It’s estimated that 15% of the world’s population—around 1 billion people—has some sort of disability, and, according to the World Health Organization, “the number of people experiencing disability is increasing due to a rise in chronic health conditions and population aging.”1 Disability varies in type and limitation and can affect mobility, vision, hearing, speech, and cognitive abilities. Are you prepared to handle a call from someone who is trapped due to a fire, flood, or building collapse and unable to evacuate on their own?
Gone are the days when you would tell a trapped caller to stay there and wait for the fire department to arrive. When updating the Fire Priority Dispatch System™ (FPDS®), the International Academies of Emergency Dispatch® (IAED™) Fire Council of Standards looks at past incidents—like the Grenfell Tower fire in London (England) and the widespread flooding from Hurricane Harvey off the Gulf of Mexico—and does a retrospective review. What happened at the fire department level? What happened in the dispatch center? What information did dispatch get from the caller? Did they then pass it on to the fire department? Was it accurate?
During the World Trade Center (New York, USA) bombing in 1993, retrospective reviews showed that a majority of people survived because they were able to evacuate the building without assistance from responders. That meant firefighters and other responders could focus their resources on rescuing people who weren’t able to get out by themselves for whatever reason. The IAED looked at that incident and others like it to devise a plan to give people instructions to minimize their chances of death or injury if they can’t get out.
“We tell people to move away from danger,” said Mike Thompson, Fire Protocol Academics and Standards Expert, IAED Academics, Research, and Standards Division.
That includes people with disabilities.
The National Fire Protection Association (NFPA) outlines four elements of evacuation information that people need in case of emergency: Notification (What is the emergency?), Way finding (Where is the way out?), Use of the way (Can I get out by myself or do I need help?), and Assistance (What kind of assistance might I need?).2 The information the FPDS has you gather and the instructions it has you give during the calltaking process address all four elements. Tactically, people with and without impairments are treated the same in fire rescue—if they can’t get out, they can’t get out, no matter the reason. The difference is that if someone is in a wheelchair or bedridden, the responding fire department will need to know beforehand so they can prepare the appropriate resources.
When you think about “resources,” you probably think about trucks and other mechanical instruments that the fire department has. And you’re right! But don’t forget that the firefighters are also a resource. Thompson said that in most cases, at least two firefighters should be allocated to assist people with disabilities out of the building. If the agency knows this as soon as possible, they can plan and call for backup from other agencies if necessary. This is why the BUILDING EVACUATION AND HEALTH/LIFE SAFETY instructions give the option to ask, “Do you or anyone else require a walker or wheelchair, or is anyone bedridden (immobile)?” if your local jurisdiction approves it.
Speaking of wheelchairs, not every person who uses a wheelchair is incapable of walking. There are two kinds of mobility impairments ambulatory and non-ambulatory. People with non-ambulatory impairments aren’t able to walk independently at all. People with ambulatory mobility impairments are able to walk independently, either with or without the use of crutches or a cane. They may be able to negotiate stairs with minor assistance in an emergency. Even people who use a wheelchair or scooter for long-distance travel may be able to walk independently in an emergency.
Because of the difference between ambulatory and non-ambulatory impairments, it’s helpful to know if a person in a wheelchair needs the wheelchair to be moved with them. Convey that information to the firefighters, as they will need different equipment or more manpower than if they just need to carry the person out.
How will you be able to tell the difference? Ask! The person with the disability is the best authority on their capabilities. The PDIs you’ll give to a trapped caller will help move them away from danger—away from the flames and smoke or the floodwater. A person in a wheelchair might not be able to navigate the stairs very well on their own, but they might be able to get to another room with a window in it or put a cloth over their mouth to keep the smoke out of their lungs.
In some cases, it’s helpful to remind the caller to look around for another way out because stressful experiences can lead to tunnel vision. Gentle prompting can help callers look again and notice a door or window they didn’t see before. However, if your caller says they cannot follow the instruction, believe them and move on to the next step.
The FPDS also references “areas of rescue assistance/refuge” in commercial buildings. Thompson said, “These are pre-designated locations where disabled occupants can gather in the event of an incident in that building. In many instances, it is possible to send a separate alarm from those areas which indicates there are occupants there that cannot self-rescue and will need immediate assistance.”
Areas of refuge may also be designated in any building that qualifies as a HIGH LIFE HAZARD. A HIGH LIFE HAZARD building is “[any] location that poses multiple life threats due to difficulty exiting or lack of mobility of the inhabitants” and includes “churches, hospitals, large apartment complexes, lodging locations (hotels), nursing homes, schools, and subway (metro) stations.” Most nursing homes and hospitals should have evacuation plans that take the abilities of their residents into account.
The instruction “Make yourself known to the firefighters (responders) when they arrive—wave, call out to them, yell for help” (which might be repeated multiple times during a call where the caller is trapped) is one that most people will be able to follow, even if they haven’t been able to follow any of the other instructions. If they can’t get out of the building, the next best thing is to keep them safe and make them as easy for the firefighters to find as possible.
Any call involving a trapped person will receive an ECHO-level Determinant Code no matter the ability of the caller.
Not every caller will let you know if they have a disability if it’s not relevant to the situation. For instance, a person using a cane or a walker might be able to navigate stairs well enough to get out of the building, but the stairwell might be flooded or smoky. People know themselves and their abilities better than you do. If a caller does mention a disability, believe what they’re telling you and give them the best help you can. Be patient and give instructions they will be able to follow.
Remember, even if you aren’t able to guide callers outside the building or area, you can still aid in their rescue by giving instructions that move them as far from danger as possible and by passing relevant information to responders.
Sources
1. “Disability and health.” World Health Organization. 2021; Nov. 24. https://www.who.int/news-room/fact-sheets/detail/disability-and-health (accessed May 16, 2022).
2. “Emergency Evacuation Planning Guide for People with Disabilities.” Disability Access Review and Advisory Committee. National Fire Protection Association. 2016; June. nfpa.org/-/media/Files/Public-Education/By-topic/Disabilities/EvacuationGuidePDF.ashx (accessed May 16, 2022).
