First Responder Fitness and Knowledge Challenge: Event Planning Manual

First Responders in the United States

First responders are professionals who initially respond to emergency situations in order to provide treatment or assistance. "First responder" is a broad term that includes volunteers as well as professional workers, such as:

Training Requirements for First Responders

Becoming a First Responder in the United States generally begins with training in the most basic of first aid techniques, with subsequent levels of expertise built upon that foundation. Therefore, obtaining a CPR certification is a logical first step. This certification is most commonly offered by the American Heart Association or the American Red Cross. After a CPR certification is obtained, further training depends on the desired specialty and the level of expertise that is dictated by the individual's role as either a professional or volunteer.

Since training varies from discipline to discipline, we can look at firefighters as an example of training requirements for first responders. Fire training depends on whether the ultimate goal is to volunteer at the local level, or to become a professional, career firefighter. For the former, becoming a volunteer firefighter generally begins with joining a local fire department. The process of joining a city fire department, such as the Fire Department of New York, however, is more structured than that of a smaller, community-based department. These municipalities will generally offer a path for new recruits to become fully-trained members, usually involving an "essentials of firefighting" course. Length of training often depends on the individual and department and often seeks to develop in the candidates a variety of skills including: external firefighting, internal firefighting, vehicular rescue, hazardous materials, enclosed spaces rescue, among others. Overall, direction of the firefighter training process at the national level is heavily influenced by the ProBoard. However, regulation of fire

some statistics from an article entitled "First Responders Are Beginning to Address Their Own Health" by Jim McKay (2018):

• Law enforcement: 75% divorce rate; firefighters: 80%+ risk of experiencing mental health issues; dispatchers: 25% chance of developing PTSD symptoms

Additionally, many think the primary cause of harm and death for firefighters is by burns or smoke inhalation. This assumption is incorrect, however, as the proven number one cause of deaths for firefighters is stress and exertion, which harm or kill about 50 firefighters nationwide each year in the United States (Humboldt State University, 2015). It is clear that focus has been placed on the mental health conditions and issues that FRs face, and actions have been taken by organizations to begin to address this problem. There are published statistics and data supporting the notion that FRs face work-associated mental illness, and organizations have utilized that data to implement support and solutions. For example, the Code Green Campaign is an organization that raises awareness about first responders. It is oriented towards mental health and providing education about the numerous health issues first responders face. This organization provides peer support and crisis referral for hundreds of providers. They also provided $1000 in treatment scholarships in 2017 (Code Green Campaign, 2019).

September 11, 2001 Attacks

One of the best ways to see a global picture of the various impacts on the lives of first responders is to look at the 9/11 Attacks because they emulate and shine a light on the challenges that FRs face in the United States.

Of the 2,977 victims killed in the September 11 attacks, 412 were emergency workers in New York City who responded to the World Trade Center. This included:

• 343 firefighters (including a chaplain and two paramedics) of the New York City Fire Department (FDNY);
• 37 police officers of the Port Authority of New York and New Jersey Police Department (PAPD);
• 23 police officers of the New York City Police Department (NYPD); and
• 8 emergency medical technicians and paramedics from private emergency medical services
• 1 Patrolman from the New York Fire Patrol

(911 Health Watch, 2017).

Research Gap

While it is evident that first responders in the United States face a multitude of emotional, mental, and disease-related issues as a result of the requirements of their jobs, it is also important to emphasize that often-times, first responders are physically "out-of-shape" and therefore unable to adequately and effectively respond in certain situations.

While the current existing literature focuses more on mental health issues associated with first responders in the United States, there is a gap in research surrounding the physical health statuses of first responders. While some information is known about 9/11 associated diseases, for example, there is not much, if any, existing research on the physical component of first responder preparedness and health. While anecdotal evidence suggests that many first responders are overweight or out-of-shape, there is no supporting evidence to prove these assumptions necessarily to be correct. No existing studies have been conducted to investigate this issue, which then inhibits community members, first responders, and other interested parties from designing a solution. In fact, Gina Solomon, co-director of the occupational and environmental medicine residency and fellowship program at the University of California, San Francisco, has stated that "Emergency responders have not been adequately studied and they tend to be ignored." Some people at UC San Francisco do suggest that first responders may be overweight or out-of-shape because they are overly demanded at work and therefore do not have enough time outside of work to go to the gym and to buy healthy and fresh food. Plus, it is common for first responders to work multiple jobs, due to a low average salary. Therefore, after a long day of work or a stressful shift, a first responder may instead choose to spend their time off by sleeping or eating faster, less healthy meals. Therefore, there is little opportunity for health promoting activities such as creating healthy meals, sleeping, and exercising.

Call to Action

Existing literature and statistics focus on the mental health component of the challenges first responders face. And thankfully, some organizations are beginning to address this and provide support and solutions. But, because there is minimal research on the physical health, fitness, and preparedness of first responders, we are attempting to begin to bridge the gap by creating this manual and event outline. We urge you to utilize this information and to allow it to inspire your efforts to help local first responder units.

Contacting Local First Responder Departments: Letter Template

To Whom It May Concern:

Additionally, event organizers can also provide non-physical activities for supporters who are physically unable to complete any challenge variation. It is important, in this case, to make sure that you have the space to accommodate them! Non-physical activities are a great way to increase engagement and can be opportunities to raise more funds to support your local first responders.

Other Non-physical Event Ideas:

• Recruiting information for those interested in becoming a first responder
• More information about local EMS (# of fires put out, lives saved, etc.; what EMS do and do not do)
• Thank-you station — write a letter to an EMS/family member
• Basic skills workshops beyond what is tested in the event
• Donations basket (raffles, prizes for donation levels, etc.)
• Information on how to "Adopt a FR unit" for employers, wellness centers, etc.

There are myriad options for skills challenges, depending on the types of equipment available, your chosen venue, and desired degree of difficulty. Skills can vary from simple to multi-faceted and advanced, with any conceivable combination. However, depending on your desired outcomes, we suggest skills that would be most beneficial for civilians to learn in order to maximize the effectiveness of the event.

First-Aid

• Bleeding control
• Tourniquet application
• Splinting of extremities
• Patient evaluation (basic vitals, triage, etc.)
• CPR
• Treatment for burns

Rescue Skills

• Knot tying (basic rescue knots such as bowline)
• Creation of improvised stretchers
• Patient packaging and transport (scoop stretchers, Reeves litters, stair-chairs, etc.)
• Improvisation of rescue devices (litters with poles and blankets; partner carrying, etc.)

Physical Skills

• Carrying equipment (fire hoses, ladders, tools, etc.)
• Traversing obstacles (simulated debris)
• Breaching doors

General Knowledge / Emergency Preparedness

• Tactics for evading or confronting gunmen/other attackers
• Hazardous materials identification and response

Time of Day

Work with your FR contact to decide on the best time of day to hold your event. For the safety of the community, an appropriate first responder staff must be working at all times, so it is important to consider the availability of local first responders at certain points during the day or week. Also note that the stress that many first responders routinely face might deter many first responders from opting to participate during a day or shift off.

Modifying the Event for Volume

Especially in an event's first iteration in your community, it is hard to estimate the volume of participants that will attend the event. However, estimating participant volume can be one of the most useful metrics in planning your event location and time, so consider the following options for their feasibility with your available resources:

• Pre-paid, online registration (most accurate estimation of volume)
• Non-paid registration (can include "early bird" specials to be paid on-site; can use free online survey software to gather participant information)
• No pre-registration
  • Make marketing widely available
  • Have a plan for getting more people (heats, activities, teams, etc.) and fewer people than anticipated

If you are not able to accurately gauge your expected attendees, you must be ready to adapt and modify your event for having more or fewer people than you expected. This can be easily done with ample planning!

Volunteers

The more volunteers, the better. Volunteers can both assist in facilitating the event and participate depending on the staffing needs of the event. Volunteer positions you may want to consider include:

• Check in, registration
• "Judging" each skill challenge
• Direction-givers along the way (especially useful if using an outdoor trail)
• Timers at the start and end of the course
• Facilitators of any non-physical activities

• Could participants be injured by equipment?
• Could over-exertion cause harm to participants (such as cardiac issues, strains/sprains, fractures, etc.)?
• Could application of first aid or rescue techniques cause harm to volunteer patients?
• Will there be bystanders at the venue for the event? Could non-participants be injured if bumped, jostled, struck, etc. by participants?

Answering these initial safety questions is the beginning step of the safety plan. Addressing the answers should be the next step. Again, these steps will likely be dependent on individual events and venues. If environmental concerns are identified, potential solutions should be developed. For example, if the event is going to be held in the spring or summer in a sunny location, organizers could address the risk of heat-related injury by providing tents or awnings to provide shade, bring sunscreen for participants and volunteers, and by providing water. Other environmental hazard solutions could include contingency plans. Event organizers should know where the nearest sheltered locations are and have a plan to evacuate participants if needed. Organizers must also develop guidelines for deciding if the event needs to be postponed or cancelled due to extreme weather.

One of the most important safety considerations is to have EMS on standby at the event. While many of the participants would likely be able to help in the event of an injury or illness, they cannot replace having a fully stocked and staffed ambulance ready to provide rapid transport to the nearest emergency room. Additionally, event organizers must be aware of and adhere to local regulations regarding events.

While an adequate safety plan should mitigate the risk for participants and volunteers, there will always be uncontrollable variables. For this reason, it is imperative to inform participants and volunteers of inherent risks and ensure that they understand and accept any risks, as well as protect organizers from potential liability. Such informed consent is best obtained by requiring participants to sign a liability waiver. Such waivers are common to many voluntary events such as this, but should be written by an attorney or other professional familiar with developing such documents. Finally, organizers should consider purchasing a one-day liability insurance plan.

EVENT DESIGN: Do's & Don'ts

Here are some photos to assist you with designing and planning your event!

Marketing Timeline

Figure 2 is an example of a timeline that could be very helpful to keep your team on track.

Figure 2. Marketing Timeline

References