By Perry Denehy
The firefighter's body suffers incredible stress while working in hot environments, even more so when you factor in the use of full turnout gear and SCBA. Departments need to make every effort to minimize the risks of injuries and deaths to members during both training exercises and real live calls.
There is a range of rehab-related products available out there that agencies may want to consider for purchase to protect firefighters. This is not a complete list, and we would encourage you to write in with any suggestions or additions that you have found to be beneficial. You might also stop and visit a neighboring fire department that has a rehab team established. I am sure that they would be more than willing to show off their rig and equipment.
The main areas of rehab and related products and equipment are:
Cooling and misting fans
Watch any NFL and most college football games and you will see the players being misted while sitting on the bench. There are several manufacturers and styles available when it comes to cooling and misting fans. Before making your decision of which one to purchase, keep in mind that you will need an electrical source, enough space to store the unit, and a continuous water supply for refilling. Obviously having electrical power and water at fire scenes can be met by your emergency apparatus. An example of these units may be found at Mistngo.com or Schaefer.com, a site currently under constrction at time of writing. There are several other excellent vendors that might be available in your area. The biggest obstacle on the use of these fans is storage, getting them set up, and cost.
The replenishment of lost water and electrolytes due to perspiration at the fire scene is vital to the firefighter's health and wellbeing. There is a vast array of manufacturers of sports drinks, energy drinks, vitamin waters, etc. These can be purchased in individual plastic bottles or in powdered form, that can then be mixed into the bottles or larger coolers. You should note that getting the powder to adequately dissolve in large 5 and 10-gallon coolers can be problematic. Keeping an adequate supply on hand may also be difficult unless supplies are kept in a special vehicle. All rigs should at least have an initial supply for their own crew.
Although I have already mentioned the simple importance of re-hydration fluids in rehab operations, several companies now offer an array of containers and powered coolers to deliver the drinks. These containers and powered coolers provide a more hygienic process in the replenishing of fluids, but the cost and storage space is obviously higher. An example of these products may be seen at Waterboysports.com or Cramersportsmed.com. You will actually see most sports medicine departments use these along sidelines at games instead of cups or water bottles.
Limb and body immersion
I remember seeing an old photograph of my fire department at a large barn fire. It must have been in the heat of summer, and the picture showed several members cooling off inside the full dump tank set up for water supply. What a novel approach to cool down! Today this probably wouldn't get the formal nod of approval from administration. But recently a new product — Kore Kooler Rehab Chairs from The Total Fire Group — came on to the market that can be seen as a modern-day version. Essentially, these are collapsible beach chairs with two mesh pockets in the arm rests. You place provided plastic liners in the sleeves and fill with room temperature water. Your arms and hands can be submerged into the water, which helps to reduce blood temperature. I have personally used this device at fire scenes, training evolutions and sporting events, and have done exhibiting for it here in Ohio.
It's common sense that shade is one of the most important features in any rehab area. We were at a condo fire this week and fortunately a nearby canopied car port provided the perfect rehab sector site. However, these obviously aren't always available and neither are large, shaded trees. An ideal alternative are portable tents. Before purchasing such a product, there are issues that would need to be thought through: weight, available storage space, who'll be responsible for setting up the ten, etc. Some tents, including those you can see at Bigfogg.com even have a misting component incorporated into them. Many departments will call in air-conditioned busses for their members, which is an excellent option if they are available and able to get to you quickly.
It sounds impossible that in this day and age that any department would not have an on-site EMS unit available. And if your department has an actual rehab unit or designated staff, the following equipment would be desirable:
- Blood Pressure cuffs and stethoscopes
- Rectal and ear thermometers
- Pulse CO-oximeter
- Other BLS and ALS equipment as authorized.
Finally, in my other role as an athletic trainer for a large Ohio suburban high school, I provide medical coverage at various outdoor sporting events where heat and humidity can take a toll on any athlete.
So I can certainly recommend departments getting in contact with their local high school or college and asking to speak with their athletic trainer. One of their roles for the athletic teams is to prevent and treat heat emergencies. They may be able to offer some advice on procedures and product vendors in your area. As the summer temperatures begin to climb, please review and enhance your department's rehab guidelines so that everyone goes home safely. Other columnists at Firerehab.com have provided excellent articles on why rehab is so important.