Food for thought.... (heat stroke)

[FIREGIRL4EVER]

I thought I'd share this email with everyone that our fire dept. sent out to us the other day... We had record highs all week in North Carolina and many other places. Please stay safe and be careful. I don't ever want to see a fellow firefighter like this.

Hey...
The Fairhope (AL) Firefighter who collapsed Wednesday from heat
stroke is improving but remains in intensive care.

FF Chantez Jones' condition is now fair after being critical
originally. Jones had responded to a mobile home fire on Wednesday
afternoon, when the heat index was about 107 degrees. Before
responding to the fire call, Jones had been working outdoors in his
job with Fairhope Public Works, which increased his risk for heat
stroke. Jones was stretching a supply line to a hydrant when he
collapsed and passed out. He was taken to Thomas Hospital and
diagnosed with heat stroke, which is often life-threatening.

This is an example of how serious this hot weather can be and the
impact it has on Firefighters. While emergency calls must be
answered, additional staffing on the 1st (and greater) alarm as well
as proper rehab including hydration, rest and rehab chairs that cool
firefighters core temperatures are vital to our survival.
We have some suggested information available at:
http://www.firefighterclosecalls.com/downloads.php (search for the
word "rehab" on that page). Additional links related to Firefighter
rehab: http://www.firerehab.com/Columnists/...ticles/290923/ as
well as: http://www.firerescue1.com/Columnists/denehy/ .

Outdoor training should also be strongly re-considered. You may
remember the tragic LODD involving Frederick County (Maryland)
Firefighter recruit Andrew Waybright, 23, who died of heat stroke on
July 2, 2002, his first full day of training, after collapsing in
humid, 84-degree heat near the end of an hour-long outdoor workout.
Much of the nations weather has been much worse than that lately.

CORRECTION: Deputy Chief Jerry Donley Deputy Fire Chief, of the
Swetsonville VFD, who passed away on duty in his firehouse, was 45
years old.

WTF !? Go to the below link for a view on why "just a little more
work" probably needs to be done related to FF safety, health and
survival...all conveniently shown all in one picture....just for you.


http://www.ksffa.com/Firenews%20Augu...harpe_fire.htm

[THEFIRENUT]

I hope that FF Jones fully recovers from this ordeal. It's dangerous out there guys/gals so keep your cool.

Now on this picture:

Maybe these guys were just trying to keep their cool. I think that they would be better off if they had gone with shorts and sandals myself

p.s. Just in case you didn't realize this......I was kidding!!!!

[shfd739]

I saw that about the Fairhope FF in our local paper,fairhope is about 40 mins from where I live. the heat and humidity down here has been awful,worse than normal. Our dept in trying to deal with it has a one bottle rule,after one SCBA bottle you go to rehab. If our manpower wont support this, then call for mutual aid. In rehab all gear comes off, coats come off,pants go down to ankles. We have sports drinks,snacks and water for the guys to intake. Our medics check vitals and have a guideline sheet to follow with vital sign ranges on it. If initial vs are above certain limits then you get an automatic trip to the ER,if after 30 mins rest the VS are above another set of limits you have to stay in rehab and are not allowed to function on scene anymore. our medics can also pull anyone from performing on scene if they feel that person can no longer function safely.

[FIREGIRL4EVER]

Originally Posted by shfd739

I saw that about the Fairhope FF in our local paper,fairhope is about 40 mins from where I live. the heat and humidity down here has been awful,worse than normal. Our dept in trying to deal with it has a one bottle rule,after one SCBA bottle you go to rehab. If our manpower wont support this, then call for mutual aid. In rehab all gear comes off, coats come off,pants go down to ankles. We have sports drinks,snacks and water for the guys to intake. Our medics check vitals and have a guideline sheet to follow with vital sign ranges on it. If initial vs are above certain limits then you get an automatic trip to the ER,if after 30 mins rest the VS are above another set of limits you have to stay in rehab and are not allowed to function on scene anymore. our medics can also pull anyone from performing on scene if they feel that person can no longer function safely.

That's how we're doing it. The heat is so bad the medics come just to bring water too. We've had some guys get dehydraed(cant spell im blonde). Yea the one bottle rule is good to go by in these kin of conditions.

[Hazmat91180]

I totally agree with being hydrated and having proper rehab procedures setup, no matter if it is training or the real deal.

I do disagree with the article that suggests, "Outdoor training should be avoided.."

I believe that is crucial to understanding exactly how the body is going to react in the certain amounts of heat/cold. I certainly would rather have experienced my body going through these changes while on a training scene instead of an actual incident where more confusion is taking place.

Throughout the day I am monitoring my water intake to make sure I stay hydrated so that if we do get something I should be ready to go for at least a couple rounds.


We had a fellow FF pass out recently due to eating too much at dinner and then getting called out on a fire. You just have to be careful and remember what call could be coming in.

[ladymed]

Although I am not a paid FF and, to an extent, have a choice as to which calls to go on (as a volunteer), I also agree that training should be done in various temps for the reason stated by Hazmat - it is so important to know how your body will react in various temps and in various weather conditions. On hot days, more rehab will be needed; perhaps other FFs/stations, etc., might be needed because of this. Many people do not want to admit they are tired/exhausted, etc., and try to push themselves, but this is not the time of year to be doing this. (I am a paramedic; I don't mind meeting people, but not this way! )

[THEFIRENUT]

Originally Posted by shfd739

Our medics check vitals and have a guideline sheet to follow with vital sign ranges on it. If initial vs are above certain limits then you get an automatic trip to the ER,if after 30 mins rest the VS are above another set of limits you have to stay in rehab and are not allowed to function on scene anymore.

I would like to know what your Vital Sign limits are for both cases. Is this set on prior base line on your firefighters or is it a general number that is the same for everyone? Very curious!!

[FIREGIRL4EVER]

Tell you the truth I don't really know. If someone could tell us it would interest me.

[Catch22]

This is straight out of our SOG for rehab. I believe it came from a cut/paste type SOG from somewhere...

a. Transportation to the hospital is required when the diastolic blood pressure is ≥130.
b. Transportation to the hospital is also required when the diastolic blood pressure is ≥110 and the individual is symptomatic.
c. An individual may be transported to the hospital for further evaluation when the diastolic blood pressure is ≤110 and the individual is symptomatic.
d. The individual may be transported when the systolic blood pressure is ≥200 and after further evaluation and rest the systolic blood pressure remains ≥200.
e. When a pulse rate of ≥140 is found, administer oxygen and fluids, rest for a minimum of 10 minutes, and reassess the individual. If the heart rate is less than 140, the individual may return to work.
f. If after 10 minutes the heart rate still remains above 140, the individual must rest for an additional 30 minutes. Administer fluids and oxygen, and record the heart rate and rhythm on a cardiac monitor and obtain an EKG printout.
g. If after 30 minutes the pulse rate remains above 140, transport the member to a medical facility for further evaluation.
h. In the above cases, Medical Control will be contacted in every situation and treatment or transport will be determined in conjunction with Medical Control.

[shfd739]

Here is our EMS Rehab Guidelines For Fire Ground: (this is kind of long but good) Ours kind of matches Catch22's

Acceptable initial BP: Systolic 90-200, Diastolic less 110
Acceptable after 20 minutes cool down : Systolic 100-140, Diastolic less than 90

Recommended Hospital Transport:
Systolic over 200 anytime
Diastolic over 120 anytime
Systolic less than 110 and person symptomatic
Heart rate over 170 anytime
heart rate over 130 after 30 min cool down
Temp over 101 after 30 min cool down
Moderate to severe headache after cool down

Required Hospital Transport:
ALL Chest Pains
ALL shortness of Breath
ALL altered mental status
ALL syncope/seizures
ALL severe muscle cramps.

We keep Gatorade on all our trucks and the guys are encouraged to drink one enroute to calls to prehydrate. Cool down consist of removing all gear,drop pants to ankles is fine, and sitting in the rehab unit,if it isnt on scene then sit in the shade. As for training in the heat, we'll do stuff early in the morning before the heat is bad but its good for some guys that are A/C jockeys at work and never get to experience the heat to feel it and feel it's effects on the body.

[THEFIRENUT]

Thanks for the info on Rehab. I noticed that there is a slight difference between the numbers. Does anyone know of a written guideline that we could go by?

Maybe this needs to come from Medical Control. I will check and see as soon as I get a chance.

[jrscvfs]

Ok, on the topic of rehab units, my county has no, i said, NO, rehab units, im not sure on our prcedures in hot weather because the only calls we've had have been brush fires. We also had a couple of structural, but they were at times when the sun wasnt up. But yeah, we have water on the trucks, i think thats about it!!