1 4 1 Personnel are to rotate through Rehab after IDLH work period of 2/30s or 1/45-minute SCBA cylinder or anytime the environment, workload and/or atmospheric conditions indicate the probability of injury or temperature related illness to personnel. This includes, but is not limited to, working fires and haz mat incidents when encapsulating suits are worn. 1 At the entry point prior to entering Rehab, fire fighters are to use a personal hand washing station with water, hand soap and towels. In lieu of soap and water, utilize disposable wipes for hands, face and neck. 1 An evaluation will occur each time a fire fighter enters Rehab to include the following: time, name, unit, mental status, any symptoms such as chief complaint, shortness of breath, poor gait, confusion, dizziness, nausea or vomiting, cramps, aches and pains. All symptoms will be thoroughly evaluated by the appropriate EMS level of care. 1 Personnel not in the IDLH but within the hazard zone (pump operators, IC, etc.) should be observed and periodically monitored for potential exposure to toxic gasses and/or heat and cold stress. 1 In warm weather, removal of turnout gear is necessary in order to allow the body’s temperature regulating mechanism to function properly. The duration of the ventilation process will depend on the workload and atmospheric air temperatures. 1 The use of tarps for shade and electric fans to provide airflow may be necessary during hot weather, and other appropriate shelter should be utilized during inclement weather. 1 Fluid replacement is necessary in order to maintain the high metabolic demand placed on fire fighters during emergency operations. It is recommended that members drink one liter of water per hour in order to replace fluids lost due to dehydration. After one hour, electrolyte additives should be added to the water source (NFPA 1584). 1 Caffeinated beverages and “energy drinks” should be avoided during the emergency incident due to their diuretic effect. OVERHAUL The primary emphasis during post-fire operations should be the safety of all fire personnel operating on the scene. Decontamination, rehabilitation and rehydration procedures should already be in place. When crews are able to exit the structure as soon as reasonably possible, they allow for the chemicals to dissipate naturally and their overall exposure will be reduced. An additional benefit of timely crew removal is that it will allow Fire Investigators to gather information before a scene is further disturbed by overhaul. As a best practice, the most contaminated crews should be sent home first for showers and change of clothing to remove the toxic products of combustion that accumulate on fire fighters during fire fighting operations. The Jacksonville (Florida) Fire and Rescue Department (JFRD) has had a policy in place since 2010 (SOG 437) that designates a new crew be dispatched to the scene of working fires as a CUT Team. An acronym for "Clean Up Team," the primary job of CUT is to "perform overhaul duties and assist the Fire Investigator at structure fires.” This allows the original fire fighting crews to return to quarters and clean up after their fire fighting operations. 1 During the structural cooling off period, the IC can develop an overhaul plan that includes the identification of safety issues like holes in floors or unstable walls/roofs and the establishment of hot, warm and cold zones. 1 SCBA is mandatory to be used for any work performed inside the structure for duration of overhaul. Monitor for fatigue, hydrate and cool crews. 1 Fire investigators can begin interviews and investigation outside the structure during the structural cooling off period. 1 Fire investigators are subject to the same toxic environments as other fire fighting personnel. They must be protected from respiratory and dermal absorption hazards when operating inside the hot zone (WAC 296-305-05002 (16)). OPERATIONS: EMERGENCY Accumulation of soot and chemicals on turnouts can lead to persistent exposures of carcinogens to fire fighters. Turnouts should then be cleaned after each exposure to toxic products of combustions. continued on page 16