Fire Panic

I have worked several years in East Africa. Most buildings there have iron bars covering windows to prevent thieves. When I first arrived in Tanzania, I felt like I was in prison when inside buildings. That was intensified when the first night my family was in Dar es Salaam, the lock to our bedroom jammed while we were inside. I had a hacksaw blade in my bags that got us out, but it took 15 – 30 minutes.

When I was working at Kibosho Girls Secondary School in Moshi, Tanzania 1994-95 there was a terrible fire at another school in the area and many (40-200?) girls died, locked in their dormitory. In the excited state this news caused, one night at our school a rumor got going that lead to some people being slightly injured in a panic to go out of their dorms.

I prepared the presentation below. We also followed up with role playing, particularly about the situation where a crowd tries to leave a building through an inward swinging door.

Emergency Behavior

What can we learn from Sunday night?

”We have nothing to fear but fear itself” Winston Churchill

Panic = extreme fear that prevents proper thinking

Though there was no fire, hundreds of pupils rushed out in the darkness and risked hurting themselves.

Panicked crowd

Many people in panic is very dangerous, even if there is no other danger. Many people have died or been hurt unnecessarily because of panic. They have been trampled under people’s feet or crushed against walls, fences or other hard things. Try to avoid being in or forming a tightly packed crowd. This usually only makes things more difficult and dangerous. If you do get caught in a crowd, try to keep some space in front of you by holding your arms out some in front of your stomach. You may be able to protect a child in this space also. Try to lift both feet often to prevent people standing on them and trampling you down. Try to be like a ball floating on stormy water. Try to calm people down, make them quiet, give them hope, give them something to laugh about. If the mass of people starts moving, try to avoid coming next to a wall or other non-movable object.

Darkness

If it is dark also the danger increases. What can I do in the dark? If you don’t know for sure there is an acute danger, it could be safest to just stay where you are. If you don’t stay where you are, but you have a torch (or anything that produces light, such as clock with light on dial), it can help you find your way. Use it sparingly (as little as possible) so you know there will be some left when you need it. If you have no light, feel your way, following the wall or things along the wall. If there could be bare electric wires, feel with the back of your hand or a knuckle of your fist (closed hand). (An open hand can grip an electric wire with an involuntary cramp so you can’t let go). Move calmly with small steps. Hurrying is dangerous!

Noise

If you are quiet, your hearing can help you ”see” because of the sound which bounces back from things. If the people make a lot of noise, it can increase the fear and prevent people from getting necessary information.

For example if everyone tries to get out of the dormitory at once and they are all pushing toward the door. If the door opens inward (as they do at present), no one will be able to open the door. If there is a lot of noise, the people at the back will not hear people in front tell them to back up.

Fire

Should a fire happen what should you do? The best thing is to put it out quickly it you can do that without danger. A fire needs 3 things: fuel, oxygen and heat. If you take away any one of these three there will be no fire.

How can I take away the fuel? If there is a leak of gas or kerosene, maybe I can turn it off. If a chair or dust bin is burning, maybe I can throw it outside of the building. If I can’t get it out (for example a bed), maybe I can move other burnable things farther away.

How can I keep oxygen away from the fire? Put water, sand, a heavy cloth over it. A cloth must be applied quickly, other wise it will just be more fuel. Use a fire extinguisher which sprays carbon dioxide, foam, other chemicals over the fire. Remember that you must hit the base of the fire, not the upper flames. Shut doors and windows. Water should NOT be used in these cases:

  • A fire in oil should not be hit with water. It can be like an explosion as the water becomes steam in the hot oil. Cover it! If it is in a pot, put on the lid or a metal plate.
  • If there is electricity, the electricity can follow the water back to the person throwing the water.

If a persons clothing is burning, it will burn most and spread fastest if he is standing up and the flames go around the face. If your clothing starts burning, roll around on the ground, if you don’t have water. Roll up in a blanket or other heavy cloth, with your head out. If another person’s clothes burn, help them in the same way.

One way of taking heat away from a fire is to beat it with a coat, branch, rug.
If you are in a building and there is (maybe) a fire going on, don’t open doors quickly. See first if the handle is hot. If the door opens toward you, put your foot against it as you open it a little bit. Don’t have your face near the opening, as flames might shoot out through the opening.

If you are in or must go through a room with smoke in it, keep your face close to the floor! Smokey air is very dangerous. Hot gases with smoke go up, so the cleanest air is near the floor. Besides being safer to breathe, you can see better. 3 inches from the floor you can sometimes see 10 meters across the room, while 1 foot up, you can’t see your finger 4 inches away.

Prepare

Whenever you get to a new place, it is good to look around. Find what different ways you can get out, where things to put out fires are, where lifebelts are on a boat, so you don’t waste time in an emergency. Tell the people in charge if something is missing, faulty or seems dangerous.

Look around your dormitory to see where there are electric outlets, lamps and other wiring. Especially, find where you can turn off the electricity. This can be good to know if the electricity itself is making a fire or giving a person a chock. It can also be good if you are going to put out a fire with water and don’t want to risk getting electrocuted (killed by electricity). Notice which ways doors open! Doors should go outwards in public buildings, but they don’t always. Do extra emergency doors work? Where are the keys?

If I must jump down, where would be a good spot? What should I avoid? What could I do to make it safer? Throw down mattresses to jump onto, tie together sheets to make a rope. Hang as low as possible before letting go. Have knees slightly bent as I land. REMEMBER Jumping is dangerous! Don’t jump until absolutely necessary.

If I have to leave the dormitory, where should we assemble? If this is not decided and followed it will be difficult to know if someone is inside or has just gone somewhere else. This can endanger other people that try to ”save” the missing person who is no longer inside.

Postscript

I think the contents are OK, The only addition I’d like to make when I look at it now (2009) is about a detail in smothering a fire in a person’s clothing. At my job in Sweden, CFL 2008, we had some exercises about this. It is important that a person doesn’t have fire around their head. Inhaling then can do big damage. It is important for the person to lie down on the ground. If someone tries to smother a fire in someones clothes by putting on a blanket, rug or coat it can feel more natural to start from the feet and cover upwards, but this drives the flames up towards the head!  So don’t do that! Start from just below the head and cover down towards the feet. This drives the flames away from the head.

Though I am interested and have tried to collect what I think is good advise, I am not an officially certified rescue trainer. Because this page is about life and death questions, I really hope you will point out anything that  might be wrong or that should be added. 

PPS

2019  I have now been a member in training at Svenska Sjörädningssälskapet, SSRS, (Swedish sea rescue organisation).  It is quite interesting. It includes some fire fighting, as well as first aid, boat handling, search and rescue at sea.  

Antidepressiva läkemedel ökar självmord?

Om ni kollat i mina sidor så kan ni märka att jag väljer i första hand näring, motion, avstressning och förbättrade sociala kontakter framför mediciner och operationer i de flesta fall.

Antidepressiva mediciner har även självmord och våldsamhet som deklarerade biverkningar i FASS och bipackssedel.  De flesta skolskjutningar har begåtts av personer som använde de. (Det bevisar inte att de mediciner orsakat dessa katsstrofer, men bevisar att man inte kan räkna med att de förhindrar de.)

Läste nyss en artikel  Recent-study-confirms-that-antidepressants-increase-suicide-risk  som byggde på en svensk studie.

Borde man skriva ut antidepressiva om självmord befaras?

Trots min allmänna tveksamhet mot syntetiska mediciner, så kan även jag undra ”om någon funderar på självmord, kanske det vore idé att ge den antidepressiva åtminstone tillfälligt”.

Därför ville jag förstå artikel så bra som möjligt. Det fanns några grafer som inte var självklara att tolka. Även om författaren uppenbart upplevde att studien hon åberopade pekade på ”inte ge antidepressiva” så kunde jag inte utesluta att högre andel ”lyckade” självmord med antidepressiva i kroppen bara var en ”naturlig” följd av mera självmord, snarare än orsak.

Ursprungsstudien

Antidepressants and suicide among young women in Sweden 1999-2013.

CONCLUSION:

An increasingly larger proportion of young women (15-24 year old) who later committed suicide, had in the last few years been treated with antidepressants, prior to and at the time of the suicide. The previous assumptions that treatment with antidepressants would lead to a drastic reduction in suicide rates, are incorrect for the population of young women. On the contrary, it was found that an increasing tendency of completed suicides follow the increased prescription of antidepressants.

Prescription of antidepressants to women (15–24) in Sweden in the years 1999–2013, counted in DDD/TIND.

Y-axeln anger DDD/TIND. Jag fick kolla vad det betydde. ”Antalet dygnsdoser av det aktuella läkemedlet som genomsnittligt sett kan sägas konsumeras av en given del av befolkningen, i detta fall 1000 invånare, i det aktuella området.
DDD står för defined daily doses.” och det på svenska ”förmodad genomsnittlig dygnsdos då läkemedel används av en vuxen vid läkemedlets huvudindikation”

Så 1999 så var det 14 dygnsdoser per 1000 kvinnor mellan 15-24 år och jag antar att det är per dygn- i så fall 14 av 1000 i gruppen tog medicinen varje dag.  2013 hade det ökat till 52 av 1000 tog det varje dag. Man skulle hoppas att den nästan 4-faldigt ökade förskrivning av antidepressiva hade lett till en minskning av självmord.  Eller i vilket fall att om något annat (deprimerande media bild av världens tillstånd t ex) ledde till ökade självmordsfrekvens så borde andelen av de som hade antidepressiva i blodet då de dog bli mindre om antidepressiva minskade risken.

Findings of antidepressants in toxicological analyses of suicides by women (15–24) in Sweden in the years 1999–2013, calculated as a percentage of the cases investigated, which were on average 93% of all confirmed suicides.

Diagrammet visar hur stor andel av kvinnor (15–24år) som hade antidepressiva i kroppen då de begick självmord. (I medeltal så undersöktes det i 93% av alla självmord.)   Under 1999 till 2013 gick självmords frekvensen från 7,7 till 8,9 per 100.000 (variation 4,8-9,9 under perioden)

självmord

Självmord (säkra och osäkra) per 100 000 kvinnor för olika åldersgrupper i Sverige

SÅ under den perioden så var det någorlunda konstant självmordsfrekvens i gruppen samtidigt som antidepressiva ökade nästan 4 gånger och under perioden så ökade andelen som hade antidepressiva när de dog drygt 3 faldigt. Skall man vara snäll i bedömning av medicinen så skulle man kunna säga att hade det varit helt utan positiv verkan hade andelen som hade antidepressiva när de dog också ökat 4 faldigt. Skall man vara sträng mot medicinen skulle man kunna säga att trots en 4 faldig ökning av medicinen var självmordsfrekvens för gruppen ganska konstant.

Självmordsförsök

självmordsförsök

Denna diagram, självmordsförsök kvinnor i Sverige, gör att man undrar vad som var på gång 1997 till 2007 och vad som hände då för de unga kvinnorna.

1997 till 2007 är det en brant ökning av försöken samtidigt som antidepressiva också ökar mycket.  Mer det minska betydligt efter 2007 samtidigt som antidepressiva fortsätter öka.  Så något enkelt samband hoppar inte fram här. En (av många möjlig tolkningar) antidepressiva ökade tendensen att försöka begå självmord men man var för oskarp för att ”lyckas” och sedan efter 2007 så blev man så apatisk så man inte ens försökte. Men tolkningen säger kanske mer om min världsbild än om hur det är.

Till vidare slutsats

Jag kan inte helt utesluta att kanske antidepressiva skulle kunna ge en mycket liten minskning av risken att man skall ”lyckas” begå självmord då tolkning av statistik i efterhand har låg bevisvärde.

Men en 4 faldig ökning av antidepressiva medicin förskrivning har inte gett någon minskning av självmorden, så man skall satsa på andra åtgärder i första hand.