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

Audience description

All personnel assigned to rehab and operations personnel

Prerequisite

Review rehab equipment

Lesson goal 

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

Cognitive objectives

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

 

Psychomotor objectives

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

Recommended schedule

Didactic portion: 2 hours
Practical evolution: 2 hours

Content outline

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