Policy 2127: Emergency Incident Rehabilitation
YAKIMA COUNTY FIRE DISTRICT 12
10000 ZIER ROAD
YAKIMA, WA 98908
POLICY # 2127
COMMISSION CHAIR SIGNATURE s/b Ken Eakin, Chair
EFFECTIVE DATE:
REVISED DATE: 11/11/08
POLICY TITLE: EMERGENCY INCIDENT REHABILITATION
REFERENCE: WAC 296-305-05001 (13) – SOG 3-3
WAC 296-62-095
1.0 PURPOSE
It is the policy of the District to establish a rehabilitation plan that ensures the physical and mental condition of members operating at the scene of an emergency, or a training exercise, do not deteriorate to a point which affects the safety of each member or that jeopardizes the safety and integrity of the operation.
2.0 INCIDENT COMMANDER
The Incident Commander shall consider the circumstances of each incident and make adequate provisions early in the incident for the rest and rehabilitation for all members operating at the scene. These provisions shall include: medical evaluation, treatment and monitoring; food and fluid replenishment; mental rest; and relief from extreme climatic conditions and the other environmental parameters of the incident. The rehabilitation shall include the provision of Emergency Medical Services (EMS) at the Basic Life Support (BLS) level or higher.
3.0 SUPERVISORS
All supervisors shall maintain an awareness of the condition of each member operating within their span of control and ensure that adequate steps are taken to provide for each member’s safety and health. The command structure shall be utilized to request relief and the reassignment of fatigued crews.
4.0 PERSONNEL
During periods of hot weather, members shall be encouraged to drink water throughout the work day. During any emergency incident or training evolution, all members shall advise their supervisor when they believe their level of fatigue or exposure to heat or cold is approaching a level that could affect themselves, their crew, or the operation in which they are involved. Members shall also remain aware of the health and safety of other members.
5.0
Rehabilitation should be considered by the Incident Commander during the initial planning stages of an emergency response. The climatic or environmental conditions of the emergency scene should not be the sole justification for establishing a Rehabilitation Area. Any incident that is large in size, long in duration, and/or labor intensive will rapidly deplete the energy and strength of members and therefore merits consideration for rehabilitation.
5.1 Climatic and environmental conditions which indicate the need to establish a Rehabilitation Area are a heat stress index above 90˚ F (see Appendix).
6.0
A critical factor in the prevention of heat injury is the maintenance of water and electrolytes. Water should be replaced during exercise periods and at emergency incidents. During heat stress, the member should consume at least one quart of water per hour. The re-hydration solution should be a 50/50 mixture of water and a commercially prepared activity beverage and administered at about 40 F. Re-hydration is important even during cold weather operations. Heat stress may occur during fire fighting or other strenuous activity when protective equipment is worn. Caffeine and carbonated beverages should be avoided during strenuous activities because both interfere with the body’s water conservation mechanisms.
7.0
The department should provide food at the scene of an extended incident when units are engaged for three or more hours. Soup, broth, or stew are highly recommended because they are digested much faster than sandwiches and fast food products. Fruits such as apples, oranges, and bananas provide supplemental forms of energy replacement. Fatty and/or salty foods should be avoided.
8.0
All medical evaluations shall be recorded on standard forms along with the member’s name and complaints and must be signed, dated and timed by the Rehab Officer or his/her designee.
9.0
Members assigned to the Rehabilitation Sector/Group shall enter and exit the Rehabilitation Area as a crew. The crew designation, number of crew members, and the times of entry and exit from the Rehabilitation Area shall be documented by the Rehab Officer or his/her designee on the Company Check-In/Out Sheet. Crews shall not leave the Rehabilitation area until authorized to do so by the Rehab Officer.
10.0
Resources: The Rehab Officer shall ensure all necessary resources required to adequately staff and supply the Rehabilitation Area are available and include but not be limited to:
10.1 Fluids - water, activity beverage, oral electrolyte solutions and ice.
10.2 Food - soup, broth, or stew in hot/cold cups.
10.3 Medical - blood pressure cuffs, stethoscopes, oxygen administration devices, cardiac monitors, intravenous solutions and thermometers.
10.4 Other - awnings, fans, tarps, heaters, dry clothing , floodlights, blankets and towels, traffic cones and fire line tape (to identify the entrance and exit of the Rehabilitation Area.).
11.0 OUTDOOR HEAT EXPOSURE
To ensure compliance with the outdoor heat exposure rule WAC 296-62-095 for employees who are exposed to temperatures at or above 89˚F.
11.1 From May to September of each year when temperatures are above 89˚ F drinking water will be provided.
11.2 Each year prior to May all members will be provided training on signs and symptoms of outdoor heat exposure and on Department policies, guidelines and procedures to prevent heat related illnesses.
11.3 Members will be trained on the following topics:
11.3.1 Environmental factures that contribute to the risk of heat related illness.
11.3.2 General awareness of personal factors that may increase susceptibility to heat related illness.
11.3.3 Importance of removing heat retaining PPE during breaks.
11.3.4 Importance of frequent consumption of small quantities of water.
11.3.5 The different types of heat related illnesses and the signs and symptoms.
11.3.6 Importance of immediately reporting signs and symptoms of heat related illnesses.
11.4 Prior to supervising members working in outdoor environments with heat exposure potential, Supervisors will be trained on the following topics:
11.4.1 The procedures supervisors must follow to meet WAC 296-62-095.
11.4.2 The procedures supervisors must follow if an employee exhibits signs and symptoms of heat related illnesses.
11.4.3 The procedures for moving and / or transporting a member to receive EMS care if necessary.