MariaCatEMT
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Here is what I have done on the Firefighter II - MOD B - Study Guide, it (so far) contains the following two chapters:
Building Construction
EMS
I still have to complete the chapters on:
Forcible Entry/Ventilation
Water Supply/Nozzles & Fire Streams
Rescue/Ropes & Knots
I will get to these last three chapters when I can, I'm pooped out today! No more studying, I have class tonight.
Take care everyone.
--Maria
FIREFIGHTER II – MOD B – STUDY GUIDE
Contents: Building Construction
Emergency Medical Care
Forcible Entry/Ventilation
Water Supply/Nozzles & Fire Streams
Rescue/Ropes & Knots
BUILDING CONSTRUCTION
1. Types of building construction – NFPA 1001: 3-3.11
2. All firefighters should have a basic knowledge of the principles of building construction. Knowledge of the various types of building construction and how fires react in each type give the firefighter and the fire officer an edge in planning for a safe and effective fire attack.
3. TYPE I (FIRE-RESISTIVE) CONSTRUCTION – structural members (walls, columns, beams, floors, roofs) made of noncombustible or limited combustible materials, fire-resistive compartmentalization, primary fire hazards are the contents of the structure, ability to confine fire may be compromised by openings (in walls, ceilings or floors), overhaul is difficult, sprinklers and fire resistive coating on all structural members.
4. TYPE II (NONCOMBUSTIBLE OR LIMITED COMBUSTIBLE) CONSTRUCTION – similar to fire-resistive construction except that the degree of fire resistance is lower, has a fire resistance rating on all parts of the structure (exterior, load bearing walls and building materials), materials with no fire-resistance (untreated wood) may be used in limited quantities, one of the primary protection concerns is the contents of the building, heat buildup from a fire can cause structural supports to fail, type of roof may be a problem (often have flat, built-up roofs containing combustible felt, insulation and roofing tar) and fire extension to the roof can eventually cause the entire roof to become involved and fail.
5. TYPE III (ORDINARY) CONSTRUCTION – (very common construction type from 1900-1950’s) Exterior walls and structural members constructed of noncombustible or limited combustible materials, interior structural members (walls, columns, beams, floors and roofs) are completely or partially constructed of wood (in smaller dimension that that required for Type IV heavy timber construction), primary concern is the problem of smoke and fire spreading through concealed spaces (between walls, floors and ceiling), heat from the fire may be conducted through finish materials (drywall, gypsum board or plaster), building collapse is a major concern with this type of construction
6. TYPE IV (HEAVY TIMBER) CONSTRUCTION – features exterior/interior walls and their associated members made of noncombustible or limited combustible materials, other interior structures (beams, columns, arches, floors and roofs) are made of solid or laminated wood with no concealed spaces, dimensions must be large enough to be considered heavy timber (this type of construction was used extensively in old factories, mills and warehouses, occasionally today in churches), primary fire hazard is the massive amount of combustible contents in the building, heavy timbers remain stable for a long period of time under fire conditions, but give off tremendous amounts of heat posing a serious exposure problem for firefighters.
7. TYPE V (WOOD FRAME) CONSTRUCTION – typical single family residence, wood-frame construction (exterior/interior walls, floors, roofs and supports completely or partially constructed of wood), unlimited potential for fire extension within the building of origin and nearby structures, firefighters must be alert for fire coming from doors or windows.
8. WOOD – used in various structural support systems, reaction of wood to fire depends upon the size of the wood and the moisture content of the wood (the smaller the size the faster it loses structural integrity, the higher the moisture content the slower the rate of burn), water used during extinguishing operations does NOT have a substantial negative effect of the structural support strength of wood construction materials, applying water to burning wood minimizes damage by stopping the charring process.
9. MASONRY – includes bricks, stones and concrete masonry products, commonly used for fire wall assemblies (fire wall), block walls may be load bearing, most brick and stone walls are veneer (decorative), bricks rarely show signs of serious deterioration, stones may lose portions of their surface (spelling), blocks may crack but usually retain most of their basic strength and stability, the mortar between bricks should be checked for weakness, rapid cooling from extinguishing operations (water) may cause masonry to crack (common problem in chimney fires).
10. CAST IRON – rarely used in modern construction, typically found in older buildings and commonly used as an exterior surface (veneer walls or ceilings), stands up well to fire but may crack or shatter when rapidly cooled with water, primary concern is that the nuts or bolts that hold the cast iron to a building can fail, causing large sections to fall.
11. STEEL – primary material used for structural support in modern buildings, steel structural members elongate (lengthen) when heated (Example: a 50 foot beam may lengthen by as much as four inches when heated to 1000 degrees), if the steel is restricted from movement at the ends it buckles and fails in the middle, failure of steel can be anticipated at approximately 1000 degrees (lighter members such as an open truss will fail quicker than a heavier I-beam), primary concern is collapse (pushing out of load bearing walls), water can reduce risk of failure by cooling steel structures.
12. REINFORCED CONCRETE – concrete that is internally fortified with steel reinforcement bars or mesh, does NOT perform well under fire conditions, heat may cause a failure between the concrete and steel reinforcement, loses strength and spells.
13. GYPSUM – inorganic product from which plaster and plasterboards (drywall) are made, high water content so therefore fire resistant, provides insulation to steel and wood structural members, breaks down gradually under fire conditions.
14. GLASS/FIBERGLASS – glass is not typically used for structural support but rather in sheet form for doors and windows, wire reinforced glass may provide some thermal protection but for the most part is NOT an effective barrier to fire extension, heated glass may shatter when struck by a cold fire stream, fiberglass is typically used for insulation purposes and the glass component isn’t a significant fuel but the materials used to bind fiberglass may be combustible.
15. BALLOON FRAMING AND PLATFORM FRAMING - The main difference between platform and balloon framing is at the floor lines. The balloon wall studs extend from the sill of the first floor all the way to the top plate or end rafter of the second floor. The platform-framed wall, on the other hand, is complete for each floor. In balloon framing, both the wall studs and the floor joists rest on a sill anchored to the foundation. The studs and joists typically are toe-nailed to the still with eight-penny nails and nailed to each other with at least three ten-penny nails. Balloon and platform framing are the two basic types of light wood framing. Heat will spread upward into the building more so with balloon-frame construction where the wall studs are continuous from the foundation to the roof, as there may be no fire stops between the studs (a basement fire will commonly extend into the attic with balloon framing.
A. Balloon Framing – construction can have open channels from the foundation to the attic, framing is usually covered with an interior finish of plaster or drywall.
B. Platform Framing – construction has each floor constructed on it’s own platform, reducing open channels in the walls, framing is usually covered with an interior finish of plaster or drywall.
16. MAIN COMPONENTS OF LIGHTWEIGHT FRAMING CONSTRUCTION (BALLOON/PLATFORM):
A. Footing – part of the building that rests on the bearing soil and is wider than the foundation wall, also the base for a column, spreads the weight of a wall or column and presents settling.
B. Foundation – supporting part of a wall usually of masonry or concrete and at least partially underground.
C. Plate – top or bottom horizontal structure member of a frame wall or partition.
D. Stud – vertical structure uprights which make up the walls and partitions in a frame building.
E. Joist – framing member which directly supports the floor.
F. Rafter – beam that supports the roof.
G. Sill – bottom rough structural member that rests on the foundation or the bottom exterior member of a window or door or other masonry below.
H. Header – top of window or doorframe.
I. Ridge Board – horizontal timber or beam at the ridge of a roof, to which the upper ends of the rafters are attached.
J. Eave – lower edge of a roof, usually projecting beyond the sides of a building.
K. Cornice – horizontal projection that crowns or finishes the eave of a building.
L. Fascia – flat vertical board located at the outer face of a cornice.
M. Soffit – lower horizontal surface such as the underside of eaves or cornice.
N. Interior Finish – Plaster and Drywall.
O. Plaster – fire-resistive cement material that is applied over lathing, which is either a wire mesh or a gypsum board with fibrous paper.
P. Drywall – system of interior wall finish using sheets of gypsum board and taped joints.
Q. Exterior Finish – Brick Veneer and Sheathing.
R. Brick Veneer – single thickness of brick wall facing placed over frame construction or masonry other than brick.
S. Sheathing – covering applied to the framing of a building to which siding is applied.
17. TYPES OF ROOFS: (three basic types are: flat, arch, and pitched) [Page 355 in the Firefighter II text]
A. Flat Roofs
B. Arch Roofs (Curved)
C. Pitched Roofs
18. COMMON ROOF STYLES: [Page 355 in the Firefighter II text]
A. Mansard
B. Hip
C. Butterfly
D. Gambrel
E. Shed
F. Lantern
19. LARGE STRUCTURAL SYSTEMS COMPONENTS:
A. Beams – structural member subjected to loads perpendicular to it’s length.
B. Columns – vertical supporting member.
C. Arches – curved structural member in which the interior stresses are primarily compressive, arches develop inclined reactions at their support.
D. Cables – flexible structural members in which the stresses in the cable are tension stress.
E. Trusses – framed structural units made of a group of triangles in one plane.
20. TRUSS CONSTRUCTION COMPONENTS
A. Chords – top and bottom horizontal members of a truss.
B. Web or Diagonal Members – vertical members between the chords.
C. Gusset Plates – plate that is used to connect the members of a wood or metal truss.
21. HAZARDS ASSOCIATED WITH TRUSS/LIGHTWEIGHT CONSTRUCTION (Most commonly found in houses, apartments and small commercial buildings such as car dealerships, bowling allies, factories and supermarkets):
A. Will succumb to the effects of fire more quickly than heavy timber buildings.
B. Trussed roofs create dangerous ventilation problems and contribute to fire spread and early failure of the roof. (1/2 inch of charring will cause a wood truss to fail, steel fails at 1000 degrees, average temperature of a fire is 1300 degrees at the ceiling)
C. When one truss fails, the others follow in a domino effect: roof failure.
D. Firefighting operations increase the risk of building collapse (extra weight).
E. Lightweight (both wood and steel) trusses will fail after 5-10 minutes of exposure to fire.
F. Designed to support only own weight*
G. If one (truss) fails, a domino effect usually occurs until total collapse has resulted*
H. Rapid failure under fire conditions*
22. BUILDING COLLAPSE – results from damage to the structural system caused by the fire and by fire fighting operations (structural collapse), indicators of building collapse are:
A. Cracks or separations in walls, floors, ceilings and roof structure.
B. Evidence of structural instability (presence of tie rods and stars)
C. Loose bricks, blocks or stones falling from building.
D. Deteriorated mortar between the masonry.
E. Walls that appear to be leaning.
F. Structural members that appear to be distorted.
G. Fires beneath floors that support heavy machinery or other extreme weight loads.
H. Prolonged fire exposure to the structural members.
I. Unusual creaks and cracking noises.
J. Structural members pulling away from walls.
K. Excessive weight of building contents.
23. TYPES OF WALLS:
A. Load Bearing Wall – wall that support structural weight.
B. Non-Load Bearing Wall – wall that does not support structural weight.
C. Party Wall – load-bearing wall that support two adjacent structures.
D. Fire Wall – separates two structures, or divides one structure into two smaller portions to prevent spread of fire.
E. Partition Wall – non-load bearing wall that divides two areas within a structure.
F. Cantilever (unsupported) Wall – freestanding firewalls usually found in shopping centers or churches.
G. Parapet Wall – low wall at the edge of a roof.
24. DANGEROUS CONDITIONS CREATED BY FIRE AND FIRE SUPPRESSION:
A. Conditions that contribute to the spread of fire: fire loading (presence of large amounts of combustible materials in an area of a building and arrangement of combustible materials in a building), combustible furnishings and finishes, roof coverings, wooden floors and ceilings, building collapse, lightweight and truss construction, construction (putting up a building), renovation and demolition.
25. EFFECTS IN A BURNING BUILDING:
A. Intense heat – causes access problems for firefighters during operations, and contributes to fire spread.
B. Dense smoke – hampers firefighting operations, proper ventilation is required (removal of smoke, stability of building)
C. Water (large volumes poured into/onto the structure) – compromises the integrity of construction materials, accumulation of water on the upper floors or roof will add to the live load of an already weakened structure.
EMERGENCY MEDICAL CARE
1. LEVELS OF EMS CARE:
A. Basic First Aid
B. CPR
C. First Responder
D. EMT-Basic
E. EMT-Intermediate
F. EMT-Paramedic
2. CPR/OBSTRUCTED AIRWAYS (I will provide photo-copied handouts for CPR and OBSTRUCTED AIRWAY MANAGEMENT, along with this study guide)
A. Adult Single Rescuer CPR
B. Child Single Rescuer CPR
C. Infant Single Rescuer CPR
D. Adult Two-Rescuer CPR
E. Obstructed Airway – Conscious Adult/Child/Infant
F. Obstructed Airway – Unconscious Adult/Child/Infant
3. INFECTION CONTROL – FOUR BASIC WAYS TO SPREAD INFECTION:
A. Direct Contact – handshake or fluid contact with an infected person.
B. Indirect Contact – contact with an object handled by an infected person.
C. Droplet Infection – inhaling droplets discharged by coughing/sneezing of an infected person.
D. Sexual Contact – transmission thru close sexual contact.
4. INFECTION CONTROL – EXERCISE EXTREME CARE AROUND PATIENTS WITH THE FOLLOWING:
A. Fever of unknown origin.
B. Diarrhea.
C. Draining wounds.
D. Bleeding wounds.
E. Jaundice.
F. Dialysis treatment in progress.
G. A rash.
H. Known history of communicable diseases.
5. INFECTION CONTROL – PRECAUTIONS:
A. Use an airway and pocket mask when administering artificial respiration or CPR.
B. Wear exam gloves on all EMS calls.
C. Take extra care to avoid needle sticks. Do not pick up needles. Identify needles to paramedics and allow them to handle needles.
D. Avoid skin contact and mucous membrane contact with blood and body fluids of an AIDS patient. Wash your hands thoroughly afterwards with soap and water as soon as possible.
E. Wash hands frequently with hot soap and water.
F. Clean blood spills with a solution of chlorine bleach and water (1/4 cup of bleach to one gallon of water)
G. Place clothes or linen soiled by blood or body fluids in a plastic bag marked “blood contaminated.” Launder the items per department regulations.
H. Keep hands and equipment clean.
I. Keep inoculations up to date.
J. Keep your hands away from your face, avoid introduction of germs through mucous membranes.
K. Avoid touching open skin lesions or any draining wounds.
L. Wash hands after each patient contact, new gloves for new patient.
M. Wear a disposable mask around infectious patients.
N. Clean equipment after each use.
6. PRIMARY SURVEY
A. Upon arrival at the scene, a rapid assessment of the scene must be made to deem the hazard zone safe for entry by rescuers.
B. Safety of the responder is of the utmost importance, things to consider at the scene:
*Weapons
*Downed Wires
*Leaking Gasoline
*Hazardous Materials
*Fire
*Confined Spaces
*Terrain
*Stability of vehicle or structure
C. As the first responder approaches the patient a quick visual survey should be performed to assist in determining how serious the patients condition is (should be done in approximately 60 seconds)
*Is the patient awake?
*Does the situation/environment pose threat or further harm to the patient?
*The position of the patient.
*Any objects or people in the area of the patient that may have contributed to the injury or illness.
*Skin color of the patient: Cyanotic (blue), Ashen (grey), Flushed (red).
D. Upon reaching the patient, the first responder must conduct a primary survey of the patient’s basic signs of life and life threatening injuries:
*Level of consciousness, is the patient awake, can the patient talk, does the patient respond appropriately?
*Airway, does the patient have an open airway
*Breathing, is the patient breathing, assess quality (short, rapid, deep, slow, absent)
*Circulation, does the patient have a pulse, assess the quality (full, thready, rapid, slow, regular, irregular, absent)
*Bleeding, is there major bleeding, if the patient is seated or lying down check under the patient for bleeding, control major bleeding immediately.
7. EXTERNAL BLEEDING
A. Arterial Bleeding – blood spurts with the rhythm of the heartbeat, blood is bright red in color (rich in oxygen), blood loss is rapid and profuse.
B. Venous Bleeding – blood oozes from wound at an even rate, blood is dark red or bluish in color (CO2/waste), bleeding can be profuse.
C. Capillary Bleeding – blood oozes slightly (abrasions, etc), color of blood varies from bright to dark red, bleeding often stops by itself.
D. The human body has natural systems for controlling bleeding.
E. Clotting is effective when bleeding is not too serious.
F. Platelets in blood combine with proteins to form a clot.
G. Profuse bleeding washes away clots and requires external efforts to stop it.
8. CONTROLLING EXTERNAL BLEEDING:
A. Direct pressure – place a sterile dressing over the wound, apply pressure directly over the wound using fingers or heel of hand, maintain pressure 3-5 minutes, if injury is to arm or leg—elevate it—except in cases of fracture, embedded object or possible spinal cord injury. When bleeding is under control, apply a pressure bandage over the wound, then apply a universal dressing over the original dressing firmly and securely, then check for proper circulation (pulse distal – away from –wound)
B. Pressure points – compress artery supply area, NEVER at a fracture site, use ONLY when direct pressure and elevation fail:
*Temporal – lateral portions on each side of the cranium (temples)
*Maxillary – upper jawbone (space between joint and ear)
*Carotid – major artery that supplies head/brain (on either side of larynx)
*Brachial – inside of upper arm
*Radial – thumb-side of lower arm
*Femoral – groin area
*Popliteal – behind the knee
*Tibial – inside of foot, under ankle
*Pedal – in front of ankle, top of foot
C. Tourniquet – use ONLY when all else fails:
*Apply a pad over the artery to be compressed.
*Wrap tourniquet twice around extremity and tie a half knot, never remove once applied.
*Place a stick, or similar object, over the half knot, tie a square knot over the stick.
*Twist the stick just enough to stop the bleeding.
*Tie the ends of the tourniquet in place.
*Mark the tourniquet with the time applied to the patient’s forehead
9. SIGNS/SYMPTOMS OF TRAUMATIC SHOCK
A. Extreme thirst.
B. Restlessness or anxiety.
C. Nausea or vomiting.
D. Dull, vacant look.
E. Dilated (wide open) pupils.
F. Cold/clammy skin (cool and sweaty).
G. Pale or cyanotic (blue) face.
H. Rapid, shallow breathing, possibly labored, irregular or gasping, patient requires more oxygen.
I. Weak, rapid pulse.
J. Falling blood pressure (late sign of shock – less than 90 mm/Hg systolic)
K. May be sleepy, disorientated or unconscious.
L. Monitor vital signs frequently (unstable patients every five minutes)
M. Signs of shock may be delayed for an hour or more, do not wait for blood pressure to fall before treating for shock.
N. Pay particular attention to the elderly, they do not withstand shock as well as others.
O. Watch children carefully, the do not exhibit signs until deep in shock, shock signs in a child are an emergency.
P. Different types of shock exhibit different signs:
*Neurogenic Shock has warm dry skin (associated with spinal cord injuries)
*Anaphylactic Shock – hives, swelling of face and hands, life threatening (allergic reaction)
Q. Shock cannot be reversed, but proper treatment can keep it from worsening.
R. Establish airway (FIRST)
S. Administer oxygen.
T. Treat causes of shock (control bleeding, splint fractures, etc)
U. Position patient to reduce stress to vital signs, lying down with legs elevated.
V. Prevent loss of body heat.
W. Avoid rough handling of patient.
X. Do not give the patient food or drink.
Y. Monitor vital signs and level of consciousness frequently.
Z. Arrange for immediate transport to a medical facility.
10. THERMAL BURNS
A. First Degree Burns – damage superficial layers of skin, moderate sunburn or scald, produces redness and pain, usually heal within one week, partial thickness burn.
B. Second Degree Burns – penetrate deeper into skin, blistering and swelling, extremely painful, deep second degree burns are less painful, significant body fluid loss possible, heal within 2-3 weeks, most often caused by burning liquids, partial thickness burn.
C. Third Degree Burns – skin is pale and dry, possibly charred and leathery with a burned smell, usually not painful (nerve endings destroyed), rapid and significant body fluid loss, hypovolemic shock, damaged skin cannot heal itself, skin contracture and grafting necessary, full thickness burn (thru skin and perhaps into fatty and muscle tissues).
11. RULE OF NINES: a quick way to estimate the amount of surface area that has been burned by dividing the body into sections. For those of you that are EMT’s, the rule of nines here is different for children than it is in the EMT text.
A. Adults
*Head = 9%
*Chest = 9%
*Upper Back = 9%
*Abdomen = 9%
*Lower Back = 9%
*Each Arm = 9% x 2 = 18%
*Front of each Leg = 9% x 2 = 18%
*Back of each Leg = 9% x 2 = 18%
*Groin = 1%
*Total for All = 100%
B. Children
*Front of Head = 9%
*Back of Head = 9%
*Front of Torso = 9%
*Back of Torso = 9%
*Each Arm = 9% x 2 = 18%
*Each Leg = 9% x 2 = 18%
*Groin = 1%
*Total for All = 100%
12. SEVERITY OF BURNS:
A. Minor burns
*First degree on less than 20% of the body.
*Second degree on less than 15% of the body.
*Third Degree on less than 2% of the body.
B. Moderate burns
*Second degree involving 15-30% of the body.
*Third degree involving 2-10% of the body.
C. Severe (Critical) burns
*Respiratory injury
*Face
*Hands and Feet
*Genitalia and Buttocks
*Fractures or major soft tissue injury
*Electrical burns
*Deep acid burns
*Burn patient with underlying medical problem
*Very young patients
*Elderly patients over 60
13. EMERGENCY MEDICAL CARE OF THERMAL BURNS
A. Thermal Burns
*Extinguish any clothing on fire
*Check for signs of respiratory involvement (burns around face, unconscious in burning area, patient who has been exposed to smoke or hot gases, singed nasal hair, hoarsness, cyanosis)
*Administer oxygen
*Check vital signs (every 5 minutes, watch for increasing pulse and signs of shock)
*Cover burns with dry sterile dressing.
B. Chemical Burns – Water Soluble
*Flush area with large amounts of water
*Remove contaminated clothing
*Continue flushing for at least 15 minutes
*Prevent personal injury by avoid skin or clothing contact
*After flushing is complete, apply dry sterile dressing
C. Chemical Burns – Non Soluble
*Dry Lime – brush from clothing and skin, flush with large quantities of water
*Phenol – place patient under running water, wash affected area with alcohol or oil
*Chemical burns to eye – flush eye for at least 20 minutes, cover eyes with sterile wet dressing
14. INGESTED POISONS AND DRUG OVERDOSE
A. Signs/Symptoms:
*Nausea
*Vomiting
*Drowsiness
*Unconsciousness
*Cramps
*Severe Abdominal Pain
*Abnormal Breathing
*Abnormal Pulse Rate
*Convulsions
*Burns around victim’s mouth
*Stains around victim’s mouth
*Unusual breath odors
*Odors on victim’s clothing
*Sweating
*Dilated pupils
*Constricted pupils (usually associated with specific kinds of drugs)
*Excessive salivation (drooling)
*Foaming at the mouth
B. Drug Overdose Information:
*Many drug users take combinations of drugs to heighten effects, leading to life-threatening injuries
*Emergency intervention is more effective with orally taken drugs (doesn’t absorb into the blood stream as fast)
*Injected or inhaled drugs take effect almost immediately
*Street names of drugs are important to know in determining appropriate treatment
*Poison Control Centers or hospitals are available for diagnosis and treatment 24 hours a day
*Record the local/regional poison control center and hospital numbers in easily accessible locations
*If you suspect poisoning or drug overdose, contact the poison control center or hospital IMMEDIATELY
C. Emergency Medical Treatment for Poisons and Drug Overdoses:
*Perform initial assessment (ABC’s)
*Contact nearest poison control center or hospital
*Perform basic life support as necessary
*Administer first aid as directed
*Speak to patient in soothing voice, try to reduce anxiety
*Call for police assistance immediately with combative patients
15. FRACTURES
A. A fracture is a break in the continuity of a bone and is usually accompanied by a muscular spasm in the area of the fracture
B. Two classifications of fractures:
*Closed or Simple – overlying skin is intact
*Open or Compound – wound at fracture site, bone ends may or may not protrude
C. Significant bleeding may occur with either type
D. Open fractures are more serious, risk of contamination and infection
E. Signs and Symptoms of Fractures:
*Deformity, extremity at an unnatural angle
*Pain, tenderness, soreness at the site of the fracture
*Swelling and discoloration, may or may not be immediate
*Loss of function, extraordinary pain with movement of injured extremity
*Exposed bone fragments
F. Emergency Medical Care of Fractures:
*Sling and Swathe
*Pillow Splint
*Rigid Splint
Building Construction
EMS
I still have to complete the chapters on:
Forcible Entry/Ventilation
Water Supply/Nozzles & Fire Streams
Rescue/Ropes & Knots
I will get to these last three chapters when I can, I'm pooped out today! No more studying, I have class tonight.
Take care everyone.
--Maria
FIREFIGHTER II – MOD B – STUDY GUIDE
Contents: Building Construction
Emergency Medical Care
Forcible Entry/Ventilation
Water Supply/Nozzles & Fire Streams
Rescue/Ropes & Knots
BUILDING CONSTRUCTION
1. Types of building construction – NFPA 1001: 3-3.11
2. All firefighters should have a basic knowledge of the principles of building construction. Knowledge of the various types of building construction and how fires react in each type give the firefighter and the fire officer an edge in planning for a safe and effective fire attack.
3. TYPE I (FIRE-RESISTIVE) CONSTRUCTION – structural members (walls, columns, beams, floors, roofs) made of noncombustible or limited combustible materials, fire-resistive compartmentalization, primary fire hazards are the contents of the structure, ability to confine fire may be compromised by openings (in walls, ceilings or floors), overhaul is difficult, sprinklers and fire resistive coating on all structural members.
4. TYPE II (NONCOMBUSTIBLE OR LIMITED COMBUSTIBLE) CONSTRUCTION – similar to fire-resistive construction except that the degree of fire resistance is lower, has a fire resistance rating on all parts of the structure (exterior, load bearing walls and building materials), materials with no fire-resistance (untreated wood) may be used in limited quantities, one of the primary protection concerns is the contents of the building, heat buildup from a fire can cause structural supports to fail, type of roof may be a problem (often have flat, built-up roofs containing combustible felt, insulation and roofing tar) and fire extension to the roof can eventually cause the entire roof to become involved and fail.
5. TYPE III (ORDINARY) CONSTRUCTION – (very common construction type from 1900-1950’s) Exterior walls and structural members constructed of noncombustible or limited combustible materials, interior structural members (walls, columns, beams, floors and roofs) are completely or partially constructed of wood (in smaller dimension that that required for Type IV heavy timber construction), primary concern is the problem of smoke and fire spreading through concealed spaces (between walls, floors and ceiling), heat from the fire may be conducted through finish materials (drywall, gypsum board or plaster), building collapse is a major concern with this type of construction
6. TYPE IV (HEAVY TIMBER) CONSTRUCTION – features exterior/interior walls and their associated members made of noncombustible or limited combustible materials, other interior structures (beams, columns, arches, floors and roofs) are made of solid or laminated wood with no concealed spaces, dimensions must be large enough to be considered heavy timber (this type of construction was used extensively in old factories, mills and warehouses, occasionally today in churches), primary fire hazard is the massive amount of combustible contents in the building, heavy timbers remain stable for a long period of time under fire conditions, but give off tremendous amounts of heat posing a serious exposure problem for firefighters.
7. TYPE V (WOOD FRAME) CONSTRUCTION – typical single family residence, wood-frame construction (exterior/interior walls, floors, roofs and supports completely or partially constructed of wood), unlimited potential for fire extension within the building of origin and nearby structures, firefighters must be alert for fire coming from doors or windows.
8. WOOD – used in various structural support systems, reaction of wood to fire depends upon the size of the wood and the moisture content of the wood (the smaller the size the faster it loses structural integrity, the higher the moisture content the slower the rate of burn), water used during extinguishing operations does NOT have a substantial negative effect of the structural support strength of wood construction materials, applying water to burning wood minimizes damage by stopping the charring process.
9. MASONRY – includes bricks, stones and concrete masonry products, commonly used for fire wall assemblies (fire wall), block walls may be load bearing, most brick and stone walls are veneer (decorative), bricks rarely show signs of serious deterioration, stones may lose portions of their surface (spelling), blocks may crack but usually retain most of their basic strength and stability, the mortar between bricks should be checked for weakness, rapid cooling from extinguishing operations (water) may cause masonry to crack (common problem in chimney fires).
10. CAST IRON – rarely used in modern construction, typically found in older buildings and commonly used as an exterior surface (veneer walls or ceilings), stands up well to fire but may crack or shatter when rapidly cooled with water, primary concern is that the nuts or bolts that hold the cast iron to a building can fail, causing large sections to fall.
11. STEEL – primary material used for structural support in modern buildings, steel structural members elongate (lengthen) when heated (Example: a 50 foot beam may lengthen by as much as four inches when heated to 1000 degrees), if the steel is restricted from movement at the ends it buckles and fails in the middle, failure of steel can be anticipated at approximately 1000 degrees (lighter members such as an open truss will fail quicker than a heavier I-beam), primary concern is collapse (pushing out of load bearing walls), water can reduce risk of failure by cooling steel structures.
12. REINFORCED CONCRETE – concrete that is internally fortified with steel reinforcement bars or mesh, does NOT perform well under fire conditions, heat may cause a failure between the concrete and steel reinforcement, loses strength and spells.
13. GYPSUM – inorganic product from which plaster and plasterboards (drywall) are made, high water content so therefore fire resistant, provides insulation to steel and wood structural members, breaks down gradually under fire conditions.
14. GLASS/FIBERGLASS – glass is not typically used for structural support but rather in sheet form for doors and windows, wire reinforced glass may provide some thermal protection but for the most part is NOT an effective barrier to fire extension, heated glass may shatter when struck by a cold fire stream, fiberglass is typically used for insulation purposes and the glass component isn’t a significant fuel but the materials used to bind fiberglass may be combustible.
15. BALLOON FRAMING AND PLATFORM FRAMING - The main difference between platform and balloon framing is at the floor lines. The balloon wall studs extend from the sill of the first floor all the way to the top plate or end rafter of the second floor. The platform-framed wall, on the other hand, is complete for each floor. In balloon framing, both the wall studs and the floor joists rest on a sill anchored to the foundation. The studs and joists typically are toe-nailed to the still with eight-penny nails and nailed to each other with at least three ten-penny nails. Balloon and platform framing are the two basic types of light wood framing. Heat will spread upward into the building more so with balloon-frame construction where the wall studs are continuous from the foundation to the roof, as there may be no fire stops between the studs (a basement fire will commonly extend into the attic with balloon framing.
A. Balloon Framing – construction can have open channels from the foundation to the attic, framing is usually covered with an interior finish of plaster or drywall.
B. Platform Framing – construction has each floor constructed on it’s own platform, reducing open channels in the walls, framing is usually covered with an interior finish of plaster or drywall.
16. MAIN COMPONENTS OF LIGHTWEIGHT FRAMING CONSTRUCTION (BALLOON/PLATFORM):
A. Footing – part of the building that rests on the bearing soil and is wider than the foundation wall, also the base for a column, spreads the weight of a wall or column and presents settling.
B. Foundation – supporting part of a wall usually of masonry or concrete and at least partially underground.
C. Plate – top or bottom horizontal structure member of a frame wall or partition.
D. Stud – vertical structure uprights which make up the walls and partitions in a frame building.
E. Joist – framing member which directly supports the floor.
F. Rafter – beam that supports the roof.
G. Sill – bottom rough structural member that rests on the foundation or the bottom exterior member of a window or door or other masonry below.
H. Header – top of window or doorframe.
I. Ridge Board – horizontal timber or beam at the ridge of a roof, to which the upper ends of the rafters are attached.
J. Eave – lower edge of a roof, usually projecting beyond the sides of a building.
K. Cornice – horizontal projection that crowns or finishes the eave of a building.
L. Fascia – flat vertical board located at the outer face of a cornice.
M. Soffit – lower horizontal surface such as the underside of eaves or cornice.
N. Interior Finish – Plaster and Drywall.
O. Plaster – fire-resistive cement material that is applied over lathing, which is either a wire mesh or a gypsum board with fibrous paper.
P. Drywall – system of interior wall finish using sheets of gypsum board and taped joints.
Q. Exterior Finish – Brick Veneer and Sheathing.
R. Brick Veneer – single thickness of brick wall facing placed over frame construction or masonry other than brick.
S. Sheathing – covering applied to the framing of a building to which siding is applied.
17. TYPES OF ROOFS: (three basic types are: flat, arch, and pitched) [Page 355 in the Firefighter II text]
A. Flat Roofs
B. Arch Roofs (Curved)
C. Pitched Roofs
18. COMMON ROOF STYLES: [Page 355 in the Firefighter II text]
A. Mansard
B. Hip
C. Butterfly
D. Gambrel
E. Shed
F. Lantern
19. LARGE STRUCTURAL SYSTEMS COMPONENTS:
A. Beams – structural member subjected to loads perpendicular to it’s length.
B. Columns – vertical supporting member.
C. Arches – curved structural member in which the interior stresses are primarily compressive, arches develop inclined reactions at their support.
D. Cables – flexible structural members in which the stresses in the cable are tension stress.
E. Trusses – framed structural units made of a group of triangles in one plane.
20. TRUSS CONSTRUCTION COMPONENTS
A. Chords – top and bottom horizontal members of a truss.
B. Web or Diagonal Members – vertical members between the chords.
C. Gusset Plates – plate that is used to connect the members of a wood or metal truss.
21. HAZARDS ASSOCIATED WITH TRUSS/LIGHTWEIGHT CONSTRUCTION (Most commonly found in houses, apartments and small commercial buildings such as car dealerships, bowling allies, factories and supermarkets):
A. Will succumb to the effects of fire more quickly than heavy timber buildings.
B. Trussed roofs create dangerous ventilation problems and contribute to fire spread and early failure of the roof. (1/2 inch of charring will cause a wood truss to fail, steel fails at 1000 degrees, average temperature of a fire is 1300 degrees at the ceiling)
C. When one truss fails, the others follow in a domino effect: roof failure.
D. Firefighting operations increase the risk of building collapse (extra weight).
E. Lightweight (both wood and steel) trusses will fail after 5-10 minutes of exposure to fire.
F. Designed to support only own weight*
G. If one (truss) fails, a domino effect usually occurs until total collapse has resulted*
H. Rapid failure under fire conditions*
22. BUILDING COLLAPSE – results from damage to the structural system caused by the fire and by fire fighting operations (structural collapse), indicators of building collapse are:
A. Cracks or separations in walls, floors, ceilings and roof structure.
B. Evidence of structural instability (presence of tie rods and stars)
C. Loose bricks, blocks or stones falling from building.
D. Deteriorated mortar between the masonry.
E. Walls that appear to be leaning.
F. Structural members that appear to be distorted.
G. Fires beneath floors that support heavy machinery or other extreme weight loads.
H. Prolonged fire exposure to the structural members.
I. Unusual creaks and cracking noises.
J. Structural members pulling away from walls.
K. Excessive weight of building contents.
23. TYPES OF WALLS:
A. Load Bearing Wall – wall that support structural weight.
B. Non-Load Bearing Wall – wall that does not support structural weight.
C. Party Wall – load-bearing wall that support two adjacent structures.
D. Fire Wall – separates two structures, or divides one structure into two smaller portions to prevent spread of fire.
E. Partition Wall – non-load bearing wall that divides two areas within a structure.
F. Cantilever (unsupported) Wall – freestanding firewalls usually found in shopping centers or churches.
G. Parapet Wall – low wall at the edge of a roof.
24. DANGEROUS CONDITIONS CREATED BY FIRE AND FIRE SUPPRESSION:
A. Conditions that contribute to the spread of fire: fire loading (presence of large amounts of combustible materials in an area of a building and arrangement of combustible materials in a building), combustible furnishings and finishes, roof coverings, wooden floors and ceilings, building collapse, lightweight and truss construction, construction (putting up a building), renovation and demolition.
25. EFFECTS IN A BURNING BUILDING:
A. Intense heat – causes access problems for firefighters during operations, and contributes to fire spread.
B. Dense smoke – hampers firefighting operations, proper ventilation is required (removal of smoke, stability of building)
C. Water (large volumes poured into/onto the structure) – compromises the integrity of construction materials, accumulation of water on the upper floors or roof will add to the live load of an already weakened structure.
EMERGENCY MEDICAL CARE
1. LEVELS OF EMS CARE:
A. Basic First Aid
B. CPR
C. First Responder
D. EMT-Basic
E. EMT-Intermediate
F. EMT-Paramedic
2. CPR/OBSTRUCTED AIRWAYS (I will provide photo-copied handouts for CPR and OBSTRUCTED AIRWAY MANAGEMENT, along with this study guide)
A. Adult Single Rescuer CPR
B. Child Single Rescuer CPR
C. Infant Single Rescuer CPR
D. Adult Two-Rescuer CPR
E. Obstructed Airway – Conscious Adult/Child/Infant
F. Obstructed Airway – Unconscious Adult/Child/Infant
3. INFECTION CONTROL – FOUR BASIC WAYS TO SPREAD INFECTION:
A. Direct Contact – handshake or fluid contact with an infected person.
B. Indirect Contact – contact with an object handled by an infected person.
C. Droplet Infection – inhaling droplets discharged by coughing/sneezing of an infected person.
D. Sexual Contact – transmission thru close sexual contact.
4. INFECTION CONTROL – EXERCISE EXTREME CARE AROUND PATIENTS WITH THE FOLLOWING:
A. Fever of unknown origin.
B. Diarrhea.
C. Draining wounds.
D. Bleeding wounds.
E. Jaundice.
F. Dialysis treatment in progress.
G. A rash.
H. Known history of communicable diseases.
5. INFECTION CONTROL – PRECAUTIONS:
A. Use an airway and pocket mask when administering artificial respiration or CPR.
B. Wear exam gloves on all EMS calls.
C. Take extra care to avoid needle sticks. Do not pick up needles. Identify needles to paramedics and allow them to handle needles.
D. Avoid skin contact and mucous membrane contact with blood and body fluids of an AIDS patient. Wash your hands thoroughly afterwards with soap and water as soon as possible.
E. Wash hands frequently with hot soap and water.
F. Clean blood spills with a solution of chlorine bleach and water (1/4 cup of bleach to one gallon of water)
G. Place clothes or linen soiled by blood or body fluids in a plastic bag marked “blood contaminated.” Launder the items per department regulations.
H. Keep hands and equipment clean.
I. Keep inoculations up to date.
J. Keep your hands away from your face, avoid introduction of germs through mucous membranes.
K. Avoid touching open skin lesions or any draining wounds.
L. Wash hands after each patient contact, new gloves for new patient.
M. Wear a disposable mask around infectious patients.
N. Clean equipment after each use.
6. PRIMARY SURVEY
A. Upon arrival at the scene, a rapid assessment of the scene must be made to deem the hazard zone safe for entry by rescuers.
B. Safety of the responder is of the utmost importance, things to consider at the scene:
*Weapons
*Downed Wires
*Leaking Gasoline
*Hazardous Materials
*Fire
*Confined Spaces
*Terrain
*Stability of vehicle or structure
C. As the first responder approaches the patient a quick visual survey should be performed to assist in determining how serious the patients condition is (should be done in approximately 60 seconds)
*Is the patient awake?
*Does the situation/environment pose threat or further harm to the patient?
*The position of the patient.
*Any objects or people in the area of the patient that may have contributed to the injury or illness.
*Skin color of the patient: Cyanotic (blue), Ashen (grey), Flushed (red).
D. Upon reaching the patient, the first responder must conduct a primary survey of the patient’s basic signs of life and life threatening injuries:
*Level of consciousness, is the patient awake, can the patient talk, does the patient respond appropriately?
*Airway, does the patient have an open airway
*Breathing, is the patient breathing, assess quality (short, rapid, deep, slow, absent)
*Circulation, does the patient have a pulse, assess the quality (full, thready, rapid, slow, regular, irregular, absent)
*Bleeding, is there major bleeding, if the patient is seated or lying down check under the patient for bleeding, control major bleeding immediately.
7. EXTERNAL BLEEDING
A. Arterial Bleeding – blood spurts with the rhythm of the heartbeat, blood is bright red in color (rich in oxygen), blood loss is rapid and profuse.
B. Venous Bleeding – blood oozes from wound at an even rate, blood is dark red or bluish in color (CO2/waste), bleeding can be profuse.
C. Capillary Bleeding – blood oozes slightly (abrasions, etc), color of blood varies from bright to dark red, bleeding often stops by itself.
D. The human body has natural systems for controlling bleeding.
E. Clotting is effective when bleeding is not too serious.
F. Platelets in blood combine with proteins to form a clot.
G. Profuse bleeding washes away clots and requires external efforts to stop it.
8. CONTROLLING EXTERNAL BLEEDING:
A. Direct pressure – place a sterile dressing over the wound, apply pressure directly over the wound using fingers or heel of hand, maintain pressure 3-5 minutes, if injury is to arm or leg—elevate it—except in cases of fracture, embedded object or possible spinal cord injury. When bleeding is under control, apply a pressure bandage over the wound, then apply a universal dressing over the original dressing firmly and securely, then check for proper circulation (pulse distal – away from –wound)
B. Pressure points – compress artery supply area, NEVER at a fracture site, use ONLY when direct pressure and elevation fail:
*Temporal – lateral portions on each side of the cranium (temples)
*Maxillary – upper jawbone (space between joint and ear)
*Carotid – major artery that supplies head/brain (on either side of larynx)
*Brachial – inside of upper arm
*Radial – thumb-side of lower arm
*Femoral – groin area
*Popliteal – behind the knee
*Tibial – inside of foot, under ankle
*Pedal – in front of ankle, top of foot
C. Tourniquet – use ONLY when all else fails:
*Apply a pad over the artery to be compressed.
*Wrap tourniquet twice around extremity and tie a half knot, never remove once applied.
*Place a stick, or similar object, over the half knot, tie a square knot over the stick.
*Twist the stick just enough to stop the bleeding.
*Tie the ends of the tourniquet in place.
*Mark the tourniquet with the time applied to the patient’s forehead
9. SIGNS/SYMPTOMS OF TRAUMATIC SHOCK
A. Extreme thirst.
B. Restlessness or anxiety.
C. Nausea or vomiting.
D. Dull, vacant look.
E. Dilated (wide open) pupils.
F. Cold/clammy skin (cool and sweaty).
G. Pale or cyanotic (blue) face.
H. Rapid, shallow breathing, possibly labored, irregular or gasping, patient requires more oxygen.
I. Weak, rapid pulse.
J. Falling blood pressure (late sign of shock – less than 90 mm/Hg systolic)
K. May be sleepy, disorientated or unconscious.
L. Monitor vital signs frequently (unstable patients every five minutes)
M. Signs of shock may be delayed for an hour or more, do not wait for blood pressure to fall before treating for shock.
N. Pay particular attention to the elderly, they do not withstand shock as well as others.
O. Watch children carefully, the do not exhibit signs until deep in shock, shock signs in a child are an emergency.
P. Different types of shock exhibit different signs:
*Neurogenic Shock has warm dry skin (associated with spinal cord injuries)
*Anaphylactic Shock – hives, swelling of face and hands, life threatening (allergic reaction)
Q. Shock cannot be reversed, but proper treatment can keep it from worsening.
R. Establish airway (FIRST)
S. Administer oxygen.
T. Treat causes of shock (control bleeding, splint fractures, etc)
U. Position patient to reduce stress to vital signs, lying down with legs elevated.
V. Prevent loss of body heat.
W. Avoid rough handling of patient.
X. Do not give the patient food or drink.
Y. Monitor vital signs and level of consciousness frequently.
Z. Arrange for immediate transport to a medical facility.
10. THERMAL BURNS
A. First Degree Burns – damage superficial layers of skin, moderate sunburn or scald, produces redness and pain, usually heal within one week, partial thickness burn.
B. Second Degree Burns – penetrate deeper into skin, blistering and swelling, extremely painful, deep second degree burns are less painful, significant body fluid loss possible, heal within 2-3 weeks, most often caused by burning liquids, partial thickness burn.
C. Third Degree Burns – skin is pale and dry, possibly charred and leathery with a burned smell, usually not painful (nerve endings destroyed), rapid and significant body fluid loss, hypovolemic shock, damaged skin cannot heal itself, skin contracture and grafting necessary, full thickness burn (thru skin and perhaps into fatty and muscle tissues).
11. RULE OF NINES: a quick way to estimate the amount of surface area that has been burned by dividing the body into sections. For those of you that are EMT’s, the rule of nines here is different for children than it is in the EMT text.
A. Adults
*Head = 9%
*Chest = 9%
*Upper Back = 9%
*Abdomen = 9%
*Lower Back = 9%
*Each Arm = 9% x 2 = 18%
*Front of each Leg = 9% x 2 = 18%
*Back of each Leg = 9% x 2 = 18%
*Groin = 1%
*Total for All = 100%
B. Children
*Front of Head = 9%
*Back of Head = 9%
*Front of Torso = 9%
*Back of Torso = 9%
*Each Arm = 9% x 2 = 18%
*Each Leg = 9% x 2 = 18%
*Groin = 1%
*Total for All = 100%
12. SEVERITY OF BURNS:
A. Minor burns
*First degree on less than 20% of the body.
*Second degree on less than 15% of the body.
*Third Degree on less than 2% of the body.
B. Moderate burns
*Second degree involving 15-30% of the body.
*Third degree involving 2-10% of the body.
C. Severe (Critical) burns
*Respiratory injury
*Face
*Hands and Feet
*Genitalia and Buttocks
*Fractures or major soft tissue injury
*Electrical burns
*Deep acid burns
*Burn patient with underlying medical problem
*Very young patients
*Elderly patients over 60
13. EMERGENCY MEDICAL CARE OF THERMAL BURNS
A. Thermal Burns
*Extinguish any clothing on fire
*Check for signs of respiratory involvement (burns around face, unconscious in burning area, patient who has been exposed to smoke or hot gases, singed nasal hair, hoarsness, cyanosis)
*Administer oxygen
*Check vital signs (every 5 minutes, watch for increasing pulse and signs of shock)
*Cover burns with dry sterile dressing.
B. Chemical Burns – Water Soluble
*Flush area with large amounts of water
*Remove contaminated clothing
*Continue flushing for at least 15 minutes
*Prevent personal injury by avoid skin or clothing contact
*After flushing is complete, apply dry sterile dressing
C. Chemical Burns – Non Soluble
*Dry Lime – brush from clothing and skin, flush with large quantities of water
*Phenol – place patient under running water, wash affected area with alcohol or oil
*Chemical burns to eye – flush eye for at least 20 minutes, cover eyes with sterile wet dressing
14. INGESTED POISONS AND DRUG OVERDOSE
A. Signs/Symptoms:
*Nausea
*Vomiting
*Drowsiness
*Unconsciousness
*Cramps
*Severe Abdominal Pain
*Abnormal Breathing
*Abnormal Pulse Rate
*Convulsions
*Burns around victim’s mouth
*Stains around victim’s mouth
*Unusual breath odors
*Odors on victim’s clothing
*Sweating
*Dilated pupils
*Constricted pupils (usually associated with specific kinds of drugs)
*Excessive salivation (drooling)
*Foaming at the mouth
B. Drug Overdose Information:
*Many drug users take combinations of drugs to heighten effects, leading to life-threatening injuries
*Emergency intervention is more effective with orally taken drugs (doesn’t absorb into the blood stream as fast)
*Injected or inhaled drugs take effect almost immediately
*Street names of drugs are important to know in determining appropriate treatment
*Poison Control Centers or hospitals are available for diagnosis and treatment 24 hours a day
*Record the local/regional poison control center and hospital numbers in easily accessible locations
*If you suspect poisoning or drug overdose, contact the poison control center or hospital IMMEDIATELY
C. Emergency Medical Treatment for Poisons and Drug Overdoses:
*Perform initial assessment (ABC’s)
*Contact nearest poison control center or hospital
*Perform basic life support as necessary
*Administer first aid as directed
*Speak to patient in soothing voice, try to reduce anxiety
*Call for police assistance immediately with combative patients
15. FRACTURES
A. A fracture is a break in the continuity of a bone and is usually accompanied by a muscular spasm in the area of the fracture
B. Two classifications of fractures:
*Closed or Simple – overlying skin is intact
*Open or Compound – wound at fracture site, bone ends may or may not protrude
C. Significant bleeding may occur with either type
D. Open fractures are more serious, risk of contamination and infection
E. Signs and Symptoms of Fractures:
*Deformity, extremity at an unnatural angle
*Pain, tenderness, soreness at the site of the fracture
*Swelling and discoloration, may or may not be immediate
*Loss of function, extraordinary pain with movement of injured extremity
*Exposed bone fragments
F. Emergency Medical Care of Fractures:
*Sling and Swathe
*Pillow Splint
*Rigid Splint
