At some point, a firefighter will experience a "major working fire." These types of fires are usually large in scale and require 6-12 hours (or more) of active working, crew changes, staging areas and subsequently a "fire watch" with one unit on standby at the scene after the fire has been extinguished to assure there are no rekindles.

These drawn-out battles take a toll on firefighters, both mentally and physically, regardless of their rank or position.

When I started back in early '80s, resources available for fighters were limited. We never carried water coolers on our trucks. Only one truck had a water cooler — the "Air Truck" responsible for refilling the air cylinders at the scene of a working fire. Now, every suppression apparatus has a water cooler.

Feeding firefighters back in the day involved a volunteer who manned an old canteen truck called the "Code One Association" truck. On the scene, they would provide hot dogs, sodas and other prepared food.

What we did not realize in those days was that sodas were not the best type of hydration. As there was no way of decontaminating or washing our hands prior to consuming food, we would easily absorb any of the contaminants/impurities/toxins on our hands.

We have since provided a trailer that gets dispatched to large fires. The supplies on it are powdered packets of Gatorade, to be diluted to half strength in the water coolers, along with single-serving snack crackers, granola bars, nuts, etc. The goal is to consume food with minimal hand contact.

Probably the biggest trend that has occurred and is now common practice is the advent of the firefighter rehab area. It is now required that you visit the rehab area anytime you expend the air of two air cylinders from your SCBA packs, back to back.

Every apparatus now has a waterless disinfecting hand-cleaning dispenser mounted somewhere in a compartment or in the cab. The rehab trailer also has hand-washing stations that can be filled with water, dispensed via a foot pump, with sanitizer and paper towels built in and readily available.

The rehab trailer also provides camp-style chairs, fans, cooling adjuncts and other amenities to assist in cooling firefighters down (lowering their core temperature). This was never done in the past.

At my former department, one advanced life support (ALS) transport unit and crew was assigned to firefighter rehab. This unit had specific standard operating guidelines and procedures to monitor and take vital signs of firefighters reporting to their area — parameters for blood pressure, time frames for recovery, pulse rates, respirations per minute, etc. Any firefighter not meeting the required parameters would get transported to the hospital immediately.

Another required standard operating procedure was the addition of “rapid intervention teams," better known as RIT teams. A minimum of three firefighters would be staged at the incident commander's location/vehicle.

They would have their firefighting gear donned SCBAs on, but not "on air" — near a tarp or salvage cover laid on the ground with the necessary gear needed in case of a report of a "firefighter down" or a "mayday" transmission was received. Each response unit was issued a "RIT" bag. Its contents included search ropes, extra SCBA mask and cylinder, wire cutters, bolt cutters, multipurpose pry axe, webbing, flashlights, etc.

Any time a RIT team would enter a building, there would have to be at least two people at the entry point in case problems arose with the RIT. It was called the "two in, two out" rule. As you can see, there are redundancies and backups to the backup plans.

Crew accountability was a recent advent. In our department it was known as "PAR" procedures (personnel accountability report). A PAR was to be conducted every 30 minutes by the incident commander.

Each operating unit would have to report back with specific language/communication. If there was a major change in operations, i.e., a structural collapse, mayday or other event, an immediate PAR was required, followed up by a report every 15 minutes instead of 30 minutes.

Every crew would have to be trained in various rescue techniques for getting "downed" firefighters out of buildings. This included drag techniques, rope operations for raising and lowering, search techniques and patterns, use of radio communications, PASS (personal alert safety signal), feedback-assisted rescue and other various skills.

The goal was to try to simulate the same conditions encountered at a live fire, by incorporating darkness, use of smoke generating machines, noises and sounds that could be experienced, and falling objects or distractions.

Many do not realize the paramedic and/or rescue units established by the fire departments were only for the use of "downed" firefighters at the fire scene. We have come a long way since those days, and we now use these units with the trained personnel to benefit all firefighters and citizens in the communities we serve.