Standard Operating Procedures

1
Standard Operating Procedures

• Incident Rehabilitation Procedures

2
Purpose

• Utilize firefighters to their fullest
  capabilities without extending them beyond their
  limits of durance.
• This program stresses the importance of
  monitoring the physical and mental conditions of
  personnel at emergency scenes.

3
Implementation

• The Logistics Officer will be responsible for the
  implementation of rehabilitation (Rehab)
  procedures for personnel operating at emergency
  incidents.
• The Logistics Officer shall determine the
  appropriate level of Rehab warranted.
• If a Logistics Officer has not been assigned then
  the responsibility will fall back on the IC.

4
Rehab Level One

• Level One Rehab is the systematic but informal,
  procedure of providing rest and recuperation to
  those members operating at routine incidents.
• Level One Rehab normally occurs when the tactical
  objective has been achieved.
• Level One Rehab normally suffices when the
  tactical goal is achieved within 15 minutes of
  the Incident on Scene time.
• Level One Rehab will not normally require
  additional resources such as EMS, Fire Companies
  from Staging, Tarc (Rehab Bus), Rehab Officer,
  vital sign monitoring, etc.

5
Rehab Level Two

• Level Two Rehab is the systematic and formal
  procedure of providing medical evaluation, rest,
  and recuperation to those members operating at a
  multiple alarm, Level 2 HazMat or other complex,
  time intensive incident.
• Level Two Rehab may be established at extra
  equipment incidents if deemed warranted by the
  IC.
• Level Two Rehabs will require additional
  resources and considerations.

6
Level Two Rehab Procedures

• Logistics Officer Responsibilities
• IC shall be responsible if a Logistics Officer
  has not been assigned.
• The Rehab area location shall be identified.
• The Rehab area should be adjacent to the incident
  staging area and large enough to accommodate an
  SCBA Bottle Filling Station, a Rehab Bus (Tarc),
  one or more EMS Units and, at major incidents a
  EMS Command Bus.
• Any mobile canteen unit(s) which responds to the
  Incident (Salvation Army, Red Cross, etc.) should
  also be placed within the Rehab area. Exceptions
  to these guidelines would be interior rehab
  locations.
• A Rehab Officer shall be designated and
  identified.

7
Level Two Rehab Procedures

• Rehab Officer Responsibilities
• Request the response of the following to the
  Rehab area
• 1. EMS Unit(s)
• 2. Rehab Bus (Tarc)
• 3. SCBA Bottle Filling Station
• 4. Red Cross and/or Salvation Army
• If EMS units are unavailable, a firefighter/EMT
  may be utilized until an EMS unit arrives on
  scene.

8
Level Two Rehab Procedures

• Rehab Officer Responsibilities CONTINUED
• Develop a list of all companies/units in-service
  at the incident.
• Collect all accountability tags of companies in
  rehab and document time in and time out of rehab.
• Communicate with the Staging Officer information
  regarding the arrival and exiting of companies at
  Rehab.

9
Level Two Rehab Procedures

• Rehab Officer Responsibilities CONTINUED
• Maintain documentation of all Rehab activities,
  including the recording of each members vital
  signs.
• Ensure that all companies in active service at
  the incident are processed through Rehab prior to
  departure from the scene.
• Prepare a post incident rehabilitation report
  (utilizing the Rehab Report Form) which lists all
  personnel who were processed through Rehab, along
  with their vital signs recordings. This report
  shall be forwarded through the chain of command
  to the Safety Officer.

10
Level Two Rehab Procedures

• Company Officer Responsibilities
• Collect tags from Accountability Officer and
  report immediately to the Rehab Area, when
  directed. It is important that vital signs are
  taken within 3-5 minutes of released from duties.
• Company Officer will report to the Rehab Officer
  and provide him/her with Tags.
• When the entire company to report to the Rehab
  together, (pump operator) the Company Officer
  shall ensure that all assigned members are
  evaluated before leaving the scene. Company
  Officer shall hold his company in Rehab until
  departure is authorized by the Rehab Officer.

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Level Two Rehab Procedures

• Rehab and Staging
• During Level Two Rehab operations, one or more
  companies should be maintained in the Staging
  area.
• As companies are directed to report to Rehab, the
  replacement companies should be assigned from the
  staged tactical reserve.
• Upon completion of Rehab, the company may be
  directed to report to staging, given a tactical
  assignment, or released from the scene.

12
Documentation

• The following information shall be recorded as
  soon as possible after a company reports to the
  Rehab area
• Company Designation
• Names of Personnel
• Age
• Time In
• Vital sign evaluations
• Blood pressure
• Pulse
• Time Out

13
Supplies

• Water
• F.F.s should remove gear and relax and
  recuperate for min. of 10 minutes.
• SCBA cylinders should be exchanged for full
  cylinders.

14
Released From Rehab

• No one is to be released from Rehab without
  further medical attention if their vitals are not
  within the established parameters.
• A second set of vitals must be taken on everyone
  whose first set was outside the parameters.
• The second vital sign evaluation should be taken
  after a 10 minute rest period.

15
Vital Sign Parameters

• Blood pressure
• Systolic pressure should be between
• 160 and 100
• Diastolic pressure should be between
• 90 and 50
• Pulse
• Between 110 and 50
• Other Signs or Symptoms
• Other signs or symptoms that the evaluator
  determines may require further medical evaluation.

16
Vital Sign Parameters

• It is important to emphasize that vital sign
  readings outside the established parameters may
  or may not indicate a medical problem.
• These parameters are established to aid
  rehabilitation evaluators and to increase the
  level of protection for personnel at emergency
  scenes.

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Vital Sign Documentation

• The Rehab Officer shall maintain documentation of
  all vital signs taken during Level Two Rehab by
  causing the Rehab Report Form to be filled out.
• All persons whose vital signs are not within the
  established parameters should be identified in
  Remarks section of the form, including all
  subsequent vital sign readings (back side of the
  form may be used if additional space is needed).
  Blank Rehab Report Forms shall be available on
  command vehicles.

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