Health and wellness
Written by David Gillis and Ruth Lamb
Firefighter David Gillis never knows when a response to a call will trigger the symptoms of post-traumatic stress disorder (PTSD). But through a program called Strategic Resilience for First Responders, Gillis is able to manage the mental and physical reactions that used to stop him in his tracks.
Written by David Moseley
The neigbouring fire department calls you about a multi-casualty collision to which it responded. Among the dead are well-known community members, some related to responders.
Written by Laura King
Editor Laura King interviewed Ontario Labour Minister Kevin Flynn in April, a year after the Supporting First Responders Act made PTSD a presumptive illness, and in the lead up to PTSD Awareness Month in June.
Written by Keith Stecko
Making a conscious effort to build your personal resilience is one of the most important things you can do for yourself as a firefighter. Being a firefighter is physically and emotionally demanding. Having a tailored personal resilience program can produce positive results and help to maintain work-life balance.
Written by Wayne Jasper
Mental-health programs teach us that the effects of trauma can be cumulative. As a chief officer, do you know how much exposure your crews have had to traumatic incidents such as fatalities or calls involving children?
Written by David Moseley
Not all critical incident stress management (CISM) programs are equal. Having had the privilege to work on four CISM teams, it is clear that certain practices and protocols enhance the program for both facilitators and participants. If your department is looking to adopt a CISM program, here are some considerations.
Written by David Moseley
Dead children, severe mutilation, homicide, known victims, aircraft crashes, injured and dead firefighters: sadly, I don’t think my experiences of fire fighting are unusual. Who could deny this takes an emotional toll on us? Who would argue that as an organization, a profession, we don’t have an obligation to address the emotional cost?
Written by Mike Vilneff
Life is too short; we have all heard this cliché many times, but it seems that the older you get the more you hear and use it. So, if life is too short, what are you doing to make the most of it?
Written by Rob Grimwood
For many years, firefighters took pride in the soot that covered their bunker gear, helmets and gloves; it was a sign that they had been to a good job, and evidence that they had been on the front lines of fire attack. As fire prevention efforts paid off and the number of structure fires decreased, fewer firefighters engaged in fire attack; when they did, they were sure to leave all the evidence in place.
Written by Maria Church

June 2016 - Fire Chief Colin Shewell and Deputy Chief Roree Payment are the only full-time members of Clearview Fire and Emergency Services in Ontario. The department heads were naturally nervous when they decided to introduce a mandatory annual physical-abilities test for all paid-on-call firefighters.

Written by Gord Schreiner
Much has been written about cancer and its relationship to the fire service. The bottom line is that if you are a firefighter you have a higher chance of getting cancer than a non-firefighter. Rather than argue about how many times more likely we are to get cancer, I would rather discuss some ways chief officers and firefighters can help reduce these odds.
Written by Mike Vilneff
Hernia: the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it.
Written by Elias Markou
Electrolyte deficiencies and dehydration are the most common preventable occupational hazards faced by firefighters. Firefighters, similar to high-level athletes, lose water rapidly during physical exertion. Water is the carrier of electrolytes, so dehydration leads to electrolyte depletion. Almost all firefighters have experienced an intense fire with searing, radiant heat, hours of physical activity in heavy bunker gear and quick changes in core body temperatures. The body depends on sweat to cool itself, so an extreme fire situation can quickly empty its water reserve.

There are a number of risk factors that affect depletion of water and minerals in a firefighter. Firefighters, wearing layers of non-breathable clothing to protect themselves, often deal with high temperatures inside a structure or outside on a hot summer day. Extreme sweating in these conditions depletes the body of all its water and good minerals.

Research conducted by the University of Cumbria in England, in collaboration with Cumbria Fire and Rescue Service, highlights how vital proper hydration is to a firefighter’s performance. The study identified that a high percentage of firefighters arrived to a training exercise or a real fire incident already significantly or severely dehydrated.

Electrolytes are minerals that are essential for the body to function. When water with electrolytes is consumed, the minerals are dissolved in the water and they enter the blood system. These minerals have ionic electrical charges that drive the function of every cell in the body. So imagine the importance minerals such as potassium, sodium, calcium and magnesium play in holding water in the body, making your cardiovascular system function and allowing energy production in muscle, brain and vital organs. Water and electrolytes are critical for peak performance, but are by far the most important health issue often overlooked. Dehydration, in extreme cases, can cause death.

 Potassium is probably the most important mineral in the body. Potassium helps maintain electrical activity in the brain and the heart. Potassium deficiency, for firefighters in extreme occupational situations, can be life threatening.  

The second most important and the second most abundant mineral in the body is phosphorus. Phosphorus is used for protein, fat and carbohydrate synthesis in the body; these key nutrients are integrated into DNA and cellular membranes. For firefighters, this mineral is mostly used in recovery after intense firefighting activity.

Sodium is known to regulate the level of water in the body. The more water you drink, the more sodium will be removed from your body via the kidneys. Sodium is used in transmitting important but subtle information from cell to cell in the body. Finding a good balance between sodium and water intake is critical.

Magnesium is responsible for more than 400 biochemical interactions in the body; about half the magnesium is found in critical organs such as the heart, nerves, muscles and the immune system. When firefighters experience muscle cramping during or after an intense fire, they should reach for large dosages of magnesium to reverse the effects. Depleted magnesium stores in the body prevent the muscles from physiologically performing. If a muscle does not slide properly, sudden movements can damage the tissue. A muscle pull is the most common fire-scene injury for firefighters.

There are many signs associated with electrolyte and water deficiency and imbalance. In the rush of life and especially fire fighting, we often overlook the simple act of rehydration. Examples of symptoms associated with water and electrolyte deficiencies include muscle spasms, restlessness, insomnia, dizziness, headaches, fever, heart activity, heart palpitations and blood pressure issues. If ignored and not treated, these symptoms become chronic and sometimes life threatening.

Finding electrolytes and water in whole, complete foods is a great way to increase minerals in the body. Vegetables are an excellent source of electrolytes, especially when combined in a soup. Consider adding kale, artichoke, spinach, parsley and Swiss chard into your diet. Another way to boost mineral intake is to use salts that contain more minerals, such as Himalayan, Celtic or sea salt. Fruits can also be a great source of minerals and water, including bananas, coconuts and avocados.

As a firefighter, make sure you are properly hydrated and balanced with electrolytes to maintain an optimum performing body.

Elias Markou is in private practice in Mississauga, Ont., and is the chief medical officer for the Halton Hills Fire Department. Markou was a volunteer firefighter for six years and is now a firefighter health expert and blogger who is regularly featured on television and radio and in print. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Written by Laura King
May 2016 - There’s one in every station – the ticking-time-bomb firefighter whose demeanour slips Jekyll-and-Hyde-like between everyone’s best friend and look-at-him-sideways and he’ll snap.
Written by Maria Church
May 2016 - Last summer, Luanne Donahoe was worried about her son, Josh. The 17-year-old’s father, a firefighter, died in the line of duty when Josh was nine, and he has had a rough time dealing with his absence.
Written by Maria Church, Ruth Lamb and David Gillis
March 2016 - A college in British Columbia has developed a program to help first responders learn to be more resilient.
Written by Elias Markou
In the past few months I have conducted many firefighter physical exams for a number of fire departments. As I was going through the medical assessments, I observed an interesting trend: a significant number of firefighters still smoke.
Written by Bernie Van Tighem
There is a sort of cliché that Americans and many Canadians say to returning military: “Thank you for your service.” Some soldiers appreciate it; many hate it because they figure that it’s easy to say but doesn’t begin to reflect an understanding of what they’ve been through.
Written by Matthew Johnston
September 2015 - Have you ever found yourself at a social event and sparked up a conversation with a random person that went something like this:

Random person: “So what do you do for work?”

You: “I am a firefighter.”

Random person: “I could never do that . . . to see what you must see.”

You probably brushed this comment aside and moved along with your evening. But this conversation is an important reminder that in order to deal with the duties of professional fire fighting, at some point in your life, your mind was forced to alter the way you interpret a traumatic experience. As with the formation of a callous on your hand, your mind had to blister first in order to thicken and harden.

This psychological process meant that you had to let the analytical aspect of your mind – getting the job done – suppress nearly all of your natural emotional responses. This shift, through training and experience, changed the way your brain organizes information to the point that what was once considered traumatic became a normal part of your daily reality.

Recent events have made it clear that witnessing trauma can affect firefighters to the point that they become victims of their own professions. In the summer of 2014, Global News reported that 13 Canadian first responders had committed suicide over the spring of that year. In the 10 weeks that followed, the number rose to 23, and by publication, according to the organization Tema Contour, the number was at least 29. (The actual number of first responder suicides is likely significantly higher than media reports suggest as many suicide completions are often masked by lethal methods that appear accidental.) The spike in numbers indicates a firm systemic mental-health crisis is now gripping first responders across Canada. Media articles often point to post-traumatic stress and other mental illness as the root causes of first responder suicides, which paints a bleak picture for the struggling individual who may be apprehensive to reach out for mental-health support.

Adding to the stigma, the suicide of a colleague often leaves many co-workers in shaken, introspective states, filled with questions and uncertainties of how effective they are at assessing their own personal mental health and wellbeing. For these reasons, first responders, employers and mental-health professionals across Canada have the common interest of finding new ways to assist first responders in recovering from the trauma they regularly experience.

Current challenges
Global News reported last year that some of the Toronto police officers who had taken their own lives were getting various forms of psychological services and supports. First responders that may be struggling with symptoms consistent with post-traumatic stress disorder (PTSD), often have the daunting task of undoing many years of trauma in the face of time-limited therapy.

Well-intentioned therapists commonly implement a variety of short-term, solution-focused interventions in the hope of temporarily alleviating the layered effects of longstanding trauma. These deeply seeded traumatic memories continue to resonate within the individual’s being well beyond the clinician’s office, and are often camouflaged by more recognizable and, oddly, more acceptable personal crises, such as divorce, interpersonal conflict and substance use. This therapeutic complexity makes traditional employee-assistance programs (EAPs) inadequate in addressing the often multiple, traumatic work-related events that underlie many of the personal crises faced by struggling first responders.

There is a unique subculture in a paramilitary workplace that extends into the lived emotional reality of first responders. Police, firefighters, paramedics and prison staff work under a command structure in which personal decision-making is restricted by industry protocols and department guidelines. This paradigm of training creates dependable, logic-based behaviour that dominates personal thoughts and actions in the face of extremely stressful situations. These protocols serve to reassure first responders that they did everything they could during a potentially traumatic situation. However, many first responders struggle the most when they physically leave work, yet remain emotionally handcuffed to the memory of a troubling call. In order to understand the power of a traumatic memory, first responders may benefit from exploring how their workplace duties and subcultures impact their everyday functioning.

Building a wall
Our limbic system consists of brain structures that largely govern emotions, behaviours and long-term memory. During a potentially traumatic encounter, first responders are trained to remain calm so that emotional and behavioural patterns follow predictable paths, reflecting industry best practices. This consistency requires first responders to place personal feelings, beliefs and sensations on hold as the analytical mind overrides the emotional challenges of the circumstances.

In order to achieve a calm state, the limbic system is suppressed to cope with the demands of a situation that would either paralyze or cause most humans to flee the given situation. The traditional fight, flight or freeze reaction to stress and anxiety – responses that have been integral to human evolution – are simply not behavioural options for first responders attending emergency situations.

Over time, first responders attending calls of a traumatic nature, typically develop a strong dissociative barrier between risk and action. This allows first responders to run into a burning building, confront a robbery suspect or quell the bleeding of a young child. In these moments, the needs of civilians supersede the physical and emotional harm that first responders may experience. While such actions may be well-suited for risk-taking personality types, it also shows the power that a well-trained analytical mind can have in overriding the natural emotional and behavioural reactions to a dangerous situation.

Without a variety of techniques to release the effects of witnessed traumas, the analytical minds of first responders can build up like dams and create barriers that interrupt natural flows and ranges of emotions. A restricted emotional energy leaves a struggling first responder to experience a fast-flowing, albeit limited range of thoughts and feelings. These buoyant thoughts and feelings have a tendency to fuel a hyper-aroused state of mind that can produce raw, unprocessed emotional reactions. As unresolved trauma continues to build, the integrity of an emotional and cognitive dam is often breached, which releases uncontrollable images that prevent healthy recovery from taking place. A lost sense of internal control can ultimately progress towards the debilitating state of mind known as PTSD.

If a struggling first responder chooses to ignore certain signs and symptoms, traumatic imagery has the power to dominate attention and is intensified by the thoughts and feelings that accompany emotional pain. This type of imagery can become so powerful that the mind misinterprets or ignores important social cues to the point that it can drive friends, co-workers and loved ones away without any awareness on behalf of the struggling individual.

A closed loop of traumatic thinking and feeling fuels a hyper-aroused state that leads a first responder to having difficulty unwinding from work and experiencing sleep disturbances that exacerbate anxiety-based symptoms. Therefore, it is important for first responders to identify activities that cultivate a peaceful state of mind and quell restlessness. It is only during these moments that traumatic material will have adequate time to aerate, leading to effective stress recovery.

You should seek the help of a professional mental health clinician when you have:
  • Difficulty sleeping including frequent nightmares and night terrors
  • Unwanted thoughts and feelings that affect concentration
  • Flashbacks and powerful, troubling imagery
Chronic fatigue and loss of interest in usually enjoyable activities
  • Irritability towards others including co-workers, strangers and loved ones
  • Addictions including alcohol, drugs and body enhancement supplements
  • Self-isolating behaviours, including a lack of interest in social connectedness
  • Frequent feelings of hopelessness, shame and/or guilt
  • Compulsion to work excessively at the expense of important relationships
Invest in your mental health
One of the advantages that some first responders have is the opportunity to achieve adequate work-life balance. Shift-work rotations combined with holidays throughout the year enable members to have sufficient time off to engage in healthy self-care activities. These opportunities allow firefighters to experience both physical and emotional recovery from work-related duties – but only if the first responder is open to actively engaging in healing practices. While hobbies and interests should not be viewed as an alternative to accessing mental-health services, engaging in regular, healthy activities can lead to many of the same outcomes as effective talk therapy.

Tip: The more resistance you have to engaging in a healthy activity, the more you should push yourself to do it. Limbic memory steals a lot of healthy energy and taking an active approach to quell its powerful impact is one of the few ways to accelerate recovery from work-related stress.

During difficult times, first responders, as with all humans, have a tendency to turn away from many of the activities that can bring them greater work-life balances. Immersing in healthy activities fosters a state of mindfulness – where the first responder’s full attention is in the present without conscious awareness or judgement. This state of mind is a universal stress-recovery practice that reduces the dissociative barrier between the analytical and emotional mind.

During mindfulness-based activities, emotional pain is allowed to aerate spontaneously and naturally. We simply feel better after spending time in nature, finishing a hobby-based project or helping others. Keeping up with a variety of mindfulness-based activities is especially important for first responders who are resistant to accessing professional mental-health services.

Common activities that cultivate mindfulness:
  • Breathing exercises and cardiovascular activities including sports and hiking
  • Creativity woodworking and restoration activities
  • Healing imagery, music, photography and cooking
  • Compassion – volunteering and helping others
  • Connectedness – spending time with loved ones and friends
  • Nature engagement camping, fishing and hunting
  • Physical healing massage therapy and yoga
  • Spiritual religious practices and setting time aside to experience silence
Engaging in mindful self-care measures along with talk therapy allows firefighters to not only digest the effects of work-related trauma, but also reclaim a healthy emotional life. A life filled with positive relationships, an improved outlook and ultimately greater
life expectancy are goals that everyone should strive for, and deserves. Mindfulness activities can reduce symptoms consistent with PTSD, while also counteracting other related psychological issues including depression and anxiety.

Moving forward, the test for all first responders is finding ways to actively engage in healthy activities during the most challenging points in their careers and lives. While this process will involve a level of vulnerability that may be unfamiliar to most, the emotional crises faced by first responders across Canada warrant the need to embrace and expand on additional ways to recover and heal from witnessed trauma.

Dedicated to #287, #318 and #445; rest in peace, brothers.

Matthew Johnston is a full-time firefighter in British Columbia and a trained mental health clinician. He is certified in critical incident stress management and operates a mental health clinic that specializes in treating first responder trauma. Email him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Written by Keith Stecko
In June I attended the BC Fire Expo and Fire Chiefs Association of BC conference in Penticton. During the conference, I sat in on one session in particular that stirred powerful emotions not only within me but also in every fire officer in the entire room. The energy was raw, and, at times, the silence was deafening. It was a story told by firefighter Nathalie Michaud about her post-traumatic stress disorder (PTSD).

This was the first time that Michaud stood in front of a packed room and bared it all: the dark thoughts and feelings of suicide and hyper vigilance; waking up in the middle of the night in a sweat-soaked bed; flashbacks; self medicating with alcohol; anger and helplessness. She relived the horrific images, smells, and sounds that have haunted her.

On Jan. 30, 2010, Michaud reported to her station in Otterburn Park, Que., for duty and found Fire Chief Richard Stringer hanging in the fire hall. Not only was Stringer her chief, he was also her husband.

As I looked around the room packed with fire officers, it was as if all the air had been sucked out of it.

Three years later, Michaud was one of the responders to Lac-Megantic and explained that she was often referred to as the rock by her peers and the people who know her well. They saw her, she said, as steady and strong, but, as she pointed out in her talk, “It turned out to be the very thing that also hurt me.” How else was she expected to act when something traumatic happened?

I sat still in my seat and listened to Michaud tell her story of finding her husband. I watched her, standing tall in her uniform, stoic and steadfast, occasionally trembling, sometimes squeezing her stress ball. It was obvious to me that every word she uttered came at a great emotional cost as she summoned strength to tell her story.

When Michaud stepped back from the lectern to signal that she was done, the audience stood and erupted with applause. It was a clear demonstration to Michaud of the support from her fire-service family.

Michaud is no doubt one of the bravest and most courageous people I have had the pleasure to meet. She stands a beacon of light for those who are suffering from PTSD in silence. She described the effect of the disorder with perfect clarity: “I’ve learned that there are two ways PTSD can kill you. First, you’re still alive, but you’re slowly dying inside. Second, suicide.”

Later at the conference I connected with two of my colleagues; both confided in me that they were struggling with PTSD. One colleague had just starting to talk to someone about his experience. As we talked, I could see by the look on his face that it weighed heavily on him.

My other colleague has been off work and has been receiving help, however, insurance coverage is limited and he is desperately seeking all avenues of assistance, including worker compensation. The situation has been emotionally draining and stressful for him; the process includes recounting his many years of responding to various traumatic calls in order to determine if he actually is suffering from PTSD.

In both of these circumstances, I mentioned to my colleagues that suffering in silence needs to stop. Coming forward and opening up is the most important step to take. Keeping the poison of PTSD inside will only continue to erode a person and can become very destructive. I was grateful that they felt they could talk to me openly about how they feel.

I believe that PTSD treatment needs to be a national strategic priority for all fire-service associations. That means pursuing and having clear discussions with provincial and territorial governments to have PTSD recognized under presumptive legislation. If a first responder is diagnosed with PTSD, the condition should be presumed to have risen out of and in the course of employment, unless the contrary is proven.

Members of the fire service respond in their communities with pride. The first word in their vocabulary is action, and they do so by putting both their physical and emotional safety at risk.

We need to talk about PTSD openly, and support and educate one another without fear of being seen as damaged goods, marginalized or cast aside. Maybe the most important action you can take is to check in with one of your fire-service colleagues and ask, “Is everything OK?”

Keith Stecko is the fire chief and emergency program co-ordinator in Smithers, B.C. He joined the fire service in 1986 as a firefighter/paramedic level 2 advanced life support, served in the Canadian Armed Forces, and is a graduate of the Lakeland College bachelor of business in emergency services program and the public administration program from Camosun College. Contact Keith at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and follow him on Twitter at @KeithStecko

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