Protocol Status: PUBLISHED
Protocol:
Version: 2026.01
Effective Date:
Last Reviewed:
Medical Director Approval:
Clinical Note: This content reflects current GCEMS clinical guidelines as of the dates listed above. If content appears inconsistent with current policy, use the most recent approved guideline and notify leadership for correction.

Firefighter Rehabilitation

 

Policy:

 

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

 

Purpose:

 

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

 

Procedure:

 

  • 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.

 

Notes:

 

  • 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