|Editor's note: Jeffrey Lindsey's series on training for rehab is built on a course lesson plan, which gives the instructor all the ingredients for a successful training session. You can read the lesson plan here, and over the coming months, Lindsey will build upon it to create a comprehensive training program for personnel involved in rehab.|
If you mention the word 'characteristics,' you typically think about a person and their traits or what stands out about them. When you mention the phrase 'rehab area characteristics,' you should begin to think about what traits or appearance a rehab area should have.
There are seven characteristics of the rehab area to focus on. They are:
b. Designated PPE area
c. Environmental protection
d. Vehicle placement
e. Size of area
f. Establishing a medical monitoring and treatment area
g. Transport issues
a. The first is PPE. Personnel conducting rehab may need to consider the use of certain PPE. The classroom setting should afford personnel the ability to practice donning and doffing PPE.
b. In the same respect, personnel entering the rehab area need a place to store their PPE while in rehab. Identifying a secure area that will allow personnel to remove and stow their equipment until they complete rehab is important. It also keeps the rehab area organized. If there is not a designated area, equipment will get lost, damaged, and create a cluttered environment at rehab.
c. Various conditions including heat, cold, and wetness can hinder rehab. Efforts need to be made to determine what type of protection will be provided for personnel to get them out of these elements. Depending on what you have available and what is available may depend on where personnel establish a rehab area.
d. Vehicle placement is a critical element of the rehab area. Incident scenes tend to get very congested with apparatus, equipment, and personnel. Consideration needs to be made on where to establish the site taking into consideration other apparatus and equipment. In some instances, rehab may need to be relocated. You don’t want to box the rehab area that it would make it difficult to relocate if it would become necessary. When conducting your class you want to make sure participants are taking into account the entire picture and not tunnel visioning on just rehab. Rehab is the main focus of this class; however, at an incident scene there are many factors to take into account. What may be an ideal site on paper may not work at the incident scene.
e. The size of the area is many times a challenge. As discussed, many geographic areas in your district may limit you to the space available. Try to get participants to think outside of the box. Look around at various landmarks in the area to see if a location may provide the area you need. Have the participants discuss some of the pros and cons to the location and how critical the size of the area needs to be.
f. As part of the size of the area you need to take into consideration the medical treatment and monitoring area. Hopefully, this area will not be needed or be limited in its use, nonetheless it needs to be able to be expanded at a moments notice. This area is separate from civilian treatment areas and should remain separate. This area should be dedicated for emergency personnel only. Be sure to incorporate what equipment is necessary for this portion of the rehab area.
g. Along with medical treatment and monitoring comes transport. There will be times when personnel will need to be transported to a medical facility. As part of the selection and establishment of a rehab area, consideration needs to be made for access of ambulances to the rehab area. You don’t want to have transport units stationed at the rehab area only to be boxed in by other apparatus or hoselines blocking their egress from the scene.
The class setting is the perfect opportunity to get personnel to begin thinking about these characteristics. In addition to the rehab area, personnel will also be thinking about the placement of apparatus at the scene and the entire scene management. Rehab is not an isolated event; it is part of the entire incident event. Getting personnel to think about rehab at an incident is just as important as getting personnel to think about water supply. Holistic medicine, which has become very popular in the medical world, is taking the entire body into consideration when treating an illness. The fire service should start to take a holistic approach to the incident, taking into account all aspects of the incident scene. Get personnel to start thinking about rehab and how it fits into the entire picture.
We discussed a number of training ideas throughout this article for this part of your rehab course. Here are a few more practical ideas to consider when conducting your training.
- Have the participants in class diagram a rehab area. There are a variety of methods that you can accomplish this. For example, you can use a large erase board. Diagram an incident scene on the erase board. Assign a group of participants the task to establish a rehab area. Have them designate all the areas along with the equipment they will need to establish the rehab area. Have another set of participants critique the rehab area and provide feedback about things they agree with or would consider doing differently.
- Another technique would be to do practical evolutions involving finding and establishing a rehab area. Contact locations in advance to get permission to go to their site and establish a rehab area.
- When conducting training on other topics, incorporate rehab into the training. This will encourage your personnel to be thinking about, 1) establishing rehab on an incident scene, and 2) the practice of establishing a rehab area. In addition, rehab is just as important to conduct at training as it is on the incident scene. Personnel can suffer the same injuries and illnesses at training as they do at an incident scene.
There are a variety of instructional methodologies for this section of the training. Firefighters and EMS personnel are not ones to sit in a classroom and listen to lecture. A facilitated classroom works best and incorporating hands-on and interactive exercises will only enhance your class and make it that much more valuable. Train how you will work at an incident scene.
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