Urban firefighting: Qualitative exploration of occupational challenges faced by firefighters of Kathmandu valley, Nepal

Introduction: Urban firefighting is a challenge however very less is known about how the firefighters manage on addressing fire disasters when it occurs or what sort of health risks they generally face. The health risks in firefighting are abundant however very less is explored, in regard to the Nepalese context. This study thus aims to explore general characteristics and potential stress causing factors among urban firefighters of Kathmandu valley as Nepal lacks any such study. Methods: A qualitative study design with in-depth interview questions were used to interview 15 currently employed firefighters and the station in charge of Kathmandu valley and thematic analysis was done to derive results. The study was conducted in two phases, the first phase including the use of locally translated and validated DASS-21 (Depression Anxiety and Depression Scale) tool to identify potentially stress suffering firefighters while the second phase included use of in-depth interview (IDI) and key informant interview (KII) format to explore stress causing factors among firefighters. Results: The results showed that most firefighters were stressed due family separations, difficult PPEs, lack of human resource adequacies, income insufficiency, underwhelming response at active site and lack of health addressing programs in the station. The firefighters additionally mentioned stress due to recurring bluff calls and unmanaged traffic in the city. Conclusion: Despite the solvable problems, the station lacked standard operating guidelines, physical fitness and mental well-being programs, deemed essential for the occupation in general. Therefore, concerned authorities must prioritize the needs of urban fire station and firefighters.

Multi-Hazard Risk Assessment of Kathmandu Valley, Nepal

Natural hazards are complex phenomena that can occur independently, simultaneously, or in a series as cascading events. For any particular region, numerous single hazard maps may not necessarily provide all information regarding impending hazards to the stakeholders for preparedness and planning. A multi-hazard map furnishes composite illustration of the natural hazards of varying magnitude, frequency, and spatial distribution. Thus, multi-hazard risk assessment is performed to depict the holistic natural hazards scenario of any particular region. To the best of the authors’ knowledge, multi-hazard risk assessments are rarely conducted in Nepal although multiple natural hazards strike the country almost every year. In this study, floods, landslides, earthquakes, and urban fire hazards are used to assess multi-hazard risk in Kathmandu Valley, Nepal, using the Analytical Hierarchy Process (AHP), which is then integrated with the Geographical Information System (GIS). First, flood, landslide, earthquake, and urban fire hazard assessments are performed individually and then superimposed to obtain multi-hazard risk. Multi-hazard risk assessment of Kathmandu Valley is performed by pair-wise comparison of the four natural hazards. The sum of observations concludes that densely populated areas, old settlements, and the central valley have high to very high level of multi-hazard risk.

Exploring Spatiotemporal Accessibility of Urban Fire Services Using Real-Time Travel Time

The accessibility of urban fire services is a critical indicator in evaluating fire services and optimizing fire resource allocation. However, previous studies have mainly concentrated on measuring the spatial accessibility of fire services, and little, if any, consideration has been paid to exploring the spatiotemporal dynamics of the accessibility of urban fire services. Therefore, we used real-time travel time to extend an existing spatial accessibility method to measure the spatiotemporal accessibility of fire services in a case study of Nanjing, China. The results show that (1) the overall accessibility of fire incidents and fire stations in Nanjing, China, is uneven, with relatively high accessibility in the southwest and northeast of the city center; (2) the number of fire incidents with low-level accessibility apparently increases in rush hours (i.e., 07:00–09:00 and 17:00–19:00 hours) in the southeast and north of the city center, and the fire incidents with medium-level and high-level accessibility easily change to lower levels under the influence of traffic congestion, with fire incidents with medium-level accessibility being affected the most; (3) the accessibility of fire stations changes over time with an obvious W pattern, with lower accessibility during rush hours than at other times, and several fire stations in the city center present an asymmetric W pattern; (4) the accessibility decline ratio for fire stations in rush hours is greater in the city center than in urban suburbs, and the decline ratios are strongly related to the travel time increase and the percent increase in uncovered fire incidents during rush hours. The results and findings demonstrate that our method can be used to explore the spatiotemporal dynamics of the accessibility of fire services, and so can guide policymakers in improving fire services.

A Pilot Study to Assess Urban, Fire-Based Paramedic Accuracy in Identification of Anatomical Landmarks Necessary for Cricothyrotomy and Needle Chest Decompression Using Live Patient Models

Background: Cricothyrotomy and chest needle decompression (NDC) have a high failure and complication rate. This article sought to determine whether paramedics can correctly identify the anatomical landmarks for cricothyrotomy and chest NDC. Methods: A prospective study using human models was performed. Paramedics were partnered and requested to identify the location for cricothyrotomy and chest NDC (both mid-clavicular and anterior axillary sites) on each other. A board-certified or board-eligible emergency medicine physician timed the process and confirmed location accuracy. All data were collected de-identified. Descriptive analysis was performed on continuous data; chi-square was used for categorical data. Results: A total of 69 participants were recruited, with one excluded for incomplete data. The paramedics had a range of six to 38 (median 14) years of experience. There were 28 medical training officers (MTOs) and 41 field paramedics. Cricothyroidotomy location was correctly identified in 56 of 68 participants with a time to identification range of 2.0 to 38.2 (median 8.6) seconds. Chest NDC (mid-clavicular) location was correctly identified in 54 of 68 participants with a time to identification range of 3.4 to 25.0 (median 9.5) seconds. Chest NDC (anterior axillary) location was correctly identified in 43 of 68 participants with a time to identification range of 1.9 to 37.9 (median 9.6) seconds. Chi-square (2-tail) showed no difference between MTO and field paramedic in cricothyroidotomy site (P = .62), mid-clavicular chest NDC site (P = .21), or anterior axillary chest NDC site (P = .11). There was no difference in time to identification for any procedure between MTO and field paramedic. Conclusion: Both MTOs and field paramedics were quick in identifying correct placement of cricothyroidotomy and chest NDC location sites. While time to identification was clinically acceptable, there was also a significant proportion that did not identify the correct landmarks.