Transcript REHAB POLICY - Fire Training Tracker

REHAB POLICY
Zone 3
Lesson Objectives
Upon completion of this lesson, the student will
be able to:
Describe when rehab is established
Identify the terminology used in the rehabilitation
process
Describe when an individual reports to Rehab
Define basic rehabilitation components
Describe how rehabilitation fits place within ICS
Lesson Overview
Establishment of Rehab areas
Rehab area location
Informal and Formal Rehab
Roles and responsibilities
Rehab Components
Roles of responders
Where Rehab fits within ICS
Policy References:
NFPA 1584 – Standard on the Rehabilitation of
Members Operating at Incident Scene Operations and
Training Exercises.
WAC 296-305-05001 (13) Emergency Fire
ground operations — Structural
WAC 296-62-095 Heat Related Illness in the
Outdoor Environment
FEMA. (2008),
Emergency Incident Rehabilitation,
(USFA publication No. fa-314). Emittsburg, MD.
Related Documents:
Rehab Area Crew Check In/Out Form
Medical Information Report Form
Rehab Area Manager check list
Zone 3 Rehab Guideline
Policy Statement
To ensure that the physical and mental condition of personnel
operating at the scene of an emergency or a training exercise does
not deteriorate to a point that affects the safety of each member or
that jeopardizes the safety and integrity of the operation, a Rehab
Area will be established at all emergencies of a significant nature in
which it may be expected that the work interval will last longer than
30 minutes or when climatic or environmental conditions warrant.
BASE
That location at which the primary logistics
functions are coordinated and
administered (Incident name or other
designator will be added to the term
“Base.”).
The Incident Command Post may be colocated with the base.
There is only one base per incident.
A rehab area is established…
At all emergencies of a significant nature in
which it may be expected that the work interval
will last longer than 30 minutes
When climatic or environmental conditions
warrant.
At extended training exercises
When physical exertion can reasonably be
expected to adversely impact personnel.
Considered during the initial stages of an every
emergency response.
Rehab Area
That designated support
function established near to an
emergency or training event at
the direction of the IC during
evolutions that pose increased
physical, and emotional stress
to event participants.
established with ease of
access, preferably within
walking distance of a defined
event.
Personnel assigned to a
Rehab area are out-of-service
until re-assigned.
Informal Rehabilitation
Informal rehabilitation is a
routine and shorter duration
rest period that occurs at the
end of a work cycle.
It may be self-directed, or
directed by a supervisor, and
does not require members
report to Formal Rehab for
evaluation.
Personnel may be designated
out-of-service during Informal
Rehab, depending upon event
circumstances.
Formal Rehabilitation
A Rehab Area is a dedicated area
May be located adjacent to the Staging
Area,
situated in a manner that provides the
maximum benefit of rest away from noise,
activity and danger.
Capable of handling all personnel involved
in an incident or event.
Forms
Rehab Tracking Form - used to record entry and exit
of individuals and crew members reporting to an
established Rehab Area and to record the medical
information collected during examinations of individuals
and crews reporting for formal rehabilitation.
Rehab Area Manager Check List – A job aid to
assist the RAM in managing rehabilitation activities.
MIRF – Medical Information Report Form
Rehab Area Manager (RAM)
Is responsible for overseeing the organization of
the Rehab area;
Directs the acquisition of facilities, equipment
and supplies to support the Rehab function and
for discharge of rehabilitation activities,
Reports to the Medical Unit Leader if
established.
If the Medical Unit is not established at an
incident, the Rehab Area Manager shall report to
the Incident Commander or Operations Section
Chief.
When to Report
Personnel shall report to Rehab at any time they
exhibit or feel symptoms of weakness,
dizziness, chest pain, muscle cramps, nausea,
altered mental status, or difficulty breathing,
signs of heat or cold stress.
Through their Company Officer, personnel may
request informal rehabilitation
Informal self-rehabilitation cycles do not require
members report to Rehab for evaluation.
When to Report
An IC may be permitted to adjust the following time
frames based upon the needs of the incident or event.
Having worked for 2 full 30 minute air bottles, 1 full 45 or
60 minute air bottle.
Having worked through 1 full air bottle after already
being in Rehab.
40 minutes of intense work time in full PPE without
SCBA.
Whenever personnel are working in fully-encapsulating
chemical protective clothing
Whenever directed by the IC or Company Officer.
Decontamination
Personnel reporting to the Rehab Area
shall undergo appropriate levels of
decontamination prior to their arrival.
To minimize cross-contamination, turnout
clothing, tools and equipment should be
removed prior to entry into the Rehab
Area, if practical.
Medical
The Rehab area shall be assigned a Medical
Service Officer, when available, and shall be
designated as the Rehab Area Manager (RAM).
In the absence of a MSO, a Company Officer
may be assigned as the RAM.
Shall be staffed by qualified EMS (minimum BLS
level caregiver) personnel
The Rehab Area Manager shall be responsible
to ensure that adequate resources are available
for hospital transport.
Shelter
The Rehab Area Manager shall address the
needs for sheltering personnel against
environmental effects.
Consideration may include using adjacent
buildings, lower floors, aid vehicles, fire
apparatus, busses, Explorer Rehab Units, tents,
awnings/tarps, trees and other means to reduce
the impact of weather and temperature.
The Rehab Area Manager may request such
equipment and devices necessary to facilitate
rest, cooling, heating and recovery.
Hydration
During air bottle exchange or while in Rehab,
personnel shall re-hydrate by drinking at least 8
oz of fluids and will be encouraged to drink 1
liter (32 oz) of water before leaving.
It is recommended that all first response
apparatus carry a minimum compliment of 12
(12 oz) bottles of water for each 3 person crew
and 16 (12 oz) bottles of water for each 4 person
crew.
All Zone response units shall carry adequate
water for their assigned crew.
Hygiene
Hands shall be washed before drinking or
ingesting anything on the fire ground.
Provisions shall be made to provide hand
washing or cleaning facilities at the Rehab
Area.
Waterless hand sanitizers, waterless hand
wipes or similar sanitation products may
be used in place of portable wash stations.
Nourishment
Food shall be
provided within the
Rehab area, at the
scene of an extended
incident or event,
When units are
engaged for three or
more hours or
At the Incident
Commander’s
discretion.
Rest
– The objective
evaluation of
personnel’s fatigue
level will establish the
criteria for rehab time.
– Rest must not be less
than 15 minutes and
may exceed an hour
as determined by the
RAM.
Recovery
Personnel in Rehab should maintain a high level
of hydration.
Personnel should not be moved from a hot
environment directly into an air-conditioned
area. An air-conditioned environment is
acceptable after a cool-down period.
Removal of turnout gear should be considered in
order to allow the body’s temperature to cool.
Medical Evaluation
Visual assessment of
member’s appearance and
physical condition.
Vitals:
– Exceed Heart Rate of 100 bpm
– Exceed Temperature of 100.6 F.
(orally)
– Exceed Blood Pressure of160/90
Rest times are increased, or further
medical treatment may be
required.
Reassignment
At the discretion of the MSO, personnel may be
relieved from duty reassigned pending further
rest and/or medical evaluation.
In the event that personnel are relieved,
reassigned or placed out of service, the MSO
shall notify the Medical Unit Leader, Operations
Section Chief, or Incident Commander.
Personnel will report to Staging only when
evaluation presents normal and the Rehab Area
Manager has released them.
Documentation
A MIRF is filled out for anyone transported to a
medical facility.
All medical information shall be documented on
the Rehab Tracking Form.
The RAM ensures the all forms are completed
accurately and submitted to the Incident
Commander, Planning Section Chief or
Documentation Unit Leader.
These forms will be available on all apparatus.
Accountability
Personnel assigned to Rehab shall enter and exit as a
crew.
The Rehab Area Manager or designee shall document
the arrival of members reporting to the Rehab area using
the Rehab Tracking Form.
The Rehab Area Manager shall obtain and passports
until members are released from the Rehab Area.
Crews shall not leave the Rehab area until authorized by
the RAM.
Crews leaving the Rehab area shall return to Staging
report for assignment unless directed otherwise by the
RAM.
Firefighter
Must monitor the condition of each member operating
within their crew provide for each member’s safety and
health.
When fatigued and rehab is necessary, they must report
to the rehab area.
Encouraged to drink water and activity beverages
throughout the workday.
Shall advise their Company Officer when they believe
that their level of fatigue or exposure to heat or cold is
approaching a level that could affect themselves, their
crew, or the operation in which they are involved.
Ensure apparatus are stocked with Rehab Tracking
Forms, MIRFs, and water at the start of each shift.
Company Officers
All officers are responsible for the safety
and physical well being of personnel under
their command.
Company Officers are to monitor their
personnel’s air usage and physical
condition at all times.
They are to notify their supervisor if their
crew needs to be evaluated in Rehab.
Incident Commander
Consider rehab during the initial planning
stages of an emergency response.
The I.C. shall appoint a RAM to
coordinate Rehab.
Shall acquire adequate provisions to
support Rehab activities based upon
climatic and environmental conditions.
Consider requesting additional alarms or
resources to support Rehab activities.
Rehab Area Manager
Secure all necessary resources required to
adequately staff and supply the Rehab Area.
As the scope of an incident or event warrants,
the Rehab Area Manager may establish Medical
Evaluation/Treatment Unit, Transportation Unit,
and Reassignment Unit for the sole purpose of
evaluation, transport and release of incident
personnel from the Rehab Area.
Rehab Area Manager
Maintain all documentation including
Rehab Tracking Form, and MIRFs to be
turned in at the end of the incident.
The Rehab Area Manager shall maintain
personnel accountability using the
Passport Accountability system whenever
the Rehab Area is established.
Rehab Area Manager
The Rehab Area Manager retains
discretion to determine individual status,
and shall inform the Incident Commander
of instances where an individual must be
reassigned or place out-of-service due to
their medical and physical condition within
the conditions set forth in this policy.
Modular Development of ICS
IC
ReHab
Staging
Staff
Engine
Engine
Engine
Ladder
Modular Development of ICS
IC
Staff
Operations
Rehab Area
Strike Team
Division
Resources
Staging Area
Medical Unit
Rehab Unit
Modular Development of ICS
IC
Staff
Operations
Rehab Area
Division
Planning
Staging Area
Logistics
Service
Fin/Admin
Support
Division
Communications
Resources
Medical
ReHab
Food