Emergency Response Workbook, American Red Cross

Title:		Emergency Response Workbook
Author:		American Red Cross
Rating:

This is the companion workbook to the first aid textbook I have been reading for my first aid class. Alas it is just as full of errors and goofs as the textbook is.

In addition, however, here you are exposed to the astoundingly stupid kinds of test questions that the Red Cross expects you to answer about first aid. The questions break down into three categories as I see things:

• Stupid questions. As a first responder, do I need to know what the most common cause of injuries to people in some age range is? No, I don't. I need to know how to help keep them alive if they are injured. I hate to say it, but I'd guess that a third or so of the questions in this book (and on the tests that I have and will be taking) are of this nature. It's fine as background material, and it might aid in comprehension and retention, but when the rubber meets the road and I hop off the fire engine on Highway 17 to pull someone out of a burning car, it is pointless. In my mind, testing me on it is pointless too.
• Questions with no good answer. There are various reasons this happens. Sometimes the question doesn't give you enough information, and all the answers make assumptions. Sometimes they are assuming a particular kind of first responder, and various answers might be right depending on the point of view you're taking as the responder. Sometimes they just make no sense at all. This is perhaps 5% of the questions here.
• Reasonable questions. These are actually relevant questions that test your retention of specific facts you need to know to perform first aid at the minimum level to get the certificate. They make up the rest of the content.

If it seems like I might be clutching at straws here, let me demonstrate with an example. To do so, you need to know that the first and foremost thing stressed with first responders is not to become another victim. If you have any doubt about what is going on, your job is to keep back, keep others away, and call for more advanced help. Simple, eh? And it makes a LOT of sense in cases like (say) hazardous materials spills, fires, etc. If you lack the training and the gear, staying safe and keeping others safe is a great thing to do.

OK, with that in mind, there was a question on my midterm that said something like: you've come upon an accident at a busy intersection just below a hill. There are 4 victims. 3 of them are in X, Y, and Z condition. The 4th victim was thrown from the car and is lying in the middle of a lane of oncoming traffic. What do you do about that 4th victim? Your answer choices are things like "ignore him and care for others", "move him", "park a vehicle to block traffic so he won't get hit", and so on.

Note the total lack of detail. What sort of first responder am I? A fire fighter with a truck full of equipment and help, or am I entirely on my own? How busy is it? Is the victim lying in the road visible to oncoming traffic, or is he below the rise so he's going to get hit any second now? What risk would I be in if I went into that lane of traffic to look him over? Also note that having been thrown from a car means a high likelihood of neck or back injuries, among other things, and you don't move those folks without cervical collars, head restraints, and backboards unless you absolutely have to.

Well, after you digest all of that and guess at an answer (since none of the answers are really right) you find out they think the answer is to move the victim out of traffic. Now as a fire fighter in training I know that is the right answer, but as a fire fighter I am expected to take certain risks to help others. Without more detail, I have no idea if a citizen first responder should do that or not. And it certainly seems like it might violate the "don't become another victim" teaching. But fine. Whatever.

Later in the same exam, though, I hit a different question that says something like: a car accident has occurred. A car has left the road and hit a building. The victim is inside the vehicle and appears unconscious. You can see blood. Blah blah. The building is damaged but seems stable. (My emphasis.) What do you do about this victim? And the choices - among other things - are "wait for advanced help to stabilize the building" and "treat the victim now".

Here again, I have all kinds of problems. If it seems stable, as a fire fighter, I have news for you: I am going to go treat the victim. By the time an engineer shows up and says things really are safe the victim could have died of shock or any number of other things. But the answer they wanted was wait for advanced help. Now we're back to not becoming another victim. And while I respect that point of view, I hope it is obvious that the answer for the first question and the answer for the second question are in conflict in terms of what the first responder is expected to actually do.

That's the kind of thing a good editor would have found and avoided. If it was only one or two questions like this, I'd probably just ignore it, but it is endemic to the entire book, as well as the tests that I have to take. The Red Cross really needs to get some professional educators involved in their test material creation, along with that previously mentioned editor. This stuff could all be so much better than it is.

Emergency Response, American Red Cross

Title:		Emergency Response
Author:		American Red Cross
Rating:

I have spent the past three months going through this book, page by page, as part of my training to become a volunteer fire fighter. As a result of that time and effort I should wind up with a first responder certificate in a few weeks, and that will be the last straw that lets me finally ride the fire trucks here and help people in need.

With that much time spent slogging through this book, you'd think I'd have a definite opinion about it. And I do, sort of.

On one level, the book is good. The material is important and the basics of first aid should probably be learned by almost everyone in an ideal world. Thus, learning what to do in various cases to save a life is important, and this book is good because it assists that process.

On the other hand, this book sucks. It desperately needed a serious editor to remove all the internal inconsistencies and errors, and to make the overly complex presentations of simple concepts easier to understand.

Here's what I hope for: new CPR protocols were announced late in 2005, and they are a significant departure from the current CPR protocols. In addition, some of the other first aid guidelines are changing as well. As a result, the Red Cross has to redo its books to match those new protocols. If they are on the ball this is a chance to clean up all the stupidities in this book and create something much, much better.

As you may have figured out somewhere along the line, I am a cynic about human nature, though, and I predict here that their new books will be just as bad as this one. Only time will tell, and I'd love to be wrong, but I would bet money on it from what I know.

If you're interested in First Aid and participating in your community, you'll see this book (or the new version) when you take an advanced first aid class via the Red Cross or any organization teaching this stuff. In that context you'll understand how important this stuff is, and yet how bad it can be. I encourage you to take such a class if you can. It might matter one day. And when you do, try to be patient with the poor training materials.

Haz-Mat Course Book, CDF

Title:		Haz-Mat Course Book
Author:		CDF
Rating:

This was the next in an ongoing series of assembled course materials that I have to read as a volunteer fire fighter. It was, frankly, dry as dust. The main things I need to know as a fire fighter coming onto any event scene are:

• Be aware that apparently non-hazardous materials events might actually be (or become) haz-mat events
• If a haz-mat situation is discovered, I get to:
• worry about everyone's safety, including my own
• setup a perimeter around the haz-mat, maybe rescue people (depending on a risk/benefit analysis), and deny entry to anyone wanting in
• call in the big guns who know how to deal with haz-mat situations better than I do

That's it. Really. An entire, thick, three ring binder of stuff that can be digested down to those few bullet points. Probably 250 pages of text.

Accompanying that tome was three days of in-class training to be told about this stuff.

To be honest, I am happy I took the training and read the book. My eyes are opened a bit wider to the real issues around haz-mat events. In reality, though, most of that eye opening experience comes from the real-life stories that the instructors told us about haz-mat situations they've been involved in. Some nasty things happen to fire fighters.

The volunteer company I am in responds to accidents on something like seven miles of the main highway between San Jose and Santa Cruz, CA. A huge amount of cargo is hauled over that road each day, some of it hazardous, and nearly all of it unmarked. The things that could happen there are a bit scary. Never-the-less, I will continue my studies and make myself available to respond to calls as soon as my training allows. This course - and the book - are a state mandated part of the training that lets me do this. I can live with that.

In a followup post to the original review, I added this:

In the interest of sharing lots of possibly useless information...

There are 2 major ways that hazardous materials are identified, that I know of, so far:

• On trucks there are department of transportation (DOT) mandated placards for some loads and contents.
• On buildings, tanks, and other stationary things, there is an "NFPA 704" placard.
  

DOT Placards

These are diamond shaped placards, generally containing a magic number, and often a symbol of some sort, or at least some unique color scheme. They are defined in a book called the "Emergency Response Guidebook". You can find and download a mid sized PDF version of that book online here: http://phmsa.dot.gov/hazmat/library/erg, and if you google "Emergency Response Guidebook" you'll find a few places that sell hard copies for a reasonable fee.

This book contains ways to identify some of the hazardous materials that are hauled around in trucks. There are several sections of the book:

• White Section: general information on placards, placarding requirements, etc.
• Yellow Section: look up a number to determine material (or class of material) and proper initial response data.
• Blue Section: look up a material by name.
• Orange Section: guide pages to describe how to handle the spill initially.
• Green Section: isolation and protective action (evacuate or shelter in place, depending on many things) distances for the really bad stuff, which is highlighted in the yellow and blue sections. (This is the "methyl-ethyl-die-for-sure-inol" section, as my instructors called it.)

Why would you want this book? Well, I may actually need one for real at some point, but in actuality, I am a nerd, and it amuses me to know what is in the vehicles around me:

Me, driving the car: "Hey, what's in that truck? Placard number 2810."
My wife, thumbing through the book: "VX nerve gas."
Me: "I think I'll back off."

Yes, VX really is listed in here. Along with 5 forms of uranium hexafluoride, the nastiest of which (I think) is called "Uranium hexafluoride, fissile containing more than 1% Uranium-235." If you see a truck placarded 2977, I'd keep my distance. Then again, the military is not required to placard any of their trucks, regardless of what they are carrying. Not good.

NFPA 704 Placards

The NFPA is the National Fire Protection Association. They created the standard (number 704) that defines the 4 color (blue, red, yellow, white) diamond placards you have seen on tanks, buildings, etc. You can find a short but reasonable description of that standard here: http://en.wikipedia.org/wiki/NFPA_704. Alternately, you can buy the entire description of the standard from here: http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=704&cookie%5Ftest=1. A brief description, though, is as follows:

The 3 colored diamonds each contains a number ranging from 0 to 4. 0 means no hazard. 4 means a very high hazard. The 4th (white) diamond has other information in it. The colors each have a specific meaning, starting from the left and working clockwise:

• Blue: health hazards
• Red: flammability hazard
• Yellow: reactivity hazard
• White: symbols indicating unusual or specific hazards.

So, for example, an NFPA 704 reading "421" with a "W" with a line through it means:

• a severe health hazard
• a moderate flammability hazard
• a low reaction hazard
• whatever it is reacts badly to water

Given all that, you might not want to go into that building, depending on the circumstances.

I hope all of this information is interesting to someone other than me.

Basic Firefighter Academy (2005), CDF

Title:		Basic Firefighter Academy (2005)
Author:		CDF
Rating:

I am embarking on a new "career" as a volunteer fire fighter. Or at least, I hope I am. There are still many opportunities to wash out.

This book is actually a three ring binder of information assembled by the CDF that covers basic, overview stuff about working in the volunteer firefighting business. It doesn't actually cover anything about fighting fires - or medical response, or anything else directly call related like that - that's all coming in additional books and training. This volume really is more of an introduction to the CDF / County fire department and how it works.

Sections covered things like the incident command system, basics of vehicle safety, how to put on the structure firefighting clothes, some legal issues, etc.

If it wasn't 200 pages or so, I'd have ignored this volume and waited to claim something more meaty, but it did take time away from my other reading, so here it is.

There are more of this sort of thing coming, I'm sure.