Protocol on firefighter rehab

[flyin dutch]

Hi all . . .

Looking for input for developing protocols on firefighter "rehab" after exiting a fire in which air packs have been used. This is for a volunteer ambulance and fire department, separate entities but same community, ambulance dispatched simultaneously for all structure fires, etc. Firefighters have a limit of 2 times in total with packs on, and have to be evaluated by EMT's after exiting the fire each time. What systolic and/or diastolic BP, heart rate, signs/symptoms should put them in a "time-out," what warrants treatment/transport? Remembering that BP, heart rate normally elevated somewhat in these situations. Have considered having a list of baseline vitals, updating yearly, not allowing said firefighter back in if greater than X% above baseline . . . Any ideas, thoughts welcome.

[joesph]

How many bottles should they go threw man that's hard to say. but I do know from previous experience that dehydration and body temperature are huge problems. I have seen studies of FF's core temp climbing to 104 in a working fire. And the base line fitness of the FF is important yearly fit tests or Pak tests are not out of line and if that doesn't go over to well try intercollegiate sports participation or if they are on shifts daily exercise. BP criteria is critical to say in a percentage but if they rehab after a couple of evolutions inside they should rest until there vitals return to near normal. Also try to convince them to prehydrate on the way to the call.

[Mateo_1387]

Here is the protocol the Wake County EMS system uses. Good Luck.

[Chief1C]

I'd have to take their boots away to make them rehab. Can't force it, when fire officers won't agree to enforce it.

[crotchitymedic1986]

A good strategy (but you have to be mindful of HIPPA) is for "the fire officer" to have a folder that lists everyone's "normal vitals" in his/her vehicle. By the time you are doing rehab, the officer should be on scene. You can then know what is normal, and not allow the firefighter to return until he is close to his normal again. If anyone is concerned about their HIPPA rights, you can use something like first name and radio ID# or unit #, or last 4 of SS number, or just use thier initials, in the folder.

This also helps to keep the FF in the rehab area, when they want to go back, but shouldnt. If the officer knows that the person's normal B/P is 110/60, and it is now 140/90, he/she would be less likely to send that person back in. Although it takes a little work to compile that info, I have never met a Chief who refused to order it to be done.

P.S. We only listed vital signs, no personal or history info. And this was usually smaller departments, for larger departments the folder could be kept in each apparatus' driver's door pocket.

[Chief1C]

[spoil:d0100f884f]HIPAA[/spoil:d0100f884f]

We tried that, actually had a little plastic card to have their vitals/allergies/name/blood type/etc on for their TOG. Then their tag number would correspond with the rehab form in each ambulances locked cabinet. However, nobody would agree to participate. :roll: Not even the fire officers.

[CBEMT]

We are by SOP supposed to staff and respond a second truck (non-duty crew personnel, who should be onscene) to any confirmed structure fire.

When the second truck arrives, the first is put back in service after leaving the SPCO with the on-scene truck. (Don't ask.) The "Rehab truck" has a form for each firefighter's name, vitals, etc. As far as I can tell, whether or not the firefighter goes back is up to the EMS crew, and the fire chief has made it clear that he will back us up.