January 11, 2024

NIOSH Advisory Urges Training Regarding Unresponsive Firefighters and PPE

A new safety and health advisory published by NIOSH highlights the importance of training fire service workers to rapidly remove unresponsive firefighters from turnout gear and self-contained breathing apparatus (SCBA). A firefighter’s personal protective equipment can impede rescuers’ ability to assess their airway, breathing, and circulation as well as delay emergency medical care, including effective chest compressions in response to cardiac arrest or arrhythmia. Firefighters wearing PPE can become unresponsive due to medical issues like reduced oxygen supply to the brain, heat stroke, severe dehydration, and neurological problems. Wearing PPE during periods of intense exertion and heat exposure increases firefighters’ risk of experiencing a cardiac medical emergency, which can result in unresponsiveness.

The agency recommends that fire departments and training facilities train firefighters, officers, and instructors on when and how to rapidly remove turnout gear and SCBA so that emergency medical care can start quickly. Rapid removal methods include Firefighter Down CPR, which NIOSH describes as a 10-step process involving multiple rescuers working together to remove an unresponsive firefighter from PPE in less than 30 seconds, and cutting off turnout gear using manual shears, scissors, or battery-powered fabric cutters. NIOSH urges fire departments and training facilities to practice these methods during standalone training and as part of other training scenarios. Other recommendations that departments and facilities should consider include appointing a safety officer and including emergency medical services providers at the scene of all emergency response and training activities where firefighters are wearing turnout gear and SCBA during strenuous physical work.

The full safety advisory is available on NIOSH’s website.