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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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Updated NWCG Standards for Wildland Fire Resource Typing, PMS 200 Now Includes Off-Highway Vehicle Typing Standards

Date: May 13, 2025
Questions?  Please contact:
Mobile Fire Equipment Subcommittee 

The NWCG Standards for Wildland Fire Resource Typing, PMS 200 has been updated to include newly developed Off-Highway Vehicle (OHV) typing standards. These standards organize OHV information into logical categories and outline key safety requirements for occupants.

NWCG Standards for Wildland Fire Resource Typing, PMS 200 establishes minimum typing standards for aircraft, crews, and equipment used in national mobilization to wildland fire incidents. Typing designations are assigned based on measurable capability and performance criteria.

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NWCG Standards for Wildland Fire Resource Typing, PMS 200

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Date: May 12, 2025
Questions?  Please contact:
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S-204, Interpersonal and Critical Thinking Skills for Safety Officers focuses on facilitating hazard mitigation conversations and building trust to influence safety-related decisions. Individuals can self-enroll through the Wildland Fire Learning Portal (WFLP).

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1.

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S-204, Interpersonal and Critical Thinking Skills for Safety Officers 

NWCG Safety Officer, Field (SOFF) Position Page

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Date: May 7, 2025
Questions?  Please contact:
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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

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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). 

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Air Operations Summary (ICS 220 WF)

National Interagency Aviation Committee

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