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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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EMC Memo 25-001: Interim Rapid Extraction Module (REMS) Training and Qualification Requirements

Date: June 3, 2025
Questions?  Please contact:
Emergency Medical Committee

The Emergency Medical Committee has issued interim guidance for Rapid Extraction Module Support (REMS) teams. Until further notice, Type I and II REMS teams must designate a team leader qualified at Firefighter Type 1 Squad Boss (FFT1) or higher. This temporary change replaces the Single Resource Boss (SRB) requirement, which is currently not feasible due to administrative barriers.

This memorandum does not include any other changes to the NWCG Standards for Rapid Extraction Module Support, PMS 552. This interim change takes effect immediately and will remain in place until further notice.

References:

EMC Memo 25-001: Interim Rapid Extraction Module (REMS) Training and Qualification Requirements

NWCG Standards for Rapid Extraction Module Support, PMS 552

Equipment Bulletin 25-002: Chaps, Chain Saw, M-2020, Nonconformities Affecting Use, Appearance, and Serviceability

Date: June 2, 2025
Questions?  Please contact:
Equipment Technology Committee

The Equipment Technology Committee issued Equipment Bulletin: 25-002 to address a manufacturing nonconformity affecting Forest Service specification, 6170-4K Chain Saw Chaps. The issue applies to chaps manufactured in 2024 and 2025 and distributed through FedMall. These chaps may have incorrectly bound edges that expose inner protective layers.

Independent purchasers should inspect all chain saw chaps received from FedMall beginning in 2024, prior to use. Review the full Equipment Bulletin: 25-002 for inspection criteria and recommended actions.

References:

NWCG Alerts

ETC Equipment Bulletin: 25-002

2024 Wildland Fire Emergency Medical Service Awards

Date: May 22, 2025
Questions?  Please contact:
Emergency Medical Committee

The NWCG Emergency Medical Committee (EMC) is proud to announce the recipients of the 2024 Wildland Fire Emergency Medical Service Awards. Each year, EMC recognizes individuals and groups who have demonstrated exceptional actions or accomplishments that go above and beyond their normal mission or job duties.

Congratulations to all the awardees and nominees. Through leadership and initiative, they have made significant contributions to the safety and well-being of the wildland fire community. These honors are well deserved.

References:

2024 Wildland Fire EMS Awards

NWCG Emergency Medical Committee

NWCG Welcomes the Incident Management Teams Association as an Associate Member

Date: May 21, 2025
Questions?  Please contact:
https://www.nwcg.gov/contact-us

The NWCG Executive Board is honored to announce that the Incident Management Teams Association (IMTA) has joined the National Wildfire Coordinating Group as an associate member.

IMTA is a dedicated group of incident management professionals committed to enhancing the profession by promoting standards and fostering collaboration across federal, state, local, Tribal, and private sector partners throughout all phases of incident management.

“Joining NWCG aligns with our mission to elevate incident management professionals nationwide,” said Dr. Randal Collins, President of IMTA. “This is a proud moment for all of us committed to advancing public safety.”

References:

Incident Management Teams Association

National Wildfire Coordinating Group