By Justin Schorr
What happened: At just after noon recently in Los Angeles, the LAFD was dispatched to a report of 20 children sick at a school. Normally as responders, we would prepare for a traumatic incident, perhaps a bus crash or building collapse, but imagine the surprise of the rescuers when they encounter a playground of 17 children and 9 adults all reporting symptoms of skin irritation from jet fuel falling from a plane overhead.
Your evil EMT school instructor dreamt this up, I’m sure.
Delta flight 86, leaving LAX for Shanghai, experienced a mechanical problem and was returning to the airport for an emergency landing. Because the Boeing 777 aircraft carries close to 50,000 gallons of JetA fuel, they have to dump all that weight before landing, or risk overshooting the runway.
Why it’s significant: Jet fuel dumps are commonly done over large bodies of water, when possible, but this time, the fuel fell on a residential neighborhood, including the Cudahy Elementary School. Rescuers correctly declared a hazardous materials MCI and began to treat accordingly.
Top takeaways: So what are our priorities as first due in this situation?
1. Solid initial report
Gather as much information as you can regarding the number of persons impacted and the cause. Determine a safe route of approach for the other units responding and identify your casualty collection area. This should be easy to find and have easy access to where your ambulances will enter and exit. Transmit this information using the LCAN format:
- Location
- Conditions
- Actions
- Needs
For this scenario, it may sound like this: “Control, Medic 99 on scene at Cudahy Elementary. (Location) We have approximately 20 children exposed to a skin irritant, unknown cause. (Conditions) Medic 99 declaring a hazmat MCI, deploying a triage team. (Actions) Put Cudahy Command in service, have units stage outside the main parking lot entrance. Start a second alarm and 5 ambulances. (Needs)”
2. Decon over triage
In this scenario, you’ll discover quite quickly that all your patients fall into the green RPM category, so triage will be simple. As the scenario starts to slow down as you discover it was falling fuel, not a continued release, we can focus on dealing with JetA fuel. The Emergency Response Guidebook (ERG 128) focuses mostly on large jet fuel spills or vapor clouds. We want to focus on limiting ignitable sources nearby and treating the skin irritation. Rinse exposed areas with water for 20 minutes and wash the skin with soap and water. Flush eyes as well and do not induce vomiting if swallowed.
Decontaminate the children by rinsing their clothing with running water for 20 minutes. In essence, the whole school needs a big, long shower.
Also keep in mind, you too will be exposed to the fuel film on the school and you probably drove through it to reach the scene. Make sure to decontaminate yourself, your partner and your gear before returning to service.
What happens next: What started as a nightmare scenario from EMT school really places an emphasis on information gathering, good radio reporting and knowing how to use your ERG guide once you determine what happened. None of the 26 exposed to the fuel were transported, and the adults were cleared quickly. Decontaminating children, then releasing them to worried parents is your next challenge, as well as making sure that the parents arriving are not walking through more fuel to retrieve their frightened children.
Now imagine the scenario waiting for me, the ARFF EMS supervisor back at the airport, as the Boeing 777 is making an emergency landing with 307 souls on board.
Additional resources for hazmat MCI response
Learn more about fire and EMS response to hazmat MCIs with these resources from EMS1 and FireRescue1:
- Training day: Disaster response, transporting patients from the scene
- How to practice the EMS response to an MCI
- How to use SALT to triage MCI patients
- Engine company first strike MCI
- How firefighters can train for hazmat transport incidents
- Buffalo Wild Wings inhalant response: Making on-scene resource decisions
- Remember 2 Things: Disaster Response
- NSC releases responder resources for ‘fourth generation agent’ incidents
- How to deliver strong initial on-scene size-up reports
About the author
Justin Schorr is a second-generation firefighter, currently serving as an ARFF Paramedic Captain at San Francisco International Airport. His 24 years in EMS include urban, suburban and rural systems as a volunteer, EMT and paramedic.