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Concussion and Head Injuries

 

Being struck in the head is unfortunately common in the wildland environment. Snags, equipment, loose scree, and UTV use all abound in our environment. Hard hats and helmets are a must and provide a degree of protection. But what if your co-worker gets a hit to the head (with helmet on!) and stumbles to the ground?

Image
Twelve symptoms that could indicated concussion.

Consider the scenario:

Your crew is walking along a trail when a large tree branch falls and hits the head of a team member. They are knocked to the ground but do not appear unconscious. No other injuries are identified and after a few minutes they seem to be OK. With relief, you hike onwards. A few minutes later they ask, “Where are we?” and you answer. Again, after a couple minutes the same question—same answer. This happens several more times and pretty clearly, they are not able to process or retain the information. What’s going on? What should you do? 

A blow to the head–with or without loss of consciousness–which results in some impaired cognition is a concussion. Concussed individuals sometimes repeatedly ask the same question and can’t seem to process the answers. They may complain of headache, dizziness, nausea. More severe concussions can result in being off balance, vomiting and some degree of panic as they cannot understand what has happened no matter how much you explain.

Fortunately, thanks to mainly the field of Sports Medicine there are now standard approaches to patients with concussions, as well as clear guidelines.

Follow the three 6 Rs: recognize, report, and recover.

Or even better are the 6 R’s:

  • Recognize. Learn the signs and symptoms of a concussion.
  • Remove. If an individual has a concussion or even a suspected concussion, they must be removed from duty immediately.
  • Refer. Seek medical attention.
  • Rest. A minimum of 24 hours for mild symptoms – 72 is better.
  • Recover. And then begin a gradual process of low levels of physical and mental activities over the next 7-14 days.
  • Return. If all symptoms have resolved and you are cleared to do so by a medical provider.

Allowing a person with a concussion to continue on duty is not only detrimental to their recovery but could put the entire crew in jeopardy if quick thinking or movement is required.

 

Category
Firefighter Health & First Aid
References
NWCG Emergency Medical Committee
AANS, Concussion – Symptoms, Diagnosis, and Safety Guidelines
IRPG, PMS 461 – Emergency Medical Care (red pages)

Last Modified / Reviewed:


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Updated NWCG Guide for Wildland Fire Modules, PMS 431

Date: May 14, 2025
Questions?  Please contact:
Fire Use Subcommittee

The updated NWCG Guide for Wildland Fire Modules, PMS 431 serves as a supplemental resource for wildland fire module operations, providing information frequently used in the field.

PMS 431 defines the organizational structure, staffing, and qualifications for Type 1 and Type 2 Wildland Fire Modules, outlining their roles in wildland fire suppression, prescribed fire, and resource management. The NWCG Guide for Wildland Fire Modules, PMS 431, should be used in conjunction with the NWCG Standards for Wildland Fire Module Operations, PMS 430.

References:

NWCG Guide for Wildland Fire Modules, PMS 431

NWCG Standards for Wildland Fire Module Operations, PMS 430

Updated NWCG Standards for Wildland Fire Resource Typing, PMS 200 Now Includes Off-Highway Vehicle Typing Standards

Date: May 13, 2025
Questions?  Please contact:
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The NWCG Standards for Wildland Fire Resource Typing, PMS 200 has been updated to include newly developed Off-Highway Vehicle (OHV) typing standards. These standards organize OHV information into logical categories and outline key safety requirements for occupants.

NWCG Standards for Wildland Fire Resource Typing, PMS 200 establishes minimum typing standards for aircraft, crews, and equipment used in national mobilization to wildland fire incidents. Typing designations are assigned based on measurable capability and performance criteria.

References:

NWCG Standards for Wildland Fire Resource Typing, PMS 200

NEW! S-204, Interpersonal and Critical Thinking Skills for Safety Officers Now Available

Date: May 12, 2025
Questions?  Please contact:
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The S-204, Interpersonal and Critical Thinking Skills for Safety Officers self-directed online course is now available! Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Safety Officer, Field (SOFF) incident qualifications.

S-204, Interpersonal and Critical Thinking Skills for Safety Officers focuses on facilitating hazard mitigation conversations and building trust to influence safety-related decisions. Individuals can self-enroll through the Wildland Fire Learning Portal (WFLP).

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1.

References:

S-204, Interpersonal and Critical Thinking Skills for Safety Officers 

NWCG Safety Officer, Field (SOFF) Position Page

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Great Basin Cache Upgrading to New Inventory System

Date: May 7, 2025
Questions?  Please contact:
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Phone: (208) 387-5104
Fax: (208) 387-5573

The Great Basin Cache (GBK) is transitioning to a new inventory system to better serve the wildland fire community. During this upgrade, GBK will be unable to process standard orders from Part 1: Fire Supplies and Equipment and Part 2: Publications between May 8-20, 2025, with exceptions made for emergency fire orders. Orders will be accepted through close of business May 7.

To browse the latest available items, please refer to the National Fire Equipment System (NFES) catalogs. 

References:

NWCG NFES Catalog-Part 1: Fire Supplies and Equipment, PMS 449-1

NWCG NFES Catalog-Part 2: Publications, PMS 449-2