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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

Great Basin Cache Upgrading to New Inventory System

Date: May 7, 2025
Questions?  Please contact:
Great Basin Cache
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

NEW! Air Operations Summary (ICS 220 WF) Now Available

Date: May 2, 2025
Questions?  Please contact:
National Interagency Aviation Committee

The Air Operations Summary (ICS 220 WF) provides the Air Operations Branch with the number, type, location, and specific assignments of helicopters and air resources. The new ICS 220 WF also includes medical extraction capabilities and air resources tracking.

Understanding the capabilities of aviation assets is critical for effective medical and extraction responses. Coordination with the Medical Unit Leader is essential to ensure alignment and consistency between the ICS 220 WF and the Medical Plan (ICS 206 WF). 

References:

Air Operations Summary (ICS 220 WF)

National Interagency Aviation Committee

Incident Command System (ICS) Forms

Incident Position Standards and Next Generation Position Task Book Available for Firing Boss, Single Resource

Date: April 30, 2025
Questions?  Please contact:
Fuels Management Committee

NWCG is excited to announce that the NWCG Incident Position Standards for Firing Boss, Single Resource, PMS 350-105, and the NWCG Position Task Book for Firing Boss, Single Resource (FIRB), PMS 311-105, are now available. 

These resources, part of the Performance Support Package developed through the Incident Performance and Training Modernization (IPTM) effort, support trainees, qualified personnel, and evaluators. 

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:

NWCG Firing Boss, Single Resource Position Page

NWCG Incident Position Standards for Firing Boss, Single Resource, PMS 350-105

NWCG Position Task Book for Firing Boss, Single Resource (FIRB), PMS 311-105

Incident Position Standards and Next Generation Position Task Book Available for Helicopter Crewmember

Date: April 28, 2025
Questions?  Please contact:
Interagency Helicopter Operations Subcommittee

NWCG is excited to announce that the NWCG Incident Position Standards for Helicopter Crewmember, PMS 350-22, and the NWCG Position Task Book for Helicopter Crewmember (HECM), PMS 311-22, are now available.

These resources, part of the Performance Support Package developed through the Incident Performance and Training Modernization (IPTM) effort, support trainees, qualified personnel, and evaluators.

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:

NWCG Incident Position Standards for Helicopter Crewmember, PMS 350-22

NWCG Incident Position Standards for Helicopter Crewmember, PMS 350-22

NWCG Position Task Book for Helicopter Crewmember (HECM), PMS 311-22