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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)

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NWCG Latest Announcements

NEW! S-290, Intermediate Wildland Fire Behavior (Blended) Available Now

Date: Aug 15, 2025
Questions? Please contact:
Fire Behavior Subcommittee

NWCG is excited to announce that the S-290, Intermediate Wildland Fire Behavior (Blended) training is now available on the Wildland Fire Learning Portal. S-290 (Blended) training combines online training and instructor-led training components that support individuals working towards any Single Resource Boss or Fire Effects Monitor incident qualifications.

This second course in the series collectively serves to develop fire behavior prediction knowledge and skills, and provides more detailed information on fuels, weather, and topography that affect wildland fire behavior for safety purposes.

Students are required to finish the prerequisite S-190, Introduction to Wildland Fire Behavior, before enrolling in S-290, Intermediate Wildland Fire Behavior (Blended).

References:

S-290, Intermediate Wildland Fire Behavior (Blended)

S-190, Introduction to Wildland Fire Behavior

Wildland Fire Learning Portal

NEW! S-271, Helicopter Crewmember (Blended) Now Available

Date: Aug 14, 2025
Questions? Please contact:
Interagency Helicopter Operations Subcommittee

The S-271, Helicopter Crewmember (Blended) is now available. Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Helicopter Crewmember (HECM) incident qualifications. 

S-271, Helicopter Crewmember (Blended) training combines online training and instructor-led training components. This course is designed to provide students with the knowledge and skills necessary to perform the duties of the HECM position, as described in the NWCG Incident Position Standards for Helicopter Crewmember, PMS 350-22.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

S-271, Helicopter Crewmember (Blended)

NWCG Helicopter Crewmember (HECM) Position Page

Wildland Fire Learning Portal

Incident Position Standards and Next Generation Position Task Books Now Available for FBAN and LTAN

Date: Aug 13, 2025
Questions? Please contact:
Fire Behavior Subcommittee

NWCG is excited to announce that Incident Position Standards and Next Generation Position Task Books are now available for Fire Behavior Analyst (FBAN) and Long Term Fire Analyst (LTAN).

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization (IPTM) effort. These resources support trainees, qualified personnel, and evaluators in their respective roles.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

NWCG Fire Behavior Analyst Position Page

NWCG Long Term Fire Analyst Page

ETC/RMC Safety Bulletin: 25-001 New Guidance on Laundering Wildland Fire Clothing to Reduce Contamination

Date: Aug 8, 2025
Questions? Please contact:
Equipment Technology Committee
 Risk Management Committee

The Equipment Technology Committee (ETC) and the Risk Management Committee (RMC) have issued Safety Bulletin 25-001: Laundering to Decontaminate Wildland Fire Clothing. Recent research revealed that wildland fire flame-resistant pants and shirts can be contaminated with chemicals from combustion byproducts, including carcinogens, and that common laundering practices can effectively remove these harmful contaminants from wildland firefighter clothing more effectively than previously understood. It is recommended to decontaminate wildland fire clothing as frequently as possible. 

Frequently Asked Questions about this new information and how to implement recommendations can be found on the NWCG Alerts page. Read the complete ETC/RMC Safety Bulletin: 25-001 to learn more. 

References:

NWCG Alerts

ETC Safety Bulletin: 25-001

Frequently Asked Questions (FAQ) on Laundering to Decontaminate Wildland Fire Clothing

Equipment Technology Committee

Risk Management Committee