Operating A Rehab Area - Part 2

Mike Wieder describes ways to care for injured, exhausted, dehydrated and hungry firefighters at the scene of a major incident.


Rest/Hydration/ Replenishment Unit Responders who have satisfactory vital signs and no injuries, but are simply tired, should be directed to the rest/hydration/replenishment unit of the Rehab Group/Sector. It is at this location that they will be able to rest, drink fluids to replace those lost...


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Rest/Hydration/ Replenishment Unit

Responders who have satisfactory vital signs and no injuries, but are simply tired, should be directed to the rest/hydration/replenishment unit of the Rehab Group/Sector. It is at this location that they will be able to rest, drink fluids to replace those lost through sweating, and get a bite to eat if they are hungry or in need of an energy boost. The person in charge of this function is known as the rest unit leader.

In hot weather and if the rest area is in an air conditioned environment, responders should be allowed to let their bodies cool down at ambient temperatures for a few minutes before entering the air conditioning. Otherwise, the body’s cooling system can shut down in response to the external cooling that is taking place. In cold weather, there should be no delay in getting responders into a warmer environment.

The amount of time that responders will require in the rest area will vary depending on a variety of conditions, including:

  • The responder’s level of physical conditioning.
  • Atmospheric conditions.
  • The nature of the activities the responder was performing before entering rehab.
  • The time needed to adequately rehydrate and/or eat.

It is recommended that departments establish a minimum amount of time that all personnel should spend resting in the rehab area. Local policies will vary depending on normal atmospheric conditions and the number of available responders. However, a good rule-of-thumb is that each person should be allowed at least 10 minutes of rest at this stage. Members who still appear fatigued at this point may be allowed additional rest time.

There is no set maximum amount of time that a responder should be allowed to rest. However, any responder who has not recovered sufficiently to return to service within 30 minutes should be sent to the medical treatment/evaluation unit for a more thorough check-up. At this point they will need to receive further treatment or be sent home.

Obviously, the hydration function that occurs in this part of the rehab area is also important to responder recovery. Personnel who are performing heavy work, under stressful conditions, and while wearing heavy personal protective clothing are subject to excessive fluid loss.

While it is obvious that this occurs during hot weather (because of excessive sweating), do not overlook the fact that dehydration also occurs in cold climates. Dehydration is not as evident during cold weather because there may not be as much visible sweat on the responder. That is because cold air tends to have less humidity than warm air; thus, perspiration is more likely to evaporate quickly off of the skin. The various layers of clothing worn by the responder also are likely to absorb any wet perspiration that forms.

The prevention of heat- or stress-related illness and injury is greatly aided by maintaining a sufficient level of water and electrolytes within the responder’s body. Under extreme sweating conditions, it may be necessary for the responder to consume as much as one quart (one liter) of water per hour in order to maintain safe levels in their system. The recommended rehydration drink is a 50/50 mixture of water and a sports activity beverage. This should be served at a temperature of about 40°F (4°C). Caffeinated, alcoholic and carbonated beverages should not be used for rehab purposes because they can interfere with the body’s ability to conserve water.

Drinks should be easily accessible to responders who are in this area. They may be served in individual serving containers (cans or bottles) or dispensed from large coolers. If dispensable coolers are used, there must be an ample supply of disposable drinking cups provided nearby. Responders should be encouraged to drink as much as they feel they need to quench their thirst and replace the fluid in their body. The amount each person needs will vary.

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