Firefighter rehab: 6 keys to successful planning

Summer means added stress on firefighters' bodies; a well-planned and executed rehab will mitigate that danger


How prepared are your firefighters for fighting fire and the heat of the day? The reality of today is that most of us enjoy our air-conditioned vehicles, homes and offices. We are not, generally speaking, outside people.

As we all know, firefighting requires a considerable amount of physical exertion, and in the summertime that exertion compounded with heat and heavy gear adds stress to our bodies.

In many cases, our body will react in a negative way to the additional stressors. That often means illness that removes firefighters from duty either at that incident or for longer periods; it can even lead to a line of duty death.

A fire department's approach to rehab cannot be reactionary. By then, firefighters are already in trouble. The approach must be proactive, well-planned and set expectations for all individuals.

One of the goals of preparation and rehabilitation is to improve the personnel's resistance to injuries.

Six keys
In many cases, the approach to improving physical capabilities starts with the fire chief. It is about attitude and recognizing the criticality of physical preparedness.

Here are six things that need to happen in order to have a fully implement and effective rehab program.

  • Appoint and empower a safety officer.
  • Continually educate personnel on physical preparedness.
  • Labor and management must buy into the program.
  • Establish a non-punitive reporting system.
  • Analyze available data.
  • Establish a fitness and wellness program.
  • Conduct an operational risk analysis.

Once the rehab structure is in place, we must plan for and provide adequate time for rest, medical monitoring and recuperation including rehydration during emergency operations.

The physical and mental demands associated with firefighting and other emergency operations exceed those of virtually any other occupation.

The stressors of responding to these events with extreme heat and humidity significantly increase the risk to the health and wellness of the emergency response personnel.

Recognizing the signs
Fatigued firefighters have an increased risk of injury due to impaired judgment and increased reaction time. Risk of heat stroke or heat exhaustion is also increased and often at the root of impaired judgment and reaction time.

Everyone needs to know and be able to recognize the signs of heat stress on themselves as well as their brothers and sisters. Don't ignore the symptoms. Get rehabbed early and frequently.

The Mayo Clinic lists several signs of heatstroke. A body temperature of 104 F or higher is the main sign of heatstroke. Altered mental state or behavior including confusion, agitation, slurred speech, irritability, delirium, seizures and coma is another telltale sign.

There are also alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry. However, in heatstroke brought on by strenuous exercise, your skin may feel moist.

Additionally, those with heatstroke may present nausea and vomiting, flushed skin, rapid breathing, racing heart rate and headache.

WebMD lists two types of heat exhaustion: water depletion and salt depletion. Water depletion signs include excessive thirst, weakness, headache and loss of consciousness. Salt depletion signs include nausea and vomiting, muscle cramps and dizziness.

Heat exhaustion isn't as serious as heat stroke. However without proper intervention, heat exhaustion can progress to heat stroke, which can damage the brain and other vital organs, and even cause death.

Rehabilitation is an essential element of the incident command system and should not be ignored as a critical staffed component, especially in the heat of the summer.

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