What point to you force a crew to go to rehab and not allow them to go back in the fire? We have had this fight on many admin meetings. Right now after 2nd bottle you must go to rehab have medic check HR and BP pulse Ox and clear you to return to duty. I have suggested we change that to before the second bottle but then find I dont want to follow it..(yes thats ego and bad judgement) I am just wondering what other think and policies in place.

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Our policy is the same, after 2nd bottle you are sat down, away from the fight, vitals taken and bottled water or Gatorade is drank. You are out for atleast 15 minutes and then, if all looks well, you can go back. And I agree with you, no one wants to stop and miss the fire but it is essential and a very good idea. So you have to take the break and do it.
Our policies are the sam two cylinders an you are done for awhile. We get them hydrated and let them rest before we let them go back in.
I have a question. What do you compare the vitals to? How do you know what their baseline is to make a decision whether or not the blood pressure is too high to go in? What is the cut off for poor vital signs to not allow someone back into a fire? I just ask because I know some departments that don't do baselines on people to have an understanding of their "normal" vital signs. I also know departments that take vital signs almost every shift.

Also, is it only a vital sign check? What are the expectations for temperature checks? Rehydration and nutrition? Removal of clothing to lower basal body temp?

Great discussion topic, I'll be interested to see what people say.
Yup, two bottles here too. Vitals, water, snack if need be and back at it when needed. We have enough people that when you get back to it, you're usually doing overhaul, unless of course it's a multiple alarm fire.
No one wants to follow it, we all want to stay in there and get dirty, but our Chiefs and Safety Officers keep a close eye on us and are sure we're taken care of.
Our policy is pretty much the same. Although if an officer thinks you need it sooner, he/she will tell you. Our firefighters pretty much follow the rule. Once in a while we'll get a cowboy that doesn't want to listen, but peer pressure or direct orders will get them to.

We also check vitals, give water, and have food available if needed.
After the second bottle its at least 20 minute down time with re hydration and we don't do it every shift but at drills when we do any real strong work we do vitals and record them. This is a new practice. Any BP over 160/100 gets stopped and HR over 120 and pulse ox less then 96. but this is not prefect for sure its more the 20 minute down time.
When I was younger this would be hard but now I am older and after 2 bottles I am not afraid to stop and I also know when I need a break. I also remind all the younger guys we will have plenty of work when the fire is out so get ready for that. Weather is an issue as well when I was in Miami Hot humid took its toll but here in the great white north cold and snow is another issue in its self.
We live by the two bottle rule as well, two bottles then mandatory rehab, guys are responsible for knowing whats normal for them as far as their vitals go, and screening is always available. If EMS feels the vitals for any firefighter are not WNL they have the right and obligation to order more rehab time. Generally rehab lasts about 15 minutes with wet towels, dry towels, hot/cold drinks depending on weather. Officers don't see as much rehab, but are held to the same standard if they are operating as a member of an interior crew.
We have a 2 bottle the rehab. Only issue with this is noone enforces the bottle issue, or rehab, and on the offbeat chance you pup high BP you get your chops busted for weeks.
Put rehab near bottle change area
That's awesome to hear. Hopefully more departments will start practicing effective and adequate rehab in the training environment as well.
What happened at the Mill fire we had (86 combined fire/ems apparatus on scene) was the EMT's went looking for firefighters, and they kept a very good eye on who was doing what and pulled people for BP, and rehab. It was a great idea on their behalf, although they were met by some stiff resistance by some, one of the Numerous white hats would step forward and end the conversation and off to rehab they went. Good idea for location, if it is feasable. The EMS and FD are seperate entaties here, so the EMS may be located a little ways outside the fireground. (4 or 5 houses away)

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