Up In Smoke: Fire Prevention and Management

One of the most interesting ironies in the history of man is fire. In our early days, fire was an important survival tool, and remained an integral fact of life well into the 20th century. However, fire can also be one of the most dangerous, deadly, and devastating things that can be visited upon anyone or any group of people, not only because of the many hazards to life that it throws off or the enormous destruction to property and infrastructure, but also because of the many repercussions that can follow a single domestic fire. There's a few things you're going to need to know about fires- first, I'll be talking about the different sources and types of fire, and why fire is such a danger to life and limb; then, we'll discuss how to best prevent and (if all else fails) respond to a fire and associated hazards; Finally, we'll talk about how best to work with responders after the fact.

Know thine enemy: The kinds of fire and the hazards they bring with them

Fire can be classified in any number of ways, but we'll be primarily sorting them by their sources and by the things they attack (structure, car, etc). Also, at the end of the list of the kinds of fire, we'll discuss the associated hazards.

First on our list is the basic spark-and-fuel fire: This kind of fire is easy enough to understand- something really hot starts to burn something that can be used as fuel. It's why you don't allow kids to play with matches (seriously, there have been cases in the area where I'm at- don't let your kid play in the backyard with a lighter and a full gasoline can because you don't want them interrupting your viewing of America's Got Talent). It's also why you should always have someone make sure that the wiring in your new house is up to code, and why you should never skimp on cleaning your fireplace flume if you're going to use it. Also, try not to use the stove when there's combustible items (such as any sort of aerosol spray or paper) nearby, and don't leave the coffee pot or stove on when you leave. These fires, on the more obvious level, are fairly easy to prevent if you just pay attention to what you're doing when dealing with something hot or an open flame, and don't go out of your way to do anything spectacularly dumb. However, there are less obvious risks that can lead to this problem that you should always make an effort to keep in check (such as faulty wiring, faulty electrical devices, uncleaned fireplaces, furnace or water heater malfunction, or home gas malfunction). All of these fires are vulnerable to copious amounts of water (except sometimes the electrical fire), and a good fire extinguisher if you can catch them early enough, though in some circumstances, they may be immediately beyond your control the moment they start- in which case you need to call the fire department and enact your evacuation plan (you should always have an evacuation plan) ASAP. Also, try to take your fire extinguisher outside with you, as well as any home oxygen and/or prescription medications if you have the time and ability to do so. Try to only make one trip outside in this situation, though, since fires can spread EXTREMELY fast in the residential and/or business environment. Never EVER go back inside of a burning building.

The next type of fire is the grease fire- I'm making this a section of its own because it's handled differently from the typical fire. If you pour water on a grease fire (basically, your cooking oil has ignited), it's going to flare up and get worse. You can prevent these fires with just a little common sense when cooking, as well as by keeping your stove, grill, or other cooking unit and cooking utensils (pots and pans) clean. If, for some reason, you are the subject of a grease fire, you can quickly manage it by either using the fire extinguisher that you bloody well SHOULD have in your kitchen at all times, or by smothering the fire with a towel (it needs to be large enough to cover the whole pan or at least 1 and a half times the size of the base of the fire, and it's preferable to make it quite thick). Since you shouldn't have wet the towel because you know that water aggravates a grease fire, make sure that the towel doesn't now catch fire from the stove burner or the grill itself.

Another kind of fire is the car fire. If your car catches fire or begins to smoke profusely, whether or not it was the result of an accident, you should immediately pull over, shut off the vehicle, exit it, and assist other occupants in getting to safety (which, preferably, means being able to obscure the vehicle from sight with the thumb of an outstretched hand). If you have a fire extinguisher on board (which you should), you can go ahead and try using that to immediately handle the fire, but if it's not successful, you should take the fire extinguisher with you and leave immediately. Once a car is heavily on fire, do not attempt to extinguish the flames because most cars have frames made of some form of magnesium (which is what we used to burn to get a flash for photography before we had battery-powered flashbulbs, so it burns quite hot and fast), and when you attempt to cool that magnesium rapidly, it WILL explode and send off extremely hot pieces of metal. This is why firefighters will often allow an engulfed car to burn itself out, because the pieces of magnesium that it might send off if they intervened can be hot enough to burn slap through all of their gear the same as a cotton t-shirt. If it's too dangerous for the professionals, it's definitely too dangerous for you.

The next type of fire is the forest or wild fire. These fires can be extremely hot and can move through an area at ridiculously high speeds, especially when being driven by wind. You can help prevent these epic disasters by not throwing your cigarettes out of the window while driving, always making sure to follow appropriate campfire safety and thoroughly dousing it when you're done, not breaking burn ban and reporting or advising them about the ban to those who do, and by reporting even small forest fires to 911. Sometimes, these fires are too hot and too big for armies of firefighters to easily control, so the best policy to have if you know a wildfire is headed your way is to get out of there as soon as you hear about it. Some things to look for if you're camping and have no access to the news are definitely going to be thick clouds of smoke with no apparent source, a constant smell of smoke without smoke, a red or violet glow in the sky at night (or a visible fire perimeter). If you get any of these signals, it's time to either call for help or get out now, because these fires- once they're on top of you- move faster than you can run, and there's always a risk of being closed into a literal ring of fire. If you own property in a risk area, do your best to maintain a viable insurance policy, always keep a ready-to-go disaster kit in the house and car, and don't try to make a stand against the fire. Again, firefighters die fighting these fires, and if it's deadly for the professionals, what is it for you and your family?

Chemical fires and gas fires are especially hazardous to your continued life, not only because they can quite literally explode with tremendous force or burn with unexpected intensity, but also because they may throw off extremely lethal or highly dangerous chemical byproducts. If you get an overpowering smell of natural gas (which is naturally odorless- it only obtains its characteristic smell(s) after the gas company processes and ships it), especially with a wooshing sound of gas escaping, leave the area immediately, put a good deal of distance between you and where you first noticed the smell, call the gas company (if you can), and alert the fire department. If you notice a chemical spilling out of a tanker container (train or truck), a tanker container on fire, or a vapor or smoke coming out of a chemical tanker, you should move back to a safe distance (again, be able to cover the entire scene with the thumb of an outstretched hand), try to stay uphill and upwind of the scene (though this isn't as important as keeping your distance), keep your vehicle running (if you've stopped) and dial 911.

The associates of a fire can be every bit as deadly and dangerous as the fire itself, so now we'll do a quick review of them, starting with Carbon Monoxide. Carbon Monoxide (Or 1 Carbon and 1 Oxygen forming a molecule, not to be confused with CO2- carbon dioxide-, which is blamed for global warming and is a considerably less dangerous gas) is an extremely dangerous gas that often results from any sort of combustion, be it an open fire, a running gasoline or diesel engine, or cooking with a gas appliance. Carbon Monoxide kills by binding to the part of the red blood cells that would normally carry oxygen through the body, thus internally asphyxiating your body. In an open environment, carbon monoxide is fairly harmless, since it will usually diffuse and disappate instead of be concentrated or form a cloud. Inside of a structure- be it a garage, house, or business- however, carbon monoxide can build up (sometimes quite quickly, depending on the situation) to lethal concentrations. This build-up is most commonly seen during the winter-time, when people have closed up their homes to prevent as little air exchange between the inside and outside as possible, and is often times pushed into the level of being hazardous by using a gas stove as a heater, using a propane heater indoors, or running an internal combustion engine (such as that found on portable generators) indoors. It's also quite commonly witnessed when people are working in their garages, leaving their car running, or operating some sort of combustion engine inside without proper ventilation. Carbon monoxide is a silent, stealthy killer- quite capable of killing everyone in a single household, and some level of poisoning occurs to thousands of people every year, so it must be treated with the utmost seriousness. You can help prevent carbon monoxide poisoning by ensuring that you've got the appropriate level of ventilation available to you any time you're working with combustion- at least a nearby window halfway or fully open for gas cooking, a door or several windows open through the area for a propane heater, and never operate a gasoline or deisel engine indoors unless you're in the garage and you've got the car door open. You can also purchase carbon monoxide detectors or combination smoke/carbon monoxide alarms, which should be placed everywhere you would place a smoke alarm.

Some signs that should throw off red flags of carbon monoxide poisoning (which should prompt you to IMMEDIATELY leave the residence and dial 911- don't go back inside) are everyone feeling bad or feeling nauseated at roughly the same time, everybody inside passed out and either unresponsive or responding inappropriately (minus the smell of alcohol on their breath), generally feeling tired or sleepy, feeling dizzy or lightheaded, and people acting unusually. Don't rely on the classic 'cherry-red' skin color, because this is usually a late sign, often occuring well after death, though it can rarely occur while the victim is still alive. You must consider these signs against what you see in the house (ex: Has someone been using their gas oven as a heater without opening any windows?) and how others present in the house. Usually, everyone- even pets, especially small pets- in a household will be effected.

Smoke and superheated air are going to be the primary hazard to your sustained life in the event of a fire, far surpassing the threat posed by the fire itself. If you're in one of these fires, you need to keep in mind that heat and smoke will rise- meaning you need to crawl. The superheated air in a residential or business fire can reach 1800 degrees feirenheit at head height- that's hot enough to melt a fireman's headgear and faceshield in a number of seconds that you can count on one hand. Again, if it's even too dangerous for firefighters to walk through a residential fire, it's just plain stupid for you to attempt to walk out. Don't walk- crawl! If you have to stand up, or if you're hit with a gust of hot air, attempt to exhale slowly or hold your breath after light exhalation- but whatever you do, don't inhale. Also, inside a fire, attempt to get your air from off the floor if you can't get out before you need to breathe again, and inhale slowly through your nose as much as you can. You might also consider wetting a cloth or some clothing and covering your mouth and nose (be sure you can remove it quickly, in case it catches flame). Also, the faster you can get out with the least exposure to the fire, the better. Now, don't go hurling yourself out of tenth-floor windows, but if you're fairly close to the ground and you've got the option of a window or going through the 'hot zone' to reach another exit, take the window every time. Don't hesitate- break it out with whatever you can find, make sure you knock out all the glass if you've got the time- even the small stuff along the bottom and the sides-, and, again, if you've got time, you should lay something very thick, like a leather jacket, over where you plan to be having contact with the window frame. This will all help to prevent extremely serious and life-threatening airway burns.

Smoke, like superheated air, can be extremely, ridiculously hot. Smoke, however, carries additional hazards, such as toxins like Phosgene, Cyanide, and Carbon Monoxide. Also, smoke carries fine particles that can hold heat for longer than air alone can, and can also form deposits in the respiratory passages. You can help decrease your exposure to smoke by installing smoke alarms in every room, floor, and hallway (or by making sure your apartment landlords have taken these steps), and by following all of the same steps you would to avoid superheated air.

Collapses and Explosions are very dangerous mechanisms that can sometimes result from a fire. If there's any sorts of containers (gasoline cans, soda cans, water tanks, gas/air canisters, especially cargo tanks and gas tanks on vehicles) or pressurized vessels of any sort that are near or inside of a fire, you need to alert the fire department or 911 if they're not on scene and you need to leave the area as soon as possible. To avoid structural collapses, you shouldn't enter condemned, on fire, or otherwise damaged buildings, and you should avoid travelling through them whenever possible. If you're the subject of a structural collapse and become pinned, dial 911 if you can, or if you can't or emergency personell or already on scene, scream, shout, wave your shirt around (if you can), do everything you can to get someone's attention. You should also try writing down or remembering the time that you became pinned, if you can, so that you can tell responding fire and EMS personell how long you've been stuck (which can prove extremely relevant to how you're handled as a patient).

The best survivor is the smart survivor: Preparedness measures

No matter where you go- your house, your car, your work, even a hospital, mall, school, or other area you may be just visiting, make sure that you either have or know the evacuation plan in the event of a fire- it'll save you a lot of trouble, and possibly your life. You should hold a home fire drill at least once a year, though four times is preferable. You should also take strides to include prescription medications; a go-kit containing clothes, keys, cash, and other essentials you'll need in worst-case scenarios; and pets in your evacuation plan. You should know all your exits and attempt to have a contingency plan for every 'what if' you can think of. You should also pay attention enough to familiarize yourself with where the fire extinguishers and fire alarms are (by the way, it is illegal to pull those alarms for the sake of causing mischief or without need, because people can and do panic and get hurt- so don't be tempted). You should consider keeping at least one large fire extinguisher in your house (I would also recommend a small one to keep in the kitchen), and one small fire extinguisher to keep in your vehicle of choice. Make sure you have smoke alarms in every hallway, large room, and level of your house, and make sure they're in working order- they can't work if they don't have any batteries, can they? (There are varieties that plug into your house's electrical system, but the battery operated ones are preferable because they'll continue to work even during a power outage.) You should also try to ensure that there are at least two ways out of your house, no matter where you're at in it. As far as burn care goes, you should have ice, gauze, and ibuprofin on hand for small burns. If the burn develops blisters, DON'T POP THEM- doing so may increase your risk for infection. For deep burns with blackened or charred skin, large burns, burns near the mouth, or if you or someone else's voice is suddenly hoarse after exposure to hot air or fire, you should seek emergency care immediately!

When all else fails: How to survive
If you're there to witness the start of an unintentional, uncontrolled fire, you should immediately dial 911 in case you can't handle it, because fires can grow fast, and the sooner that the fire department is on its way, the better. You can try to manage the flames by smothering them, dousing it with water, or, preferably, with a fire extinguisher- if you've got one one hand. The right way to use one is by following the instructions on the extinguisher, standing about three feet back at the most, and spraying in a sweeping motion at the base of the fire until the extinguisher is fully discharged. Failing that, you need to pull the fire alarm and initiate your evacuation plan ASAP.

Okay, so you weren't able to prevent it or handle it before it became a problem. The first thing to do is get out. Forget everything else- it's all replaceable, you're not. Also, if there is considerable risk to yourself, don't go to help someone else or you'll probably end up becoming victim #2. If you haven't already, now's the time to call 911, by the way. First, you're going to want to dress appropriately. If you can quickly throw on a shirt, do it- roll down your sleeves, put on a cap, raise your collar, slip on some shoes, it will all help protect you, but don't do it if it's going to take more than five seconds per item. If you come to a closed door, place your handle on the knob. If the knob is unbearably hot to the touch (the whole house may be generally hot by this point), don't you dare open that door- there's fire on the other side- you'll need to enact your other way out. You should also watch for smoke coming from beneath the door, as well as feel the door itself. If the smoke is coming from under the door in puffs, especially if it's white smoke, or the door feels extremely hot or like it's breathing, whatever you do, never, EVER open that door! The reason for this is that there's a potential flashover (which is where a room has fuel and lots of heat, but no oxygen to support a fire. As soon as it recieves the oxygen, the entire area literally bursts into flame) waiting to happen, and in a structural fire, there's very rarely something approaching the raw deadliness of a flashover. In fact, you need to get as far away from that door as you can as soon as possible, because the heat will eventually eat through it and initiate a flashover. Once you're on your way out, remember to get low to the ground and crawl- DON'T WALK- out. If you must, you can exit through a window, as I detailed earlier. If it's too dangerous for you to leave where you're at, don't attempt to leave. You need to tell 911 exactly where you're at in exactly what room you're in, or you need to text this to someone you know on the outside. If you're near a window, but can't get out through it, break it out and wave SOMETHING out of it, be it a T-shirt, a rag, whatever to get someone's attention. You should also try placing a- preferably wet- towel or thick cloth of some kind at the base of any doors that are emptying smoke into where you're at. You should stay low, consider turning on a flashlight to increase your visibility to responding firefighters, and listen to the dispatcher or firefighter's instructions.

Once you're outside, the danger isn't over. In a fire scenario, emotions can easily run very high among complete strangers, friends, family members, even between victims and responders. You need to keep your mind about you after a fire, pay attention to responder directions, listen to what they tell you, and don't get a bruised ego if they don't take the time to be nice with you- they're stressed, possibly every bit as much as you are, and they're busy trying to handle a job, so understand that they're not trying to be rude. You should also be prepared to handle an angry or agitated victim who may be extremely aggressive- don't get a hot head about it, and don't try to show them up, handle yourself like a professional, understand that people under the influence of emotion say and do things they don't really mean. If it gets excessive, however, be prepared to ask for law enforcement or responder assistance in calming them down.

The Beloved Killer

There is something sinister that's taken root in the United States over the last century, and we're not alone- it's infected every industrialized nation in the world, even the third world ones. According to the United States Centers for Disease Control, it kills more than 41,000 Americans every year- 43,000 in 2005- which means it killed well more than 3x more Americans than homicide by firearm, and more than double the number of people killed by total gun deaths in the US (that is, counting suicides and unintentional as well as homicide), and over 10x the number of people killed in the september 11th terrorist attacks. This didn't just happen one year, or for a few years and then we fixed it, it's happening, every year. People die year-round, every day, around the clock from this killer that hides in plain sight. Even more shocking is that people, all the time, accept, and even want, this danger around them as part of life. Most of the time, we don't even think about protecting ourselves from it- and yet, it's easily the most deadly or unsafe presence in almost everyone's day-to-day life.

"Where is this killer?" you may be asking. Well, it's right outside your door. Don't believe me? Quickly now, run to your windows and look out at your driveway, look out on the street to see if you can see it moving past, or look in your garage to see if it's invaded your home. If it's got wheels and an engine, you're looking at our killer- motor vehicles. If you haven't thought about it before, maybe you should consider just how little respect people have for the use of something as life-endangering as a motor vehicle (especially when combined with the heart-stopping excitement of AM radio and additional cupholders). Take, for example, a regular road in a regular urban area: a 35 mph speed limit in both directions seems to be the normal thing. Seems safe, right? Well, when you consider that a head-on impact with another car actually obeying the speed limit means that you're really running into them at 70 mph- that's interstate speeds. Imagine running into a car parked on the shoulder of the interstate at that speed. Not pretty, is it? Urban roads aren't that wide, and it's not too difficult for a distracted driver to end up unintentionally blundering into just such a wreck. Visualize, with the same concept in mind, a head-on impact on a 45 mph zone- a total 90 mph impact assuming you're both, by some miracle, obeying the speed limit. Now imagine a head-on wreck on the interstate. Albeit much rarer, it's that much worse- being an impact at the equivalent of 140 mph.

The moral of this story is pay attention. Driving is dangerous business, no matter how safe you think or feel it is, and if you're not paying attention, you can't react in time to save someone else or yourself. Whatever it is- your cell phone, your dog, your baby, a stray soda bottle, a cigarette (I've watched, many a time, in mixed horror and frustration as a smoker has taken both hands off the steering wheel and took their eyes completely off the highway until they successfully lit their cigarette), IT CAN WAIT. Enforce a little common sense, wait until you reach a red light, until you can pull into a gas station, at a stop sign, and if it simply can't wait, then pull into a driveway or onto the shoulder of the road. The fact that you're probably saving yourself and someone else a traumatic event, at least a 15,000 dollar hospital bill, an insurance rate hike, and life should make it all well worth heeding this advice. To provide you with a good rule to go by, though, is something that I quickly learned when I first took up motorcycling: Assume that all other drivers are out to run you over. It's saved my life at least twice, so I'm sure it will help you.

Now, something that, being a rider myself, I feel obligated to stress to anyone who drives, be it from the front or the back seat, is to watch out for motorcycles. You've probably heard it a thousand times, but traffic studies back up the facts: most drivers simply don't see or even look for motorcycles. Now, the point isn't to call regular drivers stupid incompetents that aren't fit to be operating a hot wheels toy, let alone a car- despite what we all mutter to ourselves on our less than best days- but to remind them that, honestly, that's just the case. Most of the time, you only see other cars, trucks, big trucks, and bigger trucks because that's usually what you're looking for. You're not going to notice something that's maybe 1/4 of the size of a normal vehicle. Studies have also shown that the majority of motorcycle impacts occurred from the cyclist's front-left side and front. What this means is that whenever you're preparing to merge with traffic, move to the right lane, cross traffic, or make a right or left turn, it wouldn't hurt to slow down and take an extra half second to be sure that the way is truly clear. That half second may save someone's life and save you a whole lot of grief.

Now, let's talk traffic laws, saving the legal talk for the lawyers. Most of us consider traffic laws and installments to be a nuisance, right? What's the point of a stop sign if nobody's there, right? Or the point in obeying the speed limit or traffic lights if it's the middle of the night and the roads are abandoned? Why even wear a seatbelt? Most people simply view it as a way for police departments to rake in the cash, but I'd like to make a few points to the contrary. Traffic lights and stop signs all exist because people are selfish, and if they can help it, they're not going to yield to anyone unless they're plainly bigger and badder than they are. You'd end up waiting an hour at a busy intersection as opposed to a few minutes were it not for traffic lights. You'd probably have front-end and side collisions on a regular basis at intersections were it not for stop signs. Just imagine how many people would be more than happy to blast through an urban intersection at top speed without much more than a glance for other traffic or pedestrians. Even at night time or on a deserted highway, you should still obey these installations, as well as the speed limit, because you're not the only person in a hurry, and simply assuming the other guy, or even that you will be able to react in the sliver of time you've limited yourself to by ignoring them is just plainly absurd, and 99 times out of 100, you'll be coming to consciousness with me and a dozen of my buddies huddled around you inside the back of an ambulance. Speed limits exist because they are the safe speed for that road- considering the twists, turns, visibility, wildlife, width, and a number of other factors, that's about the optimum speed for both efficient travel and giving yourself plenty of room to react to any hazards. Your seatbelt is there because it-will-save-your-life. Next time an officer pulls you over to issue a ticket or warning for a vehicle malfunction, remember that he might just be saving your life with that slap on your wrist. Next time an officer issues you a warning or ticket for a driver malfunction, remember that he's enforcing good safety practice to protect both you and those around you.

If you regularly tailgate people- that is, you drive very close to the rear of the car in front of you- I'm shaming in your general direction. Be ashamed. Be very, very ashamed. Tailgating is a dangerous practice for the tailgater and the tailgatee because of a lessened amount of response time for the tailgater, and it leaves the tailgater legally responsible for any resultant accident damages in most places. A good rule of thumb is to pick a landmark- such as a mile marker- that the car in front of you is about to pass up. As soon as the rear end of your lead car passes that landmark, start counting in mississippis. Ideally, you should be able to count to two mississippi before you reach the landmark. If you can't utter the full "one mississippi, two mississipi" before you reach it, you're too close to the vehicle in front of you. For semi trucks, the rule changes to "four mississippi" because they're actually able to stop faster than your regular vehicle can to a shocking extent, as well as because once you get so close, the trucker will be completely incapable of seeing you behind him. Believe me, no matter who was doing what right or wrong, thinking that you'll win in a collision against a semi is like thinking that your head will win in a collision against a ton of bricks- give yourself and the trucker enough room to react.

If you're not fit to drive, don't drive. Get a friend to drive you, get a family member to drive you, get a taxi to drive you, take a nap in your car, or just wait it out over a cup of coffee. By driving when you're unfit to, you put both yourself and others in immediate danger. I don't care what it is- haven't slept in 72 hours, just got a dose of demorol from the ER, or if you're drunk enough to get others drunk by smelling your breath, it's all simple stupidity and outright indifference for the well being of yourself and those around you to be driving if you're not fit to, no matter the circumstances, no matter the excuses. What's more is that if you're not fit to be driving and you get found out, you could be on the business end of serious legal charges- though not nearly as serious or ugly as running from the police to avoid being charged. The worst part, though, is that the myth that impaired drivers often survive the accidents they create, even when their victims don't, leaving them with a crippling, unforgettable guilt- isn't a myth.

Now, it's time for some shorts:
- If you try to beat the train, the train will beat you. Every time. Seriously, there's not much to it: if your vehicle stalls out on the tracks, get out of it and call 911. If you're late, you'll be really late when what's left of you is getting packed into a closed coffin. Trains are about as deadly as it gets, treat them as one would treat a dozen rattlesnakes or a bucket of battery acid.

- If you're in a hurry, it is still absolutely no excuse to drive like an idiot and endanger not only your life, but those of your passengers and fellow drivers. If your relative is hospitalized, they're not going to be feeling any better if you get yourself hospitalized too. If you think you're late now, you're going to be really late when EMS sends you on the detour of a lifetime.

- If you see an emergency vehicle on the side of the road, tending to an accident or preforming a traffic stop, PLEASE try to give them an additional lane of clearance and, if you think you can do it without causing problems, slow down a bit or at least let off the gas pedal. Also, do your best to avoid rubbernecking. I understand that for those of you who don't regularly deal with it, and even for some of us who do, it's interesting, but rubbernecking a scene is a dangerous, not only because you can end up inadvertently drifting right into the middle of the scene and injuring the responders, but because you're not paying attention, and you could end up slamming right into the drivers in front of or to the side of you and take a ride in an ambulance yourself. Be patient, and be safe. Police, fire, and EMS, we're here for when you need us. If you see us and don't need us, respect the fact that someone else does, and you'd want that person to respect your need if you were in their shoes.

- On a related note, if an emergency vehicle (police, fire, ambulance) comes up behind you with lights and sirens going, the appropriate course of action is to -safely- pull to the right, pull onto the shoulder, or partially off the road. Do not slam on the brakes, please. I've nearly been the subject of a dozen accidents because drivers panicked and slammed on their brakes when they saw our ambulance, lit up like a Christmas tree and wailing like a banshee in their rear-view mirror.

- Next to pay attention, the number one rule of the road is to stay calm. If you're about to lose control, stay calm. Panicking can and will kill you, because you will lose your mind, therefore you will lose control. Even if a wreck seems inevitable, stay calm and stay in control. You can do a lot in those last seconds to soften the blow and maybe even avoid the wreck altogether. One more aside- try not to lock up if you expect a wreck. If you stay limp and loose, your body will be better able to survive and roll with any forces put on it by the crash than if you're tensed up. That's why impaired drivers will infamously survive the crashes they create while their victims won't- their reaction time is too poor to tense up before the wreck occurs.

- Follow the advice and instructions of your vehicle's manuals. Putting a baby in the front seat, facing forward, is absolutely dangerous. If you get in an accident and that airbag goes off, it will seriously injure and possibly kill that child. If the warnings say not to let a child younger than 12 ride in the front seat, understand the reason for it is because that child may be exaclty in all the wrong places for the car's airbag and end up getting hurt worse than if they didn't have the airbag there. Of course, respecting the airbag isn't just for children. We're basically talking about a huge balloon of air that's supposed to erupt out of your steering wheel or dashboard in a matter of a split second in order to counteract and soften the forces involved in a car crash, and that means that, ironically enough, that bag puts out a lot of force when it's activated. If you're driving, the best way to hold the steering wheel is at the ten and two-o-clock positions with both hands on the wheel- not only because it gives you better, more deliberate control of the vehicle but it also keeps your hands and body much safer from the airbag, because when they're designed, that's where they consider the driver's hands to be. The safest way to place a baby in a car is in the center of the back seat, as close to the midline of the car as possible, and, of course, secured in a car seat. Children up to as old as five can need car (or 'booster') seats to get the most of a vehicle's safety features.

-If you get in a major accident in which your car rolled over, severely cratered in somewhere, struck multiple times, you or a passenger was ejected from the vehicle, a passenger was killed or severely injured, the best place to go is nowhere at all. Turn your car off, if you can, and stay exactly where you're at (This is of special importance if you can see downed utility lines outside or on the car or if you've struck a phone or utility pole). Immediately dial 911, take a tally of your injuries and those of your passengers, remain calm and clearly relay what you know to the dispatcher so they'll be able to send all the right resources. Some things to take note of are how fast you were going when you crashed, how many passengers there are on your part, how badly a passenger or yourself is injured, and particularly whether or not you're suddenly missing a passenger or two. The only time you want to get out of your vehicle in the event of a major accident is once you're sure it is safe to do so AND if there is an absolute need to do so, such as the car catching fire or becoming submerged. Please allow EMS to 'check you out' and make sure you're stable, preferably while you're still inside your car.

- Finally, take the time to do your regular maintenance. Good tires will keep you on the road, keep you in control, and keep you out of accidents in situations where bad tires won't. A burned out indicator or dysfunctional brake lights can be the reason for a completely avoidable accident.