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Rehab NFPA 1584
1
Rehab: Rules of Engagement for Incident Commanders
Objective
To ensure all firefighters who endured strenuous physical activity at a working fire are rehabilitated and medically evaluated for continued duty and before being released from the scene.
Chapter 4 pgs. 254-266
Reasons for Rehab & Expectations
- Firefighter's suffer more than 80,000 injuries and 100 LODD a year.
- More than half of firefighter deaths are due to cardiovascular events, and nearly a quarter of the injuries are attributed to overexertion and strain.
- Dangers of extreme heat and humidity or extreme cold.
- When fatigued the ability to operate safely is impaired.
Before the Response
Goal!
The goal of rehab is to get firefighters either back into the action or back to the station in a safe and healthy condition.
Goal of Rehab
Rehab Responsibilities
- Physical assessment
- Revitalization
- Medical evaluation and treatment
- Continual monitoring of physical condition
- Transportation for those requiring treatment at a hospital
- Initial critical incident stress assessment and support
- Reassignment
Rehab Responsibilities
Portable Equipment used for Rehab Operations
- Rehab Area Marking Equipment
- Portable Shelters
- Active Cooling Devices
- Lighting and Electrical Generation Equipment
- Chairs and Tables
- Drink Dispensing Equipment
- Trash Collection Equipment
Equipment for Rehab
Simple and Effective
DCFR Equipment Ideas
ICS – What is it and Where Does Rehab Fit?
The responsibilities for any portion of the ICS structure that are not activated remain the responsibility of the IC.
ICS – What is it and Where Does Rehab Fit?
Rehab Supervisor
Incident command or other personnel will have authorization to initiate rehab, in line with the department standard operating procedures (SOP).
NFPA 1584 suggests this should occur when emergency operations pose the risk of members exceeding a safe level of physical or mental endurance.
When to activate Rehab?
Climatic or environmental conditions that indicate the need to establish a rehabilitation area are a heat stress index above 90 degrees (F) or wind chill index below 10 degrees (F) per DCFR Manual
Assign Rehab Sector.
NFPA 1584 calls for a minimum of BLS care available at incident scenes, and resources for transport if they’re needed.
Rehab Officer
The person designated as the Rehabilitation Officer, (commonly called "Rehab Officer"), should be of the highest medical certified personnel available on scene of an incident and designated to supervise the Rehab Section activities by the Incident Commander.
DeKalb County Fire Rescue Employee Manual, Effective Date 2/1/2013 Page 255
The "big three" Considerations.
1. The estimated number of responders who will need to be rehabbed.
2. The climatic conditions at the time of the incident.
3. The duration of the incident.
Rehab Site Selection
Setting up the rehab area
Hydration and Dehydration Concerns in Rehab Operations
Perhaps the most important function carried out in the rehab operation is ensuring that firefighters receive adequate hydration to support their body’s need to replenish fluid lost during emergency operations or training evolutions.
Food and Refreshments for Firefighters
- During periods of extreme exertion, some people may lose as much as 1 liter (about 1 quart or 2.2 pounds) of sweat per hour.
- While water balance is indeed crucial, so are electrolytes present in the body.
- Sports drinks are formulated carefully to ensure that they provide the user with needed water, electrolytes, sugar (carbohydrates), and other nutrients.
Food
Food and Nutritional Support during Rehab
There are no set rules for when food operations should be established, but you should typically plan for them if the incident will be more than 3 to 4 hours in duration.
When making these selections it is important to consider the three basic types of nutrients that make up a normal diet: carbohydrates, fats, and proteins.