Seeking Rehab Vehicle/Unit Info

[EMT Lady 0]

I'm interested in finding out what departments have either a Rehab Unit or a Rehab plan in place. What supplies do you stock for your rehab? Is this kept on the truck at all times or in a designated place to be taken out in the event of a working fire only? Is the rehab handled by the fire personnel, the EMS personnel or a Ladies Auxillary? I appreciate any info you can give me with this. I'm very interested to know what other departments are doing and what rehab plans they have in place. Thanks everyone in advance for your help!

[irishfire2491 24]

As for Cortlandt VAC we have a Unit 8805 set just for fire rehab and MCI if needed, We have the van stock with the basic stuff 3 coolers of water, Coffee posts X2 some small snacks Gatorade mix for one of the jugs, two water jugs, a mister fan, rehab chairs working on the arm cooler chairs, lots of towels, ice packs, B/P cuffs make sure you have several to get firefighters check and ready to go back if needed, Supplies regular part 800 as for the State, we have pop up tent and a camping tent that can hook up to the back of the van for heat or A/C depending on the weather and situation going on it could also be used as IC command post with the tent hooked up to the back. We have a Propane heater for the winter time, we have use the van on some fire calls, M/A calls, Standby for local events, Ice water Rescue training. Our Van is always stock and set up for any department that needs if for rehab. It also set up for any departments that has a big MCI with 25 backboards and several splints with a MCI Tarp for traige and vest. If you are intrested on setting up a REHAB class i suggest talking to Tommy Mac (ALSFirefighter) and see if he can do a rehab class for your department it helped alot and what to look for in FF for rehab and other supplies you may need. i know they are looking to place a CO2 dector for Pt Care for any angecy that is going to do rehab. We have REHAB sheets to keep record of all FF or Other personal that will come to us so we have record.

[Guest alsfirefighter]

Is the rehab handled by the fire personnel, the EMS personnel or a Ladies Auxillary?

Certain aspects of rehab can be easily handled by any available members. Medical monitoring (extremely important), treatment and (obviously) transport has to be handled by a minimum of BLS trained personnel by NFPA 1584 requirements.

i know they are looking to place a CO2 dector for Pt Care for any angecy that is going to do rehab.

This is a semi-accurate statement. NFPA 1584 states that "any firefighter exposed to CO or presenting with headache, nausea, shortness of breath, or gastrointestinal symptoms must be measured for CO by pulse CO oximetry or OTHER AVAILABLE METHODS

While I like the RAD, cost can be a factor and I would love to have one in every EMS bag in my agency, but until we can figure out the cost factor hopefully we will be able to get at least one to our BLS transporting agency. The "other available methods" is a key term and that can include transport to a medical facility for further eval via blood or as in the case of our local hospital the use of the RAD pulse co oximetry unit they have.

[ems-buff 81]

As for Cortlandt VAC we have a Unit 8805 set just for fire rehab and MCI if needed, We have the van stock with the basic stuff 3 coolers of water, Coffee posts X2 some small snacks Gatorade mix for one of the jugs, two water jugs, a mister fan, rehab chairs working on the arm cooler chairs, lots of towels, ice packs, B/P cuffs make sure you have several to get firefighters check and ready to go back if needed, Supplies regular part 800 as for the State, we have pop up tent and a camping tent that can hook up to the back of the van for heat or A/C depending on the weather and situation going on it could also be used as IC command post with the tent hooked up to the back. We have a Propane heater for the winter time, we have use the van on some fire calls, M/A calls, Standby for local events, Ice water Rescue training. Our Van is always stock and set up for any department that needs if for rehab. It also set up for any departments that has a big MCI with 25 backboards and several splints with a MCI Tarp for traige and vest. If you are intrested on setting up a REHAB class i suggest talking to Tommy Mac (ALSFirefighter) and see if he can do a rehab class for your department it helped alot and what to look for in FF for rehab and other supplies you may need. i know they are looking to place a CO2 dector for Pt Care for any angecy that is going to do rehab. We have REHAB sheets to keep record of all FF or Other personal that will come to us so we have record.

How much did all that cost, and did you get a grant for it?

[moggie6 54]

I'd try and find someone who is familiar with Mobile Life Support. They have a SORT Team that can respond to any incident and I know their personnel are trained to go out and do rehab at fire scenes and haz mat incidents. They have their stuff together.

[tonyc856 16]

A great web site to help you with rehab and CO questions is

http://www.firerehab.com/

[FDVA356 23]

Croton FD soon to be Croton EMS has just taken delivery of 2 Masimo Rad 57 detectors. This will be an essential tool once in service for fire scenes, CO calls, rehab of firefighters, every day emergencies. Both of our ambulances also will carry at a min. of 2-3 cases of water and I'm also looking into purchasing cooling vests with chairs for rehab operations. You will soon find Pedialyte and Gatorade as well on both rigs to rehydrate and restore electrolytes.

Another item hat will be ordered shortly is a small gazebo/tent that is a pop-up to keep patients, rescuers and personnel out of the sun etc.

[Future Fireman 4]

Certain aspects of rehab can be easily handled by any available members. Medical monitoring (extremely important), treatment and (obviously) transport has to be handled by a minimum of BLS trained personnel by NFPA 1584 requirements.

This is a semi-accurate statement. NFPA 1584 states that "any firefighter exposed to CO or presenting with headache, nausea, shortness of breath, or gastrointestinal symptoms must be measured for CO by pulse CO oximetry or OTHER AVAILABLE METHODS

Quick question, what is defined as Basic Life Support? EMT-B? NFPA does not state requirements for BLS in NFPA 1584.

Mike

[xfirefighter484x 234]

I altered the title of this thread. I was afraid to open it for a while, lol, thinking it had something to do with a drug or alcohol rehab issue.

[ny10570 745]

Mike, it would be whatever the local standard for Basic Life Support is.

[irishfire2491 24]

How much did all that cost, and did you get a grant for it?

yes we did recvieve a grant for the van and the supplies for it when we set up our MCI drill in MAY 2007

[mfkap 0]

A great web site to help you with rehab and CO questions is

http://www.firerehab.com/

This is a good website, but it appears to be sponsored by the RAD manufacturers. As with any information, take with generous salt when sponsorship is involved. As for the RAD 57, they cost around $3K or $4K each. Not something to stock up on.

There was an excellent and not-very-well-attended class on EMS Intro to Fire Rehab given at WCDES a few weeks ago. They went over a lot of the cooling devices and NFPA 1584 itself. I would check to see if the class is offered again, it was a little short on some details, but it is a work in progress, and had a lot of good information.

One thing I have noticed about a lot of fire rehab programs is that they all have water and electrolytes, towels and granola bars, but are usually pretty short on seating, and I haven't seen a really well done shelter yet. Fire rehab is supposed to have a private area to allow for the firefighters to remove their gear for passive cooling, but really all I have seen are quick-tents that have no sides, and if they did have sides, could seat about 6 people. It would be great to see some progress made in this area.

[tonyc856 16]

The Viallage of Wappingers got grant money to buy 4 active cooling chairs (we have already tried them and they are amazing they cool by soaking your arms in cold water), A 10x10 tent with sides, 2 fully stocked BLS bags with O2, 20 cases of water, 4 cases of energy bars.

[EMT Lady 0]

Many Thanks to all of you who replied to this posting. Thanks for all the input and many ideas and suggestions. I appreciate all the great info I received. THANKS!!!!

[Guest]

valhalla ambulance also has an MCI/ Rehab Unit. not as much as cortland has, but just some basic items to do the job. boards, collars, mci kits, water, cooler and a nice size tent. 82U1 is the rig, and its still a work in process. very little money was used for the project, the vehicle (an old little school bus) was donated by sleepy hollow/tarrytown schools. there's a pic of it somewhere on emtbravo. the first rehab call it did was the sleepy hollow on beekman fire a few weeks ago, what we had seemed to work out well. i think our next step is to put main O2 tanks in the rig for O2 therapy, and maybe some misting fans.

[Guest CRASH]

great info very interesting these are things all departments should have in place maybee even on a scaled down version but should be in place...

[Guest paramedico987]

If money isn't a huge obstacle... Welch Allyn make this really cool system which uses radio transmission from a theoretically endless number of separate monitoring units to centralize data. [much like an ER has for pt monitoring] I think the thing's called a "ProPaq."

A system like the one I got to use in NYC for an event could really be helpful for a rehab operation that relys on trending vital signs. It allows multiple parameters [EKG, SPO2, BP, RR] to be measured on multiple personel and documented via computer.

So for instance you put FF Smith on monitor #1 and tell the computer that #1 is FF Smith... then when the safety officer [or whoever is in charge] want's to know about his/her people all they need to do is look at the data in front of them. Most importantly I can see a system like this as being useful for just keeping a record of things. I can't even remember my patients' blood pressure when there's just one of them.

ALSO I'd want to see something I don't see in the field at all now... Core body temperature! If you read the USFA rehab document you'll see how important core temp can be to catching a serious illness. I'd recomend something like a tympanic thermometer since I can't see too many MOS dropping their britches!

[Guest]

If money isn't a huge obstacle... Welch Allyn make this really cool system which uses radio transmission from a theoretically endless number of separate monitoring units to centralize data. [much like an ER has for pt monitoring] I think the thing's called a "ProPaq."

A system like the one I got to use in NYC for an event could really be helpful for a rehab operation that relys on trending vital signs. It allows multiple parameters [EKG, SPO2, BP, RR] to be measured on multiple personel and documented via computer.

So for instance you put FF Smith on monitor #1 and tell the computer that #1 is FF Smith... then when the safety officer [or whoever is in charge] want's to know about his/her people all they need to do is look at the data in front of them. Most importantly I can see a system like this as being useful for just keeping a record of things. I can't even remember my patients' blood pressure when there's just one of them.

ALSO I'd want to see something I don't see in the field at all now... Core body temperature! If you read the USFA rehab document you'll see how important core temp can be to catching a serious illness. I'd recomend something like a tympanic thermometer since I can't see too many MOS dropping their britches!

being in a vac, we generally gets peanuts in tax money compared to an fd, so money in an issue. but even if it weren't an issue, i can't see ems being in charge of this system. for major scenes im my experiences, we (the vac) are always the last "emergency service" agency to be called...sometimes upwards of almost 45 min from the initial tone. i think this system in revolutionary, but meant to be handeled by the fd, not ems.

that core body temp system is cool too, and cheaper. does anyone have this system in westcheser?

and does anyone have the (approx.) prices on either system?

[Guest alsfirefighter]

NFPA cannot state what "bls" is because it varies so much state to state. It states in the definitions of "Basic Life Support" as the level established by the AHJ. Which in this case would be NYS DOH.

Crash you are absolutely right. The one thing is this has to be done by NFPA standard and and as with any tactic should be scaled to the incident and needs. Active cooling is one critical aspect that always needs to be accomplished, there is no real "scaling" down on how its done, but more size wise.

MfKap, thanks for the positive and constructive comments on the Rehab class I did. I'm fine tuning it to add the detail through many of the questions you all asked.

[xfirefighter484x 234]

The Viallage of Wappingers got grant money to buy 4 active cooling chairs (we have already tried them and they are amazing they cool by soaking your arms in cold water), A 10x10 tent with sides, 2 fully stocked BLS bags with O2, 20 cases of water, 4 cases of energy bars.

I have heard a lot of good things about those cooling chairs. For those that do not know how they work, there are basically trenches built into the arms of the chairs, allowing Rehab to fill them with cool water. You leave your arms in the cool water, since the vessels in your arm are close to the surface than in other areas of your body (and easily accessible) it cools your core a lot faster.

[Bnechis 3,961]

that core body temp system is cool too, and cheaper. does anyone have this system in westcheser? and does anyone have the (approx.) prices on either system?

NRFD uses it (for Hazmat Pre/Post Entry) you can get tempatic Thermometers at CVS they run about $100.

I have heard a lot of good things about those cooling chairs.

Yep they work real well.

[EMT Lady 0]

Which is a better way of cooling? The misting fans or the cooling chairs? Also what is the approximate price comparison for each of these items?

[Guest alsfirefighter]

Research has shown that forearm immersion works the best in all types of humidity and temperature. Personally I have say that the chair for me has always made me feel cooler fast and more refreshed then mister fans. The forearm immersion also works better because it doesn't cause peripheral vasoconstriction that can occur sometimes from the mister fans and if you enter an air conditioned environment too quickly, not allowing your core body temp. to decrease.

As far as price you'll have to google that yourself.

Kore Kooler Chair is what you want to look up. I'm not sure if there are several retailers or just one.

The mister fans I'm sure you can just google by that.

[tonyc856 16]

The chairs work amazingly fast. The user will experience some discomfort in the arms, due to the cold. Within 5 mins. All have stated that they feel a cooling sensation going up their spine. Shortly after they say they do feel a lot colder. Some even saying that they feel the coolness when they breathe.

What’s nice, besides cooling, we are able to get the firefighter out of the gear … have them sitting and make it easier for medical evaluation.

We are using the Kore Kooler Chair.

[Guest alsfirefighter]

TonyC...what temp are you keeping the water in the trays at? The thing to keep in mind is that the water needs to be cool, not cold and not ice cold. Using cool water will still lower core temp and not cause discomfort or that spine tingling sensation. You do not want to run the risk of shocking the system and causing a rapid shift to vascular constriction, you want to them to get to normal body functioning temperature not from hot to shivering.

[tonyc856 16]

TonyC...what temp are you keeping the water in the trays at? The thing to keep in mind is that the water needs to be cool, not cold and not ice cold. Using cool water will still lower core temp and not cause discomfort or that spine tingling sensation. You do not want to run the risk of shocking the system and causing a rapid shift to vascular constriction, you want to them to get to normal body functioning temperature not from hot to shivering.

We been using mixture of water and ice, the discomfort last a very short time, only because their body is over heated and feels colder to them then it really is

[JM15 386]

There is an interesting article in JEMS from the May issue about rehab for the fire service it is title "More than just a standard." It gives info on how to setup protocols and starting a program. It also explains NFPA 1584 and what is required. This article is definately a good resource for anyone trying to set up a program.

Somers FD is in the process of designing a rehab/MCI vehicle it will be designated as U-88. It is a converted Heritage Hills bus that we acquired. I'll try to get pictures and a list of what it will carry.

[NJMedic 96]

In our Special Operations Unit we carry:

3 misting fans

10, ten gallon water containers

40 gallons of water

150 Pints of water

22 chairs

8 tables

2 HO-20 Western Shelters

1 3.5 ton, 42,000btu HVAC unit

1 60,000btu indirect air heater

25 army style cots

4 raven litters/rickshaws

We preety good at getting the Western Shelters up, about 10 minutes with two guys. We typically respond on the third alarm/Level A Haz Mat or whenever special called.

Some photos from a recent job.....