1. 19 Fire Fighter Rehabilitation

2. 2 Objectives (1 of 3) Define emergency incident rehabilitation. Describe why fire fighters need emergency incident rehabilitation. List and describe the types of extended fire incidents where fire fighters need emergency incident rehabilitation. 19

3. 3 Objectives (2 of 3) Describe the seven functions of a rehabilitation center. List four parts of revitalization. Describe the types of fluids that are well suited for fire fighters to drink during emergency incident rehabilitation. 19

4. 4 Objectives (3 of 3) Describe four other types of incidents where fire fighters would benefit from emergency incident rehabilitation. Describe the types of food that are well suited for fire fighters to eat during emergency incident rehabilitation. Describe the personal responsibilities related to emergency incident rehabilitation. 19

5. 5 Introduction (1 of 2) You must take care of yourself so you can continue helping others. Rehabilitate: to restore to a condition of health or to a state of useful and constructive activity. Even seasoned fire fighters can quickly become fatigued. 19

6. 6 Introduction (2 of 2) Without rest and recovery, you may experience: –Fatigue –Headaches –Gastrointestinal problems –Depression –Flashbacks –Amnesia 19

7. 7 Factors, Cause, and Need for Rehabilitation (1 of 5) Physiological job stressors: –From sleep to full activity in seconds –Not enough time to eat or drink –Physical demands –Emotional stress Environmental job stressors: –Adverse weather conditions –Unfamiliar locations –Smoke-filled environments 19

8. 8 Factors, Cause, and Need for Rehabilitation (2 of 5) Personal protective equipment (PPE) –Can weigh up to 40 lbs. –Contributes to heat stress –Increases energy needed to move –Traps body heat 19

9. 9 Factors, Cause, and Need for Rehabilitation (3 of 5) Dehydration –State in which fluid losses are greater than fluid intake –Can lead to shock and even death if untreated –Body can lose up to 2 quarts of fluid in less than 1 hour –Fluid loss reduces strength, endurance, and mental judgment 19

10. 10 Factors, Cause, and Need for Rehabilitation (4 of 5) Energy Consumption –During strenuous activity, the body burns carbohydrates and fats for energy –Essential to refuel energy sources with nutritious food 19

11. 11 Factors, Cause, and Need for Rehabilitation (5 of 5) A well-rested, well- conditioned person has more endurance and can tolerate the stresses of firefighting. 19

12. 12 Types of Incidents Affecting Fire Fighter Rehabilitation (1 of 3) Rehabilitation required at all incidents –Small incidents may require only water for rehydration. –Major incidents may require a full rehabilitation center. 19

13. 13 Types of Incidents Affecting Fire Fighter Rehabilitation (2 of 3) Structure fires –Intense heat and stressful conditions cause rapid dehydration and fatigue. High-rise fires –Energy resources are drained quickly. 19

14. 14 Types of Incidents Affecting Fire Fighter Rehabilitation (3 of 3) Wildland fires –Crews need to work in shifts so their bodies can recover. –Large fires may require hundreds of fire fighters and take weeks to extinguish. 19

15. 15 Other Types of Incidents Requiring Rehabilitation (1 of 3) Hazardous materials incidents Long-duration search-and-rescue activities Large-scale training activities 19

16. 16 Other Types of Incidents Requiring Rehabilitation (2 of 3) Non-emergency events –Athletic events –Stand-by assignments 19

17. 17 Other Types of Incidents Requiring Rehabilitation (3 of 3) Nourishment and fluid replacement are essential whenever fire fighters must be ready for action. Weather conditions –Heat causes rapid dehydration and fatigue. –High humidity reduces evaporative cooling. –Cold weather can cause hypothermia. 19

18. 18 How Does Rehabilitation Work? Seven Functions: Physical Assessment Revitalization Medical Evaluation and Treatment Regular Monitoring of Vital Signs Transportation Critical Incident Stress Management Reassignment 19

19. Physical Assessment Fire fighter’s vital signs should be taken. Signs and symptoms of fatigue indicate need for rehabilitation. Crew should be questioned and observed for signs of emotional stress. 19

20. 20 Revitalization (1 of 7) Four components of revitalization –Rest –Fluid replacement –Nutrition –Temperature stabilization 19

21. 21 Revitalization (2 of 7) Rest –Opportunity to disengage from stressful activities and remove PPE Fluid replacement –Rehydrate with water. –Restore electrolytes with diluted sports drinks. –Avoid caffeinated and sugar-rich drinks. 19

22. 22 Revitalization (3 of 7) Nutrition –Glucose needed to burn fat and release energy –Need to balance glucose levels for the body to work properly Too low = weakness, shaking Too high = sluggishness 19

23. 23 Revitalization (4 of 7) Nutrition (continued) –Carbohydrates Major source of fuel Readily used by the body during high- intensity activities –Proteins Used by the body to grow and repair tissues 19

24. 24 Revitalization (5 of 7) Nutrition (continued) –Fats Used for energy, insulating and protecting organs, and breaking down vitamins –Simple sugars stimulate insulin production Sugar consumption can lead to lower energy levels. 19

25. 25 Revitalization (6 of 7) Nutrition (continued) –During short incidents Consume low-sugar, high-protein sports bars. –During extended incidents Eat smaller, balanced meals that include complex carbohydrates. –Proper nutrition is part of a healthy lifestyle. 19

26. 26 Revitalization (7 of 7) Temperature stabilization –Remove turnout gear as soon as possible. –Remove damp clothing and replace with blankets. –Consider using cold compresses. –Move to climate-controlled environment. –In cold conditions, use a heated rehabilitation center. 19

27. 27 Medical Evaluation and Treatment, Monitoring of Vital Signs Medical evaluation and treatment –Abnormal vital signs, pain, and injury necessitate further medical treatment. Monitoring of vital signs –Monitor at regular intervals. –Vital signs should return to normal before fire fighter is reassigned. 19

28. 28 Transportation to a Hospital Ambulance available at rehabilitation centers to: –Transport ill fire fighters –Transport injured fire fighters 19

29. 29 Critical Incident Stress Management CISM –Confronts critical incidents, defuses them, and directs the fire fighter toward physical and emotional balance –Team members may meet with companies or individual fire fighters. 19

30. 30 Reassignment Fire fighters released to reassignment following: –Rest –Rehydration –Refueling –Rechecking that they are fit for duty May return to the same or different tasks 19

31. 31 Personal Responsibility in Rehabilitation “Safety Begins and Ends with You” Take care of yourself first, your team second, others third. Know your own limits. Be responsible: participate in emergency incident rehabilitation. 19

32. 32 Summary (1 of 5) Rehabilitation is a special designated area where emergency personnel can rest. Rehabilitation helps prevent injuries and illness. Rehabilitation centers are often required at wildland fires and structure fires that are large or continue for long periods of time. 19

33. 33 Summary (2 of 5) Other incidents requiring rehabilitation include: –Hazardous materials incidents –Long-duration search and rescue activities –Training activities and athletic events may require rehabilitation centers. Adverse weather conditions increase the need for rehabilitation. 19

34. 34 Summary (3 of 5) Seven parts of revitalization: –Physical assessment –Revitalization –Medical evaluation and treatment –Monitoring of vital signs –Transportation to a hospital –Critical incident stress management –Reassignment Revitalization is of most concern to new fire fighters. 19

35. 35 Summary (4 of 5) Replace fluids before signs of dehydration become obvious. Meet nutritional needs during minor incidents with low-sugar, high-protein sports bars. During longer incidents, eat small frequent meals that contain the appropriate nutritional balance. 19

36. 36 Summary (5 of 5) Know your limits, listen to your body, and use rehabilitation facilities. Safety begins and ends with you. 19