7 things you need to run an effective rehab sector

Like any fireground activity, a well-run rehab sector begins with planning and ends with execution

This article first appeared on FireRehab.com, sponsored by Masimo.

By EMS1 Staff

We all know that a working fire taxes firefighters physically and mentally. Getting firefighters into an effective fireground rehab area will improve their short-term health issues, such as dehydration and heat-related illness, and improve their long-term health conditions, such as hypertension. Most fire departments accept that in theory yet struggle to execute it in practice.

Below is a list from rehab and medical experts of seven elements fire departments need for effective rehab sectors and, ultimately, healthier firefighters.

1. Sound guidelines and procedures
The first step to making sure the rehab sector works is having your procedural ducks in a row. Once sound standard operating guidelines and procedures are in place, train your staff to reinforce the importance of these rules and to identify holes or gaps that may need altering.

2. Clear landmark
Have a flag or some other marker that is clear and easy to identify on the fireground to let firefighters know where the rehab sector is. A highly visible landmark makes it impossible to deny rehab's existence.

3. Quick intake
If firefighters have to wait 10 to 15 minutes for anyone to see them, they very well may wander away. Engage them quickly, not only to make sure there is nothing life-threatening occurring, but also to get them in the system and make sure they stay in rehab for the appropriate amount of time.

4. Team of responders
To support quick intake, it is critical to have enough medical responders available to monitor, evaluate and treat firefighters in the rehab sector. The amount of personnel needed will be dictated by the size of the incident, the number of firefighters on scene and the environmental conditions.

5. Vital signs
Getting vital signs can often be a rehab bottleneck, but this is a must-have. Get heart rate and blood pressure readings first and quickly, before those rates naturally drop. In the field, automatic blood pressure devices are less reliable; do it the old-fashioned way.

A third important vital sign is a carbon monoxide reading. Using CO oximetry allows medics to get both a heart rate and a CO level with one action.

6. Food, drink, supplies, shelter
Rehab sectors should be well-stocked with healthy food and drinks – this means no sugary beverages. Always have plenty of water available.

Also, have enough medical supplies at the ready to treat any emergency likely to come up on a fireground, paying special attention to dehydration, heat-related illness, cardiac events and exhaustion. Provide warming or cooling shelters when the weather dictates their need.

7. Designated scribe
Have a person dedicated to recordkeeping. This person will need to log the name and unit of each firefighter who comes through the sector, as well as the time in and time out and the firefighter's vital signs. A simple form is key.

An effective rehab sector plan will include the elements listed above. Adequate supplies, training and staffing are key to successful execution.

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