In December 2007, NFPA released the new 1584 Standard on rehab at the scene of incidents and training events. When a new standard is released the first step is to read the standard, which goes without saying. The next step is to train personnel on the Standard. But where do you start with the training?
A lesson plan is the foundation to any training session. The following lesson plan is designed for training personnel on NFPA 1584.
Sample Lesson Plan for Rehab Training
All personnel assigned to rehab and operations personnel
Review rehab equipment
Upon successful completion of this lesson, the participants will be able to: Have a broad understanding of the objectives, processes, and methods of typical incident scene rehabilitation
Define the terms related to rehab Discuss the department’s SOG on rehab Explain the medical protocols for rehab Compare and contrast heat and warm stresses Explain pre-incident preparation Describe rehab characteristics Discuss incident and training rehabilitation Differentiate between heating and cooling of personnel Explain the purpose of medical monitoring Discuss the importance of pulse CO-Ox monitoring Review accountability at rehab Define release from rehab Discuss post-incident
Identify a rehab area Establish a rehab area Conduct rehab for personnel at the scene of an incident or training exercise Conduct medical monitoring of personnel Disassemble the rehab area
Recommended list of equipment and supplies
(1) Portable shelters (2) Fans/blowers (3) Blankets (4) Portable heaters (5) Dry clothing (6) Lighting (7) Electrical generating equipment (8) Misting and cooling equipment (9) Rehabilitation area designation marking equipment (10) Chairs (11) Beverage-serving equipment (12) Exposure protective garments for rehabilitation staff (13) Personnel washing equipment (basins, soap, water, towels) (14) Cups (for hot and cold beverages) (15) Potable water (16) Large clock (17) Traffic cones (18) Fireline tape (19) Log book, forms, and writing utensils (20) Paper towels (21) Sanitary facilities (portable toilets) (22) Food (including appropriate serving devices and equipment) (23) Trash receptacles (24) Medical monitoring supplies including but not limited to: Blood pressure cuff, stethoscope, heart monitor with 12 lead capability, CO-Oximetry unit, oxygen, medical supplies, and other equipment per protocol
I. Terms associated with rehab a. Cooling. Active Cooling. Passive Cooling. b. Core Body Temperature. c. Emergency Incident. d. Emergency Operations. e. Hydration. f. Incident Commander (IC). g. Incident Management System (IMS). h. Medical Monitoring. i. Personnel Accountability System. j. Procedure. k. Recovery. l. Rehabilitation. m. Rehabilitation Manager. n. Sports Drink. o. Standard Operating Guideline p. Standard Operating Procedure. q. Supervisor.
II. Preparedness a. Review rehab SOG b. Discuss medical protocols associated with rehab c. Recognition of heat/cold stresses i. How the body regulates core temperature ii. How to recognize the signs, symptoms, and controls for heat and cold stress iii. Health related fitness programs d. Pre-incident and training operations i. Proper hydration ii. Proper nutrition iii. Diet to maintain normal body function iv. Scheduled events
III. Rehab Area Characteristics a. Area for rehab b. Incident commanders’ responsibilities c. Shelter requirements i. Hot environments ii. Cold or wet environments d. Multiple rehab areas i. Identify incidents that require multiple sites ii. Geographic names e. Site characteristics i. PPE ii. Designated PPE area iii. Environmental protection iv. Vehicle placement v. Size of area vi. Establishing a medical monitoring and treatment area vii. Transport issues
IV. Incident Scene and Training Rehabilitation a. Criteria for implementation i. Commencing rehab ii. Assigning personnel iii. EMS role iv. Time parameters for rehabbing personnel b. Rehab efforts c. Rest and recovery d. Cooling and warming e. Medical monitoring and emergency medical care i. BLS ii. ALS iii. Symptoms to be alert for iv. Vital signs v. CO-Oximetry monitoring vi. Symptomatic members or abnormal findings vii. Treatment f. Accountability g. Release h. Company/crew level rehab i. Documentation i. Time in/out ii. Medical monitoring iii. Emergency care iv. Recordkeeping
V. Post-Incident Rehabilitation a. Policy b. Rehydration
VI. Practical Evolution a. Identify rehab area b. Access all equipment c. Set up rehab area d. Conduct rehab e. Terminate rehab f. Disassemble rehab site
This lesson plan gives the instructor a guide to conducting a four-hour training session on rehab. We will look at further developing each of the areas in the lesson plan over the next few months. At the end we will have a comprehensive training program in rehab as described by NFPA 1584.
References Lindsey, J. (2007) Fire Service Instructor Prentice Hall, Upper Saddle River, NJ
NFPA 1584 Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises (2008) National Fire Protection Association Batterymarch, MA
About the author
Dr. Lindsey is an Assistant Professor in Emergency Health Services at George Washington University. He retired from the fire service as the Fire Chief for Estero Fire Rescue. Additionally, he serves as the education coordinator for 24-7 EMS and author for Brady Publishing.
He is an experienced leader, educator, lecturer, author, and consultant in emergency services. Dr. Lindsey earned his doctorate and masterís degree in Curriculum and Instruction from USF. He holds a bachelorís degree in Fire and Safety Engineering from the University of Cincinnati, and an associate in paramedicine from Harrisburg Area Community College.
Dr. Lindsey has more than twenty-nine years of diverse experience in the emergency services industry. He is an associate member of the Prehospital Research Forum. He serves as an Advisory Council member for the National EMS Advisory Council and the State of Florida EMS, and a representative to the Fire and Emergency Services Higher Education EMS degree committee.
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