NFPA 1584

Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises

Rehab in the fire industry is a requirement of National Fire Protection Agency (NFPA) 1584. While numerous states are NFPA compliant, that does not dictate whether a firefighter needs rehab.

Regardless of the compliance of a state with NFPA, the needs of the firefighter are the same: Everyone needs a period to recharge, cool, and rest their body. This is true not only in an active firefight, one-hour MCI, or extended incident but also during physical training of one-hour or more.

Approximately 10% of a firefighter’s time is spent on an active fire ground with almost 50% of firefighter deaths and up to 66% of injuries occurring on the scene. While it is not clear exactly how many instances of fatigue result in injury, many studies seek to prove that fatigue is the main factor in on-scene injuries. It is the job of the incident commander to keep firefighters on the ground safe, this means rehabbing. While many might see needing rehab as a sign of weakness, the truth of the matter is everyone needs to be able to let their body rest and replenish in order to be an effective part of the team. It does not matter what age, how much experience a person has, how physically fit a person is, or what their title or rank is. One overly fatigued firefighter is a danger to every other team member who must pick up their workload. How can rehab be enforced by a

How can rehab be enforced by a department, not in an NFPA compliant state? The first step is for the command of the department to create Standard Operating Guidelines (SOGs) outlining what the department expects of its members in regards to rehab, what that rehab will consist of and what happens if the policy is not followed. A big part of being able to enforce rehab SOGs for your agency is educating members about the benefits of rehab and having the proper tools in place. Understanding what the actual components of rehab are is crucial for every commander:

How do you enforce something you don’t understand yourself?

There are nine main components to rehab:

Relief from climatic conditions: Place your rehab staging area away from the active scene in a smoke-free area where the firefighter cannot see what is going on to give them a chance to decompress for a few minutes.
Rest and recovery: Members are given at least 10 minutes of uninterrupted rest (more if needed) before returning to the scene.
Cooling and rewarming: Have the members remove their head sock, helmet, gloves, and coats. Provide are warming or cooling area depending on your situation. Cooling systems that help bring members’ core body temperatures down to a safe level in a short amount of time are available here.
Re-hydration: Provide fluids that will replenish the nutrients and fluid loss during sweating and the physical output. Stay away from sugary and/or caffeinated drinks.
Calorie and nutrient replacement: Depending on the type of incident, this can be as simple as a granola bar. For extended incidents, this may include meals. Try to stay away from salty food that will throw the re-hydration off. It is a good idea to provide towels for the members to wash their hands and face with quickly before eating.
Medical monitoring: This will fall on EMS that is on the scene. EMS should know what needs to be monitored in the patient. Rehab tracking systems are available to make this an easier system that will help ensure everyone is ready to go back to work.
EMS treatment in accordance with the local protocol: EMS should be on scene and able to transport any member needing medical attention. This unit is separate from your rehab unit. Rehab needs to remain on scene to continue medical monitoring of the other members.
Member accountability: A solid rehab tracking system will not only document what rehab has been completed and when, but also gives a backup to fire ground accountability. This way the commander knows where everyone is at all times. You can find all accountability systems offered here: Accountability Tracking Systems
Release: Before leaving the rehab area, EMS must agree that the member is medically able to return to duty. Strong documentation of this helps to cover both the EMS provider and the department if anything were to happen medically or physically to a member on the scene or for a period after.

Overall, to achieve a solid rehab system is not difficult. Provide them with an area away from the scene, provide a tracking system to ensure everyone is cycling through and healthy, provide a way to warm or cool, provide fluids and some food, and have EMS on the scene to handle the medical portion. At the end of the day, regardless of what state you live in or if your state complies with NFPA, the ultimate goal of everyone in the fire service is for everyone to go home to their families safe and healthy. That is why strong rehab is a necessity at every incident.

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