How Does Your Department Handle Firefighter Rehab?

[firecapt32 282]

its the middle of July and we are in for a long period of hot sticky weather. How does your department contend with firefighter rehab?? What precautions are you taking to make sure your firefighters are safe from the elements. What are you useing to replenish fluids for you firefighters. Share your ideas so other departments can learn. We know what to do when the saws run out of fuel but do we understand what happens to our firefighters when they run out of fuel??

[KRF178 49]

In my dept. we keep water on all if not most of the apparatus. Some in coolers with ice some not...lack of ice machines around the houses. On the apparatus I'm responsible for the cooler is drained and new ice is replaced every day or other day depending on the heat. Another thing I would recommend is one of those "cool mist" fans that blow air and cool water on you, it works wonders. For those of us in the northern westchester area who have the luxury of utilizing Cortlandt VAC's disaster rehab unit, it's the best. The members of CVAC respond out and do an excellent job with ice cold water, mist fans, and cold towels. They have been at a few of our warm weather incidents and have always gone above and beyond to make sure that FF's properly rehab and don't overheat. It's also always great to have your local VAC there ready with BP cuffs and O2 just in case, lets face we're all not superman....everyone needs a break!

[EMT Lady 0]

I am in the process of working with my Chief to put together a Rehab plan for our department. Currently we have water and/or gatorade on every truck, engine and ambulance. We are in the process of getting misting fans, cooling chairs, shelter, chairs, disposable towels and other items that will be put in place and a deployment plan for whenever these rehab supplies are needed. I also make sure that as the temperatures rise I keep a cooler jug filled with ice water in the firehouse available for everyone.

Rehab is currently a hot topic and articles can be found in many of the fire and ems magazines. Also, there is a lot of good info to be found online and I got much of my info from feedback I obtained from many on this site. Some departments have really good rehab plans in place. I also took the Rehab class that was offered awhile ago at the Fire Training Center. It had some very good suggestions to take back to my department and build upon.

[Goose 188]

rehab in westchester? it's non existant...

[Guest alsfirefighter]

We know what to do when the saws run out of fuel but do we understand what happens to our firefighters when they run out of fuel??

Haven't I heard that somewhere before? lol.

Also cool mist fans are ok...however forearm/hand immersion is proving to be the most effective and efficient to lower body core temperature. These are not manufacturer studies either, one was the British Navy and another was in Canada that utilized simulated firefighting activities in a climate controlled room.

[JM15 386]

Somers has recently implemented a structured rehab program. We now have utility 88 which is a converted passengeer bus. It has heavy duty air conditioning and heat for the winter months. It is a place to get out of the elements and where monitoring can be done by EMS personell. It also carries tons of water and gatorade, chairs, a large tent, and other supplies for prolonged operations or anything where rehab is needed. Our department has also instituted the policy where after two air bottles at a fire you are immediately sent to rehab where the rehab officer holds onto your interior tag untill he feels that you are ready to go back to work. We do blood pressure monitoring and we have a detector that can measure how much CO is in your body while you are in rehab.

As a side note our Utility 88 ( the Rehab and cooling bus) is available for mutual aid to whom ever requests it.

[GAW6 66]

rehab in westchester? it's non existant...

Next time do some research before making a general statement like that!

[Guest alsfirefighter]

I'm just gonna chime in every so often after some replies.

Keep in mind that vitals while important and should be taken don't have as much standing in the new NFPA 1584 standard where the physicans on the standard committee stressed that body core temperature (oral or tympanic) is the most critical and important number to utilize to determine fitness for re assignment. It is not uncommon for vital signs to return to normal only to have body core temperature still increasing.

As for air conditioning you need to be cautious when utlizing it. Blasting the environment to make a meat locker is not good and most texts recommend having the persons body temp come down to ambient temperature before entering. If you enter a cooled environment too quickly, your thermoreceptors on your skin will register your cold..that is why you get goosebumps when your peripheral vascular system constricts to conserve warmth. Hence making your body core temp increase because it can't get to your skin to evaporate and convect.

Additionally....NFPA requires that member report to rehab after the use of 2 30 min. rated cylinders, 1 45 or 60 min. cylinders or 45 mins of work w/o the use of SCBA. Not only is it a requirement by NFPA standard..its also just a good rule to use for policy.

Edited July 15, 2008 by alsfirefighter

[firecapt32 282]

mac you know me better then that i steal whenever i can I know its your line but i am useing it am i working wed night with you?

[ex-commish 490]

rehab in westchester? it's non existant...

How is it non existent?

[EMT Lady 0]

From what I have seen there are more and more departments that are setting up rehab plans for their departments. Some have specific vehicles stocked with supplies solely for the purpose of rehab. Of course many in the fire service still think they don't need rehab, but it should not be an option. It's for their safety as well as those working around them to rest and stay hydrated to be able to continue to perform the job and most important to stay safe!

[jack10562 414]

rehab in westchester? it's non existant...

Please do reply. I'd also like to hear more information and/or proof you have to back up that statement.

[Guest alsfirefighter]

I'm not going to jump into the fire with goose. However I will say from my own observations that rehab overall in Westchester is either inefficient and/or ineffective at best. There are a few that do it really well and there are those that while thinking it works isn't getting the maximum of what benefit their could be or not getting anything out of what they are doing at all. Then there are some that I guess think it will happen by accident.

FireCapt....sure come on over brother...always willing and look forward to us working together.

EMT Lady...great post.

[EMT Lady 0]

Thanks alsfirefighter! Loved the class and now I'm doing my best to put it to good use. Would like to go over it with you sometime if either of our schedules ever permits it! ha ha

[Monty 35]

rehab in westchester? it's non existant...

Next time do some research before making a general statement like that!

How is it non existent?

Please do reply. I'd also like to hear more information and/or proof you have to back up that statement.

Maybe the original post was a bit flippant - maybe tongue in cheek. However, in my department we do not have any set up for rehab - other than the Ladies Auxiliary. Most of the trucks carry some water on them - but that's hit and miss between the different companies.

In my travels, I've not seen vitals being taken, cooling chairs, any organized or enforced rest periods. sounds like Cortlandt VAC have some good resources - and also some of the more progressive departments are putting things in place - but that definitely doesn't apply to the whole County. There are still quite a lot of incidents where there isn't even any EMS coverage.

[ny10570 745]

Orange County (California) recently ran a study to examine hydration, exertion, core body temp, and cooling techniques. The majority of the results were more of the same, we're dehydrated before we start, we work harder then most medical experts realize, and forearm immersion and wet towels are the most effective cooling techniques. The one new piece that has also come into question in some other research is that tympanic membrane temps may not accurately reflect core body temp. Using a non-digestible capsule swallowed before the test they found that as the core body temp got higher the discrepancies between the two increased. There is supposedly research underway to determine if the discrepancies are predictable but I don't know where it is.