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FIre Engineering Technical Editor Glenn Corbett forwarded this video of a jet axe in use in Elmira, New York, back in the day. The video was taken by Charles Jennings, Associate Professor of Fire Science at John Jay College of Criminal Justice/CUNY, who also provided us with a description of the incident (below). Take a look:




I was what would be called a fire buff as a teenager. At this stage of my life, I was an Explorer scout for my volunteer fire department, and would keep a scanner on at home, and respond via bicycle if there was a fire nearby. On this day, I heard the police talk about calling for barricades, which was the sure-fire way to know that Elmira had a worker.

The fire was in the third floor storage area of a large, mid-block ordinary construction building that housed a J.J. Newbury Department store, complete with a lunch counter. The retail space was on the ground floor and basement. The upper stories (2 and 3) were not accessible to the public. It had one of those false facades on the street side, which extended up the entire store, covering the windows and greatly limiting the potential for ventilation.

When I arrived, they had the two aerials working and were attempting to make headway on the fire, which burned through the roof. I distinctly recall a water motor gong sounding, but clearly the sprinklers were not effective. Water was rolling out the front doors.

In the rear of the building, which is where this was filmed, you see crews who were attempting to attack the fire through two windows off of a fire escape on the third floor. This was a stubborn fire that was frustrating extinguishment efforts. At one point I remember heavy green smoke issuing from the roof, so who knows what was burning in there.

I was lined up on the roof of a parking garage watching the action, when word came over the fire radio that they were going to try the jet axe to breach a wall and get access to the fire. Working from the roof of the one-story section of the store, a ground ladder was raised and the jet axe was attached to the wall. Te firefighters on the roof took cover, and a countdown was given on the fire radio. You see the results. The sound was not overly loud, but it was a memorable fire -- certainly not the largest faced by the EFD, but the only time a jet axe was used that I know.

Charles Jennings
Associate Professor of Fire Science
John Jay College of Crminal Justice/CUNY

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posted by Peter Prochilo
3/25/2009 02:16:00 PM

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Blogger Nicholas said...

I am a young fire fighter (born the year this fire took place) and have never heard of the jet axe. I did an internet search and found it pretty intersting. I know several fire fighters would love playing with thing, including myself.

Wed Apr 01, 10:47:00 AM EDT  

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CNN today has an interview with firefighter Paul Embleton, founder of the BRAVE foundation, which works to train Guatemalan firefighters and EMTs. Read the article HERE.

You can learn more about the foundation at bravefoundation.org.

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posted by Peter Prochilo
3/13/2009 11:09:00 AM

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Working to improve your cardiac arrest reversal rate? Keeping an eye on Departments who proudly tout consistently high resuscitation rates? Maybe you shouldn't. Medicine, particularly cardiovascular medicine, has evolved a hundred fold in the past two decades. We used to focus most of our time and energy trying to lessen damage during an acute MI or attempting to bring the dead back to life. You still do. But the medical community took a long hard look at the causes of cardiovascular disease many moons ago and reinvested their greater energies in preventing these lethal events. And they've done a darned good job of it. In some places, that is. With statins, beta blockers, aspirin, ace inhibitors, sophisticated pacemakers, internal cardiodefibrillators, health care practitioners today have made substantial inroads against cardiovascular disease. So much so that acute MI's are caught early, treated and sent home without significant tissue damage. People prone to sudden cardiac death already have an implanted defibrillator. Heck, if your disease is so horrible, you can even take an artificial heart home with you nowadays. Bottom line: when good medicine is practiced in a community, there are less cardiac arrests. And cardiac arrests do occur, they more often than not represent terminal events - people at the end of their lives: flatline, asystole...

If you're seeing a volume of primary v-fib cardiac arrests enough to ponder over improving your resuscitation rates, maybe you should take a closer look at the quality of primary and cardiovascular care being provided in your community. Cardiac arrests should be on the decline. Cardiac arrest resuscitation rates should be dropping as well. That might be a better measure for bragging rights. Medicine has evolved; EMS needs to evolve with it.

Mike McEvoy
EMS Editor - Fire Engineering

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posted by Mike McEvoy
3/10/2009 09:43:00 PM

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Blogger Mic said...

Mike,

I agree that the incidence of sudden cardiac arrest may be falling for all the reasons you mention. There are a few items I think we should all keep in mind to keep your comments in proper context.

First, people will still have cardiac arrests - even with great primary and cardiovascular care. Medicine is helping people live longer - but at some point, fate catches up. So, the incidence of sudden cardiac arrest falls but not the overall incidence of arrests.

But even we go on fewer cardiac arrest calls because more of them are not the of unexpected variety, the survival rates for the ones we do attempt resuscitaiton on should not be going down. There have also been dramatic improvements in our understanding of resuscitation physiology, particularly in how to improve blood flow with better BLS. By reducing the amount to interruptions of chest compressions; by using compression metronomes and other devices to optimize rate; and the using technology built into some monitors to optimize the depth of compressions - BLS is getting much better.

So, we should keep tracking survival rates and with good BLS protocols, training, and QI, survival rates should be improving.

--- Mic

Mic Gunderson
Consultant, IPS
[email protected]
www.onlineips.com/publicsafety

Wed Mar 18, 11:52:00 AM EDT  
Blogger mwd101 said...

Mike,

Interesting and stimulating commentary as always, but I think a bit off the mark. While there seems to be a decrease in the number of survivable primary ventricular fibrillation cardiac arrests among young or otherwise healthy people, no one knows all of the reasons for this decrease. Medicine has made great inroads at the prevention of coronary artery disease; we are a long way from the world you describe. Nowhere is this of greater concern than the fire service. Cardiac arrests frequently occur in patients who have no known cardiac disease, in fact, as many as half of the firefighters that suffer cardiac arrest have no known cardiac history.

We must still work to improve our skills and our systems to treat those patients who suffer cardiac arrest, even while our colleagues in primary care and cardiology work to prevent cardiac arrest. We must not ignore that the differences in our EMS systems and some have rates of return of spontaneous circulation approaching 50%, and others below 10%. If a system moves from having a dismal rate to having a drastically better rate we must trumpet their success.

The chain of survival is real. Across the USA the links are not as strong as they could be. The first link must be prevention, championed by the healthcare community, as you assert. The next link must be community recognition, so no heart attack is missed, and then 911 activation, BLS, and ALS. There must be another link as well, retrospective review. Each case should be a data point that is entered in a National registry, such as the CARES at Emory, and studied the same way in every community. As Mic says, the rates should not be going down--and they won't, if we compare "apples to apples."

Are we ready to declare the war won and cardiac arrest no longer an issue for EMS? No. In fact, as you and I look at systems maturing across New York, not yet. Maybe someday.

Michael

Michael Dailey, MD
Regional EMS Medical Director
REMO
[email protected]

Sun Mar 22, 11:06:00 PM EDT  

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