(1) Fire departments must develop written
guidelines that outline a systematic approach for the rehabilitation of members
operating at incidents and training exercises. The following components must be
included in this guideline:
(a) Supervisor's
role in identifying climate conditions (hot or cold).
(b) The signs and symptoms of heat or cold
stress and how to identify them in subordinates and fellow members.
(c) How to identify the climatic condition
likely to produce heat or cold stress on members operating at emergency scenes
or during training exercises.
(d)
What steps the incident commander (IC) must take when the climatic condition
poses a heat or cold stress hazard to members.
(e) What rest-to-work (recovery) schedule the
IC must consider during climatic conditions that present a heat or cold stress
hazard to members.
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Example:
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NFPA 1584 states that after members use 2 30-minute
SCBA bottles or 1 45-to-60-minute SCBA bottle or 40 minutes strenuous work
without an SCBA the member should go to rehabilitation for a 10 to 20 minute
rest and rehydrate.
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(f)
Which active or passive cooling and warming techniques will be used based on
the incident type and climatic condition.
(g) What rehydration schedule will be
followed, including the amount and type of fluids.
(h) What the department will do to ensure
caloric replacement and electrolyte replacement during longer term emergencies
and exercises.
(i) What medical
monitoring will be provided to members in rehabilitation and what criteria will
be used to release members from rehabilitation.
(j) What the IC will do when a member is
showing signs of heat or cold stress after completing the department's
rest-to-work cycle.
(k) What
medical personnel will be present in rehabilitation to evaluate members sent to
rehabilitation during the rest-to-work cycle.
To determine what temperature triggers action at each worksite,
select the general type of clothing or personal protective equipment each
employee is required to wear and find the corresponding temperature in Table
1.
Table 1 Outdoor Temperature Action Levels
| Nonbreathing clothing including vapor-barrier
clothing or chemical resistant suits |
52°
|
| Double-layer woven clothing including
coveralls, jackets and sweatshirts |
77°
|
| All other clothing |
89°
|
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Note:
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There is no requirement to maintain
temperature records. The temperatures in Table 1 were developed based on
Washington state data and are not applicable in other states. |
(2) Employee training. Training on the
following topics must be provided to all employees who may be exposed to
outdoor heat at or above the temperatures listed in Table 1:
(a) The environmental factors that contribute
to the risk of heat-related illness.
(b) General awareness of personal factors
that may increase susceptibility to heat-related illness including, but not
limited to, an individual's age, degree of acclimatization, medical conditions,
drinking water consumption, alcohol use, caffeine use, nicotine use, and use of
medications that affect the body's responses to heat. This information is for
the employee's personal use.
(c)
The importance of removing heat-retaining personal protective equipment such as
nonbreathable chemical resistant clothing during all breaks.
(d) The importance of frequent consumption of
small quantities of drinking water or other acceptable beverages.
(e) The importance of
acclimatization.
(f) The different
types of heat-related illness and their common signs and symptoms.
(g) The importance of immediately reporting
signs or symptoms of heat-related illness in either themselves or in coworkers
to the person in charge and the procedures the employee must follow including
appropriate emergency response procedures.
(3) Supervisor training. Prior to supervising
employees working in outdoor environments with heat exposure at or above the
temperature levels listed in Table 1, supervisors must have training on the
following topics:
(a) The information required
to be provided to employees listed in subsection (1) of this section.
(b) The procedures the supervisor must follow
to implement the applicable provisions of this section.
(c) The procedures the supervisor must follow
if an employee exhibits signs or symptoms consistent with possible heat-related
illness, including appropriate emergency response procedures.
(d) Procedures for moving or transporting an
employee to a place where the employee can be reached by an emergency medical
service provider if necessary.
(4) The fire department must rotate crews as
necessary to allow for rehabilitation.
(5) All members must be provided training and
information on how the body regulates core temperatures and how to recognize
the signs, symptoms and controls for heat and cold stress.
(6) All members must be provided training on
the department's guideline addressing heat and cold stress.
(7) Employees are responsible for monitoring
their own personal factors for heat-related illness including consumption of
water or other acceptable beverages to ensure hydration.
(8) A rehabilitation area must be designated
with features that provide shade or air conditioning with a place to sit for
extremely hot environments.
(9) A
rehabilitation area must be designated with features that provide dry protected
areas out of the wind or rain and a heated area with a place to sit for
extremely cold or wet environments.
(10) Multiple rehabilitation areas must be
set up if the geographical area or size of the scene creates barriers limiting
members' access to rehabilitation.
(11) The rehabilitation area must be of
sufficient size to accommodate the number of crews using the area at the same
time.
(12) Members entering the
rehabilitation area that feel warm or hot must remove their personal protective
clothing. Personnel trained in basic life support must evaluate the member and
institute active or passive cooling as indicated.
(13) At a minimum, a person trained in basic
life support with the knowledge and training needed must be located in the
rehabilitation area to conduct medical monitoring and evaluation of crews
entering the rehabilitation area.
(14) Members must not be released from
rehabilitation until a person trained in basic life support okays their return
to work.
(15) Supervisors must
assess their crew at least every forty-five minutes and more frequently when
climatic conditions warrant to determine their need for
rehabilitation.
(16) Members on
emergency scenes and during exercises must be provided a minimum of one quart
of water per hour when the climatic conditions present heat or cold stress
hazards. After one hour, caloric and electrolyte replacement must be
considered.
(a) The employer must ensure that
a sufficient quantity of drinking water is readily accessible to employees at
all times.
(b) Employers must
ensure that all employees have the opportunity to drink at least one quart of
drinking water per hour.
(c)
Employers must encourage employees to frequently consume water or other
acceptable beverages to ensure hydration.
(17) Employees showing signs or complaining
of symptoms of heat-related illness must be relieved from duty, provided with a
sufficient means to reduce body temperature, and monitored to determine whether
medical attention is necessary.
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Note:
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For further guidance, sample policies and
information please consult the 2008 edition of NFPA 1584, Standard on the
Rehabilitation Process for Members During Emergency Operations and Training
Exercises or the United States Fire Administration's Emergency Incident
Rehabilitation Manual FA-314 issued February 2008. |