Fire department rehab - AbsoluteAstronomy.com

Fire department rehab is a vital firefighting service

Emergency service

Emergency services are organizations which ensure public safety and health by addressing different emergencies. Some agencies exist solely for addressing certain types of emergencies whilst others deal with ad hoc emergencies as part of their normal responsibilities...

on the fireground

Glossary of firefighting terms

Firefighting jargon includes a diverse lexicon of both common and idiosyncratic terms. One problem that exists in trying to create a list such as this is that much of the terminology used by a particular department is specifically defined in their particular standing operating procedures, such that...

, providing firefighter

Firefighter

Firefighters are rescuers extensively trained primarily to put out hazardous fires that threaten civilian populations and property, to rescue people from car incidents, collapsed and burning buildings and other such situations...

s and other emergency

Emergency

An emergency is a situation that poses an immediate risk to health, life, property or environment. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative...

personnel with immediate medical attention

First aid

First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...

including rehydration, treatment for smoke inhalation

Smoke inhalation

Smoke inhalation is the primary cause of death in victims of indoor fires.Smoke inhalation injury refers to injury due to inhalation or exposure to hot gaseous products of combustion. This can cause serious respiratory complications....

, and the prevention of such life-threatening conditions as heatstroke

Hyperthermia

Hyperthermia is an elevated body temperature due to failed thermoregulation. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate...

and heart attack

Myocardial infarction

Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

Equipment

Rehab equipment includes but is not limited to:

A canopy
Canopy (building)
A canopy is an overhead roof or else a structure over which a fabric or metal covering is attached, able to provide shade or shelter. A canopy can also be a tent, generally without a floor....
Misting fan
Fan (implement)
A hand-held fan is an implement used to induce an airflow for the purpose of cooling or refreshing oneself. Any broad, flat surface waved back-and-forth will create a small airflow and therefore can be considered a rudimentary fan...

s for cooling
Cooler
Cooler
A cooler, cool box, portable ice chest, chilly bin , or esky most commonly is an insulated box used to keep food or drink cool. Ice cubes are most commonly placed in it to help the things inside stay cool...

s with water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

and other beverages
Drink
A drink, or beverage, is a liquid which is specifically prepared for human consumption. In addition to fulfilling a basic human need, beverages form part of the culture of human society.-Water:...
Medical monitor
Medical monitor
A medical monitor or physiological monitor or display, is an electronic medical device used in medical monitoring that displays the monitored data, and may or may not have the ability to transmit the data on a monitoring network...

ing
Chair
Chair
A chair is a stable, raised surface used to sit on, commonly for use by one person. Chairs are most often supported by four legs and have a back; however, a chair can have three legs or could have a different shape depending on the criteria of the chair specifications. A chair without a back or...

s
Food
Food
Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...

Overview

Firefighter

rehab is designed to ensure that the physical and mental well-being of members operating at the scene of an emergency

Emergency

(or a training exercise) don't deteriorate to the point where it affects the safety of any other members. Figherfighting is inherently dangerous in the best of circumstances, and any additional physical or mental stress increases the danger.

In 1993, the US Coast Guard conducted a study dealing with the effects of interior firefighting on the human body. The researchers noted that the figherfighter's body core temperature often reaches 104 degrees Fahrenheit during the firefight, even after short exposures.

1. Primary Mission:

The primary mission for fire command is to identify, examine, and evaluate the physical and mental status of fire-rescue personnel who have been working during the emergency incident or a training exercise. Following a proper survey (see below), it should be determined what additional treatment, if any, may be required.

According to the U.S. Federal Emergency Management Agency

Federal Emergency Management Agency

The Federal Emergency Management Agency is an agency of the United States Department of Homeland Security, initially created by Presidential Reorganization Plan No. 1 of 1978 and implemented by two Executive Orders...

(FEMA), "Any activity/incident that is large in size, long in duration, and/or labor intensive will rapidly deplete the energy and strength of personnel and there merits consideration for rehabilitation."

2. Launching The Rehab Operation

A specially designated Rehab Area, (or Group) remote from the fire or emergency incident, should be established at the discretion of the Incident Commander in consult with the senior Fire Safety Officer

Fire Safety Officer

In the United Kingdom Fire and Rescue Service a Fire Safety Officer is a firefighter who has attained the rank of Sub-Officer or above, and transferred from front line operational service into the Fire Safety Department.The term "Fire Officer" may also refer to a Fire Safety Inspector who is of...

. If the Incident Commander determines that Rehab is necessary, qualified Paramedics or EMTs (assigned to the first alarm response) should be designated to manage the Rehab Sector under the command of a fire or EMS officer or supervisor.

Note the emphasis of the "first alarm response." EMS personnel must be on scene and available to provide treatment to fireground personnel at a moment's notice. If EMS does not respond as part of the initial turnout, consideration should be given to the fact that OSHA

Occupational Safety and Health Administration

The United States Occupational Safety and Health Administration is an agency of the United States Department of Labor. It was created by Congress of the United States under the Occupational Safety and Health Act, signed by President Richard M. Nixon, on December 29, 1970...

will certainly question why they weren't... especially if anyone is injured.

Because they work side by side with the front line troops, company officers play an important role in Rehab. In fact, the federal government suggests that the safety of the fireground rests here, at the supervisor level. If a company member shows signs of fatigue or illness

Illness

Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...

, the company officer will likely be the first to recognize the problem.

Anticipate Rehab needs early in the incident. During large-scale operations, Incident Command should consider augmenting existing resources by requesting additional EMS personnel or even another engine company or squad, to assist in the operation of the Rehab Sector.

3. Locating the Rehab Sector:

It is crucial for Command to establish The Rehab Sector away from any environmental hazards, or by-products of the fire, such as smoke, gases or fumes. During hot months, the ideal location might include a shady, cool area distant from the incident. In winter, a warm, dry area is preferred. Regardless of the season, the area should be readily accessible to EMS-Rescue personnel and their equipment, so they may restock the sector with supplies, or in the event that ambulance

Ambulance

An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...

transport is required.

Rehab sites can also be established in the lobbies of nearby buildings, a parking lot

Parking lot

A parking lot , also known as car lot, is a cleared area that is intended for parking vehicles. Usually, the term refers to a dedicated area that has been provided with a durable or semi-durable surface....

, or even inside municipal buses.

Misting/cooling systems, heating systems, SCBA refilling and canteen service should be stationed in or around this area as well. During large-scale incidents, like multi-alarm fires, Command should consider establishing Multiple Rehab Areas as the situation warrants.

4. Coordination and Manning:

Command of the Rehab Area should be assigned to a fire chief

Fire chief

Fire Chief is a top executive rank or commanding officer in a fire department, either elected or appointed...

or company level officer, who is designated as the Rehab Officer under most Incident Command structures. The incident itself will determine just how many people you'll need to do the job, however a minimum of two trained EMS personnel should initially be assigned to monitor and assist firefighters in the Rehab Sector. Utilize volunteer canteen or auxiliary members to assist EMS personnel in making "working" members as comfortable as possible.

5. Evaluation of Fire-Rescue Personnel:

It is important for command and company level officers to continually monitor personnel for telltale signs of exhaustion, stress, and or physical trauma

Physical trauma

Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...

. Individual members are encouraged to report to the Rehab Sector at any time that he or she feels the need to do so. Symptoms may include weakness, dizziness, chest pain, muscle cramps, nausea, altered mental status, difficulty breathing, and others.

Regardless of physical well-being, all fireground personnel should report to the Rehab Sector immediately following:

a. Strenuous Activity - Forcible Entry, Advancing Hoselines, Ventilation, etc.

b. The use and depletion of two SCBA bottles

c. Thirty (30) minutes of operation within a hazardous/dangerous environment

d. Failure of SCBA

6. Examination of Arriving Personnel

Arriving personnel should be examined by qualified EMS, who should check and evaluate vital signs
, and make proper disposition, i.e. return to duty, continued rehabilitation, or transport to medical facility for treatment. The workup should include:

a. Scoring for Glasgow coma trauma scale.

b. Checking Pupils

c. Checking Vital signs

Vital signs

Vital signs are measures of various physiological statistics, often taken by health professionals, in order to assess the most basic body functions. Vital signs are an essential part of a case presentation. The act of taking vital signs normally entails recording body temperature, pulse rate ,...

, such as blood pressure, pulse, breathing rate,

d. Checking lung

Lung

The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...

sounds

e. Administration of a 2-lead EKG, when chest pain or irregular heartbeat is presented

f. Skin condition and color

g. Body core temperature

Heart rate

Heart rate is the number of heartbeats per unit of time, typically expressed as beats per minute . Heart rate can vary as the body's need to absorb oxygen and excrete carbon dioxide changes, such as during exercise or sleep....

should be measured as early as possible in the rest period. If the firefighter's heart rate exceeds 110 beats per minute, it is recommended that an oral temperature be taken. If body core temperature exceeds 100.6F, the firefighter should not be permitted to wear protective equipment or re-enter the active work environment, until temperature has been reduced and heart rate decreased.

It is recommended that re-examination occur at ten minute intervals. Using standing orders or existing protocol, Rehab Team Members should record examination results on medical evaluation forms as indicated by the local jurisdiction.

7. Treatment During Rehab:

Upon completing the physical examination, the following steps should be taken to minimize further risk to fire-rescue personnel:

Turnout gear, helmets, masks and hoods should be removed immediately. Prior to ingesting anything orally, fluid or solid, it is recommended that the firefighter clean his/her hands and face with water and a cleaning agent, as provided by Rehab Sector personnel.

a. The firefighter should rehydrate (ORT)

b. Oral rehydration and nutrition is recommended in the form of 1-2 quarts of fluids over a span of 15 minutes.

c. Body core temperature should be reduced by cooling the body.

d. Cool body temperatures gradually using misting systems, fans, etc.

e. Individuals should be offered Oxygen therapy via nasal cannula

Cannula

A cannula or canula is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of data...

or O2 mask. (humidified or Nebulized).

f. Standing rest before reporting for further assignments

g. The firefighter will only report to manpower staging when presentation is deemed normal by the attending EMS personnel.

Note: According to FEMA, Water is the best rehydration agent, however some agencies suggest a rehydration solution of 50 / 50 mixture of water and a commercially prepared activity beverage administered at about 40F. Avoid cooling the body using ice packs or hosestreams. Cooling should be gradual, limiting further shock to the body.

In the event that presentation appears abnormal, the Firefighter should immediately receive additional treatment, especially if conditions persist following fifteen minutes of rest. As is appropriate in most locales, those complaining of chest pain

Chest pain

Chest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain.-Differential...

, difficulty breathing and altered mental status must receive immediate ALS

Advanced Life Support

Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...

treatment and transport to definitive health care. Follow your local jurisdiction's ALS protocols in this event.

8. Accountability.

Members reporting to the Rehab Sector / Group should enter and exit the area as a team. Their company designation, number of personnel, and the times of entry to and exit from the Rehab Area should be documented. This can be done either by the Rehab Officer or his / her designee on a Company Check-In / Out Sheet. Keep crews together, and don't allow overanxious members to freelance the event.

9. The Vital Importance Of Firefighter Rehab

Very few firefighters who wear the badge are athletes. But from the moment the alarm is sounded, and that first surge of adrenaline reaches the heart, we're asking our bodies to work triple overtime. Couple that with 55 pounds of business suit, 1200 degree temperatures and another 50 pounds of hand tools and equipment, and the importance of effective rehabilitation at the fire scene becomes crystal clear.

reposted with permission from the author: Lou Angeli

Personnel

Some fire departments

Fire station

A fire station is a structure or other area set aside for storage of firefighting apparatus , personal protective equipment, fire hose, fire extinguishers, and other fire extinguishing equipment...

run their own fireground rehab, or it may be provided by:

Private non-profit organization
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

s, such as so-called fire buffs http://www.ifba.org/ (not to be confused with firebug
Pyromania
Pyromania in more extreme circumstances can be an impulse control disorder to deliberately start fires to relieve tension or for gratification or relief. The term pyromania comes from the Greek word πῦρ . Pyromania and pyromaniacs are distinct from arson, the pursuit of personal, monetary or...

s or arson
Arson
Arson is the crime of intentionally or maliciously setting fire to structures or wildland areas. It may be distinguished from other causes such as spontaneous combustion and natural wildfires...

ists), sparkies http://www.legeros.com/fire/buff.shtml and other organizations
Emergency medical services
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...

(EMS)
Rehab services run by private individuals

Vehicles

Dedicated Rehab Vehicles
Converted ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...

s
Converted step van
Van
A van is a kind of vehicle used for transporting goods or groups of people.In British English usage, it can be either specially designed or based on a saloon or sedan car, the latter type often including derivatives with open backs...

s (types of step vans)
Converted canteen trucks
Mobile catering
Mobile catering is the business of selling prepared food from some sort of vehicle. It is a feature of urban culture in many countries.- Variants :...
Converted bus
Bus
A bus is a road vehicle designed to carry passengers. Buses can have a capacity as high as 300 passengers. The most common type of bus is the single-decker bus, with larger loads carried by double-decker buses and articulated buses, and smaller loads carried by midibuses and minibuses; coaches are...

es.
Pickup truck
Pickup truck
A pickup truck is a light motor vehicle with an open-top rear cargo area .-Definition:...

s

External links

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.

Equipment

Overview

Personnel

Vehicles

See also

External links