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Sponsored by:
The Rehab Training Center
by Jeffrey Lindsey
Sponsored by Masimo

Myth busting: When to establish rehab

The belief that rehab is only for incidents, especially those during hot days, is both wrong and dangerous; the culture must change

By Jeffrey Lindsey

I am teaching a fire course that is part of a university's bachelor program. The students include current officers and those aspiring to become officers, particularly chief officers. The class discusses command and control at catastrophic incidents.

One of the themes I am seeing in the responses to many of the assignments is when rehab should be established, if at all.

As much as this should not be a surprise, rehab is still not taken with importance that it should. Quite frankly, rehab should not be only for the incident scene. Rehab is an ongoing process that should happen on the scene, in the station and off duty.

There seems to be a notion that rehab is only needed when it is 100 degrees with 100 percent humidity. Rehab is not a temperature-based operation.

New mentality
Firefighting and rescue takes energy and stamina for all incidents regardless of the weather. Many have compared firefighting activities to athletic events. Athletes, in many cases, do not perform to the strenuous level that firefighters do. Yet we tend to take less care of our bodies.

The mentality of when to establish rehab has to change.

When incident command first came into play in the fire service, it was not readily accepted. But over time it has grown to the acceptance level that it is used on virtually every incident.

Safety officers have finally reached the level of acceptance that many departments now have full-time dedicated safety officers, or at least designate one on the scene. Rapid intervention crews is another area that has finally grown to acceptance level by most departments.

Every one of these is based on keeping our most important asset safe — our personnel. Rehab is that next level to provide the safety needed for our personnel.

Part of every call
However, like the other areas mentioned, rehab is not isolated only to major incidents when the temperature is hot. Rehab should be part of every call. Granted we are not necessarily going to set up a rehab group on a car fire, vehicle crash, or dumpster fire, but once back at station hydrating, showering, monitoring the crews condition, and making sure personnel are ready for the next call is all part of rehab.

The only problem is that we have to get personnel to understand rehab and incorporate it in to everyday life as a firefighter. Every second alarm should automatically get a rehab unit, or if RIT is enacted so too should rehab.

Regardless of the method, rehab has to become part of the fire service. As mentioned in a previous column, cancer rates are escalating in the fire service, heart conditions account for 50 percent of the line-of-duty deaths most years and untold numbers off-duty fatal heart attacks.

Wintertime is fast approaching and I challenge each and every department to set aside time to train and practice conducting rehab. Whether it is 100 degrees or -20 degrees or a comfortable 70 degrees, rehab needs to be part of the incident scene. 

About the author

Dr. Lindsey is the coordinator/lecturer for the University of Florida Fire and Emergency Service bachelor and master degree program. He also serves as the chief learning officer for Health Safety Institute. He retired from the fire service as fire chief of Estero (Fla.) Fire Rescue. Additionally, he is an author for Brady Publishing. 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 paramedic from Harrisburg Area Community College. He also has earned his chief fire officer designation and is a graduate of the Executive Fire Officer Program. Dr. Lindsey has over 32 years of diverse experience in the emergency services industry. He was the 2011 recipient of the James O Page Leadership Award from IAFC. He is an associate member of the Prehospital Research Forum. He served as an advisory council member for the National EMS Advisory Council and the State of Florida EMS Advisory Council, and is a representative to the Fire and Emergency Services Higher Education EMS degree committee. You can contact Jeffrey with feedback at

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Ken Henke Ken Henke Wednesday, December 04, 2013 5:39:43 PM That's something I've been preaching for years. My department at least carries water coolers and cups on all the apparatus and they're checked and refreshed with the normal morning check. I will add that we should also remain hydrated while in the station, waiting on a call.
Jim Vieira Jim Vieira Thursday, December 05, 2013 5:40:36 AM Every piece of fire apparatus along with our Rescues (EMS for us Rhode Islanders) carries a minimum of 2 cases of bottled water. At fire scenes or prolonged scenes, vitals are taken prior to a firefighter going back to work after their first bottle and are not released from EMS until their vitals signs are an acceptable level.
Gordon Knapp Gordon Knapp Friday, December 06, 2013 2:57:13 PM do not set up rehab on top of the fire or em. scene
David Hansen David Hansen Saturday, December 07, 2013 4:44:18 PM Like all good programs, they are great if there is the budget for them. Is there any money out there to help out a multiple district Rehab for rural VFD's....
Vinay Ternat Vinay Ternat Monday, December 23, 2013 8:24:10 PM Absolutely correct. Rehab should be established in any type of situation whether it is required or not, because we are unable to predict what the situation demands at a particular time.

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