Rehab Policies. When do you not allow a person to reenter?

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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Permalink Reply by Art "ChiefReason" Goodrich on August 10, 2008 at 11:28am

I think that this would apply here.
From thesecretlist today:
PA. FIRE INSTRUCTOR LODD:
It is with deep regret that we advise you that PA. Fire Instructor Sean Whiten, 47 of Stockdale (PA) a former Chief and Captain of the Roscoe VFC died in the Line of Duty yesterday during a training burn.
F.I. Whiten was operating at the Westmoreland County (Western PA) Fire Training Academy (South Huntingdon) and had lead several training burns when he decided to go to rehab. While at rehab, his vitals were determined to be good, he sat in front of cooling fan, felt better and went to an area to relax. Following that, he was found down, suffering from a medical emergency...personnel worked on him, an AED was used and he was transported to the hospital where he passed away.

My thoughts and prayers go out to all those affected by this untimely death of Chief Whiten.
TCSS.
Art

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Permalink Reply by T.J. on September 13, 2008 at 4:08am

We've got a "2 bottles and 20 minute rehab rule", and this is monitored by the safety officer if they feel you need longer then your there longer.

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Permalink Reply by Ryan James Johnsrud on May 26, 2010 at 4:10pm

We are lucky enough to have an EMS crew that monitors our CO levels when we enter Rehab. At what CO level would you recommend that a FF stay in Rehab?

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Permalink Reply by Wayne Peterson on May 28, 2010 at 4:25am

Small dept. but we use 2 bottle rule also, or if you need a rest you can sit it out. We really are a team oriented dept.

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Permalink Reply by N. Stewart on May 28, 2010 at 1:02pm

That training center is cursed I think...at a training just two weeks ago we were there and my scba shut off and i started to lose conciousness in the training building (not the live burn hall). Then someone else had an asthma attack and we were both transported to the local ER, them as BLS and me as ALS. I'm a fire science major and spend most of my time at that center...they dont even have BLS equipment or O2 available there.

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Permalink Reply by Mike "Lapo" Lapotasky on May 28, 2010 at 2:29pm

Okay...I looked through ALL the posts...so...unless I missed it...NOBODY HAS SAID ANYTHING ABOUT NFPA 1584!
It IS THE STANDARD! It is a law here in NJ. All training and live actions must be supported by EMS and all operators are to REHAB!

Stop thinking about bottles used or making judgments off the cuff about whether or not a guy is ready to go back to work! Please trust me, I know the standard well. I teach the course and everyone needs to get on track with this!

Resps. 20+/min.=another ten minutes of rehab
Pulse 100+=another ten minutes of rehab
BP 150+/100++another ten minutes of Rehab

Also, if any responder has physical complaints:
dizziness, flushed face, poor gait, trouble breathing, poor perfusion, headache, nausea, slurred speech, blurred vision, trouble standing, stomach cramps, or any other sign of exposure injuries
These must go straight to the treatment corridor.

Failure to improve (at all)in a total of thirty-forty minutes=TRANSPORT to definitive care! PERIOD.

"NFPA 1584 outlines who’s responsible for what. The company officer or supervisor is the kingpin. He must assess the crew to determine members in need of rehab at least every 45 minutes. The standard calls for individual firefighters and their supervisors to undergo rehab following the use of a second 30-minute SCBA cylinder, after a single 45-minute or 60-minute cylinder, or after 40 minutes of intense work without SCBA. Supervisors can adjust these time frames depending on work or environmental conditions. The EMS personnel staffing rehab (and providing medical monitoring) must have the authority to detain members in rehab or transport members when there are obvious indications preventing them from returning to full duty. Note, as mentioned previously, these providers may not be the same EMS members responsible for emergency medical care and transport." -The Elephant on the Fireground: Secrets of NFPA 1584 Comliant Rehab, Fire Engineering, August 1, 2008, by Mike McEvoy

In NFPA jargon, the word "shall" means you had better do it if you don't want a wrongful death suit from a widow or widower. Just DO it!

Guys, if you never have a bottle, do you think that wildland guys need rehab? They don't use bottles! So WTF?

Crew level rehab is a responsibility of the crew level officer or foreman. Drink plain old water! The best is actually a 2:1 water to gatorade mix...it's in THE STANDARD! Start reading people!

If anyone would like to know more about EIR (Emergency Incident Rehabilitation) please email me whenever!
mustang42fire@yahoo.com

Meet or exceed it! That's IT! Period. No more tough guy bullshit. We are killing ourselves!

PLEASE READ THE STANDARD AND STOP ARMCHAIR QUARTERBACKING THIS THING!

ICs...it is your responsibility!
ALL trainings, ALL responses of extended operating period of over forty-five mins.

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Permalink Reply by Mike "Lapo" Lapotasky on May 28, 2010 at 2:36pm

My apoligies gents and ladies...I did not realize that this post was from 2007.

AND...yes...other calls outside of structural jobs are often overlooked! I myself was transported from the extrication I have posted in my photos of the pick up head long into a utility pole.

I felt awful...AND apprently looked awful too!

CREW LEVEL HYDRATION IS THE BEST PROACTIVE MEASURE! "An ounce of prevention is worth a pound of cure!"

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Permalink Reply by Richard Armstrong on May 28, 2010 at 2:51pm

2 bottles out for one here to.It would be up to FF to stick his pride in his back pocket then to say he needed more rest.We do not have anyone doing vitals here but our cheif says have a look at your partners and see if you think they are good to go also and you suspect anything call the paramedic over to get him checked.