Here is a behind the scenes look at the ChamberofHoarders.com Learning Center.  Four hours of education of Hoarding and how we need to Identify, Adjust, and attack the overloaded buldings caused by Compulsive Hoarding Disorder.

 

When firefighters enter a burning building many different factors come into play.  One huge factor that can affect the outcome of the operation is the presence of increased amounts of belongings, caused by a person afflicted with compulsive hoarding disorder.  As their collection of stuff accumulates the danger in hoarding firefighting increases.

[caption id="attachment_882" align="alignright" width="180"] Firefighter Enter Hoarding


Over the past two years of reaching out to fire departments from around the world some common challenges kept coming up.  Inability to hit the seat of the fire, shielding from the heat , and difficulties in escape were top of the list.  This past weekend the chamber of hoarders had a unique opportunity to enter a “live fire” environment to experience these variables.

With the assistance of the Frontier Fire Company in Wheatfield New York a hoarding environment was set up and multiple scenarios were run.  The results were a confirmation of all the research collected. Each variable was looked at individually and together with great success.  It truly served as a reminder that hoarding changes our operations and if we are unwilling to adjust our operation it may not be successful.

Shielding from the Heat

With many safety measures in place the fire rotations started with a firefighter between the stacks of belongings with a thermal imager.  What we learned was a confirmation and an amazing result. While the other instructors took a beating from the heat in front of and behind the stacks of stuff the inside firefighters documented floor temperatures of 125 degrees with thermal imagining, shielded from the heat.

Documenting these temperatures was an unofficial, non- scientific example of the true dangers of the hoarding environment.  No monitors, measuring equipment, or recording devices were in place, just a group of firefighters with thermal imaging cameras watching something amazing.  The hoard shielded the firefighter from the heat.  It restricted the heat and pushed it past and around.  These results proved a multiple amount of points.

• Hoarding can give interior firefighters a false sense of environment


• Shielding can allow firefighters to push further inside without experiencing the normal heat levels


• Stacks of stuff can trap firefighters


• Victims can have more survivable thermal temperatures when insulated with hoarding.

With the recent research on flow paths coming to light the need to adjust them for hoarding  firefighting was revealed inside the burn room in New York this past weekend. It reconfirmed the dangers of the insulation provided by the interior conditions.  This insulation can hide the hidden heat and dangers until it’s too late.  Most firefighters advance into burning buildings using their senses to determine how far and deep they are to go.  In hoarding conditions they may keep pushing unaware of the hidden dangers waiting for them. Dangers that could present themselves in the form of rollover, flashover, or backdraft, trapping the firefighters because they don’t have secondary means of egress.

[caption id="attachment_883" align="alignright" width="120"] Hoarding Firefighting


 Conclusion

Confirmation that the shielding is real was not a surprising result.  This weekend just reconfirmed what we have been learning from survival stories from around the world.  Hoarding conditions can act as an insulator keeping high temperatures away from the victim or firefighter in the middle.  We need to educate firefighters to be aware that this shielding can lead to poor judgment to just how far we should push.

Identify, adjust, and attack when Hoarding is discovered!!!!!!!

 FDIC Flow Path Video. 

 

Since attacking the problem of emergency responses in Hoarding Conditions, from the perspective of first responders, the questions from the family members of people who are suffering from Compulsive Hoarding Disorder keep coming in.  How can I help my family member? How do I make their home safer are a small examples of the questions that are commonly asked.

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Hoarding Fire Safety Should include a Escape Plan


Answering these questions is complex and has no one simple answer, but there are some steps to help protect your loved one from the dangers of fires in hoarding conditions.  While these simple steps may not eliminate the risks to them it can improve the chances of survival if a fire were to happen. Since starting the research into hoarding fire safety many common causes have been identified.  Sharing these common causes will help family members protect their loved ones until they can be treated by the mental health professionals.

 

Cooking Fires

Cooking fires are commonly seen in the fire service today. Hoarding conditions complicate these types of fires because the clutter has accumulated to the edge of the heating source.  When the belongings are allowed to invade the space adjacent to the stove the potential for cooking fires goes up.  If you add ordinary combustibles to a heat source the resulting fire can spread fast and trap the occupant who is in the kitchen.

0"] Hoarding Fire Safety In the Kitchen.


Fire proofing your family member’s kitchen may be a huge undertaking, especially if the hoarding level is at or above waist level.  Compulsive hoarding disorder prohibits the occupant from distinguishing between things that have great or little value. If you were to try and move their “treasured” valuables you will be met with passionate resistance. Being understanding and compassionate in your response will keep the family member at ease as you try to explain the risk for fire.

Approaching them with some tradeoffs will allow them to move their belongings away from the heating source, thus reducing the risk for a cooking fire.  Example: “Can we take the belongings from the counter and move them over to the table, away from the stove.”  If the family members understand how the thought process works they will focus on a positive solution to this problem.

This approach may be met with resistance and take time to explain the risks of cooking fire inside their environment.  Persistence with this process will be needed and the kitchen may need to be revisited multiple times as the family member replaces the belongings that have been moved.

Electrical Fires

Another leading cause of fires inside hoarding conditions are electrical fires.  Having stacks of belongings closely placed near electrical outlets increase the risks of fire from a sparking electrical outlet.  Much like the cooking fires the ordinary combustibles, newspapers and like materials, can make a fire more likely and increase the burn rate trapping occupants.

Moving the stacks of belongings away from the outlets is a simple solution to this problem.  Approaching the family member with the example of electrical outlet malfunction and explain that you are not asking to throw anything away, just move it away from the outlet will ease the pain felt when approached with the thought of losing their “treasures”.   Explaining the process of “moving” not “removing” the items can reduce their anxiety.

"] Hoarding Fire Safey


A blaring similarity, in electrical fires, seen in the hoarding environment, is caused by extension cords.  They are commonly stacked one on top of the other as electric outlets become unusable.  If an electric outlet becomes non-functioning the occupant often just runs an extension cord from a functioning one increasing the chance of overloading one outlet.  When you enter the family members home you should take time to investigate the status (usable or not) of all the outlets in the home.  This access can be difficult as the access to them can be blocked with the hoard.  Use the pathways established by the occupant to access the points available first before trying to go through the stacks.

Escape Plan

Much like the education given to elementary students in fire prevention month family members afflicted with compulsive hoarding disorder should be exposed to the exit their home plan.  Fires today are known to double every thirty seconds, offering less time for occupants to escape.  Taking the time to explain this danger to your family members will help offer some simple solutions, while starting the treatment plan.

Taking the time to explain this danger and evaluate the presence of multiple exits paths is paramount for their safety.  Example: “If a fire were to happen in the current condition blocking this only exit, you will burn to death” While this sounds somewhat extreme it may be necessary to bring home the dangers presented by not having multiple exit points in their home.

Ask your family member “What is your plan in the event of a fire and this pathway is blocked?”

 

Smoke detectors

By far the most important part of the visit should be the instillation of smoke detectors in EVERY room.  When hoarding conditions are present available airflow for smoke can be restricted.  This restriction can delay the time needed for a standard smoke detector to be alerted.  Delayed alerting can lead to less time for escape of an occupant.  Expecting this delay should lead family members to install more smoke detectors, one in each room.  Mounting them on the ceiling in the center of the room is a best option, if the stacks of stuff allow.  If not the closest proximity to the center ceiling will allow for the most coverage.

Hoarding Fire Safety Conclusion 

Dealing with loved ones that are dealing with compulsive hoarding disorder can be an emotion filled challenge that takes years.  Keeping a positive, reassuring approach that always keeps in mind the complexity of Compulsive Hoarding Disorder can lead to a successful safety intervention.  While this is not a cure it is an intervention that could save your loved ones life.  Make sure to reach out to your local fire departments, hoarding tasks forces, mental health professionals, and health officials for resources to help in your journey.

 

Additional Links:

http://www.hoarders.org/f-c.html

http://childrenofhoarders.com/wordpress/

http://hoardingdisorderinstitute.com/

Hoarding Firefighting Case Study

Here is a case study of a Cluttered House fire from Wayland Massachusetts.  This is a small glimpse of the complete study that will be added to the Chaberofhoarders.com learning center.

In this Hoarder Fire case many points are reviewed as the firefighters battled a "cluttered" condition.  We would like to thank Kyle Marcinkiewicz  for submitting these great photos and description.  You will find more about this fire inside the Learning Center.

 

 

Make sure to visit Kyle's Website to see more Pictures

kjmphotography.zenfolio.com 

[caption id="attachment_40" align="alignright" width="180"] Hoarder fire. Picture Courtesy of sdfirephotos.com


Are you prepared to call a mayday, right now?  One of the most often asked question from my students is how do you know when you should call a mayday.  The answer always comes back to, anytime you can’t get yourself out or find yourself in need of assistance, PERIOD!  There are many situations that require a firefighter calling the mayday and one that holds true is a firefighter who finds themselves inside the trenches of a Hoarder Home.  Without knowing, an interior structural firefighter can find themselves with stacks of belongings that can extend up to ceiling level causing a huge problem in advancing hoses, searching for victims, and any other fire ground tasks.

How far do you push into these conditions?  At what point do you call a mayday?

These are two questions that should be considered by the individual firefighter while using some common variables.

• How high are the stacks of Stuff


• Are we experiencing small collapse of belongings

How high:

Determining the level of belongings can alter an interior attack.  Making this determination can be the challenge due to smoke conditions. Using the stream of your hose or an extended hand tool can give you an estimate of how high the stacks are.  If you carry a 24-36 in haligan you could use it to sweep above your head to determine the height.  If you choose this technique you will need to be mindful of the location of the other firefighters with you.

Either choice of techniques should be used with caution as the resulting collapse could cover up unannounced victims, secondary means of egress, or uncover hidden pockets of fire.  Most often the only part of the hoarder stacks that are burning are the top layer.  By knocking over the stacks you could expose more fuel, maybe even more flammable fuels such as newspapers that were once insulated from the heat source.

Collapsing Stuff:

Whether it’s caused by your sweeping tool or just by itself falling debris should be considered when inside the hoarder environments.  Often the pathways, or “goat paths” , that traverse the interior of the hoarding can be narrowed to a level that causes the advancing firefighter to knock stuff over, just by traveling through them.

 Hoarding Mess:

These two variables should be considered if you find yourself inside the hoarder environment.  Both can cause an added level of danger to an interior firefighter. Often, hoarding conditions can NOT be identified from the exterior of a building.  This can expose an interior firefighter to the dangers once they have passed the point of no return (5 feet inside a structure).

If you find yourself in this condition take these two variables into consideration when determining how far you want to push inside.

If you are experiencing ceiling level stuff or collapsing debris it might not be a fight that you want to take on. Even worse, if these conditions cause you to become disoriented, entangled or low on air make sure that you are ready to call the mayday and activate your pass alarm.  It is better to call and cancel the mayday, than to find yourself in a collapsed stack of stuff and running out of air.

If you’re in a mess, use your pass and make sure that hoarding doesn’t trap you inside without a way to escape a rapidly progressing fire condition!

If you would like to learn more about hoarder firefighting make sure to check out the Learning Center here on ChambeofHoarders.com.   4 + hours of content on Hoarder Firefighting 

Hoarder Fires

Welcome to the first video from the ChamberofHoarders.com.  This short video is a look into the new exciting online learning that will be released soon!  The Chamber of Hoarders Online Learning Center will be a 24/7 access to hoarding education for first responders.

Keep up to date on the new online learning center by signing up for our email blasts.
Click here to sign up.   We hope you enjoy our first video.

Without a doubt, the number one question asked is “How can I tell if the home is a Hoarder Home”.  The answer: You will need to look for the Cues and Clues of Clutter. If you are driving your district, running medical emergencies, or driving home from work you should be on the lookout for the hoarded homes in your district.  Knowing the conditions BEFORE a fire happens will make you better prepared when you arrive.  How do you find a hoarder home?  Let’s look and a new approach to identifying a clutter home in your district.

Street Level View

As we drive the streets in our districts we should be on the lookout for unique challenges.  These include a hoarder home and the potential for a response.  When driving past these homes you should be looking out for some typical cues:

• Hoarded front yards


• Large privacy fence covering back yard


• Cluttered front porches


• Blocked windows


• Overgrown shrubs, bushes or trees


• Multiple vehicles in yard that are full

These cues and clues should trigger a need for further investigation.  If you suspect one or more of the above you should begin to investigate a little deeper, but how?

[caption id="attachment_543" align="aligncenter" width="300"] Aerial view of a Cluttered House


Overhead View

Without an invitation or a need we cannot enter your property but the eye in the sky always knows.  Taking to your computer and using tools such as Google earth can let you get a bird’s eye view of the property to confirm your suspicions.  Find a point of interest, address, or something to give you a reference point and view the property from overhead.  This perspective will allow you to view the backyard, side yard, and potentially the windows without physically walking the property.

 Read More about Pre-Fire Planning Here:

http://chamberofhoarders.com/3-things-your-department-should-do-about-hoarding/

 

Read more about Non-Fire Dangers in Hoarder Homes Here:

http://chamberofhoarders.com/hoarder-homes-more-dangers-than-fire/

[caption id="" align="alignright" width="223"] New York City Hoarder Fire


Hoarding fire Staten Island

STATEN ISLAND , N.Y. -- City firefighters rescued 30 small dogs from a blaze that ignited in a two-story home -- apparently owned by a "hoarder" -- in the Clifton section of the borough.

The call about a fire at 3 Bowen Street came in at 9:29 p.m. It was under control by 9:59 p.m., said an FDNY spokeswoman.

"It looks like there was a Colliers' mansion condition in the house; that's what we call a hoarder's house," said an FDNY spokeswoman.

Read More

http://www.silive.com/news/index.ssf/2013/08/fdny_rescues_30_dogs_during_a.html

[caption id="" align="alignleft" width="270"] Hoarder Fire


Firefighters are battling fire at the home of a hoarder in Evendale. The fire broke out Friday around 1:30 pm at 3520 Glendale Milford Road. Crews from Evendale, Glendale and Springdale have been called to help fight the fire. Firefighters were forced to take up a defensive position when they could not get through the front door because of the hoarding. There are no reports of injuries.

Read More at: http://www.local12.com/news/features/top-stories/stories/fire-at-hoarders-home-evendale-1471.shtml

After spending the last two days reviewing pages and pages of tragic events, which lead to a Line of Duty Death, searching for the effects of clutter, hoarding, or large amounts of debris. A huge point of learning kept coming up.  It wasn't the clutter that killed the firefighter; it was the clutter that kept the firefighter from being able to escape the primary killer….a rapid fire event or collapse.

[caption id="attachment_505" align="alignright" width="135"] Photo Courtesy of the Dix Hills Fire Dept,


This point of learning kept me up all night long trying to figure out how to share this information with all firefighters in a sensitive, yet stern way. The last thing that any of us should do is disrespect a fellow firefighter when learning how they died, but we all should honor them by learning the how’s and why’s.

How’s and why’s constantly included these factors.

1. Extended burn times


2. Hidden pockets of fire.


3. Elevated collapse risks


4. Blocked secondary means of egress

While some had one, most had two or three of the above factors that contributed to the death of a firefighter.  We can make adjustments for these factors, most of us do. But we need to make sure that we are adjusting for them ALL.  One can be dangerous, but combine multiple factors together, and it is a firefighter killer.

We need to take some steps to make sure we don’t underestimate our enemy, the fire.  Using some common assessments during the firefight can give you a buffer of safety and keep you thinking about the potential for death.

1)      Double burn time estimates

2)      Use outside crews to coordinate secondary means of egress

3)      Scan the building for exits while approaching

4)      Constant updates to command as your hose advance progresses

5)      Be aware of Hidden Fire

Keeping these tips and keeping your head will allow you to expect the unexpected, when dealing with the large amounts of clutter.  Adjusting how we operate in a hoarding situation will allow us to search, attack, and overhaul the home safely.

HOARDER HOMES ARE NOT BREAD AND BUTTER FIRES……...

Make sure you Identify, adjust, and attack to make sure we all come home safe!!!!!!

On Saturday May 11,2013 Jumpseat Training brought a new level of training to the West Virginia Public Safety Expo in Charleston WV.  Expanding their wildly popular classroom session, Hoarder Home's Piles of Hazards for Firefighters, to include a hands on session.  Evolution's within simulated Hoarding conditions added a new level of learning and perspective to the class. This was the first time for "hands on" evolution on Hoarder Fire Training.

Allowing students to experience the challenges faced with hoarding conditions took the learning to the next level.  When firefighters are faced with hoarding conditions they must change how they operate to remain oriented to their location and adjust how the search inside these conditions.

Many great learning points were discovered by students and instructors. Jumpseat Training would like to send out a HUGE thank you to the foll0wing supporters for making this session a overwhelming success:

WV Public Safety Expo

Resa III

Drager Thermal Imaging

BullEx Smoke Generator 

Darin Virag, Training Captain Charleston WV Fire Department

FoxFury Lighting Solutions 

FDcam.com

Look for more hands on training from Jumpseat Training Soon!

 

 

One complication that firefighters face inside a home that has hoarding conditions is the need for extensive overhaul.  Stacks of compressed belongings can lead to an extended overhaul and often will reveal hidden pockets of fire.  This news video shows an example of the complications of overhauling a hoarder fire as they were called back three times for rekindles.  There are only a few options when dealing with hoarder fires and overhaul.  Keep an eye out soon for more from ChamberofHoarders.com

 

News9.com - Oklahoma City, OK - News, Weather, Video and Sports |

 

Here is a Link to a previous article on Overhauling Hoarder Fires 

Story From 23ABCnews Bakersfield 

BAKERSFIELD, Calif. - A messy home made for difficult conditions during an early-morning fire in Northwest Bakersfield.

The fire started at approximately 2:00 a.m. Tuesday in the attic of a small house on Gulf Street.

Firefighters with the Kern County Fire Department said they had a hard time locating the home's address.  The house was built in a primarily industrial area north of Gilmore Drive and west of Highway 99.

When crews arrived on-scene, they said the firefighting effort was made difficult because the home was cluttered with lots of items.

A woman living inside the home managed to escape unharmed.  No firefighters were injured in the blaze, and there is no estimate on damages.

[caption id="attachment_114" align="alignright" width="300"] Hoarder Fire Photo Courtesy of Keven Smith


During the past two years I have spent much time and energy studying all aspects of emergency responses inside hoarding conditions.  There is one key point that consistently comes up, interacting with the occupants.  Hoarding or “Compulsive Hoarding” is “the accumulation of and failure to discard a large number of objects that seem to be useless or of limited value, extensive clutter in living spaces that prevents the effective use of the space causing significant distress or impairment caused by hoarding” (Frost and Hartl..1996). The affects of someone having  this disorder takes away the ability to make rational decisions, making process to distinguish between an item with no apparent value and one of great value (example: grocery store coupon vs. baby pictures).   This compulsive behavior can cause problems with first responders when faced with a hoarding situation.  Interaction can prove difficult first due to the unwillingness to leave and second the emotional trauma of strangers touching their “treasures”, understanding and adjusting for these situations is our job to figure out before we run this call.  The first adjustment need to be the terminology that we use.  Let us look at why we should change our terminology to include “Heavy Content” when describing a hoarded environment.

Politically Correct

A very well respected friend of mine that is in a different career once looked me straight in the eye and said “you must be jaded because of all you have seen and dealt with”.  After I digested that statement I realized that is exactly what happens. We are jaded by the countless number of tragic events that we deal with on a daily basis and it most often affects how we interact with someone who is encountering an emergency.   The very first thing that happens to set the tone of the call is how we present our self; this includes body language and the terminology that we choose.  “This is a trash house” or “pack rat conditions” are two terms that first responders use when the discovery of hoarding conditions are found.   How would these terms be received if the occupant overheard their house full of treasures called “trash”?  If someone called you a “pack rat” how would you feel?  They are unable to see their surroundings in your perspective, but it is important for the brief time you spend on the call that you try to see it from theirs.

It is good to remind ourselves of the characteristics of compulsive hoarding disorder.  There is deep emotional attachment to belongings, with the inability to distinguish between trash and treasures.  This compulsion can cause an overload to the occupant if they overheard these terms broadcasted over the radio or yelled out the window.  “Hey chief, this in the interior crews, we have a “trash house”!  this statement seems to be a popular description.  All it would take would be one radio being around the occupants to have a potential for an emergency for them or you.  There have been documented cases of occupants needing to be physically restrained from trying to re-enter a burning home to save their treasures.  Another potential danger is the reaction of the occupant in a violent manner towards the first responders.  Wouldn’t it make all of our shifts easier if we took away this easy negative and replaced it with such an easy fix.

 

Being as compassionate as possible during all emergencies is the best practice scenario for all of us, this remains true when dealing with the occupants of a hoarded environment.  Occupant safety is the biggest concern of any first responder and when the problem is a compulsive hoarder; words can be just as harmful as flames.  Removing terms such as trash house and pack rat conditions will help provide a more neutral environment for the occupant while standardizing the terminology used by first responders.

Heavy Content:  A key term

Another key factor in dealing with hoarded conditions is the amount of belongings and the weight exerted on the structural supports of the building.  Collecting a large amount of belongings can lead to an overloaded structure, even before the first ounce of water is applied.  Using the term “heavy content” should remind all first responders of the overloading potential and collapse risks associated with dealing with a hoarded environment.

A heavy content environment can offer many potential for a collapse, this is usually wither from interior debris falling to a complete collapse of the entire structure.   When a building is over loaded with massive amounts of stuff it has the potential to injure or kill first responders.  Using the heavy content terminology to identify these potential risks should put all responders at a heighten level of awareness to be looking for collapse.  It should also evoke  a thought process needed to identify what is being collected inside the building.  Identifying items such as books, magazines, or car parts can help with the collapse risk assessment.   Another factor that can be used is a hoarding level scale such as the Institute for Challenging Disorganization rating scale of 1-5.  If a level 5 is determined, a No-Entry decision may be the best option.

Conclusion:

Emergency responders are dealing with compulsive hoarding disorder on a daily basis.  There is a huge difference in terminology used worldwide used when describing hoarded conditions, but there is huge effort to change that.  From “Colliers Mansion Syndrome” to “Pack Rat” conditions it seems like your terminology is based on a geographic locations.  It’s time that we standardized terminology to allow us all to understand the conditions, even if we are not familiar with the term.  Heavy Content should be used worldwide to allow a standard, politically correct term to describe these conditions.  It offers cues to us all, even if you have never heard of the term before.  Being mindful of the compulsion and trying to remain respectful to it will allow us to have an improved public perception and protect ourselves from the potential for confrontation with the occupants.

If you arrive on scene of a structure fire, would you flow water through an open window

[caption id="attachment_388" align="alignright" width="275"] Courtesy of Oxford Pa Fire Department


before making an interior push?  Transitional attack or flowing water through an opening in the exterior of a building, which is on fire, has been an often-debated tactic that had no scientific data to prove or disprove this type of suppression technique, until now.  At this year’s Fire Department Instructors Conference in Indianapolis Indiana NIST, with a partnership with the FDNY, presented their findings from a recent study on fire dynamics and tactics used.  The experiments conducted on Randal’s Island looked at different variables such as flow paths, water application, and thermal balances from each.  While watching this ground breaking study one thing kept coming to mind, Hoarder Fires.  Stacks of belongings that have taken over a structure can add a level of danger to any firefighter who makes entry.  It can also affect the variables covered by the NIST study.  Let’s look at a few of the variables exposed by the release of this ground breaking presentation and how they relate to the Hoarded Environment.

Flow Paths

One of the variables released in the study was the flow of super-heated smoke, unburned fuel.  If a firefighter does not ventilate a structure and proceeds through a door, they are crawling right into the “flow path” of heat and smoke. Hearing this information given merit with scientific evidence shouldn’t come as a surprise to any firefighter who has crawled a dark hallway.  Now that we have the data to back up our suspicions let’s take a look at the hoarded environment.

If a house has Heavy Content environment inside it has the potential for having multiple flow paths. Depending on the level of belongings, the airflow can be forced through the narrow pathways formed by the stacks of stuff.  What does this mean to an interior firefighter? Unlike entering a “normal” structure fire, a firefighter may not get relief for the heat like a firefighter who has progressed through a door and moved out of the flow path.  Channeling the heat through pathways can bring the heat directly down on an advancing firefighter. Add a variable, such as stacked belongings that raise a firefighter up to two feet higher, our PPE may be pushed to its limits.

Heat Level Reduction

Another variable revealed in the NIST study was the change in heat levels after the application of water streams.  To summarize the findings they applied water to the first floor fire and measured the second floor temperatures.  The also revealed the difference between an open door and a closed door.  These different variables can be applied to the hoarder fire environment.

First was the evidence of heat reduction with the application of water. It has been believed if we apply water through a window that we reduce the survival chances of a potential victim.  This study proved that if water is applied on a first floor fire the second floor temperatures went down.  If we were truly thinking about how this works it makes since, fire knockdown the heat should be knocked down.  Let us apply these findings to the hoarded environment.  If you apply water to a first floor fire, will there be enough airflow available to cool the upstairs?

Can you isolate a bedroom in hoarded conditions? Hoarder conditions can prevent an occupant or firefighter from closing interior doors.  As the clutter piles up to ceiling level and spills out into the hallways you may not be able to apply either of these two methods.  How does this affect an interior firefighter?  If you make entry into a fire and expect the ability to isolate yourself from the fire by closing an interior door you can be exposing yourself to higher heat levels.  Once a determination has been made that Heavy Contents are present all firefighters must estimate that interior doors will NOT close, due to the level of clutter.

Conclusion

All firefighters should take the time to review the latest release from NIST.  There works have been groundbreaking and this one is no different.  Take an hour out of your hectic schedule to watch and learn.  While you review this material, keep in mind that these rules may or may not apply to the hoarded environment.  Cluttered homes can add variables that will affect each one of their findings.  Blocked flow paths and doors that cannot be closed with complicate the use of these new findings.  While they can NOT be scientifically proven at this time we should all adjust for them if a hoarding condition has been discovered.

Watch the presentation from NIST, FDIC, and FDNY here.

 

Read more: http://london.ctvnews.ca/hoarding-a-serious-safety-issue-for-firefighters-1.1259271#ixzz2RwvFvrZv

 

 

 

Hoarding a serious safety issue for firefighters | CTV London News.

As first Responders we understand the dangers associated with responding to many types of emergencies.  From auto accidents on busy interstates to working house fires with potential hazardous materials we train on these types of events and how to protect ourselves from dangers associated with them. One danger that continues to be overlooked is the exposure risks found inside hoarder homes.  Often with the accumulation of massive amounts of belongings come the associated risks from exposure to many types of infectious disease and bio-hazards materials.  A first responders can be exposed to these dangers when walking into a situation to assist, such as a emergency medical run or assistance call.  Many of us have suspected that the houses we have been going into were dangerous, how dangerous may have been severly underestimated.  Let’s review some of the potential exposures first responders may face inside the hoarded environment.



Air Quality

Airborne contaminants inside a hoarding environment can present dangers not seen by the naked eye.  Often when entering these environments first responders do not take in account the unseen dangers.  From elevated ammonia levels to aerosolized mold anyone who enters these areas unprotected can be facing danger.  These elevated levels can be caused my animal urine, decomposing animals, fecal matter, and mold.

One common risk that can be managed with ventilation is the exposure to ammonia.  Ammonia is a irritant to the eyes and upper airway tract at or below the exposure threshold of 50-PPM (Parts Per Million). Without the proper application of ventilation the responder can be exposed to up to 150 PPM of ammonia.  This is 3 times more than the limit set by OSHA.   Ref.. (The Hoarding of animals Research Consortium) Without accurate gas meters the only detection device we will have in our sense of smell.  If you identify a heavy content environment and begin to smell high ammonia levels do not enter without aggressively ventilate the structure or use a SCBA to reduce the risks when high ammonia levels are present.

 Misc. Exposures

Without understanding the risks first responders are potentially risking their own personal health and safety when entering the hoarded environment.  Here is a list of potential exposures that have been documented inside a hoarded environment.

Human to Human

• Listeria


• Hepatitis A and B


• Scabies


• Pneumonia


• Shingle

Animal to Human

• Tapeworm


• Hanta Virus


• Psittacosis


• Cat Scratch Disease

How many of these diseases are communicable?  Without even knowing that we have been exposed we can take them home to our families, my worst fear.  If we don’t take the time to protect ourselves from exposures we could potentially place our families at risks.

PPE Discussions.

What types of PPE do you carry?  First responders only have a few choices available when selecting respiratory and splash protection.  At a MINIMUM we should be using our N-95 mask and turnout gear when entering a hoarded environment.  While a n-95 might not protect you from all contaminants it will offer some level of protection.  If the levels are extremely elevated a SCBA can be used to enter the environment.  Choosing to use a SCBA is the best option that we have available as first responders but does offer some challenges interacting with the occupant, if conscious.  We will have more info on that coming, but for this article just realizing that you should be wearing one will be enough.

Protecting yourself from contact with biohazards can be another challenge as the belongings will be stacked so  high touching them will be unavoidable.  Using gowns, coveralls, tyvex suits, or turnout gear can offer contact protection as you enter.  While none of these seem practical, except your turnout gear, they should be considered when entering this dangerous environment.  One key point is the potential for patient and/or responder decontamination.

 

 

Conclusion:
First responders worldwide have been dealing with hoarding conditions for years.  When was the last time you considered that the dangers inside can harm you and your family.  Taking the time to identify that hoarding is present, choosing the most appropriate levels of PPE, ventilating the area, and having decontamination available you will increase your safety and reduce the exposure to harmful materials.  Would you ever go into a fire unprotected?  Hoarding conditions can cause multiple problems for first responders and we have the potential to be “Most Exposed” during an assistance or EMS call.  Take the time to identify, adjust, and attack hoarding with the proper level of PPE.

Listen to this bone chilling audio of a firefighter mayday while battling a three alarm fire in Hoarded conditions.  Once the mayday was sounded the interior crews transmitted the announcement of Hoarder Fire .  Sending prayers out to the firefighter who was removed in critical conditions.

Links to News Coverage:

Firehouse

WBAL 

Station and units respond to XYZ Street for the structure fire with confirmed people trapped.  This could possibly be the most intense statement ever heard over your dispatch channel.  Immediately everyone goes into a rescue mode and everyone’s focus goes to locating the victim as saving lives,  our number one priority.

Searching and locating victims inside a house fire can be challenging process that will physically drain your firefighters in minutes.  Most firefighter chooses a type of search pattern to start with and can adjust when the search has encountered difficulty.  Hoarding conditions is a difficulty that will need adjusted for when a search is to be performed.  Compulsive hoarding disorder will cause a person to overload their homes with things that have no apparent value to you and I, what rooms do they start their collections in?

[caption id="attachment_324" align="alignright" width="120"] Hoarder Fire 4/2013


While not an absolute truth, many people that suffer from compulsive hoarding disorder begin their collections in attic spaces and basements.  Once full of belongings their collection will spill into the living spaces such as living rooms and bedrooms.  This compulsive collecting makes the living spaces that are usable become limit. How should you adjust you searching once the heavy content discovery has been made?  Let’s review some complications faced when searching for trapped victims.

 



Collapsed belongings

A recent news story of a compulsive hoarder that was reported missing for days just to be discovered days later drives home the need for an intense focus when searching.  Collapsing belongings can cover up victims and trap searching firefighters.   Compulsive hoarding disorder can attribute to a number of belongings being collected, from piles of newspapers to car parts a firefighter needs to anticipate finding various types of collections behind the doors of a hoarded home.   A few common types of belongings often collected are newspapers, DVD cases, and magazines will be stacked from floor a possible ceiling level.  Each of these stacks individually will not offer many challenges but put them all in the same small space and the chance for debris falling as a occupant tries to self extricated from the house can cover them, easily.

 

Where to start searching

Many hoarder conditions  have rooms filled to capacity and often the last to rooms to be filled are the bathroom and kitchen.  While this may seem like a useless finding, it may offer you a starting point of your search not usually thought of.  If a fire were to happen at 0200 in a residential neighborhood most firefighters would begin in the bedroom area.  In hoarded environments the bedroom may not be used for sleeping.  When sizing up a heavy content environment determining the locations and the levels of hoarding is important.  If the smoke conditions allow this the bedrooms should be assessed transmit findings to all firefighters on scene.

If the bedrooms assessment tends to show an unusable space your search will need to begin in the spaces that are usable   Starting a search in the kitchen or bathrooms may be where you will find an occupant.  This is especially true if the occupant is alerted to the fire and tries to escape.  It has been documented that firefighters have made successful rescues from these two areas. 

One problem with starting your search inside a kitchen or bathroom is the access to them.  Often these rooms can have limited access from the outside.  This means that you will have to battle your way through a area that could potentially be hoarded beyond use.  Using tactics from the exterior will offer the firefighters a barrier of safety but if you choose to go through the “goat paths” you will need to make an extra effort to stay oriented, increase crew size, and be prepared to deal with the collapsing piles of debris.

 

Final thoughts

If you are alerted to people trapped in a Hoarder Fire you should take notice that they may be covered by their own belongings.  Adjusting your search patterns, moving the piles, and sweeping under stacks of belongings are all successful tactics to use when searching in the hoarded environment.  All of these tasks should be conducted under the direction of an interior officer and assisted with the use of a Thermal Imagine Camera.  Sweeping the area with a TIC can help you see any abnormal stacks of stuff that could be hiding a victim.

In your next search drill add some different variables to it like stacks of belongings and obstacles to search under in case you are tasked with searching in a hoarded environment to make sure we all go home.

 

Here are some links to the New Jersey Case  http://www.northjersey.com/news/Sad_story_of_New_Milford_womans_death_puts_spotlight_on_disorder_of_hoarding.html

http://www.nydailynews.com/news/national/partly-mummified-woman-found-n-apt-article-1.1317931

One of the more common themes told by firefighters when asked about fires inside hoarded environments is “we won’t go in” or “can we go inside”.  The answer to this question is complicated and cannot be answered with a yes or a no.  Many different variables come into play when making the decision to enter a burning building that is filled with belongings.  From the size of the fire to the potential of victims being trapped, there is a large amount of decisions needing made in a small amount of time.  Let’s look at some examples of the decision making process to determine if we can really go inside a hoarded environment.

[caption id="attachment_324" align="alignright" width="120"] Hoarder Fire 4/2013


Pre-Planned Structures

One of the biggest keys to a successful fireground is being prepared before the bell rings.  Being aware and informed that a building has a large amount of belongings before it catches fire will allow you start the size up days in advance. If you find a building that is beyond capacity a “no entry” tag can be assigned and firefighters will not be allowed in.  Making the decision can be taxing on our personnel if a report of persons trapped is transmitted.  For the other levels of Heavy Content a number value can be assigned to allow an estimate of conditions.  The Institute for Challenging Disorganization uses a rating scale from one to five.  A level one would be clutter just outside the limits of “normal” while a level five would be packed from floor to ceiling. (http://www.challengingdisorganization.org/)



If you have these buildings pre-planned to their levels an incident commander can take this into consideration before committing firefighters to the interior.  Making this assessment can be made during or after an ems run, during a fire alarm instillation, or a drive by the location.  Gaining access to private homes will prove to be the biggest challenge.  Multi-Family dwellings make it easier with the allowing of once a year inspections and property owners access.  Adding hoarding homes to your pre fire process will offer a level of awareness and share it to everyone on the fireground.

 

Points of Entry

The next point of emphasis in making the determination to send firefighters inside is the blocked doors and windows.  Having a secondary means of egress should be a point of importance when sending firefighters inside.  If things were to go bad, can they get out?  If they cannot you should make it so they can.  Opening the structure up can intensify the fire but will also offer a level of increased safety if an escape is needed.  Beginning the Pre-Overhaul Process is a great way of making an escape route.  Removing windows, blocked doors, and sill removals should be used on all exterior windows. (caution, venting behind hose crews should not be allowed as the fire can be drawn back onto them!)

Compulsive hoarding disorder can absolutely take over a house.  From cluttered  living rooms to blocked doors often in these conditions  primary entrances and exits are blocked.  This means that taking a 1 ¾-inch handline and stretching it to the front door will not allow access to the house.  Being creative and attentive to the size up clues and ques will allow a hose team to make the correct choice of points of entry.

 

Conclusion

Can we go inside a Heavy Content fire and put it out?  Without talking in circles too much I will leave that up to you.  Use the points in this blog for some reference in reviewing with your crew.  Firefigthers have been crawling into these conditions for many years, many with successful outcomes.  If we use our heads and use the size ups, prepare secondary means of exit, and closely monitor conditions from the exterior and interior it will allow the incident commander to make the call.  Just remember that many rescues are made within six feet of an exit.  Stay safe and remember to be Heavy Content ready!

News story from a "Colliers Mansion" type conditions in northern New York State.  Prayers to the families and the first reponders.  Here is a Link for more on this tragic fire.