Practical Evolution for Rehab

Practicing rehab using the equipment at hand is critical


Editor's note: We have completed the didactic portion of our training, which you can find by clicking here. Many training courses stop at this point; however, in order for the course to bring the level of actuation necessary to reinforce the classroom material, practical training is necessary.

The one thing that has stood out most in each of the rehab training classes I conducted is the practical evolution. This is when you can see the pieces of the puzzle come together and the light bulbs going off on the realization of just how important it is to incorporate rehab training in what we do.

Regardless of whether your class is isolated for your department or if it is a multi-agency training session, practicing rehab is critical using the equipment you have at hand. When you use equipment from other agencies, you have the opportunity to see how others do their rehab and get a sense of equipment that you can use also.

During the various training classes this past year, participants have gained an appreciation of how to better establish the rehab sector and how to effectively manage the flow of personnel through the rehab sector.

As part of the practical training, you should have the participants identify the rehab area, plus:

  1. access all equipment
  2. set up the rehab area
  3. conduct rehab
  4. terminate rehab
  5. disassemble the rehab site

I have found the easiest way to do the training is to divide the participants into teams. If you have enough participants, divide them into three teams. One team is assigned to rehab, while the other two teams are part of the incident scene. The rehab team performs steps A through E, listed above. The other two teams enter rehab as they would on the rehab scene.

This is a great time to illustrate the importance of establishing a rehab sector early by having the first team of firefighters enter the rehab sector within the first few minutes of the rehab sector establishing the site. In many instances in the real world, rehab is thought about late into the incident, and when the site is being established, the first round of firefighters should have already been going through rehab. This will hopefully drive home the importance of establishing the rehab sector earlier in the incident and the amount of work needed to get the rehab sector up and running.

The practical training portion should start out providing the framework for orchestrating an organized rehab sector and understanding the equipment. As each team progresses through they should build on the previous lessons learned. I like to let the other teams critique the rehab team. There are many ways you can do this and keep it very positive. You can have the team ask why they did it a certain way, identify what they liked, or highlight how certain important aspects were orchestrated. Regardless, the value of conducting an analysis of the exercise adds value to the practice. I always go last and try to hit the points that were overlooked. Remember this should be a learning environment and not a time to criticize.

Once all the participants go through the initial practice, then begin to add in additional things like a firefighter who is symptomatic. Have scene conditions change or inundate rehab with multiple teams of firefighters at one time. Practicing in training is the time to try new things, understand the equipment and work out the bugs. The incident scene is not the time or place to be doing something for the first time. Practice how you are going to perform and you will find that it becomes second nature on the incident scene. Rehab is not new, but the emphasis on rehab has risen to a relatively new level we have never seen before. Rehab is an essential element of firefighting, just like connecting to a water supply or conducting an interior attack.

I will take a look at some best practices in future columns. For now, be safe and remember rehab starts well before the incident scene.

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

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