Assessment of wildland firefighter opinions and experiences related to incident medical providers

2023  Journal Article

Assessment of wildland firefighter opinions and experiences related to incident medical providers

Pub TLDR

The study examines wildland firefighters' attitudes and experiences regarding medical services during fire assignments, revealing that while there is high respect and trust for medical personnel, private firefighters feel they have less access to care and face discouragement in seeking treatment. The findings suggest a need for policy changes and cultural shifts to address the perceived disparities between private and agency firefighters in accessing medical services.

 

College of Health researcher(s)

OSU Profile

Abstract

Background

Medical services for wildland fire incidents are vital and fire personnel need to be comfortable seeking care and have adequate access to care.

Aims

The aim of this study was to examine wildland firefighters’ (WLFFs) attitudes towards, opinions of and experiences with the medical services on fire assignments.

Methods

A survey was used to collect information from WLFFs. The survey covered: (1) demographics, (2) injury descriptions, (3) trust/respect toward medical personnel, and (4) perceived impact of injury treatment on individual and team deployability. Analysis used contingency tables with chi-square tests to compare groups.

Key results

WLFFs in both groups respect and trust incident medical personnel. Private firefighters compared with agency firefighters report a perception of less access to care, a high level of discouragement to seek care, and a greater concern that seeking care could result in being removed from the incident.

Conclusions

Although respect and trust are high, there are concerning perceived differences between groups on several aspects of seeking and receiving medical care.

Implications

Policy changes and culture shifts may be needed to narrow the opinion and perception gaps between private and agency firefighters on multiple aspects of incident medical services.

 (2023) Assessment of wildland firefighter opinions and experiences related to incident medical providersInternational Journal of Wildland Fire32(8)
 
Publication FAQ

FAQ on Wildland Firefighter Medical Services

What are some of the significant health hazards faced by wildland firefighters (WLFFs)?

Wildland firefighters face a variety of significant health hazards including heat stress, smoke exposure, orthopedic injuries, and illnesses such as camp crud and COVID-19. The demanding nature of their work puts them at risk for injuries ranging from minor to severe, making access to quality medical care essential. Epidemiological data for injuries is limited, leading to potential underreporting of incidents as only those resulting in worker's compensation are often tracked, underscoring the need for accessible and trustworthy medical services on fire incidents.

Who provides medical services on wildland fire incidents, and where are these services typically located?

Medical services on wildland fire incidents are typically provided by a combination of employees from federal agencies and private contract companies who specialize in Emergency Medical Services (EMS) in remote environments. These providers can be found both on the fireline and in fire camps, which can range in size from hundreds to thousands of personnel. Larger camps may have medical units with over 50 EMTs and paramedics. These medical units are organized according to guidelines from the National Wildfire Coordination Group (NWCG).

What were the main objectives of the study on wildland firefighter attitudes toward medical services?

The primary objective of the study was to assess wildland firefighters' (WLFFs) attitudes, opinions, and experiences regarding medical services provided on fire assignments. The research specifically aimed to identify any potential barriers that might prevent firefighters from seeking care, such as concerns about being perceived as weak or being demobilized from an incident, and to determine if these concerns are widespread. The study also sought to understand differences in perceptions between agency and private firefighters concerning access and utilization of medical services.

How do agency and private wildland firefighters generally view the medical personnel on fire incidents?

The study found that both agency and private wildland firefighters generally have high levels of trust and respect for medical personnel working on fire incidents. This suggests that reluctance to seek care, if it exists, is likely not due to a lack of trust in the providers' competence or attitude. This trust is crucial because it's an important part of a person's decision to seek medical attention and it suggests that other factors are contributing to the lack of medical care seeking behavior.

What were the significant differences in perception between agency and private firefighters regarding access to medical services?

While both agency and private firefighters generally agree in theory that access to medical services is similar, the study found a concerning difference in disagreement. A much higher percentage of private firefighters disagreed with the statement that they have the same access as agency firefighters (43.3% of private firefighters disagreed, compared to only 6.6% of agency firefighters). This discrepancy is concerning since both types of firefighters are on the same incidents and should have the same access, indicating that there may be real or perceived barriers to care that only affect one group.

How do private and agency firefighters differ in their experience of being discouraged from seeking medical care?

There's a notable difference in experiences between the two groups. A much higher percentage of private firefighters reported being discouraged from seeking medical care compared to agency firefighters. Specifically, 50% of private firefighters reported being discouraged and 60% reported witnessing others being discouraged, while agency firefighters showed lower levels of agreement to both of those statements. This suggests a cultural or systemic issue within private firefighting where seeking medical attention might be seen as a negative behavior, while agency firefighters do not seem to report the same problem.

What concerns do private firefighters have regarding how seeking medical attention might affect their employment?

A substantial majority of private firefighters, 83.3%, perceive that seeking medical attention could negatively impact their crew's demobilization from an incident. This fear may stem from concerns about potential financial loss, since private firefighters often don't have the same guarantees of paid time off or sick leave as agency firefighters, and a demobilization can significantly impact their income. This suggests that there is a fear that is present that pushes people to avoid medical care, which could be dangerous if their injuries are not treated.

What steps are recommended to address these issues and improve healthcare access for all wildland firefighters?

The study suggests the need for policy changes and culture shifts to ensure equal access to care for both agency and private firefighters. Information campaigns may be useful to correct misinformation about access and eliminate the fear of negative consequences for seeking care. Further research is also needed to understand why private firefighters perceive lower access, whether supervisors are acting as gatekeepers, and if firefighters are self-treating or getting care from other unmonitored sources. Prioritizing the health and safety of all wildland firefighters and encouraging them to seek timely medical attention is crucial for both individual well-being and successful incident management.