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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.
Replies to This Discussion
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Permalink Reply by Joe Stoltz on
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Karen, we used to keep a list of the interior FFs and their baseline vitals in the PCR clipboard in the ambulance. These would be taken on drill or meeting nights with the FF at rest and at ease. Then at game time, someone who had gone through two bottles would be monitored and if the BP was way high the member was "encouraged" to sit out the rest of the show. We unfortunately haven't done as good a job in recent years with the baseline vitals, however a rehab station staffed with medical personnel and plenty of drinking water is routinely set up. It becomes the opinion of the medic(s) monitoring the VS whether the FF can return or has to sit out longer.
On the county haz-mat team, we do vitals on all personnel suiting up in level A or B suits - BEFORE they suit up. We record BP, temperature, weight, pulse and a brief medical interview on members selected for entry, backup and decon functions. They do not suit up if their BP is either >140 systolic or >90 diastolic. They get to help the others suit up, and with other tasks outside the warm zone.
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Permalink Reply by Amy on
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Ours is pretty much the same... suck down one bottle... take a short break while swapping bottles... suck down the second and then normally that's when you get your rehab time.
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Permalink Reply by Ryan on
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After the 2nd bottle the FF is required to go to rehab where vitals are taken and they are rehydrated with water and gatorade. We are in the process on obtaining all of our FF's baseline vital signs and organize them into a chart and that is what we will be using to compare with,along with other fire company's in our areas are doing the same for mutual aid calls. FF are required to sit for 10-15 mins anyone with vital signs in the extreme either too high or to low will sit out longer and have vital signs taken at intervals. if no changes you will be put out of service for the remainder of the emergency call.
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Permalink Reply by mike on
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we use 2 bottle rule , thens its off to rescue rig to get checked out . we use twin tones on all jaws an structure fires so we all ways have enough personel , form next station . so ff sit out the rest of the alarm .
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Permalink Reply by mck306john on
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well it all depends on the air pack... like min wise... 30 min bottle, 45 min bottle, or 60 min bottle... then it also comes down the condition of the ff, what shape the ff is, blah blah blah... in my dept we currently run 45 min bottles, after our 1st bottle were required to take a 5 min break during bottle change-out's... then after our second bottle ems or a assist- oic comes and talks to u... and gives u a min 10 min break depending on what he or she thinks... and how well ur acting- feeling... then if u get to ur 3rd bottle after u finish that bottle... ur dun... ur not going back inside the fire....
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Permalink Reply by Roger Taylor on
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We have a policie 1 tank and then you get rehab because your not helping the other guys your slowing them down. We rotate two fire fighters in rehab and rotate just like the two in two out rule that way everybody is freash and not pushing thereself to the point of falling out.
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Permalink Reply by Nicholi69 on
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Guys just remember during rehab just drink cool liquids not ice cold because it will dialate you so quick that you might posibly pass out. Then your automatically done for the day.
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Permalink Reply by Jeff Betz on
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Pretty much what the others have said, 2 bottles and a break. However, we have sinfully low manpower and end up doing more on occasion. We also have some pressure from a certain person to be "super firefighters" (our term, not his). Also, as said before, there are lots of variables: bottle capacity, fitness level, etc. That is why we don't use any certain number for holding someone back, we compare their baseline against what we find during their evaluation, and make a decision. Once the decision is made, we are pretty good about sticking with it. There are also some national standards that discuss the issue, and I think FEMA has a book on rehab also.
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Permalink Reply by Tony Leonard,Jr. on
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We Have The Same As You Do.
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Permalink Reply by Art "ChiefReason" Goodrich on
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I know that several departments like to use the ever-popular "one bottle rule" and that's fine, if you are talking about structural fires and re-hab.
What about complex vehicle extrications, trench and confined space rescues, search and rescues?
My point is that you really can't have a hard and fast on this. It takes a trained eye to notice when a rescuer is in distress, whether it is heat OR cold and over exertion. Your officers and especially whoever is designated safety officer should provide the chief officer with visual snapshots of the working crews.
One bottle is pretty simple, but really, how many small departments have that many structurals?
I'd be more concerned with the "other stuff".
IMHO.
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Excellent point, Art. We do forget about the "other stuff". We had a FF go down in the spring, at the scene of a 2 car MVA. He started out dehydrated and went downhill from there, running the tool and helping with the backboards and such. Thankfully it was heat exhaustion, although he still scared the bejeezus out of us. It wasn't even that hot out, nor was he wearing SCBA.
And while on the subject, we should all keep hydrated even before going into action. I keep a bottle or two of water in the car so I can try to load up while en route to the scene. I say try, because sometimes I forget and sometimes my daughter snags it while I'm not looking.
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You might want to check out this link.
I thought it was appropriate in light of the discussion here.
http://www.firerescue1.com/tips/320186/
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