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Adapting to Extreme Heat to be #SummerReady

On this special episode of The USFA Podcast, Dr. Lori Moore-Merrell interviews Chief Mary Cameli and Assistant Chief James Johnson from Mesa Fire and Medical Department and Assistant Chief Tim Kreis from Phoenix Fire Department to about how they are adapting to the extreme heat in the U.S.

Posted: July 20, 2023

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Extreme heat affects the environment, but also how fire and EMS departments respond, train and communicate with their communities.

Photo of a firefighter drinking water on a hot day

Listen online 24:52

Photo of a firefighter drinking water on a hot day


Estimated 16 min reading time.

Welcome to the USFA Podcast, the official podcast of the U.S. Fire Administration. I'm your host, Teresa Neal. This is a special episode of the podcast to address an emergent issue, extreme heat. The U.S. is currently experiencing skyrocketing temperatures. It is affecting our communities, environment and first responders.

FEMA recently launched the Summer Ready Campaign to provide tips on how to adapt to the rising temperatures and keep yourself, your family, pets and neighbors safe. But in response to the sustained temperatures, our U.S. fire administrator, Dr. Lori Moore-Merrell, had a conversation with a few fire chiefs to discuss how they're dealing with the heat and help all of us think about how to safely and effectively continue to operate in this environment.

Please listen in to Dr. Moore-Merrell’s interview with Chief Mary Cameli and Assistant Chief James Johnson from Mesa, Arizona, Fire and Medical Department and Assistant Chief Tim Kreis from the city of Phoenix Fire Department.

Dr. Lori Moore-Merrell

Hello, everyone. This is Lori Moore-Merrell, your U.S. fire administrator, and today I have with me leaders who are experiencing the hot seat, so to speak, like never before.

So, I have with us Chief Mary Cameli of the Mesa, Arizona, Fire Department and also Assistant Chief Tim Kreis of the Phoenix Fire Department. And so, welcome to both of you. Thank you so much for being willing to come on this podcast, USFA Podcast. And we’re excited to have you as guests this morning to talk about the extreme heat that we’re all experiencing across the nation.

So, welcome.

Chief Mary Cameli

Thank you so much, Dr. Moore-Merrell.

Assistant Chief Tim Kreis

Thank you.

Dr. Lori Moore-Merrell

Very good. Well, I have the first question that I’m going to throw out to you is just to describe what you’re seeing. What are you experiencing right now? Give us a little bit of background of what’s a day like for you right now?

So, Chief Cameli?

Chief Mary Cameli

Sure. Thank you. So, we’ll tell you the day starts out very warm. When you get up at 4 in the morning, you walk outside to go to your car and it’s already 95 degrees. So, the days in Arizona, they’re long days of heat and that’s what we’re experiencing now. The call volume in terms of what we’re responding to on folks that are impacted by this high heat index, a lot of heat-related incidents that we’re responding to today.

We are modifying our daily routine when the temperatures get really high. We recommend our crews — their workouts are minimal. We don’t want them to kind of get worn down just by their working out in the day so they can be healthy and rejuvenated to respond on the calls they’re going to be responding on.

Yeah. So, we’re — that’s just the start of the day and the temperatures will stay hot even into the evening. So, the relief is minimal during these summer months.

Dr. Lori Moore-Merrell

So yeah, when it doesn’t cool down at night, even when the sun goes down, it doesn’t help very much. Chief Kreis, what are you seeing?

Assistant Chief Tim Kreis

Well, we’re seeing about the same things that Chief Cameli described. I think 1 thing that’s so important that we’re pretty accustomed to, certainly in the Phoenix regional area, Mesa and our regional parks, is this sort of reality that heat has impact on everything. So as Chief Cameli described, it has an impact on our firefighters.

As far as heat stress is concerned, we have a variety of strategies that we’re well accustomed to to mitigate that, but it also has a major impact on our community as Chief Cameli described. We’re seeing a lot of increase in emergency medical calls related to heat. Of course, that’s very predictable, especially when it’s this hot, but it also has an impact on other things.

So, you think about, as gravity has an impact on everything, heat has a stressing impact on everything as well. So, you can see an increase and certainly urban interface-type fires. You can see an increase in fires across the board. It stresses out machinery. I mean, you’ll even see vehicles have a higher tendency to overheat and break down when it’s this hot.

So, it has an impact on everything. And it’s certainly a challenge for us as we continue through these hot weeks here.

Dr. Lori Moore-Merrell

Wow. So, I heard, as Chief Cameli, you said a minute ago that you were modifying workout routines and that sort of thing. What else are you all modifying? What’s not normal when you have this baseline risk change, then how do you adapt?

You’ve seen heat before, but for this sort of sustained period of time, sort of changes things. So, what are you all doing in the immediate here?

Chief Mary Cameli

So, you’re absolutely right. Dr. Moore-Merrell, we are changing some things when we see the heat. Number 1, our activity outdoors, our training, any kind of training that we do is minimal outdoors in these temperatures, but also the biggest thing is our response models.

With this heat, we absolutely include more resources on every type of structure fire, every type of gas leak, any type of incident that requires us to wear turnout gear and that we have to physically — really engage our members physically on calls. We are adding additional resources on every 1 of these calls. So, we have the resources available.

So, when we rotate them into rehab, we have backup already on the scene to take their place. That is probably the biggest thing we do in the summertime to make sure that our rehab stations have everything they need in terms of the equipment ready. So, when they do go to rehab, they’re instantly able to cool down as soon as they take off their turnouts, having all of the hydration fluids and everything prepared.

We limit all our fires to 2 bottles of air maximum in the summertime. We don’t want them to use more than — go through more than 2 bottles of air. And for anybody that — that’s about 15 to 20 minutes per bottle generally. Normally on fires, they can go through many more, but during the summertime, we don’t want them to do more than 2.

And the reason for that is if when someone becomes exhausted from the heat or gets what’s called heat exhaustion, are they’re more susceptible to getting it. So, we try to prevent our firefighters from ever getting there, because that could be problematic if you have a lot of firefighters that are susceptible to heat exhaustion.

So that’s something that is very important to us on the fireground, or any incident where we’re in turnouts, is to make sure that we rotate them much quicker into rehab to prevent this from happening.

Dr. Lori Moore-Merrell

So, you’re going 1 bottle into rehab, they can do 1 more bottle and then they’re done.

Chief Mary Cameli

That’s correct.

Dr. Lori Moore-Merrell

Interesting. Interesting. Wow. Chief Kreis, anything different? What are you all doing as far as adapting, whether it’s response models or the PPE? What are you doing in Phoenix?

Assistant Chief Tim Kreis

Oh, thank you very much. Well, Dr. Merrell, I can tell you that you’re aware of this, of course, but Phoenix and Mesa and the other 30 municipalities in Maricopa County are all part of the automatic aid system, so my partners there, Chief Cameli and Chief James Johnson, we utilize the same standard operating procedures, so the stuff that Chief Cameli reflected on was identical to us, but I can reflect on a couple of other sort of important factors.

And those are — Chief described the importance of our firefighters being ready to go. So, as she was working through our heat stress management SOP, that’s something that gets activated on June 1 and runs all the way through Sept. 30. And as she described, we deploy extra fire companies to a variety of different incidents to facilitate that process of getting our folks rest and rehydration and getting through that rehab sector.

What rehab sector looks like for us when we activated is it’s really about cooling our folks down, getting their vitals and making sure that they’re fit for duty to continue. So, for a firefighter who goes through rehab on the fireground, or any other hazard zone for that matter, what they’re going to experience is a scenario where we’re going to want to get out of those hot turnouts, sit down, get a cool bottle of water in the shade, in an air-conditioned truck, check their vitals. And after about 20 minutes, we’re gonna check their vitals again to see that their vital signs have stabilized.

Something else that’s important to reflect on is really the community piece of this thing as well. And the EMS-related considerations. So, for us and our firefighters and our paramedics out there, they’re stocking up on cold water, ice packs, we’ve got IV bags sitting in ice, ready to go in the trucks. Blankets, and you’re probably thinking blankets? Why would you have blankets?

Well, 1 thing that we have to protect our community against is in the event of a medical emergency or an EMS-related call that’s outside, our patients can be lying on the hot pavement and getting some pretty serious burns to their skin, so getting them up off that hot pavement and onto a blanket, onto a gurney, anything to get them off that hot pavement and reduce those burn injuries is really significant. That’s all common stuff for our paramedics and EMTs throughout the automatic aid system. And another thing that I think we can just sort of briefly reflect on is the importance of just being prepared, you know, with the heat.

We also see an increase in fire and that includes wildland urban interface-type fires. So, about the same time that our heat stress management protocol goes in, we activate our wildland urban interface deployment package, which we have pre-identified all of the areas that are at significant risk.

Throughout our community for wildland urban interface incident. And if a 911 caller calls in a brush fire or grass fire or desert fire in those areas, they get a really aggressive initial response. And what we want to do with that is prevent these 900-acre fires that are ripping through our communities and be able to stop them really quickly.

So that’s a pretty aggressive package that, I think, Chief Johnson and I worked on about 4 years ago, James. I’m sure you remember that.

Assistant Chief James Johnson:

Yes, Tim, that is exactly right. And that was huge. You guys pushed that forward. And as you said, all of our partners got on board and really embraced that. And it’s been very successful for our crews out there to get those initial units immediately on the scene.

Dr. Lori Moore-Merrell

You know, with that, guys, that’s impressive just that you’ve had that frame of mind because of the EMS call volume alone and then protecting your people. But to have the forethought of understanding that this extreme heat, and I’m sure it’s coupled with drought, if not the dry lightning strikes when we’re not getting that monsoonal moisture that is expected this time of year.

For you guys to think this through and to have that, so is that something that you’re seeing? What are you concerned about in that space? Is it the heat now coupled with the drought, of course, for you?

Assistant Chief Tim Kreis

You know, it’s a very, very good question. So, what we typically have happen is we’ll have rains and some wetter seasons sometimes in the fall and winter for us here in the region.

And when we have those seasons that are a little bit of an increase than what we would see before, you see a lot of grass growth and all those sorts of things. And as that grass sort of grows, you start leaning into the summer, late spring, summer months when you get temperatures over 100. Of course, Chief Cameli nailed it.

You know, we’re getting closer to 120 right now than 100. But when we get over 100 and our humidity is down, around 10 or less percent, you have a really high risk of having those urban interface-type incidents. So that’s really the piece there we’re looking at for us.

Dr. Lori Moore-Merrell

Perfect. So, let me ask you guys, what is your concern?

I know, Chief Cameli, you said something about it’s already setting a record. You may set the record for a day straight over 110. I mean, normally we’re hearing over 100, but over 110. So, what are your concerns about sustainability here in all of these mechanisms that you’ve put in place to keep people safe, community and your people?

How long can you sustain this?

Chief Mary Cameli

That is a great question. And, you know, we know we live in the desert, and we know our summers are hot. I think that the important thing for us is to stay on course with everything we’re doing, because we know, like, monsoons are eventually going to hit and it’s going to start cooling things down, but we have to go the distance, and it looks like we’re on track to break the record of this many days like you mentioned, Dr. Moore-Merrell.

But I think that we got to just continue keeping up on all the resources that we have in place, you know? We want to continue preparing for what’s ahead. But I think that we keep our social services division up and ready to go because when we respond on these calls where people have no air conditioning or they need a place to go, we have these cooling stations throughout our communities.

Like Tim said, we’re automatic aid, we kind of work off the same map of having these resources available but making sure that our social services teams are available and ready to respond to these folks and get them to the resources or the locations they need, so they can survive all of this too. So, we know it’s coming. We are very much prepared.

We try to really get acclimated to the temperatures out there and slowly make sure that folks stay hydrated all the time, in terms of our teams. All these things we keep reminding them. I think the daily reminders that we do because we know what’s ahead of us. We could look at the forecast 2 weeks in advance and it looks like it’s just going to be the same.

We’re going to look, it’s very much the same, if not even hotter. So we just keep up, we try to maintain all of our equipment, maintain our programs so we can take day to day as it’s moving forward.

Dr. Lori Moore-Merrell

Wow. I love that. Chief Kreis, want to add anything to that about just sustainability? Any concern?

Assistant Chief Tim Kreis

Absolutely. For us, when I think about sustainability — and I know Chief Cameli sees it the same way — we really just look at it through lenses. There’s no status quo on anything we do. We’re either moving forwards or backwards specific to heat-related preparedness and how we’re going to sustain in the future. Our package is pretty comprehensive.

Chief Cameli talked about the importance of cooling stations and protecting the community. And I’m going to add to that in a couple areas. Number 1 for us: public education efforts. So, getting the message out for folks to be smart about the heat, drinking water, not hiking in this extreme sort of heat and those sorts of things is of key importance to us.

Of course, what comes with heat as well, which can be, of course, a really good thing, is people want to get in the pools and cool off and all those sorts of things. So drowning prevention, public education messaging is super, super important right now. In addition to that, I think 1 of the most important things that we’re doing as a region and certainly as a Phoenix Fire Department is managing this that we can through our fire marshal’s office and through fire prevention efforts.

So, if you can kind of think about the different types of fires that we can go on, if we can prevent those fires, we’re preventing that exposure to certainly our community, the damages to property and God forbid lives lost. But it also prevents our firefighters from being out there for hours and hours and hours and stuff like this.

So, 1 program that we’ve done in the city of Phoenix is we’ve created an outside combustible storage facilities program where we’ve assigned for inspectors who are out there in the community, just focusing on the pallet yards and the tire storage and wrecking yards and these places that store outside combustible storage.

Making sure that those places are compliant with the rules and regulations outlined in the International Fire Code. By doing that, we’re not preventing all of those fires, but we’re sure keeping them a lot smaller. And that limits the exposure to our people — certainly power outages. And from an emergency management perspective, having really strong relationships with our utility companies, APS and SRP, to be able to know what’s going on with the utility infrastructure.

And to the extent that we need to provide additional services to those folks who may need special services and knowing where they’re at, all those things are of critical importance. And that’s a lot of our focus right now.

Dr. Lori Moore-Merrell

Wow. Everything you just described is the very essence of community risk assessment, and then responding to put resources or take actions to reduce those risks. So obviously community risk reduction is part of that. So, brilliant! I would have never thought about the combustibles, but that makes perfect sense in these kinds of climate in the sustained heat, perfect sense.

And then of course, you said something that I just want to reiterate, is everybody’s saying, you know, go to the pool, cool down, get in the water. But I haven’t heard a lot about drowning safety and that’s perfect since again, and the risk and the increased risk of from one thing to the other, in our communities.

And so, I think that’s a very important and insightful action. Really, really impressive, guys. I mean, clearly you’re the professionals in this. You’re very experienced having lived through this for many, many years now, but nothing like what we’re seeing today. I think nothing like the temperatures that are sustained for such a long period of time, coupled with the drought that is really increasing our risk for our responders as well as the community.

So, if I were to ask you what was the advice that you would give? Because this is not just Arizona. It’s in Florida. It is in, we’re hearing — Las Vegas was triple digits, very, very high. Highest in the nation. I think they had 124 in the last few days. We know California is having some heat. And then some of our states that — Washington state, over 90s in the past few days.

That’s strange for them. I mean, you’d appreciate 90, but for them, that’s strange. So, advice? What do others need to — you know, what’s front of mind? If you were giving another department advice, where do they start? What should they do first? And perhaps, what’s the most important to sustain?

Chief Mary Cameli

Dr. Moore-Merrell, I’m going to just allude to something that Chief Kreis mentioned about public information and what we shared to the public about the criticality of these high temperatures for long periods of time to not take it for granted in terms of, don’t go outside if you don’t need to. Our hiking trails are shut down usually from 11 to 5 during the heat of the day to make sure people don’t do it.

But even before that, the temperatures are still extremely high, so don’t take chances in the heat. Some people, and especially when they come in our state from out of town, they might think they can hike the trails. A lot of times, folks don’t have enough water. Things like that. So really minimize the time you expose yourself to the elements of outdoors because there are always associated risks with that.

Take advantage of the cooling stations. If you don’t have air or your air is limited, take advantage of the cooling stations that the cities and surrounding cities have to offer in your communities. Really minimize the time you are out in the weather. And at all costs possible, to kind of make sure you don’t find yourself in a situation where you become overcome from heat, heat exhaustion, heat stroke, even, which we see a lot of. And if you are going to be outside in the pools and things like that, be aware of kids around water because as Chief Kreis alluded to as well, we’ve seen more drownings coming across this year or near drownings than ever before.

So that’s a serious thing here. So, make sure you watch your kids around, you know, water, and don’t go outside if you don’t absolutely need to during these high temperatures.

Dr. Lori Moore-Merrell

That’s great, Chief. Chief Kreis?

Assistant Chief Tim Kreis

Yeah, absolutely. I’ll add a couple of things. You know, I think for us, this is sort of interesting. Our mayor, Kate Gallego, had set up almost a year ago a meeting with some officials from the city of Phoenix. I was proud to be part of it with the folks in London and their counterparts over there to talk about this exact issue. They were experiencing pretty alarming urban interface and drought and high temperatures.

I think London has a population about 9 million. So, huge city, and it just sort of emerged on them. For Chief Cameli and I and our automatic aid system, we’ve been living with it for a long time. But the advice that I would give is, you got to start with your firefighters, in my opinion, first.

So, for those fire chiefs out there and those fire service leaders, making sure that you were looking at this comprehensively. And we know that if our firefighters aren’t healthy and they’re not ready to go, that’s not a very good place to start. So, we got to look there first. I think about things like as simple as uniforms. Like for me, when I was a firefighter running calls in this seat, certainly I always had an appropriate uniform on. But when I got back to the station, myself and my crew were wearing shorts and t-shirts. And we’re cooling down and staying hydrated and following our heat stress management protocols as Chief Cameli so perfectly described.

For those fire chiefs, physicals and making sure you’re doing the NFPA-compliant physicals for your firefighters to make sure that their blood levels are healthy and cardiovascular fitness and all those things are present in there. I think I would be looking at emergency response. And we talked about a lot of those things from deploying more resources when it’s really hot outside.

So, you have folks in reserve and you can limit that exposure to your firefighters working so hard out there. Certainly public education. We discussed that a lot, and then fire prevention. I think for each community, our firefighters out there know their communities better than anyone. I think you’re all going to see it a little bit different nuances there.

But looking at your people, emergency response, public education, prevention, and then your stakeholders and partners that you got out there. That’s where I would start.

Dr. Lori Moore-Merrell

Wow, that’s impressive. In fact, I made my list. That’s excellent. This has been fantastic. I want to offer each of you some opportunity to say something you haven’t gotten to say about this scenario that we are seeing nationwide. This extreme heat and certainly for you, you have the brunt of it in your communities and you’re sort of the example that we’re all watching.

So, any last words? Chief Cameli?

Chief Mary Cameli

I think the main thing is, the preparation we do beforehand is what’s going to help us through the crisis or through the emergency that we’re living today in terms of the high heat that we’re dealing with. I think staying on course with that, with the preparing ahead of time, but know that eventually we will get through this.

We take it day by day. We have the resources in place that we need to be there for our community, for our firefighters to make sure they’re like Kreis said, that they stay healthy. We keep doing that day to day and we will get through this. The heat will eventually pass but being prepared ahead of time and knowing the resources that we have and utilizing the social services piece that we have for the community.

I think that’s going to help all of us get through this together, and we utilize each other. We have an automatic aid system here where we are able to utilize resources from each other. And that’s what helps us get through these tough times in the desert. So just using our protocols that we have in place, day to day operation, and we will get through this.

Dr. Lori Moore-Merrell

Wow. I like that, Chief Cameli. Chief Kreis?

Assistant Chief Tim Kreis

Yeah. I think Chief Cameli nailed it. I’ll go a little bit lower level. A couple points that just kind of popped into my head. Chief talked about partnerships. That is so important. You know, a couple years ago, we had some huge, significant urban interface incidences here in Phoenix.

And speaking to the value of partners, I’m on the phone with Chief Johnson, and Mesa had sent a couple of engines to North Phoenix to cover our stations. And for folks who don’t know the region, I wouldn’t expect them to. James, I think we sent a couple of your trucks, maybe 40 miles, you know, to cover those.

The only other thing I would add is we did talk about wildland urban interface. We certainly pay very close attention to red flag warnings here. So, when we have them, it definitely triggers some extra, more conservative approaches from wildland urban interface perspective, but it’s something also important to trigger some things from a structural firefighting perspective.

So, we trigger those red flag warnings, want to be really careful and cautious of sizing up structural fires to make sure we’re not having wind-driven sorts of events. We recognize that you can have rapid fire progression and those fundamental things that we’re seeing coming out of UL from door control to transitional attack.

Attack from the windward side, coordinated ventilation activities, all those things are extremely important. And outside of that, that’s all I got, boss.

Dr. Lori Moore-Merrell

Wow. I love it. I love it. In fact, we’re probably going to bring you back and have a conversation about red flag warnings, because unlike your department, not everybody, and certainly our communities, don’t see them the same as a weather warning.

So, I want to have another conversation maybe about that, but thank you all for coming on with us today. I think this is timely. It is absolutely relevant, and your messages certainly have longevity for what we’re going to experience as the climate continues to change. We see trends, the heat lasting longer and longer and higher temperatures.

And so, thank you for what you’re doing. Thank you for being so savvy for your own departments protecting your communities, but protecting your people so they can protect your communities and understand that preparedness matters. So with that, I will close up this podcast. I’m grateful again for our guests today.

This is Lori Moore-Merrell, your fire administrator, and this is your USFA Podcast. Thank you, everyone.

Assistant Chief Tim Kreis

Pleasure. Thank you.

Chief Mary Cameli

Thanks for having us.

Teresa Neal

Thank you to Dr. Moore-Merrell, Chief Cameli, Assistant Chief Johnson and Assistant Chief Kreis for having this important discussion. Please go to to learn more about being summer ready.

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