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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-219, Firing Operations (Blended) Now Available

Date: Sept 11, 2025
Questions? Please contact:
Fuels Management Committee 

The S-219, Firing Operations (Blended) course is now available on the Wildland Fire Learning Portal. Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Firing Boss, Single Resource (FIRB) incident qualifications.

This blended course combines online and instructor-led training to provide students with the knowledge and skills required to perform the duties of the FIRB, as described in the NWCG Incident Position Standards for Firing Boss, Single Resource, PMS 350-105.

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-219, Firing Operations (Blended)

NWCG Firing Boss, Single Resource Position Page

Wildland Fire Learning Portal

NWCG Committees Observe Suicide Prevention Awareness Week: September 7-13, 2025

Date: Sep 5, 2025
Questions? Please contact:
Mental Health Subcommittee

The NWCG Mental Health Subcommittee (MHSC) and Risk Management Committee (RMC) recognize the unique challenges and demands faced by the wildland fire community. The MHSC and RMC know that we are all stronger together and believe in fostering a culture of support, understanding, and resilience.

Suicide Prevention Awareness encourages us to actively connect with and support each other. For more information that could make a difference for yourself or someone else please review the materials and resources provided for the 2025 Suicide Prevention Awareness Week.

References:

2025 Suicide Prevention Awareness Week Materials and Resources

NEW! Incident Performance and Training Modernization Story Map Now Available

Date: Aug 26, 2025
Questions? Please contact:
National Wildfire Coordinating Group

NWCG is excited to announce the launch of the Incident Performance and Training Modernization (IPTM) Story Map, a new interactive resource that showcases how NWCG is transforming wildland fire training and qualifications through a performance-based system.

Since its launch in 2023, IPTM has made major strides in updating how we manage incident positions:

  • 36 incident positions now have new Incident Position Standards and Next Generation Position Task Books available for field use
  • 6 more incident positions are nearing completion
  • 111 total incident positions are being analyzed through the IPTM initiative

The Story Map guides you through the IPTM process, highlights key accomplishments, and outlines what’s ahead. Whether you are a trainer or a trainee, this tool offers valuable insight into the modernization effort shaping the future of wildland fire training and qualifications.

This effort would not be possible without the contributions of NWCG staff, NWCG committees, and hundreds of subject matter experts across the wildland fire community.

References:

IPTM Story Map

Incident Performance and Training Modernization Webpage

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