B-114 Firefighter Rehabilitation Flashcards
A rehabilitation unit (designated as “REHAB” within the ICS structure) and rehabilitation area shall be provided under the following circumstances, or at the discretion of the Incident Commander:
- Any working fire.
- Any hazardous materials incident requiring encapsulation.
- Any confined space or trench rescue incident.
- Any prolonged incident requiring firefighters to work in bunker gear.
- Any labor intensive or prolonged incident with climatic or environmental conditions indicates the need to establish a rehabilitation area (use of the Humidex and wind chill index can be used for recognition of climatic stress).
When a rehabilitation area has been established by the Incident Commander, ____ will be responsible for the management and coordination of the rehabilitation area until this duty is reassigned by the Incident Commander or designee.
- the first two available paramedics
Dispatch shall be responsible for announcement and group wide page alert of elevated ____ levels to increase awareness of on-duty personnel.
Humidex
Personnel should actively hydrate prior to responding to emergency incidents or training evolutions, as well as hydrate throughout the day. During heat stress, personnel should consume ____
at least one quart of water per hour.
Foods such as ____ provide supplemental forms of energy replacement. ____ foods should be avoided.
- apples, oranges, and bananas
* Fatty and/or salty
Firefighters having worked for ____ shall be immediately placed in the rehabilitation area for rest and medical evaluation. This does not preclude an Officer from having emergency personnel evaluated if he/she deems appropriate.
one (1) full SCBA bottle, or thirty (30) minutes of strenuous activity
Rest shall not be less than ____ and may exceed an ____ as determined by the Rehabilitation Officer.
- fifteen (15) minutes
* hour
Personnel in the Rehabilitation Area should maintain a high level of hydration. Certain medications can impair the body’s ability to sweat and extreme caution must be exercised if personnel have taken ____ or has taken ____
- antihistamines (Actifed, Benadryl, etc.)
* diuretics or stimulants.
Evaluation guidelines allow for two evaluation cycles of rehabilitating firefighters in the first ____ if no abnormal findings are present. If abnormal findings are present, or the responder complains of any symptom (dizziness, nausea, shortness of breath, chest pain/pressure,etc.) re-examination will occur ____. Abnormal finding examination will involve a minimum of:
- ten (10) minutes
- every three minutes
a. Behavior.
b. Coordination.
c. Gait.
d. Work of breathing.
e. Breath sounds.
f. Glascow Coma Score.
g. Blood pressure.
h. Heart rate.
i. Respiratory rate.
j. Temporal artery/tympanic membrane temperature.
k. Pulse oximetry.
l. Carboxyhemoglobin determination.
m. Skin condition.
n. Blood glucose level.
o. EKG/12-lead.
p. Orthostatic vital signs.
In hot, humid conditions a minimum of at least ____ minutes (____ is preferable) of active cooling shall be applied following the use of the second and each subsequent SCBA cylinder.
- fifteen (15)
* twenty
Personnel participating in live fire training evolutions shall receive pre-participation medical screenings that include the following:
i. Blood pressure.
ii. Heart rate.
iii. Respiratory rate.
The following diagnostic examinations will be provided for every member entering rehab:
1. CO-Oximetry to Measure Carboxyhemoglobin Levels. 2, Pulse Oximetry. 3. Tympanic Membrane Temperature. 4. Heart Rate. 5. Respiratory Rate. 6. Blood Pressure 7. Rate of Perceived Exertion 8. Active Cooling 9. Replenishment
Symptoms of carbon monoxide poisoning are nonspecific and easy to miss diagnostically; these include ____.
*headache, nausea, shortness or breath, flu-like symptoms, or gastrointestinal symptoms
Ranges for CO monitoring.
i. Nonsmokers range 0-5%.
ii. Smokers range 5-10%.
iii. Personnel with COhb above 10% shall receive 100% oxygen via non-rebreather mask.
iv. Personnel with COhb levels higher than 5% shall not be allowed to leave the Rehabilitation Area.
Personnel with oxygen saturation of less than ____ shall not be permitted to leave the Rehabilitation Area.
93%
Tympanic membrane temperature readings may be as much as ____ than the actual core temperature.
two (2) degrees lower
Initial tympanic membrane temperature readings at or above ____ degrees Fahrenheit shall receive immediate active cooling via forearm immersion.
103, or 100
Patients with tympanic membrane temperatures at or above ____ degrees Fahrenheit shall not be permitted to leave the Rehabilitation Area until temperature reading returns to normal ____
- 100
* (less than 100 degrees Fahrenheit).
Initial heart rate measurements above the 70% maximum target heart rate ((220-age) x .07) should initiate ____.
oxygen therapy via non- rebreather mask
An initial heart rate at or above 100% of maximum heart rate should initiate ____. Personnel with these high heart rates should seek medical attention from a physician regardless of how quickly the pulse rate returns to the normal range.
- oxygen therapy via non-rebreather mask and active cooling measures via forearm immersion
If after ____ of rest and oxygen the heart rate does not decrease to below ____ of the target heart rate, the responder will be relieved of duty for the remainder of the shift and advised to seek immediate medical attention.
- five (5) minutes
* 90%
Personnel who have not achieved a heart rate of less than ____ beats per minute by the end of twenty (20) minutes of rehabilitation shall not be released from the Rehabilitation Area and should continue to be monitored and, if warranted, transported for further medical evaluation.
100
Part of additional monitoring for abnormal findings shall include ____.
12 lead EKG, orthostatic pulse and blood pressure readings
Personnel that have heart rates above the ____ target heart rate after five (5) minutes of rest and cooling shall have ____ performed. Any abnormalities will be reported to the unit Officer and the responder will be transported to the closest appropriate medical facility.
- 70%
* a 12 lead EKG
