Fire Stand-by / Firefighter Rehab

[dahlio]

Since many on this forum are also fireman, I was curious as to what EMS can do to help fireman "rehab" after a working fire. Also, what do other units do when at a working fire, with fireman coming in and out from a "hot one" if you will. Thanks in advance for your replies.

[Cookie]

Depending on the fire, when I run the rehab unit I pull firefighters off anywhere from a half hour to an hour, depending on the type of fire, temperature etc. I take their vitals, bp, respirations, pulse, make sure they sit and drink fluids and make them sit for at least 20 minutes, recheck vitals and release them to go back or pack up. Then I get the next bunch. They absolutely hate it when I do it, because I make them sit out and rest. If I get any resistance I notify the fire chief, after all its on his orders that I pull them out. I have only had one time I had to take two firefighters away to the hospital and that is because they were caught in a fire storm. They were treated and released.

[brentoli]

Rehab. Most policies I have seen say 2 bottles then rehab.

You need to take a baseline set of vitals when they enter rehab. Make sure there is plenty of access to fluids and cooling/heating area. Diffrent people will take diffrent amounts of time to rehab up. Just remember, in the summer it is easy to overheat, and in the winter, it is easy to overcool.

Read up on cyanide poisioning.

[whit72]

We rehab the the FD. Most times though its not run correctly, the guys should be swapped out every half hour to an hour. Vitals taken, a certain amount of fluid taken in. Sometimes it isnt easy to pull a guy off the line if his buddies are inside. So we get a lot of flack depending on who the lieutenant is. I used to get pissed off and make a big deal out of it. Now if you don't want to come off the line. Thats alright but don't blame us when you pass out.

[dahlio]

I get any resistance I notify the fire chief, after all its on his orders that I pull them out.

Never thought of that, I'm sure he will comply, since he wants to keep his firefighters health up. Thanks for the tip.

[Chief1C]

We take their accountability tags away, our firemen can't go in w/ out handing a tag to the SO. If they fight it, I throw it up on top of the ambulance. If it gets to that point, they are red flagged and cannot reenter the fire scene. At the end of the call, we toss a rope over the rig and pull the tags off the back.

[whit72]

Take their helmet from them too. That usually works

[EMSGeek]

Fire monkeys can be very resentful to our actions as EMS providers when it comes to rehab. I believe, and its also the feeling of fellow providers I have spoken to, that a lot of the problems we have with FFs are because they don't respect us so my advice is to explain very clearly the medical reasons why you are not comfortable letting them go back in. Be respectful but firm and make it clear you are speaking to a fire fighting professional as an emergency medical professional. This is true even when the fire monkey you are talking to is some redneck smelling like beer (not true for all firefighters but for some). Patronizing is good, but make sure that no matter what the firefighters best interests are looked after.

[FormerEMSLT297]

Take their helmet from them too. That usually works

If any EMS weenie EVER tried to take my helmet, , you'd be in for a fight. LOL

That being said, there are many many protocols out there on the web,, for heat relatedx rehab, they reccomend a 1/2 water to 1/2 gatorade or sports drink mixture,, chilled to about 40 degrees. There are also specific things like B/P = or less than 140/90 or B/P greater tahn 140/90.....

check with the national fire academy for further info.

[EMSGeek]

they reccomend a 1/2 water to 1/2 gatorade or sports drink mixture,, chilled to about 40 degrees.

That's a good idea which I had forgotten. The 50/50 mixture is an effective and practical solution for keeping these guys hydrated. I've used that for standbys at athletic events such as marathons. Get a nice big Gatorade tank like the kinds contractors use and put that on the rig when going to a structure fire. You can get powdered Gatorade to be kept handy when needed. If local places like Sports Authority do not carry the power it is available off Amazon.com.