It started with six firefighters injured in a firestorm during the 2007 Corral Canyon Fire in Malibu, which burned 5,000 acres, destroyed 53 homes and caused $100 million in damage, according to a report from the Los Angeles Daily News.
Mary Valance, now a senior nurse instructor, was working in Division 7 when she was called to the hospital.
“I just looked at six very sick firefighters,” said Valance, a UCLA graduate with a master’s degree in pulmonary nursing who joined the Los Angeles County Fire Department in 2001. “Not only (did) they appear extremely ill, but they all had some level of difficulty breathing, major headaches, eye abrasions.”
It didn’t help that hospital staff were treating each man differently. Valance developed a treatment plan for the firefighters.
“From that, I started just diving into what it was that caused these problems that they experienced,” she said, “and I was floored.”
Valance sought to put together an evidence-based program to determine which chemicals the firefighters were exposed to and develop a treatment plan for future injuries.
Looking at wildfires “was an eye opener,” she said. “A lot of people think just plain smoke doesn’t have any toxins in it.”
Armed with her new knowledge, Valance created an awareness campaign. That program, which she called “Firestorm: Smoke Inhalation Injury and Prevention,” along with more recent research toward improving firefighter rehabilitation from heat-related injuries, was one of the driving factors behind her recent Outstanding Wildfire EMS Individual of the Year Award from the National Wildfire Coordinating Group’s Incident Emergency Medical Subcommittee.
Unlike crews battling structure fires, wildland firefighters don’t generally wear a self-contained breathing apparatus (SCBA), Valance said. Through her research, she discovered that firefighters were exposed to the highest amount of toxins while conducting overhaul activities. Now, she recommends crews wear SCBAs during that time.
Firefighters should flush their eyes whenever possible, as well as shower when they get home, to remove toxins from their environment, she discovered. They should also wash their helmet liners.
She also stresses fitness, hydration and exercise to remove toxins from firefighters’ systems.
“We know there are some simple things that can help prevent … the leading cause of firefighter deaths, which is sudden cardiac death,” she said. “If we can do something proactive, then we should try.”
In addition to particulate matter from smoke, exertional heat injuries can also cause sudden cardiac death, she said. These injuries include rhabdomyolysis, a condition where muscle fibers break down and release substances into the bloodstream that can be harmful to kidneys. This condition is found in athletes and members of the military, Valance said.
“I really just delved into the military research,” she said. “I think it’s important for firefighters to know that it came from the military; it came from the athletes.”
She teaches her firefighters to self-rehabilitate whenever possible—practice proper nutrition and hydration, as well as cooling down. Instead of simply taking off their gear to cool down, Valance recommends they use ice-cold towels.
Based on her research, the Department is now testing out cooling stations where trainees will put their arms in ice-cold water, she said, noting that Division 7 Assistant Chief Anthony Whittle has been a “huge supporter” of implementing these rehabilitation strategies.
“It was a tricky thing to do, because you’re … walking into the wildland community and saying, ‘Hey, stick your arms in a bucket,’” she said. Nevertheless, “it’s improving the lower core body temperature within 10 minutes.”
She’s also received verbal feedback from firefighters about how much better they feel.
At this point, she’s become “kind of passionate” about preventing injuries and helping the Department’s Camp Crews who “have taught me so much about wildland firefighting,” Valance admitted.
“They are the reason, I mean, for everything,” she said. “They really are amazing.”
Featured photo: Senior Nurse Instructor Mary Valance with the crew at Camp 8. Photo courtesy Mary Valance.