1. #1
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    Default Rehab.Vitals for FF with full gear on in diff weather condtions?

    Just a question to anyone out there! We are setting up a rehab policy. We have charts for warning signs for FF involved in a fire scene. As I thought to myself, a FF temp, bp and hr has to go up with SCBA and full gear on. What would be the normal for this situation. It certainly is not going to stay at 96.8., bp of 130/80 and hr of 80 In our policy we would be taking a FF off the scene when their temp reaches 99.5., bp of 160/100 and hr of 100. My question is would this be a normal temp, bp and hr when being fully geared and being involved in a interior situation? I know from experience that my own bp and hr go up during a call, and I am still medically ok. I know this may be one of those stupid question get a stupid answer. But it was just something I was curious about.
    Last edited by EMSprincess11; 09-18-2002 at 09:30 AM.

  2. #2
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    EMS,

    I'm not exactly sure by what you mean when you say pulling a firefighter out. I'm also slightly confused on how you are describing what you are going to do to evaluate or perform rehab. 99.5 is still pretty low to use as a temp. We always use 101.5 and higher as a symptom of fever in patients in the field. If you go to amazon.com, or whatever site advertised on here that sells book there is a good book on rehab that is available. I recommend having your department buy one so all of you can review.

    First, rehab should always happen, I can't see taking a persons temperature while they are operating. It should be drain a bottle off to rehab. What you do after that is up to department policy. We do not generally check temperature but do keep track of vitals on a 5 min. basis. If the vitals do not reach a certain level after 10 mins. of rehab, to the ER you go. Temperature is not always a good indicator, you could be well beyond the on-scene treatment area and well into your way of becoming a critical patient if you only go by temperature.
    ___________________________________
    IACOJ Bureau of EMS Chairman

  3. #3
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    Default Health of FF

    Yes, I do agree that firefighters are at greater risk of getting higher blood pressure and temperatures. Both of these should be taken into account. The high blood pressure, if it remains too high for a long time without showing signs of lowering can be the "silent killer" to the various people. I am not a firefighter, however, and went to an accident scene as a bystander in January, and too got a very high blood pressure reading. But with the bp and the temperature it is extremely important to monitor.

    One of my suggestions, is to have some cool, clean, water, for them to drink when they go out of the situation, for a breather. This will take down some of the risk of heat exhaustion or heat stroke, that some of them could get with the elevated heat. As for the bp, it is good to have extra guys there, so they can relieve some of the guys that are tired, to prevent heart attacks on the scene.


    I have taken the Medical Office Assistant program, so I know about some of these complications!
    Firefighters are beneficial to every community with the wealth of information they have!

    They don't get enough praise, for the information and skills they know! It could save your life one day!!!!!

  4. #4
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    Default Rehab policies

    I just proposed a change to our Rehab policy in my department and I wonder if anyone else it trying this. I proposed that a set of vitals be included on the back of our accountability tags which stay with the firefighter. The information would be Blood pressure, pulse, known alegeries, blood type and requesting medical hospital ( we have 3 to chose from ). My thinking was to have the EMS personel take a baseline reading of the BP and pulse. This would be used to allow the EMS to know what each FF's normal rates are. They can use that to determine when to release someone from Rehab. The other information will help if someone has a medical problem and cannot communicate. I feel this has a few benefits: 1). allow more interaction between the fire department and EMS ( we are separate groups ). 2). Allows the firefighter to prove to EMS that he is fine to get back to work. 3). Gives the EMS some direction on treatment and wanted hospital to be treated at. 4). It alos allows the firefighter to add any other additional medical items he/she feels should be included. IF there are any other departments that are doing either something similar or different, please let us know here. I find that I learn a great deal from these forums.
    "Fire Prevention is our Intention"

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    Stephen,
    There are many departments in my area that do what you describe & on the accountability tags. It has baseline vitals, allergies and any pertinent past medical history or medications. They do change of course and the tags get updated ever so often, but it is a start. Just keep in mind that the baseline isn't gonna mean jack once the buzzer hits and you know you have a job, everything is going to go up. The problem is if after 10 mins. and it doesn't come down.

    As far as the rest of the comments, regardless of what the outside temperature is, our body heat rises. Additionally, it is important to keep in mind that it is easier to become dehydrated in cold weather then hot. EMSPrincess, they touch on this briefly in the rehab book you have. Not only is water important, (mtwaites, FYI we always have water, many depts. don't have structured rehab procedures) but the type of food you provide.
    ___________________________________
    IACOJ Bureau of EMS Chairman

  6. #6
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    Default accountability and rehab

    This may be somewhat unrealted to vitals, but accountability is important as ALSfirefighter started talking about with tags. I feel that a sign with the company's number in the rehab station would benefit the I/C with a quick location of a company. This would be especially useful during an evacuation of the building. Just a thought.
    -Matt

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