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Emergency Incident Rehabilitation

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Fri, 7 Jan 2011|

This training presentation from the Firefighters Support Foundation deals with the needs for rehab, basic functions of the operations, and more.


Automatically Generated Transcript (may not be 100% accurate)

Applauded today's -- -- will be discussing. Emergency entered -- rehabilitation. -- -- a couple of things one of things -- we thought disgusting is how we define rehabilitation. For emergency workers discussed the importance of a rehab. If -- required emergency services and understand situations warrant him and the criteria for initiating. The rehabilitation. Black you're gonna learn different objectives. So -- all additional objective of an alarm. The impact that he's just an emergency workers and then the opposite what's the wind chill impact on emergency workers -- are appropriate. Placement for rehab area where we gonna put these we had. So we go -- -- safe operation. We're alarmed region of the state emergency workers for medical evaluation. Or also an -- to criteria that you met. Before her humor as a reason we're able to return back to duty and also this guy's Wii is without allowing injured personnel. Who returned to work active duty and also list we -- -- reasons transfer diversity workers to appropriate. Hostile to further evaluations. -- other objectives will be discussing. Will be a physiological consequences of fluid loss -- applies service and wanted to find -- similarity. And discussed the importance -- -- -- and rehydration. And the fire rescue personnel. What his rehab and why do we need it. Or background -- -- this for many years the fire services treated the elements of job related dangers a badge of courage. One with pride now firefighters. Would post and elements of danger and discussed in America by various occupations. The last twenty years is so. -- -- the wire service to its stake -- changed dramatically. Fire -- the ball officially again I realize. The -- deaths and injuries or firepower -- -- that -- had the courage but indicated the problems. -- products extended beyond that -- operation period that result. Maybe stress fatigue related illnesses and injuries firefighters although. On injured while -- -- to a point well which is jail unable to continuing the operation. And the mental on the physiological the -- firefight that they make poor decision that that he. And get hurt and cord injuries. Also what what is really bad we figure go to rehab what is -- an emergency services rehab. Or we have described the process providing rest. Rehydration. That your new nutrition -- and medical evaluation to responders who were involved in the extent to extreme incident scene operations. We have operations and not only responsible -- fire emergency. All the other activities of Bob Knight you have to pay -- we have to us. Situations. Training exercises -- -- throughout the day in the amass personal opted doing training exercises in the heat and Nicole -- never read we have area could have taken it -- Put nutrition back in his system also athletic events a lot of communities are running marathons throughout the earth that counts the -- are actually a message cannot get hours and hours and hours in the -- they got to rehydrate your -- properly. And parades and events a lot of communities have events. And the -- have parades. Dignitaries -- -- have to you have to have rehab area to the firefighters EMS personnel can get rehab. And get the nutrition is back in this system. Other activities -- the -- terrorists are getting involved with. Assisting -- fellow police officers and their training activities there are days that are out doing swat activities or live -- shooting. They'll be out this on also will be at this support them. So a lot of support activities that will be involved with the rehab and that we have -- -- the situation with who we supply water to the PD will be supply Iowa throughout firefighters. These statistics supplied to me by the National Fire Protection Association. Over 50% of wolf -- upon his death. I induce some extent -- directly -- distressed over over exertion. We're gonna discuss a little while white and a function of rehab operation. There they're physical -- You get done yet is that to a rehab that -- you can be doing physical assessment of the firefight. Revitalization. Rest rehydration. Nutritional support. Medical evaluation and treatment. Conditional -- -- physical condition to get your blood pressure take it being a -- market and -- if you need to be transpired for those required treatment at a hospital. After rehab operations you'll be getting done. Initial -- -- incidents -- assessment hopefully be available watched a -- To see if -- having any difficulties -- that incident and last but not least if I don't know we have operation you get -- reassignment if you they've figured you're gonna go back who's doing your duty you -- -- -- you next task for the next period of time. And you'll see this slide show you from the beginning to the end of what happens when you physical assessment up -- go into the medical evaluation. The revitalization. If yes we transported. The continual marketer for the -- the conditions here and start the initial group conditional stressed. Management individual and then reassignment so you'll see on -- -- that whole picture and out of rehab operation works. What is physical assessment of the fire fighter group emergency service personnel based -- what happens you get every yet that we don't basic vital signs. To be taking a medical evaluation of view the view revitalizing. And you do your reassignment. What is revitalization. That's when you get a rest. He's taken a 510 minute rest so an adequate amount of time or court temperature and your vital signs to return to normal. Fluid replenishment provide an appropriate fluids replaced those lost we lost sweating a lot of -- -- -- -- trading activity. You got put -- -- back and he -- system. And -- Should receive some nutritionally sound food we know all applause peanuts things -- that we're not Joba now hot dogs and and food at a -- digest properly going 918. Solid clues that you can usually. And take into your system. Medical -- valuation entry. Firefighters who PLO NG should be assigned to personnel the americorps valuation treatment area rehab. And he should not be delayed by providing with drinks and food most of medical evaluation. Shows this to be a priority. -- a physical conditions. Five -- -- had very -- that the conditions continuing monitored. Fireflies -- -- that could hear -- released from rehab. She -- -- for release for cash and firefighters and not respond to rest of medical attention. Very -- more intensive intervention. No -- should be released from rehab until he or she is medically sound and medically cleared. And -- transport to medical facility for further treatment if needed now you would -- -- you must be honest with out taking it your blood vitals. And statistics -- if you -- certain medications. So those still have accurate readings we know there is a situation -- -- -- on. Knowing whether it's that history yet -- -- this day to this election to go all the emerging into the rehab. It's a lessen the risk of injuries that may result mixed in an operations which are carried out adverse weather conditions. Other factors the heat and things like that -- it would do when -- least at this rehab -- it's on Iraq. Ideally we have operations should be commenced. Whenever -- -- operations as those of pose a risk. A push and personnel beyond its safety level of physical and mental endurance. -- extended fire incident has -- -- -- prolong rescue. Adverse weather conditions I was saying before. We have to deal with crimes and work with the police department and and stand offs and other crime scenes and -- activities will be out this start to prove people lost. In the woods. People falling into rivers and lakes we do a search operation you know happened at a rehab -- set up. Extended violence. What are we -- not yet mr. chuck -- applies. High -- structural flies and while -- Weather conditions hot weather ambient temperature relative humidity direct sunlight. Call weathered the ambient temperature and a big thing is the windchill factors. Hot weather on the ideal climate condition wire act that -- -- as a rescue operations. Place a -- thermal stress and respond is operating at the scene. Let's face the fact we emergency workers we must frequently perform heavy physical labor -- heated atmosphere -- -- wearing bulky heavy equipment. You -- ideal conditions. When respondents have completed assignment he goes safe areas such as we have we -- the equipment. And we will cool off systems now. You'll see on this next live picture of firefighter wearing equipment and that he. Ambient air temperatures are related humidity can be factored together to create what is often quote the heat index working in direct sunlight can add ten degrees Fahrenheit that in this heat index. Now working a full turn out equipment. -- -- add an additional ten degrees. A Fahrenheit on -- heat index and you'll see it next shot DO complete hot temperature with the heat index and how -- can really get. Why do in his physical activities. On this slide you'll see injured associated with each dressed. -- what temperature what that what happens to your system and an injury threatened and yet. On the could cause some. Sixty degrees or -- about 130 degrees on what. Extreme danger or pot potentially heat stroke the use of a fire -- can be facing. And he stressed and index the United States -- administration USF say they recommend that -- operation -- initiated without heat stress. Index exceeds ninety degrees Fahrenheit. That ninety degrees that I mentioned. The heat index those be realistic and with a seventy degree day outside what the ten degrees in the sunlight and I don't know ten degrees Fahrenheit worked -- equipment. Or had gotten my degree moloch so that ninety degree is that. Heat index who we have to worry about. Just talked about heat index in the hot weather let's -- that the yellow -- cold weather conditions. Walking all the look when determining the need for -- operations. On the effects of cold weather. -- responders who must operate low temperatures. And look have -- conditions for a long period of time. Call whether possesses different rehab challenges to emergency responders and warm weather scenarios do. Do plot like to talk about early. The potential threat to their well -- of the -- to workers from them however just as great -- whether. And emerging markets officially protected against the call they have had their body core temperature is lowered. To a dangerous. Level under extreme circumstances. That condition is called hypothermia. The most common cold weather related injuries among -- -- -- is a localized cold and you reached comical frostbite and -- net. These injuries occur one particular plot -- body exposed. To extreme call for extreme long periods of time. Just -- heat humidity combined increased impact if he called and when combined -- -- of called upon you embodies. The combination of back to call the wind is expected to wind chill factor this chart we'll show you the temperature with a win. What the actual temperature is not school the windchill factor. USF -- I fish farm ministers recommends initiating we have operations whenever a windchill factor dropped to ten degrees Fahrenheit. -- -- -- And you'll see you but -- -- ought to enact that ought to accomplish with the wind. And the temperature we hit that ten degree mark very fast and rapidly. -- to mention before other other situations that we have may be necessary. Crime scene in the standoff will work with the police department on their on their activities. -- activities we look at the lost -- -- or people lost lakes. -- -- -- Dignitaries who come into the communities and they wanted to training events on crime -- just scandalous what. What happens is bomb squad members have been operating long period of time. There where -- protective equipment. We're out there working with them on that and -- tactical units may have been operating. It positions for a long period of time as well yeah going to be needing rehab so we're gonna have to be assisting them both. Out in the field and doing rehab. -- activity to lodge area is sergeant the people -- wandered away from their homes. We had this community where we had a personal and alzheimer's actually left that house and it was twelve degrees out so we had yet personnel out -- out in the woods. Out of the streets look you'll put this woman. We -- that rehab so we didn't get some warned that this system. Our urban search and rescue incidents following natural -- manmade disasters. And -- garden out there for hours at a time day in any rehab and started to climb is Ike is and others involved -- sporting a recreational. Activities swim is we'll get lost they now have to have we have set up for the commercial service -- -- -- -- these people. Public events. Communities have to ask carnivals and all the festivals. Lot of plot while this one that. So why do when he's in -- -- -- by your -- and hot humid weather on Osama you have to have a rehab stood up put people. Walking around doing EMS work -- do -- quiet watch auto race black communities have water races parades concerts. Major sporting events. Political rallies you have now always big political rallies going on -- -- massive fires -- is that they're protecting the public. They have to have -- -- set up and -- you have religious ceremonies is Don and communities and word of violence began applying enough personnel. -- out -- assisting those who might -- doing these rallies you have to have a reading various set up. Every dog to deal with the lord -- he had not used out setting up rehab would give her rehab situation so -- into the command that might wanna -- that locals thought you know police sergeant. Who's in charge of the operation tell them. This is how we work and get this -- react to their members are safe as well and join us Dorn getting out bodies replenished. Establishing a managing a rehab area. The first five minutes of and and thinking. Dictate the outcome of the next five hours. Once the need for -- has been established. The most important decision of one of them must be made almost immediately is to win a locate that rehab step. They get good initial choice the location we have is vital try to relocate we have later in the incident. Can be very difficult to nearly impossible so once you get that locations set up. You don't wanna be taken it down put a -- to another location once you have it -- designated spot. Maintain -- spot maintain that area for to -- Locating -- rehab. Close to this -- -- command. More easily kept track of who was in rehab and he -- anticipate what people will be ready to go back to doing their jobs and assignments a more efficient use of the equipment. Away -- the is the command that. It's easy to put a personnel -- relax and are -- this distractions. Mussina next slide. The whole step of the house while where rehab. We apparatus to set up what a rehab barriers set up. I just seen a slide that we have set up there isn't really good location. Close the command to communities he -- -- in and out who's available but yet it's far enough away from everybody. It's easy access for the squad and was believed in and out of the area without being blocked -- -- fire apparatus. And apply our -- our trip and nobody -- -- -- people. What could be wrong set up through rehab that could be too close to the operation where interfere with the into the command or sometimes I've -- -- -- to put the rehab up -- throughout all the smokes while the fire into the rehab had so we got make sure you pick a location where it's not. Going to be at the fearing nor. Being affected by the fire. Once -- -- to have a rehab section the president jogged to rehab officer. Yeah -- make a decision win this had the way to rehab -- is going to be. And we just discussing that the second issue is more important that all -- -- must attend he cannot bypass gone to rehab policies will be created. A policy will reinforce that once you get done that that operation. You must go through rehab and be and be evaluated. Lot of -- a lot of members that -- image we don't need to go to rehab you have to go through. -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- And -- apparatus blown ought to us who are trying your rehab as. This site to be as quiet as possible. So we can relax we're -- now blood pressure is taking. Access this -- but it media should be restricted the last thing we need. Is immediate take your pictures -- the boss while getting out bottles being done at this site should provide SE BA replenishment and resell the -- -- -- -- change your bottle. We asked TBA -- rehab -- Also this I should have easy access and exit routes put EM once we don't wanna -- and. That didn't take us to the medical. The hospitals all the facilities the site should have a supply running in drinking water probably July drinking water and is helpful the rescue. -- -- -- -- -- -- It did that -- recovery of troop fatalities. To rehab area QB out of the view the work area. We don't want to have the people being rehab. Neither of people being brought out with fatalities we don't wanna mix them you wanna keep them separate from each of these -- this. Systematic of a floor plan of rehab steady as you are easy -- single -- to -- then. Place to -- the idea. As he BA support via a medical treatment area and an ambulance staging area this is a perfect want to be -- up for rehab area. Staffing and -- rehab area. The most highly trained qualified EMS personnel honesty should provide medical evaluation. Achievement in a rehab area EM these must -- Issue that the second provides -- state area which fire rescue personnel to rest -- receive rehydration. The end he's -- and -- fire rescue personnel. Entering a rehab area who are risk for heat and stress related injuries -- illnesses. The -- -- -- staff is the empty too much you have an eight ED readily available. -- unlikely but statistically important. Event that a fire rescue personal experience -- Iraq cardiac arrest order rehab and the Yankees must ensure accountability -- fire rescue personnel. Who enter and exit rehab. The -- must medically -- the crews determine whether they are fit to return to activity for the fire rescue operation. Require additional hydration and rest and require transportation to -- -- diploma for further evaluation. One of the most important -- of the EMT does going to rehab operation. Is they get report updates -- the as the commander to take your outlook on the progress -- -- and the health of each quiet quiet. Who's been through -- rehab section. Did not a time that responder will require -- -- Barry depending on Barry's. Of conditioning. Number wanted to respond -- level physical condition. It up firefighter in good shape the -- atmosphere conditions. He could call the naked activities responsibly -- performance pride they're entering rehab was in a very stressful situation. Confined space was declining -- right -- at a time needed putting adequate rehydration. -- -- -- -- That is recommended -- establish a minimum. -- -- of time that a fire rescue personnel spend their rehab this role Barry with the atmosphere conditions and a number of personnel available. The warning operation but a good rule of dollars each personality but -- twenty minutes -- rehab. The hydration that -- in a -- is very important respondents recovery. Personnel perform heavy work on the special conditions. Learn a heavy current heavy equipment. We're we're subject to -- that the -- -- loss. While -- losses obviously hot weather conditions do not overlook the fact that the hydration -- -- -- In the cold -- Maintaining sufficient levels the water and a lot to like about body can greatly aid. The prevention -- he was -- related illnesses and injuries. Are you see initial -- How easy it is for us to go for -- to -- -- 2% body weight took the 6% and severity and how dangerous that is the difference different. Types of injuries that we commuted car. In this water election will be talking about popularity. And -- defiant and thickness of a global flu is determined by electoral lights. And call the -- contain an -- beverage. The Heidi are hilarity along that it -- -- we'll take absorbed upload your system so in general recommended the rehydration. Solution do not exceed got similarity of 250 milligrams per. Pro leader. And you'll see -- following each ought. That they have the whole listing of from all different types of liquid that were out there and -- Larry of each one. I just -- that shot the last column has -- Larry in all different drinks for mouse sports drinks. Down two warnings -- imported from great water originally had to 20% with somebody sports drinks and sodas. A very high numbers and unfortunately we go to rehab that's where usually get his sodas in the sport drinks this what is important -- rehab centers set up. What is available water is available most times. Medical -- valuation. -- and create -- rehab each fire rescue personnel should be triage term at the medical treatment or transport is necessary. But entering any fire rescue personnel with it with the following -- -- through Chaman area Maria a blood pressure granted 200 over one bad. Or top number below ninety. No fire rescue personnel -- return. To active duty after twenty minutes arrest. If the issue presented with a blood pressure greater 160 overnight. 100. No fire rescue personnel -- return active duty if there are presented with an injury that may be worse in my return to duty. Or -- injury that might be anyway impair the performance of the injury. We wanna send you back at the up back on the job to injury is gonna put that at the feel -- your performance. And make these -- -- for yourself well for someone else. Any fire rescue personnel -- -- -- for transportation to a hospital if they had come out chest pains shortness of breath. Alerted mental status if you're not being yourself -- -- act a little weird but they -- -- Perfect for you you should be sent to the hospital skin and it's hotter -- the moist and drawing and the most important irregular pulse. Any fire rescue personnel should be considered for transportation the hospital if -- they have an oral temperature. A great of a 101 or -- 150. Feet per minute. Or pulse more than a 148 feet the minute after cooled down to be arrested at the twenty minute. And -- blood pressures are you beat the -- still 140. Usually take it to the hospital. Any fire rescue personnel to -- the transport to the hospital if the issue presents within a blood pressure to one over 130. Walk. Any emergency workers should be considered if they can -- and able to. Orally rehydrate -- to blood urine bombing if you keep the -- and uses them yet thrown of back up usually take it to the hospital right away. I -- see the next few slides -- what we just. Talk about blend bring back the apply house go back in -- back room discussed this what you offices and had to these questions this'll make it easier though you don't understand the rehab policy. To understand how what we have is all about. And how to perform rehab. And this program -- rehab we discussed a lot of things and discuss the whole different way and we have Barry -- work. So in summary all right this just capitalize -- -- issues we decided when and when and where to initiate rehab and decide whether whether -- headed up. This that is a must make it easy are fairly easy on beginning of the incident. Rehydration constant -- -- fire rescue personnel as the most important thing here we have people do do frost. And following accepted guidelines returning -- -- workers back to their duties. Wobble a ball returning -- work as a duty while at same time keep me stress. And then -- farm workers risking courting pro offered themselves to all the firefighters not based we -- want what everybody the state act the operation. I would -- operation.

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