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 Department's Commanding Officer
Established Guidelines for the activation include:
2. If the Fire Department does not have an established HSRU, an Ambulance can be considered for this function
3. The HSRU will be adjacent to the Fire Department’s staging area
4. BCAS personnel will staff the HSRU and will request additional personnel through the Duty Supervisor/Charge Dispatcher, or request trained personnel from the Fire Dept
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:
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.
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.
FOR IMMEDIATE TREATMENT OF ALL FIREFIGHTERS WHO FAIL ANY ONE, OR MORE, OF THE ASSESSMENTS
Pre-hydration is recommended @ 400-500 cc 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.