fire season.

The second memorandum documents the updates of the newly revised NWCG Standards for Interagency Incident Business Management (SIIBM), PMS 902. The summary of changes attached to the memo covers the major updates and process changes from the 2022 version.

References:

IBC Memorandum 24-01: OF 297 Signature Order and 2024 Fire Season Use

IBC Memorandum 24-02: Summary of Changes for the NWCG Standards of Interagency Incident Business Management, PMS 902

IBC Memorandum 24-02 Attachment: Summary of Changes

NWCG Standards for Rapid Extraction Module Support, PMS 552

Date: July 10, 2024
Contact: Incident Medical Unit Subcommittee 

A new publication from the Incident Medical Unit Subcommittee is now available. The NWCG Standards for Rapid Extraction Module Support, PMS 552 will be used as a guide and as an opportunity to begin to build out Rapid Extraction Module Support (REMS) modules for the remainder of Fire Year 2024. These standards will be fully implemented as the minimum standard starting in January 2025.

NWCG Standards for Rapid Extraction Module Support outlines the roles, duties, qualifications, and equipment pertinent to REMS. A REMS team, strategically stationed at wildland fires, plays a pivotal role in prioritizing swift access and medical treatment to injured or ill firefighters for safe and efficient egress off the fireline. This ensures their rapid transport to definitive medical care in cases of emergency during firefighting operations, highlighting the invaluable contribution of the REMS team to firefighter safety and well-being.

References:

NWCG Standards for Rapid Extraction Module Support, PMS 552

National Wildland Firefighter Day

Date: July 2, 2024
Contact: National Interagency Fire Center 

The National Wildfire Coordinating Group (NWCG) would like to recognize July 2, 2024, as National Wildland Firefighter Day (NWFFD). Established in 2022, NWFFD honors the dedication of wildland firefighters and support personnel. This day falls within the 2024 Week of Remembrance (June 30 - July 6), providing an opportunity to renew our commitment to wildland firefighter safety while remembering those who have fallen in the line of duty.

NWCG continues to provide leadership to enable interoperable wildland fire operations among federal, state, local, Tribal, and territorial partners. NWCG standards and training establish common practices to contribute to safe, effective, and coordinated national interagency wildland fire operations.

References:

NWCG.gov

Week of Remembrance

National Wildland Firefighter Day