Firefighter Rehabilitation




  • At the request of the fire department on-scene commander, EMS may be asked to perform firefighter rehabilitation.




  • Provide parameters for normal vital signs.
  • Identify individuals requiring treatment and transport.




  • Encourage the removal of all PPE (including bunker pants), rest, cooling, and oral hydration
  • Assess pulse rate. If greater than 85 percent maximum for age (see note below) perform orthostatic vitals. If pulse rate increases greater than 20 bpm or a systolic B/P drop, more than 20 strongly suggest immediate IV hydration and transport.
  • Assessment of vital signs after the responder has rested for 10 minutes after their last exertion.
  • Abnormal vital signs include:
  • Blood pressure: systolic greater than 200 or diastolic greater than 110.
  • Heart rate greater than 110.
  • Respirations less than 8 or greater than 40 per minute.
  • Temperature greater than 101.
  • Pulse oximetry less than 90%.
  • CO greater than 10%.
  • If any abnormal vital signs, strongly suggest rest, rehydration, and active cooling. Re-evaluate in 10 minutes and strongly suggest transport with no improvement in total rehab time of 30 minutes. Report all abnormal vital signs to the on-scene fire incident commander or rehab officer.
  • Fire personnel should not be medically cleared to return to full duty with abnormal vital signs.
  • Any person with abnormal vital signs who refuse intervention or return to full duty against medical advice will sign a refusal.
  • Transport will be encourage automatically for the following:
    • Chest pain.
    • Shortness of breath unresolved by 10 minutes of high flow O2.
    • Heart rhythm other than normal sinus or sinus tach.
    • Syncope, disorientation, or confusion.
    • Vital signs that have not returned to normal limits after 30 minutes of rehabilitation.
    • Inability to hold fluids down or vomiting.
    • Any request for transport.




  • NFPA Age-Predicted 85% maximum heart rate


Age     85%


20-25    170

25-30    165

30-35    160

35-40    155

40-45    152

45-50    148

50-55    140

55-60    136

60-65    132