This has been a milestone year already for EMS and Fire professionals in Taney County.  Not only have several departments shared a memorandum of understanding to create the Taney County EMS System, but we have also brought on a new county medical director, and released the 2013 Protocols.

 

As we wade through piles of construction materials and dust here at TCAD, I have been forced to take a step back from traditional classroom training.  To a guy who has always preferred in-person education, that is quite a step.  My venture into the computer-based learning world has definitely been a forced one, and now with construction occupying our classrooms, it has taken on new momentum in my day-to-day activities.

 

One thing I am grateful for in that move is the push it has given me to create short computer-based training sessions on the "easy stuff".  The stuff that we just don't really train over much, not because it isn't needed, but that there are so many other pressing issues.  ("I'm not going to worry about that little laceration if my patient is in cardiac arrest")  Not that anyone's training world is in cardiac arrest, mind you, but you get the idea.  Treat the big stuff first.

 

With things now geared back and computer based training our only option for the next month, it has allowed me to create small training blurbs on things such as the suction units, oxygen bottles, handheld radios and extrication tools.  None of these things are extremely complex, yet their correct or incorrect use can make a huge difference on the scene.

 

The Fire and EMS world is rife with the "Back to basics" mantra.  It has benefited me to take that approach and not forget about the big stuff, but to simply push it aside for a short time to focus on the little things that make the scene run a little cleaner, a little smoother, and sometimes can make a big difference. 

There is something to be said for specificity of training when planning strength and conditioning workouts for a firefighter. That being said, we have all seen the concept of specificity being taken to the extreme and creating an unsafe environment for the tactical athlete. I think we can all agree that heavy Olympic lifts done in full firefighting gear may not be the best choice to reduce the risk of injury. 

  

Occasionally, there are some benefits to stimulating aspects of the training environment to make workouts more effective. Previous research has indicted that wearing a self-contained breathing apparatus (SCBA) decreases performance, and increases heart rate, blood pressure, and oxygen consumption by one third compared to walking on a treadmill in duty uniforms only. 

  

One direct application of this concept is the use of a mouthguard for a firefighter's conditioning workout. The use of mouthguards has been thoroughly studied, are considered fairly safe for athletes of various fitness levels, and are currently used and accepted in a variety of sports. Does a mouthguard exactly replicate the feeling of using a self-contained breathing apparatus (SCBA)? If you have ever tried both devices (SCBA and mouthguard), the answer is absolutely not. 

  

Regardless of the difference between a SCBA and a mouthguard, a few facts remain consistent. While wearing a SCBA, breathing must be more controlled as there is a limited amount of air available. The relative fitness, and especially the level of exertion of the wearer, often results in variations of the actual usable time that the SCBA can provide air, often reducing the working time by 25% to 50%. 

  

Once your firefighters have established a base level of fitness, wearing a customized mouthguard during a conditioning workout can produce several benefits. Tactical athletes will have to pay more attention to their breathing patterns when working out, hopefully resulting in increased awareness and control of their respiratory rate. Recent research has suggested that wearing an individualized mouthguard on the lower jaw when exercising can decrease serum cortisol levels post workout. Decreased serum cortisol indicates less stress following strenuous activity, which can lead to a faster recovery after intense muscle exertion.

  

So what is the theory behind a mouthguard causing these favorable changes post workout? Mouthguards change the alignment of the lower jaw, possibly increasing cerebral blood flow to the hypothalamus. The hypothalamus is an area of the brain that controls the stress response. Enhanced blood flow to the hypothalamus can reduce the amount of cortisol that is released. 

  

References

• Dudgeon, W., Buchanan, L., Strickland, A., Garner, P. Mouthpiece Use Reduces Post Exercise Serum Cortisol Levels. Federation of American Societies for Experimental Biology. April 25, 2012. 
• Testing Physical Fitness; Davis and Santa Maria, Fire Command, April 1975.