Emergency Incident Rehabilitation

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Emergency Incident Rehabilitation
Prepared by your friends at the Zionsville Fire
Department Training Staff

• The Essentials
• This course is intended to provide a basic
  understanding for members operating on the
  emergency scene of the basics of Emergency
  Incident Rehabilitation, and is not intended to
  replace the Emergency Incident Rehabilitation
  course.

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References

• Chapter 27, Fire Service Emergency Care, Brady,
  1999
• Like anyone is really going to read the book!!!

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Introduction

• Firefighters die of stress and heat related
  illnesses far more often than they do of burns or
  injuries suffered in structural collapse.
• Although fire fighting is a hazardous, physically
  demanding occupation, appropriate emergency scene
  rehab can reduce the risk of stress and heat
  related illnesses and deaths associated with it.

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Introduction

• As a firefighter, you must be alert to your own
  physical and mental limitations when on duty and
  also for the physical and emotional well being of
  your fellow firefighters.
• You may also be assigned to evaluate and care for
  fellow firefighters when you are assigned to the
  Rehab Sector on an emergency scene.

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When to establish Rehab Sector

• Large, multi-jurisdictional incidents
• Multiple alarm fires
• Haz-Mat incidents
• Incidents of long duration (gt than 1 hr.)
• Extreme weather conditions
• At commands discretion, particularly under the
  advice of the Incident Safety Officer (ISO)

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Where to establish Rehab Sector

• Outside of and upwind from hazard area or hot
  zone
• Prompt reentry to emergency operations after
  rehab
• Protected from environmental extremes
• Large enough to handle all members in need of
  rehab
• Free of vehicle exhaust
• Not immediately available to the media
• Near SCBA refill site
• Availability of drinking and running water
• Out of view of fatality recovery operations

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Layout of Rehab Sector

• Single entry/exit point
• Accountability (log in/out)
• Space for gear storage
• Space for SCBA support
• VS checkpoint
• Rest and refreshment area
• Hydrate! (Water, 25/75 or 50/50 Gatorade and
  water mix)

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Layout of Rehab Sector

• Medical Evaluation/Treatment area
• Hydration
• Access to ambulance staging area and transport
• Should be supervised by an EMT or higher

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Common Criteria for Entry to Rehab

• Crew member at physical or emotional limits
• Upon exhaustion of two SCBA cylinders
• Upon direction of ISO or IC
• Time limit per Department SOGs, if applicable

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Common Criteria for entry to Medical Eval/Tx Area

• Pulse gt120 bpm
• BP greater than 200 systolic or 110 diastolic, or
  less than 90 systolic
• Any injuries

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Common Criteria Mandating Continued Stay in Rehab
gt20 Minutes

• Pulse still gt100 bpm
• BP gt 160 systolic or 90 diastolic or less than
  100 systolic
• Any injuries

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Vital Signs

• Fire fighters should have pulse and BP monitored
  upon entry to rehab sector

Yes, gentlemenyou are expected to remember how
to use these
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Medical Evaluation and Treatment Area

• If abnormal VS are found, Pt has any medical
  complaints or injuriesthis is the place for
  them!
• Should be supervised by an EMT or higher
• Good place to stick the blue guys from that big
  white box that often follows us to the scene

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Heat related injuries Review

• What does it look like?

• How do you treat it?

• What should you watch for
• during recovery?

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Any questions???

• Travis R. Welch, NREMT, PA-S