Post-Incident Rehabilitation

Policy
Earlier we discussed the need for a policy that governs the rehab sector on the incident scene or training grounds. In addition, the agency needs a policy on post-incident rehabilitation. What happens when the incident concludes? Simply put, crews pack their equipment, put their rigs back in service and head back to the station. If it is a career department, unless it is a shift change, the crews remain on duty at the fire station. Volunteers in many circumstances return to their home or a location other than the fire station. What happens to those firefighters on the scene that had any potential indication of a medical problem? You got it, they were of those that returned back. Fire departments need to have a rehabilitation policy in place to address what happens after the incident.

Training on rehab should address this issue based on the department’s policy. The policy should address medical follow-up for any member showing any signs of medical concern on the incident scene or training grounds. If your training session is full of firefighters, express the need for further follow-up on any medical condition. Firefighters die after an incident, back at the station or at home. Actually, it seems that a number of firefighter fatalities from heart attacks happen after returning from the fireground rather than on the fireground.

If your training session focuses on EMS personnel as your audience, discuss the need to conduct a follow-up with any firefighter who had any type of medical condition or symptom on the scene. The importance of continuing the medical follow-up and monitoring after the incident is as crucial as conducting it on the scene.

In addition to medical follow-up, the policy should address nourishment and rest. The policy should allow the company officer to determine if the crew needs rest prior to assuming any additional duties when returning to the station. It should also address the need for nourishment and provide guidance for the foods that are best to consume.

The policy does not have be complex, rather it should be simple and straightforward. The training session needs to review the expectations and process after the incident in regards to rehabilitation.

Rehydration
Hydration prior to the incident is important. Hydration during the incident is important. Guess what? Hydration after the incident is important. Hydration after an incident is critical to replace any loss of fluids due to activities performed on the incident scene or training grounds. The fluid replaced on the incident scene or training grounds does not make up for any fluid replacement needed after the incident. The type of fluid consumed should be the same as on the incident scene or training grounds. Remember that caffeine and sodas are not good for hydration. Rehydration is not only replacing the fluids consumed, but preparing personnel for the next incident.

Training is a critical element in performing to the standard expected. It also may mean the difference between life and death. You perform how you practice. As the instructor, it is your responsibility to convey the right message and provide the guidance necessary for those in your class to learn the right way. The classroom portion of our rehab training concludes after this module. At this point, you should review the materials of the class and prepare the group for the practical portion of the class. You can consider administering an exam to identify any areas that need further explanation. Exams should be used for this purpose, but that is a subject for another article.

Until next time, be safe out there.

References
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