With the temperatures climbing with summer approaching, I was curious as to ideas and current activities, procedures taken to counter excessive heat? Temperature, humidity, heat index, additional crews, and policies set for rehab. What are some of the ways that your department counters heat exposure? We all can hopefully share ideas and proven fire ground activities that have worked. Share some ideas and I will post some ideas of my own. thanks!
I have a lot to discuss and hopefully everyone will find it useful.
The Wichita Kansas Fire Department has a policy that has been implemented. Two levels consist to based off of the scene and the environment. The I.C. makes the decision of the level that will be used with input from the Fire Medical Officer(FMO) and the Captain or Lieutenant that will be assigned the rehab "leader".
level I, which consist of officers watching over and looking for fatigue. This is the officers responsibility during any activity, i.e. training evolution's or while on emergency scenes. Also the rehab unit that responds will ensure(promote) water and Gatorade to the crews. While doing so, contact is made with the crews and be "evaluated." Asking how that guys and gals are doing. This is vague, however, the crews know why we are there.
Level II is more detailed and crews are assigned to rehab and initial vital signs(VS) are taken. Hydration, removal of gear,hydration, shade, hydration, heat, and more hydration. Crews remain in Rehab for a minimum of twenty minutes. A second set of VS are taken and can then be released if their VS are within the rehab policy. All VS are recorded and kept within the department.
Now for the reality of the rehab program. Two and a half years ago we had a Fire Captain went into the rehab area from a 2nd alarm fire. He was complaining of not just feeling well. This Captain was in great shape and was in good health. Needless to say he had a heart valve prolapse causing his heart to be inefficient. The blood flow was backing up due to the injury to the heart valve. He ended up going to his primary care provider and was seen by specialist and have to have surgery to have the valve repaired. Long story short, the Captain died after the surgery. This was considered a LODD and the rehab unit and the documentation covered this and was imperative in the death being considered a LODD.
Being in the rehab program does not have the glory of fighting fire but it sure is important. But this sure does show the importance of the program. We are part of operations and make emergency calls, fire and medical alike, the same as any other unit in the department.
As for our program, we have paramedics. My shift, my station we have three FF/Paramedics, Fire Lt./Paramedic, Fire Capt./EMT FMO, and Fire Capt/EMTB. We have an Engine, Capt., two FF's. Squad, Fire Lt. and one FF. Our shift is pretty full on Paramedics. Other shifts have three and one. The reason having the Paramedics in our station is mostly for the rehab program.
As stated we have an Engine, Squad and a FMO pick up. We have also recently have gotten a "bus". The Rehab "bus" has been converted some to allow for Rehab specifically. (Attached pics) The idea is that it can be used during high temperatures and low temperatures. Normally we respond with the Squad and yet to respond the Rehab "bus". So it remains to be seen how it will be used.
Also being paramedics we do have Lifepak 12 ECG monitors and defibrillators. We have our BLS currently at this time. No IV supplies or cardiac medications, YET. Each paramedic is going through a credentialing process with our county EMS system. This will allow us to provide ALS in the field to improve the care they can get, not only to the citizens but to our fire crews. A picture is attached to show the equipment that is on our Engine. The identical gear is also on our Squad. The rehab "bus" has coolers for water and gatorade. It has heat and AC. A generator for electricity.
I hope that this will help anybody and that it has been useful.
I couple more pics for ya.
Also, I forgot to add this, it is our mobile air unit. Multiple air cylinders and coolers full of drinking water and Gatorade. Several chairs that are used by firefighters that are in rehab. It has a canopy on it as well for shade.
Our previous Safety Coordinator implemented a system based on this article. Don't know if this is allowed as its a different site but its got some great information about handling heat stress.