- 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