Firefighter Rehabilitation Critical to Safety

Fighting fire is hard work. This has been a universal truth since the inception of the fire service. No amount of tactics, resources, or technological progress will change this fact. One thing that has changed over the past 100-plus years of the modern day fire service is that firefighter rehab is absolutely necessary.  Firefighters face many hazards to health on the scene of not only large fires, but any extended incident.  In the past the firefighter simply sat on the rear bumper of the engine (near the exhaust pipe of the engine) to rest for a few minutes.  

Today firefighters are rotated through rehab for evaluation by EMS staff.  A properly implemented firefighter rehabilitation program will result in fewer accidents and injuries.  More importantly, properly rehabilitated firefighters return to duty better able to handle the workload, are better hydrated and have more productive capacity.  You may see firefighters "sitting around" during a major incident, but this period of rest and evaluation is critical to firefighter safety.

Firefighters in Rehab

CARBON MONOXIDE EXPOSURE

Carbon monoxided is present at all fires and can pose a serious health hazard to firefighters.  ICFR firefighters wear Self Contained Breathing Apparatus (SCBA) during both fire attack and mop up operations.  Firefighters may be exposed to this colorless and odorless gas on scene.   ICFR uses gas anlyzers to look for not only CO, but other hazadous gases as well.  All three ICFR ambulances are equipped with pulse co-oximeters, a new type of pulse oximeter designed to look for carbon monoxide in the blood.  Firefighters can be treated with oxygen and, if needed, trasnported to an area hospital.

Pulse Co-Oximeter

 
HYDRATION

Our bodies are made up of about two-thirds water. When someone gets dehydrated, it means the amount of water in the body has dropped below the level needed for normal body function. Under normal circumstances, we lose about two to 2.5 liters of water a day through body waste, sweat, and breathing.  Nutrition experts recommend a daily fluid intake of about 1.5 to 2.5 liters for healthy adults under normal living circumstances to prevent a liquid deficit. Small decreases don’t cause problems and go completely unnoticed in most cases.

Losing large amounts of water (in excess of 2 percent of body weight) can be a problem.  Strenuous work, particularly in protective clothing and in hot environments, can result in a loss of one to two liters of water an hour. At this rate, a firefighter may rapidly lose a significant amount of body water weight (the amount of water the body contains under normal conditions based on the size and weight of an individual). A loss of 1 to 2 percent of body water weight will compromise work performance, a loss of 2 to 3 percent will compromise mental alertness, and a loss of 3 to 5 percent can compromise the body’s ability to sustain life.

HEAT CRAMPS

The turnout gear worn by ICFR firefighters noty only protects the firefighters from external heat, but also traps heat in the firefighter and impairs the normal mechanisms of heat dispersion.  Heat cramps are the mildest form of heat/dehydration-related illness and are characterized by painful muscle spasms usually in the abdomen, hamstrings, or calves. These cramps can come on very suddenly and are excruciating. Heat cramps are caused by failure to replace the body’s lost sodium, although poor physical conditioning can also play a key role. Heat cramps can be relieved by drinking liquids or through IV therapy. Light massage and application of ice packs to the affective area may also help to relieve muscular pain during these cramps.

HEAT EXHAUSTION

Heat exhaustion is a more serious form of heat/dehydration illness. It is the result of even more severe levels of water and sodium losses through sweat. Symptoms generally include weakness and fatigue and clammy and moist skin that may appear flushed or pale. The body will continue to produce sweat at this stage, further depleting itself of electrolytes and water.

HEAT STROKE

The most serious heat/dehydration-related illness is heat stroke. This is very serious and possibly life threatening. It is brought on by a combination of the aforementioned dehydration factors as well as the body’s failure to regulate its core temperature. Sweating now stops. It is followed by mental confusion, delirium, loss of consciousness, convulsions or seizures; if left untreated, it could lead to coma or death. The core temperature of an individual experiencing heat stroke can be greater than 106°F; the patient will present with hot, dry, and mottled skin.

CALORIES
During extended incidents firefighters do require food.  ICFR has an excellent support organization, the VEES,  which responds quickly to the scene with food and fluids.  The support provided by the VEES extends beyond the time spent on scene, as firefighters return to the stations to clean and restock equipment, refill empty tenders (also known as tankers) and repair equipment.