HONOLULU (KHON) — The day after a deadly ambulance fire in Kailua, the union representing firefighters said it wants its workers to stay out of Honolulu ambulances until an investigation is done and safety measures are in place. Always Investigating looked into ambulance safety and found fire is rare, but protocols are supposed to reduce the risk.

The Hawaii Fire Fighters Association said firefighters often ride along in the back of ambulances when patients are transported, and it wants that stopped for now.

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“We don’t want our members in the back of an ambulance,” said HFFA President Bobby Lee, “and we hope that they will put great priority on doing a preliminary investigation to find out exactly how this fire started or where it started.”

Firefighters often have to come aboard as part of a co-response and patient transport. HFFA said an investigation alone won’t be enough to reassure them it’s safe to ride again and EMS may need to create “emergency protocol or whatever they need to, to ensure that this particular type of situation cannot happen again,” said Lee.

The union president formally put the Honolulu Fire Department on notice in a written request to immediately cease firefighter accompaniment within all ambulances in operation until the cause is identified, the integrity of ambulances in use is assured and safety measures are in place.

“I’m hoping that response by the end of today,” Lee said. “I actually made a phone call earlier this morning and then I followed up with a letter. They were going to look into this right away and then get back to me.”

An HFD spokesperson told Always Investigating this afternoon they’re still discussing the matter and declined further comment.

EMS workers are represented by the union United Public Workers.

“I understand we’ve been in contact with them (UPW) this morning,” said Dr. James Ireland, Honolulu Emergency Services director, “but we haven’t received any expressed concerns from them.”

An Always Investigating review of the prevalence of ambulance fires shows a spate of engine and mechanical-related problems on the mainland in the 1980s that prompted a big nationwide recall, but nothing nationally or locally in recent history.

The U.S. Fire Administration along with the Federal Emergency Management Agency studied the risk of fire involving medical oxygen equipment including ambulances.

“It happened in the back of the ambulance,” Lee said of Wednesday’s Kailua fire, “though the only accelerant that I know of that’s in the back of the ambulance is oxygen. So it seems to be some kind of failure of equipment or protocols, procedures, or lack of protocol procedures.”

It took 11 minutes to get the fire under control and another 15 minutes to extinguish the flames. Firefighters saod this suggests a strong accelerant like medical oxygen may have been the cause.

“It’s not normal for a fire generated by just normal combustible material to burn that long,” Lee said.

Among ambulance fire lessons learned in a FEMA report: training and proper handling of oxygen equipment, and flame-retardant uniforms to prevent or reduce burn injury. A Honolulu paramedic was injured in this ambulance fire.

“Personal protective equipment is a big deal,” Lee said, “and a lot of times, our firefighters even when they jumped to the back of the ambulance, they’re wearing their full personal protective gear, their fire-rated personal protective gear.”

We asked both Honolulu EMS and the state Department of Health branch that regulates aspects of EMS for data and records of compliance and are waiting to hear back.

The EMS director had praise for his staff and their HFD counterparts today.

“The Honolulu Fire Department, as well as other EMS units, promptly responded,” Ireland said, “and we thank all of our teams and crews as well as the Honolulu Fire Department for their prompt response.”

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“This is a really sad incident, you know, but if it happened one time, it can happen again,” Lee said. “As rare as it may be, it can happen again. So the fact that it did happen once, requires the employer to take safety measures.”