Take 10

There has been increasing focus on the need for fire-rescue personnel to recieve rhab earlier in an incident. NFPA calls it "company/crew level rehab". It has emerged as an essential enhancement of emergency incident operations.

Rest---Keep It Simple

Although not a lot of rest, assuming a kneeling or sitting position does provide some reduction in cardiovascular stress as opposed to constantly standing, especially when wearing full turnout gear and SCBA. If possible and safe, responders should remove their helmets and turnout coats for more efficient cooling.

Rehydration---Avoid Too Much

In structural firefighting, the ideal location for rehydration solutions is on the crews' apparatus. Placing the drink in predetermined locations, such as with spare SCBA cylinders, is an excellent strategy that encourages firefighters to replenish fluids during the initial air cylinder change or whenever they are near their apparatus.

Once concern about rehydration is consuming too much fluid, too rapidly and then immediately returning to strenuous activity. Ingesting too much fluid in this setting could result in bloating, nausea and vomiting. It's important to restrict the volume of fluid intake if the crew will be immediately returning to strenuous activity.

NFPA takes restriction to an extreme, recommending only 2-4 ounces of fluid when rehydrating at the compnay/crew level. In practical terms, it's almost impossible to restrict personnel to such a small volum after 15 or 20 minutes of very strenuous activity. A more reasonable volume may be 6-8 ounces. An easy way to restrict volume is to place 12-ounce sport-drink containers near the SCBA bottles.

Medical Monitoring---The Look Test

A formal rehab area allows objective medical monitoring: pulse rate, blood pressure and temperature. But moitoring and the crew level is a far more subjective process based on general observations. The simplest way to assess a responder's well being is the "look test":

• Poor skin color (flushed, pale or sallow)
• Altered mental status
• Loss of strength or coordination
• Poor posture
• Labored breathing

Any of these signs may indicate simple exhaustion or potentially life threatening stress or heat related illnesses.

Like a coach who watches his players fo signs of fatigue, all compay officers and members should observe fellow crew members with the specific goal of identifying thos who fail the look test. The crew should nitiate rest and rehydration as soon as the need is seen.

Recommended Time Intervals for
Rest & Rehydration at the Company/Crew Level:

• Structural firefighting: every 20 minutes
• Major medical/MCI operations: every 20 minutes
• Hazmat special operations: every 15-30 minutes
• Wildland firefighting: every 20 minutes