National Fire Fighter Near-Miss Reporting System: Rehab

Properly established rehab is an essential scene function that provides firefighters with fluid and calorie replacement, recovery, and most importantly, medical monitoring. If established early, properly staffed and stocked, rehab also provides the earliest intervention point that can identify a firefighter in distress.

“I was the Instructor in Charge (IIC) of a live fire training class that was being conducted at a facility which has a gas field for scenarios. We were following NFPA 1401 and 1403 for live fire operations for our drills…Prior to starting the scenario, we began a stringent firefighter vitals screening check in accordance with NFPA 1401 and 1403 for live fire training. After the vitals were taken, we did a walk thru of the area where the operations were being performed and how they would be conducted.

…the second entry team began their evolution. Approximately three minutes in to their evolution, one of the firefighters walked out of the hot zone stating that he did not have a good face mask seal. We started assisting with removing his gear and getting him to sit down in our rehab area. After a couple of minutes, the safety officer asked him how he was feeling. He stated he was ok and said, ‘I just need to catch my breath.’ We allowed him to rest for another five minutes while taking his vitals and giving him water…He was telling us he was ok and that he was just tired. However, the rehab sector officer decided that it was more than just being tired and he began following our local firefighter rehab protocol. While taking the firefighter’s pulse a second time, he noticed an irregular heart beat which the firefighter said he did not have…At this point the firefighter was still in defiance that there was anything wrong with him. We initiated ALS procedures and put him on an EKG monitor which showed that the firefighter had…”

Rehab is sometimes treated as an afterthought, or approached with disdain by firefighters and commanders alike. There is even a slogan, “Rehab is for sissies,” that surfaces in discussion by undereducated fire service members. This featured report clearly demonstrates that rehab is not only a necessity but it is a lifesaver as well. Underlying health problems have a way of showing up when we are placed under stress. The one point that is clear is that firefighting activities place the body under extreme stress. Once you have read the entire report (CLICK HERE), consider the following:

1. Is Rehab taken seriously by the members of your department, or is it just a place to get a drink of water?
2. Does your department have an updated SOP regarding Rehab?
3. Does your department follow NFPA 1584 regarding rehab procedures?
4. Is your Rehab group staffed with ALS capable personnel?
5. If a serious problem is found during Rehab, does a firefighter have the right to refuse treatment?

Have you saved a life due to rehab? Visit and report your near miss at today so everyone goes home tomorrow.

Note: The questions posed by the reviewers are designed to generate discussion and thought in the name of promoting firefighter safety. They are not intended to pass judgment on the actions and performance of individuals in the reports.

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