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Sponsored by:
Masimo
The Rehab Sector
by Perry Denehy
Sponsored by Masimo

Sorry, our Department Can't Comply with Rehab Standards

The National Fire Protection Association (NFPA) 1584 Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises, attained "standard" status  in March of 2008. Emergency services organizations must begin implementing the standard this year. Certainly it is the desire of every fire and EMS administrator to protect their department members in the areas of health and safety. As time proceeds, it will be interesting to monitor the a cceptance and practical application of these standards. Can we expect the "perfect emergency scene" to exist throughout the nation consistently? Where will departments fall short? Are these mandates doable, especially with shrinking budgets and manpower limitations?

Let's look at the nine key components of NFPA 1584, highlighting some practical concerns. I will be taking the "devil's advocate" role in responding to the requirements of the standard. You may note an air of cynicism that is seldom heard in the fire service. This is a very serious topic and my approach is only to show that "If there is a will, there is a way." Organize your team and resources and continue networking in order to achieve success.

Relief from climatic (weather/environmental) conditions:
Firefighting is done in extreme weather conditions. Mother Nature doesn't provide our world with moderate temperatures and working conditions. How can we escape the extreme heat or cold? We just won't respond to calls if it is too hot or cold.

Rest and recovery:
Depending on how many units are in staging, I'd love to take a 30 minute break with every bottle change. We operate two-man engine companies and the closest mutual aid company is twelve minutes out. "Hey chief, I'm tired, can I go lay down?"
We need a 3rd alarm just to get enough bodies to the scene.

Cooling or re-warming:
The only heat source is the inferno we're here to put out. Wearing all this turnout gear causes me to dehydrate before I even get into the structure. City council dinged our request for air conditioned cabs. We're lucky they let us have the air conditioners on at the firehouse. My idea of cooling is sit in the shade of the ladder truck.

Re-hydration:
Where's the closest vending machine? No one filled the engines water cooler today.
We used to carry bottled water on the rigs but the guys would drink them during truck checks. Hopefully the neighbors will show up with some lemonade to help out America's Bravest. Fire trucks have water in them, don't they? Drink that water.

Calorie and electrolyte replacement:
Hey neighbor, while you're making that lemonade, how about a turkey on rye with extra pickles? No name, free game. The mobile canteen showed up with day old doughnuts and week old bologna sandwiches. Luckily I ate a big lunch because this looks like a long one. That's why we never implemented a physical training program. We like to have our guys with some extra fat on them.

Medical Monitoring:
What do you mean my pulse and blood pressure are too high? That is my NORMAL resting pulse and BP. Maybe these extra few pounds I've been carrying around make it tough. After a couple cups of coffee and some doughnuts, they will go back to normal.
Chief needs three more hand lines stretched and we need all bodies.

EMS Treatment in accordance with local protocol:
Where are the medics? We've got an apartment building roaring and the EMS rigs are two blocks away. Just give me some O2 and I will be fine. It's not bad chest pain. Probably the chili dogs with onion I ate for lunch. I don't want to look soft in front of the young guys.

Member accountability:
I lost my tags. My crew got split up and the captain detailed me to re-fill air bottles.
I don't want to look soft by hanging out in rehab.

Release from rehabilitation:
This will not be a problem. You either get back to work or go to the hospital in the bus.
It feels kinda good here in the air conditioned rehab unit. With all that 5" that needs to be re-loaded, maybe I need to drink another liter of juice.

We all know that changing old habits comes slow for some. Budget constraints do create real challenges in meeting the needs of your department. Truly, for any department to be 100 % compliant in meeting these standards, much planning and focusing will be required. Develop a team of interested staff members to research, develop and implement these life-saving standards. Although it may take months to reach your ultimate goal, it is never too late to make improvements. Best of luck with your efforts to ensure the health and safety of your people. They are worth it!

About the author


Perry Denehy M.Ed., ATC/L. 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. If you have questions or feedback, you can contact Perry at Perry.Denehy@FireRescue1.com.



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