This procedure was written for assessment and rehabilitation guidelines used by BCAS crews and regional fire departments. Variations to this document will occur from fire department to fire department in regards to their individual standard operating procedures.
PURPOSE: To standardize procedures for BCAS paramedics involved in the assessment of/and Rehydration treatment for firefighters involved in a response.
APPLICATION: All BCAS paramedics
PROCEDURE: THE H.S.R.U. / “REHAB”
1. The decision to activate the HSRU will be determined by the Fire Dept.’s Commanding Officer
Established Guidelines for the activation include:
All Haz-Mat responses that require protective encapsulation should have blood pressure and heart rate assessed prior to full encapsulation.
(Recommendation for full sets of vitals (to identify individuals at risk of pre-existing hypertension, arrhythmias).
Each firefighter will be assessed following single SCBA bottle use and re-assessed for each bottle of air. Any Firefighter involved in lengthy tactical operations should seek assessment Q 1hour.
The Fire Department will supply HSRU personnel with a copy of the duty roster. Record of assessments will remain in the HSRU.
Any abnormal findings (SEE ASSESSMENT PROTOCOL) will result in immediate removal from duty and the beginning of treatment as set out in the treatment protocol.
The following guidelines will provide for the assessment of Firefighters during tactical operations.
The following questions require accurate answers:
NAME + PERSON, PLACE & TIME
Incoordination will mandate further assessment with rest, rehydration, cooling, blood sugar assessment & vitals q 5min - if no improvement in 10 minutes then transport to hospital.
Temperature will be assessed by oral thermometer. Axillary temperature is not adequate, due to false high readings.
>38.5C will require assessment > 40C will be treated and removed
A heart rate greater than 130 (SVT >130) or an irregular heart rate will require “ECG monitoring”. Heart rate will be assessed upon entry to rehabilitation and following a 5 min rest period. In the absence of ALS attendants, any patient who maintains a HR>130 for > 10minutes will be transported to hospital.
SYSTOLIC <100 mmHg or >150
DIASTOLIC >100 mmHg will be further assessed and a decision will be made whether to transport to hospital.
FOR IMMEDIATE TREATMENT OF ALL FIREFIGHTERS WHO FAIL ANY ONE, OR MORE, OF THE ASSESSMENTS
(Oral electrolyte solutions should be as cold as possible)
(i.e. Burns, MSI, lacerations etc.)
Pre-hydration is recommended @ 400-500cc of electrolyte solution for Firefighters to be involved in “high risk” tactical operations.
Rehydration @ 1000cc/hr of electrolyte solution & water should continue through out entire operation and is a requirement during assessment.
Hydration will be supplied via the responding agency and/or the Duty Unit Chief.