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. You might also stop and visit a neighboring fire department that has a rehab team established to see their rig and equipment for ideas.
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.
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.
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 products have come 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.
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 tent, etc. Some tents even have a misting component incorporated into them.
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: One of the most common lethal exposures present at every fire is carbon monoxide. The signs and symptoms are not reliable and cannot be used to determine if a firefighter has been exposed. Measuring the CO levels is the only way to detect if the firefighter has been poisoned allowing for prompt on-scene treatment. Early treatment reduces the immediate risk to life and safety and minimizes long-term cardiovascular and neurological disorders.
- Other BLS and ALS equipment as authorized.
- Any other suggestions? Anything we missed in the list above? Leave a comment below or e-mail firstname.lastname@example.org with your feedback.
Perry Denehy M.Ed., ATC/L. is a FireRescue1 columnist and is the Director of Sports Medicine for the Sycamore Community School District in Cincinnati, Ohio. His interest in firefighting/EMS began in 1980 while volunteering for the city of Mason, Ohio. After 20 years he "retired" as a station captain. Today he serves as a volunteer lieutenant with the Loveland-Symmes Fire Department Emergency Services Unit and is a coordinator for the Southwest Ohio Critical Incident Stress Management team.