This is a short tutorial on setting up Rehab at scenes of Training, Fires or any event that it may be needed.
Step 1: When Do We Need This?
There is several types of incidents that we may need to set up rehab for the Fire Department as laid out in WAC 296.305. These incidents can be Structure Fires, Wildland Fires, Water Rescues, and Vehicle Accidents. The main factors to be considered for needing rehab is the type of incident, duration, manpower, weather and temprature conditions.
Step 2: Heat Index Guide.
Just think of your manpower. Just because it is 90 degrees outside. doesn't mean that they are. consider humidity, weather, shade or lack of, wind etc..
Step 3: Where to Establish Your Rehab Location.
several factors to keep in mind when choosing a location. how far is it away from the actual scene. You don't want to have manpower have to walk to far to rest. is it upwind of the incident. You don't want contaminants from the scene to be drifting into the rehab area. ultimately you would have it out of direct site of the incident to allow personnel to mentally disconnect from the scene while they rest. Make sure it is still easily accessible by walking.
Step 4: Organize Your Rehab Area.
establish and area so that it will flow. people are to be tracked as they enter, move thru the eval area and rest area and then are tracked as they are released. if you have an organized are it is easier to keep track of personnel and where they are in the rehab process.
Step 5: Documentation
As you are assigned to rehab we should be using a form similar to this one to track the movement of personnel in incident rehab.
Step 6: They Have Entered Rehab Now What?
This is where the personnel will be evaluated as they enter rehab and briefly examined and if needed treated or sent to the medical unit for treatment.
Step 7: Respiratory
Respiratory rate shall be counted and monitored for rate and quality. This may include lung sounds.
Step 8: SPO2
you should check for the amount of oxygen in their blood by using the SPO2 monitor. you will also need to manually check their heart rate and quality. remember that they pulse should not be higher than 150 at any time and no more than 140 after cool down. We are also checking for irregular heart rate.
Step 9: Check Blood Pressure
you will check their blood pressure. Any Systolic blood pressure above 130 mmHg and Diastolic blood pressure above 90 mmHg will be monitored and not released to active response.
Step 10: Temprature
We will check oral temperature. any temperature over 100.5 degrees will be monitored and not released back to active response. we will also monitor them for temperature related illness such as heat exhaustion, heat stroke, and hypothermia.
Step 11: Resting and Rehydrating
personnel should be actively resting while in rehab. This means to relax and let their body take a break. you should strip down layers of PPE to allow people to cool off. Have refreshments to provide to personnel. Items provided shall be of high nutritional value. items that should be avoided are: carbonated, high-fructose-content, and high sugar drinks, foods with high fat and or high protein content, alcohol within 8 hours of duty, excessive fluids, Tobacco, Creatine supplements, ephedrine, beverages exceeding 400 milligrams of caffeine per day and Energy Drinks.
Step 12: Resting Is Done in Rehab
Personnel will need to remove themselves from the incident to have been considered to have been thru the rehab process. this is not an acceptable method of rehab. you need to be physically and emotionally disconnected from the scene.
Step 13: You Are Rested and Now Ready to Get Back at It.
remember to educate personnel that their body has been stressed both emotionally and pysically. they need to proceed with caution and if at any time they feel ill, have chest pain or shortness of breath or any medical issue to advise their company commander.
Thank you and be safe!