Using the five Es to reduce risk
By Kathy Clay
The state of Wyoming has a small population base. The estimated 2019 population base number is 572,381. In comparison, the city of Seattle has 600,000 people. Some say there are more cattle in Wyoming than people living on the land. Vast, open, wind-blown prairies frame rivers, mountains, and geysers. Grand Teton Park with its majestic mountain range and Yellowstone National Park’s geysers and hot springs are two of the Cowboy State’s gems.
Despite Wyoming’s small population base, the Wyoming State Fire Marshal’s Office has jumped out of the chute and is ready to buck! Using fire data collected from departments across the state, the data results revealed 50 percent of Wyoming fire fatalities have been in homes using home medical oxygen.
“When we learned there was a device to shunt the flow of oxygen on these home devices,” commented Deputy Director Mark Young, “we knew we needed to develop a program that could make a difference.”
Starting in January 2017, the Wyoming State Fire Marshal began focused effort to increase National Fire Incident Report System (NFIRS) reports from Wyoming fire stations. Fire stations were given free software for data entry and training. Only 50 percent of the fire stations in Wyoming at that time were compliant. This effort has greatly enhanced data collection across the state and now, of the 140 Wyoming fire departments, only 12 remain noncompliant. The State Fire Marshal’s office is optimistic that 100 percent compliance will be reached.
A group of fire officials from around the state met in Casper in May 2019 to begin planning this statewide, data-driven community risk reduction program. The group named the effort “307 CRR,” 307 being the statewide phone prefix.
Approximately 32,000 Wyoming citizens suffer from chronic obstructive pulmonary disease (COPD), and many must use medical oxygen to combat compromised lung performance. The program’s goal is to reach users of home medical oxygen, place safety devices on their units, and provide a home-risk checkup for the residents when possible.
Meanwhile, as Wyoming was working on this risk reduction plan, a nationwide plan was brewing to bring attention to community risk reduction. Members from fire departments from across the country were gathered and enjoying coffee together. As like-minded folks often do, they hit on an idea that resonated with the entire group: the idea to help promote the awareness of community risk reduction (CRR) within the fire service. This idea got legs and took off running!
The week-long effort is titled “Community Risk Reduction: Getting Ahead of the Call” and will be observed January 20-26, 2020. The event kicks off on Martin Luther King Day–a National Day of Service. The goal of CRR Week is that through building awareness within the fire service, communities will benefit as the health, safety, and resilience improves by reducing emergency events. This risk reduction reduces negative impacts to community members and to emergency responders. The work in Wyoming, mirrored in the objective of CRR Week, is an example of the fire service using the five Es to reduce risk: Education, Engineering, Enforcement, Emergency Response, and Economic Incentive.
The Wyoming group continued with its plan. With the discovery of the fire stops, the Wyoming partners received live chat-room training transmitting from London from a manufacturer of a shunt device. Connected over the Internet and sharing a screen, fire service personnel from across the 97,813-square-mile state learned together in real time.
The training included graphic videos demonstrating the effect of fire on oxygen-enhanced plastic tubing used with these home medical machines. The combination of oxygen-enriched air with the flammable plastic tubing and then adding an ignition source resulted in a fire that was quick and toxic with black smoke. There is little time for reaction with these oxygen-rich fires.
The fire stop devices are installed on the machine side of the oxygen-producing machine and just under the nasal cannula for the user. A fire stop device shunts the flow of oxygen in the event a fire develops. The device is so effective that in 2018, the Department of Veterans Affairs made these oxygen-shunting devices mandatory on all home medical oxygen used by veterans. This mandatory requirement is an example of an Enforcement measure (another one of the five Es) by the Department of Veterans Affairs office.
Developing funding for the devices is an important first step in taking the program statewide. Once funding is obtained, participants will begin seeking out medical oxygen users.
“The effort is not targeted toward smokers,” noted Mark Norford, Wyoming State Fire Marshal coordinator, “but toward anyone using home medical oxygen.” The program hopes to reach all Wyoming home medical oxygen users. When possible, a home safety visit while installing the devices on the medical home oxygen units will ensure homes have working smoke alarms and provide any further risk reduction education the user may request. Strong partnerships among many agencies will build as various needs are identified within homes.
Wyoming’s fire service personnel will be directed to resources that will help make this effort successful. Vision 20/20, the cornerstone organization of community risk reduction, offers free online training for fire service personnel. Found on its site, IFSTA’s For Wyoming’s fire service, spread out and remote, online training and online resources are critical for this program’s success. One of the goals of CRR Week is to encourage fire personnel to look for opportunities to incorporate CRR into their service delivery, explore implementation ideas, and develop interventions to reduce their community’s risk. These online tools will provide ideas, resources, and valuable training for the most remote fire stations in Wyoming.
“Smoke alarms are the first alert for home occupants that a fire is occurring,” said Wyoming State Fire Marshal Mike Reed. “We are working closely with other partners to ensure as much risk is reduced as possible in these homes.” Reed is using Education, another one of the five Es, to help his program succeed.
Engineering has provided another enhancement to smoke alarms with the new UL217 listed smoke alarm now on the market. This smoke alarm’s new technology is neither photoelectric nor ionization but a brand-new technology that detects the difference between burning toast and a burning sofa. “We believe this technology will eliminate nuisance alarms,” noted Underwriters Laboratories’ (UL’s) Bruce Johnson. “People will leave their smoke alarms in place and the alarm will sound when there is an actual reason for it to sound.” The UL217 smoke alarm becomes required technology in May 2020. The UL Web site offers information on this new technology as well as a multitude of videos on risk reduction to share when educating.
As the State Fire Marshal investigates how to fund this risk reduction program, an example of an Economic incentive would be to provide the oxygen shunting device to medical oxygen users at no charge. With partnerships and collaborations, Deputy Director Young believes both the fire shunts and, if needed, the smoke alarms will be placed within these homes at no cost to the homeowner. Collaboration is key. Stakeholders include the Red Cross, local hospitals, public health, oxygen providers, clinics, and emergency responders.
“When we get called to a home with medical oxygen in use,” said Jackson Hole Fire/EMS Chief Brady Hansen, “our providers will install the shunt device at no charge, check for smoke alarms and ensure they are working properly, and help the residents understand risk reduction in their home.” Jackson Hole Fire/EMS is a partner in this statewide effort. Fire departments across the state will help identify these homes in their Emergency Response calls to service.
“This is ambitious,” noted Deputy Chief Young, “but it is data-driven. The data show where to put our effort to the best possible use. We believe we will do more than reduce risk with this effort; we believe we will save lives.”
The Wyoming State Fire Marshal’s Office will record all installed devices to ensure the outcomes of this important work can be measured.
For more information on Wyoming’s effort, go to https://wsfm.wyo.gov.
For more information on Vision 20/20 resources, go to https://strategicfire.org.
For more information on CRR Week, go to https://crrweek.org.
For more information in UL 217 smoke alarms, go to https://smokealarms.ul.org.
Battalion Chief Fire Marshal Kathy Clay helps reduce risk in Jackson Hole, Wyoming. Serving as a member of the Vision 20/20 Steering Committee, former International Association of Wildland Fire executive board member, and Wyoming Association of Fire Marshal board member, Clay is passionate about reducing firefighter deaths and injuries through community risk reduction programs that reduce community risk as well.