NFPA 1081 Standard
Inc ipie nt Indust ria l Fire B riga de M e mbe r
NFPA 1081 contai ns no Inci pi ent Industrial Job Performance Requi rements for
thi s chapter.
A dv a nc ed Ext e rior Indust ria l Fire B riga de Me mbe r
NFPA 1081 contai ns no Advanced Exteri or Industri al Job Performance
Requirements for thi s chapter.
Int erior St ruc t ura l Indust ria l Fire B riga de M e mbe r
NFPA 1081 contai ns no Interi or Structural Industri al Job Performance
Requirements for thi s chapter.
Additional NFPA Standard
NFPA 600 Standard on Industri al Fi re Bri gades
Knowledge Objectives
After compl eti ng thi s chapter, you will be abl e to:
• Defi ne emergency i nci dent rehabi litati on.
• Descri be why bri gade members need emergency i nci dent rehabilitation.
• Li st and descri be the types of extended fi re i nci dents where bri gade
members need emergency i nci dent rehabili tati on.
• Descri be four other types of i nci dents where bri gade members woul d
benefi t from emergency i nci dent rehabilitati on.
• Descri be the seven functi ons of a rehabilitati on center.
• Li st four parts of revitali zati on.
• Descri be the types of fl ui ds that are well sui ted for bri gade members to
dri nk duri ng emergency i nci dent reha bili tati on.
• Descri be the types of food that are well suited for bri gade members to eat
duri ng emergency i nci dent rehabilitati on.
• Descri be the personal responsibili ti es rel ated to emergency i nci dent
rehabili tati on.
Skills Objectives
There are no skill obj ecti ves for thi s chapter.
 You are a process operator who works at a small refinery. Your brigade has been fighting a pump
seal fire for the past four hours without much rest. Due to your rural nature, mutual aid has still
not arrived. A large pool fire is beginning to spread and is impinging on some high pressure lines.
Your team has been ordered by the Incident Commander to extinguish the pool fire. Your team
applies a foam blanket and successfully extinguishes the pool fire. Despite the success in con-
taining the pool fire, two members of your team succumb to heat exhaustion and need urgent
medical attention. Incident command orders your team to rehabilitation.
1. What is rehabilitation, and why is it important for industrial fire brigade members?
2. Why is the incident commander assigning your entire team to rehabilitation?
3. What steps will you take to rehabilitate yourself?

Introduction Emergency inci dent rehabilitation is part of the overall

In most industrial settings, industrial fire b rigade members
are part of an emergency response team. Responding to and
fighting industrial fires are not typically the primary roles of
these brigade members. So me brigade members may not be
accustomed to the physical, mental, and emot ional stresses in
an industrial fire response. Small fires can quickly escalate into
much larger incidents; teams can qu ickly beco me tired and
exhausted ( Figure 20-1 ). Incident co mmanders must be
cognizant of the need to consider back-up teams, and due
consideration needs to be made for fire brigade members to
rehabilitate.
emergency effo rt. Brigade members and other emergency
workers who are exhausted, thirsty, hungry, ill, inju red, or
emotionally upset can take a b reak for rest, flu ids, food,
med ical evaluation, and treatment of illnesses and/or injuries
(Fig ure 20 -2 ). W ithout th e oppo rt un ity to rest and
recover, you may develop phys ical sy mpto ms such as
fatigue, headaches, or gastrointestinal prob lems.
Rehab ilitat ion en ab les b rigad e memb ers to perfo rm
more safely and effect ively at an emergency scene. The
effo rt that is requ ired to rescu e a co llapsed o r in ju red
brigad e memb er t akes t ime and resou rces away fro m fire

( Figure 20 -2) Rehabilitation provides brigade mem bers an opport unity to

( Figure 20 -1) Firefighting often inv olves extrem e physic al exertion and take a break for rest, fluids, food, medic al evaluation, and treatment of illnesses
results in rapid fatigue. and injuries.
 Briga de M e mber Re ha bilita tion 599

Brigade Member Tips

The am ount of rest needed to rec over from physical exertion is directly
related to the int ensity of the work perf ormed. Brigade members who have
exerted tremendous efforts will require a longer rec overy period t han t hose
who have performed moderate w ork.

suppression act iv it ies. Rehab ilitat ion is essential to fight

fires and perform rescues safely and effectively.

Factors, Cause, and Need for

Rehabilitation
Many conditions come together during a fire fight to pro -
d uce a st ressfu l env iro n ment . Cons ider th e st resses
invo lved in a midd le -o f-the-n ight callout at you r ho me fo r a
wo rking fire at you r facility . The loud , jarring sound of t h e
p ag er alarm jo lts yo u r s leep in g b ody awake. In response,
you must get up immed iately and without hesitation , get
dressed, driv e to the facility , and put on you r personal
protective equipment. As soon as you arrive at the facility,
you may have to drive an emergency vehicle, haul hoses,
position a ladder, and set up a master stream. A ll of these
tasks requ ire a sign ificant amount o f energy and
concent rat io n. Yo u mus t be ab le to mov e into act ion ( Figure 20-3 ) The personal protective equipment that is worn to protect a
quickly with no t ime to warm up you r muscles as ath let es brigade member also contributes to heat stress.
do before an event.
You may be called to a fire on the hottest day of the year,
the coldest day of the year, and under all types of adverse the inner cloth ing , but the evapo rat ive coo ling does not
circu mstances. Because you kno w that lives and p roperty occur.
are at risk, you may feel an added emot ional stress, wh ich
affects the body. Brigade members may end up working in
Dehydration
an unfamiliar, s mo ke -filled env iron ment, which makes the Dehydration is a state in which fluid losses are greater than
job more d ifficu lt and stressful. flu id intake into the body, leading to shock and even death if
untreated. Fighting fires is a very strenuous activity, and the
Person al Protective Equip ment large amounts of muscular energy required can produce a sig -
Pers onal protecti ve equi pment (PPE) . the pro tect ive nificant amount of heat. During this exertion, the body loses a
clo th ing and b reath ing apparatus used by brigade mem- substantial amount of water through perspiration. Brigade
bers to reduce and p revent in juries, adds heat stress on the memb ers in act ion can lose up to 2 quarts of flu id in less
body (►Figure 20-3 ). PPE can weigh 40 pounds or mo re, than 1 hour (Figure 20-4). Dehydration reduces strength,
and th e ext ra weight increases th e amou nt o f en ergy endurance, and mental judgment. Rep lenishing flu ids during
needed simp ly to move around. PPE creates a protect ive rehabilitation is essential to correct this imbalance in the body.
envelope around a b rigade member that p rotects the body
fro m the s mo ke, flames, heat, and steam of a fire. But at the
Energy Consumption
same t ime, it traps almost all body heat inside the p rotec tive Food provides the fuel the body needs to do muscular wo rk.
envelope. In times of strenuous activity, the body burns carbohydrates
Normally, evaporat ing perspirat ion helps cool the body and fats for energy. These energy sources then need to be
so that it does not overheat. PPE acts as a vapor barrier that replenished. Without a sufficient supply of the right food for
keeps harmfu l liquids and vapors out, but it also p revents energy, the body cannot continue to perfo rm at peak levels
most of a brigade member's perspiration fro m evaporating. for extended periods. During rehabilitation, it is essential to
When a brigade member is wearing PPE, perspirat ion soaks refuel the body with nut ritious food.
600 I N D U S T R I A L F I R E B R I G A D E :
Brigade Member Safety Tips
A tired or dehy drated brigade menber is more lik ely t o be injured and
runs the risk of collaps ing. Rehabilitation is essential to correct
imbalances in the body that, if left unt reat ed, could endanger the
brigade m enber, cowork ers, and others.
(Figure 20-4) When perspiring, brigade mem bers can los e up to 2 quarts of
fluid in less than 1 hour.
Tolerance for Stress
Each ind iv idual has a d ifferent to lerance lev el fo r the
stresses encountered wh en fight ing fires . Fo r examp le,
younger ind iv iduals tend to have greater endurance and can
tolerate h igher levels of stress. A person who is well-rested
and well-cond it ioned will hav e mo re enduran ce than one
who is t ired and in poo r cond ition . Carry ing ext ra weight
and perfo rming strenuous tasks will strain the heart and
increase the risk of heart attack.
Conditioning plays a significant role in a brigade member's
level of endurance. A well-conditioned person with good car-
diovascular capacity, good flexib ility, and well-developed
muscles will be better able to tolerate the stresses of fighting
P R I N C I P L E S A N D P R A C T I C E
( Figure 20-5)) A well-c onditioned brigade mem ber will have a greater
tolerance for the stresses encountered when fighting fires.
( Figure 20-6) Taking short breaks to rehabilitate reduc es the risks of
injury and illness.
fires than a person who is out o f shape (Figure 20 -5).
Because very few industrial facilities provide exercise facilities
for their emp loyees, many brigade members work out at pri-
vate health clubs to maintain their physical condit ioning.
However, even the most impressive conditioning will not keep
a brigade member fro m becoming exhausted under physically
stressful situations.
The Body's Need for Rehabilitation
Rehabilitation provides periods of rest and time to recover
fro m the fatigue and stresses of fighting fires and part icipat ing
in emergen cy operat ions . Stud ies h ave sho wn th at proper
rehabilitat ion is one way to prevent brigade members

fro m co llapsing or suffering in juries during fire suppression
activit ies. Taking short breaks, rep lacing fluids, and obtain-
ing energy fro m food reduces the risks of in jury and illness
(Figure 20-6). Rehabilitation even helps to improve the
quality of decision-making, because people who are t ired
tend to make poor decisions.
Types of Incidents Affecting Brigade
Member Rehabilitation
The concept of rehabilitation needs to be addressed at all
incidents, but it will not be necessary to imp lement all the
components of a rehabilitation center for every incident. For
examp le, fire brigades should always have fluids and
high-quality energy foods available for rehab ilitation.
Brigade members putt ing out a s mall fire in a sing le roo m
might requ ire only water for rehydrat ion while those
involved in ext inguishing a major plant process fire may need
a full rehabilitation station.
Extended F ire Incidents
Structure Fires
Large emergency incidents require fu ll-scale rehabilitation
efforts. Major structure fires that involve extended time on the
scene will be hard on crews ( Figure 20-7). Crews working on
the interior will become dehydrated and fatigued quickly due
to the intense heat and stressful conditions. They will requ ire
rehab ilitat ion so they can cont inue wo rking at a healthy and
safe level. Rotating crews off the fireground and bringing in
fresh crews also promotes health and safety and helps get the
job done in an efficient manner.
( Figure 20 -7 ) Major fires often require a strong effort for an extended
duration. Rehabilitation and crew rotation are important to limit the risk of
exhaustion and injuries to brigade members.
Briga de Me mber R e ha bilitati on 601
Fi re Marks
The introduction of struct ured rehabilitation procedures has had a very
|positive
|| impact on reducing injuries due to heat stress and exhaustion.
The old philosophy was to "fight hard until you drop," and it was not
unus ual to see ex hausted m unicipal fire fighters being carried out of
burning buildings to w aiting ambulanc es. However, this disrupted
effective fire fighting operations because the f ire fighters who could
still function were busy rescuing their injured and exhausted crew
members.
Brigade Member Tips
Various activ ities c an help develop optim al stair-clim bing enduranc e.
At the health club, the brigade mem ber may participate in step aerobics
classes or us e the stair-climbing devices (wit h or without gear) to
develop leg muscles and lung capacity. Outside of the healt h club, a
brigade m ember can us e step boxes or stairwells to enhance clim bing
capacity.
Tank Farm Fires and Flammable
Liquid or Gas Fires
Large-scale incidents involving flammab le liqu ids or gases
may require significant amounts of manpower to ext inguish,
and in the event of a storage tank fire, these campaigns can
in v ariab ly ext en d fro m s ev eral h ou rs to sev eral days (
Figure 20-8). Emergency incidents that are complicated both
fro m a technical perspective and fro m sheer magnitude of
size will create additional demands on fire b rigade members.
The mental and physical requirements o f firefighting and
other emergency operations co mb ined with the env i-
ron ment al facto rs o f ext reme cold o r extreme heat and
hu mid ity create condit ions that can adversely affect the
health and safety o f the ind iv idual fire b rigade member.
When brigade members beco me fatigued, their ab ility to
operate safely is imp aired. This impacts react ion time and
their ab ility to make critical decisions. Rehab ilitation in
large-scale incidents involving storage tanks and other flam-
mab le liquid or gas fires is essential to prevent more serious
condit ions such as heat exhaustion o r h eat st roke fro m
occurring.
Other Types of Incidents
Requiring Rehabilitation
Other incidents may also requ ire extensive rehabilitat ion
efforts to maintain the health and safety of brigade members.
Hazardous materials incidents that require brigade members
to wear full y encapsulated suits (a protective suit that fully
covers the responder, including the breathing apparatus) are
602 I N D U S T R I A L F I R E B R I G A D E : P R I N C I P L E S AND P R A C T I C E

( Figure 20-8) Tank fires are often prolonged events involving many ( Figure 20-9 ) Brigade members wearing fully encapsulated suits must be
brigade members working for days. Rehabilitation may be conducted on a carefully monitored for symptoms of heat stress.
large scale at these incidents.

especially draining (►Figure 20-9). Hazardous materials inci-

dents can expose brigade members to strenuous conditions
fo r extended p eriods o f t ime. Th ese in cidents may also
require that the staging area be located at a distance from the
hazardous materials, so brigade members will have to walk
long distances while wearing the heavy PPE. As a result, haz-
ardous materials incidents require adequate rehabilitation for
brigade members.
At times, the industrial fire brigade is involved in
long-duration search-and-rescue activities or other incidents
that require the p resence of public safety agencies for
extended periods of time. These situat ions can be both
mentally and physically stressful. The establish ment of a
rehabilitation center that b rigade members can use during
these incidents is essential.
The need for rehab ilitation is not limited to emergency ( Figure 20-10) The same type of rehabilitation procedures should be
situations. Training exercises and even stand-by assignments implemented for training activ ities as those used for actual emergency
may also require rehabilitation. Whenever brigade members incidents.

Teamwork Tips
During active operations, brigade members may be very reluctant to
admit that they need a rest. Asking an obviously exhausted brigade
member if he or she needs to go to rehabilitation almost inv ariably
brings the respons e, "No —I'm OK." All brigade mem bers need t o w atch
out for one anot her, and brigade leaders m ust monit or their teams for
indications of fatigue. It is better to go to rehabilit ation a few minut es
early than to w ait too long and risk the c onsequenc es of injury or
exhaustion. T he Incident C omm ander s ho uld always plan ahead so that
a fresh or rested team is ready to rotate with a team that needs
rehabilitation.
are required to be ready for action for an extended period of
time, so me provis ion should be made for provid ing nour -
ishing foods and rep len ishing flu ids.
Large-scale training activ ities, including live burn exer-
cises, involve the same concerns as major fire incidents, and
rehab ilitat ion should be inco rpo rated in the p lann ing fo r
these activities (Figure 20-10). Training exercises may be
conducted over a full day and involve a series of activities, as
well as time to set up each exercise. As part of the process,
time should be set aside for the participants to go to rehabil-
itation between strenuous activities.
Weather conditions can have a significant impact on the
need fo r rehab ilit at ion . Brig ade memb ers shou ld always
 Brigade Member R e ha bi l i ta ti on 603

dress appropriately for the weather, and plans for rehabilita-

tion p rocedures should take into account the ant icipated
environ mental conditions. Whether it is hot or cold, return ing
the body's temperature back to no rmal is one o f the p rimary
goals of rehabilitation.
Emergencies that occur when the temperature is very hot
will increase the need to rotate teams and allow extensive
rehabilitation. Teams working on the interior fire attack may
not notice much difference, because their environment during
the attack will be hot regardless of the temperature outside.
However, hot weather will affect teams working on the out-
side. These brigade members will tend to become dehydrated
and fat igued much faster than they wou ld if t emperatures
were in a more comfortable range. Another factor that must be
considered is the humid ity of the air. Hu mid ity p lays an
important role in evaporative cooling. High humidity reduces
evaporative cooling, making it mo re difficult for the body to (Figure 20-11) The physic al condit ion of eac h brigade mem ber who arrives
regulate its internal temperature. at the rehabilitation center should be evaluated, and vital signs should be
Co ld weather also increases the need for rehab ilitation recorded by assigned medical personnel.
and crew rotation. The cold can be just as dangerous as the
heat. Hypothermia, a condit ion in wh ich the internal body
temperature falls below 95°F (35°C), can lead to loss of coor- Physical A ssessment
dination, muscle stiffness, coma, and death. Even in co ld Whenever possible, entire teams should be assigned to reha-
weather, the weight of PPE and the physical exert ion of fight- bilitat ion and stay together in the rehab ilitat ion center. A ll
ing a fire will cause the body to sweat inside the protective brigad e members shou ld be id ent ified as th ey ent er and
clothing. Damp clothing and co ld temperatures can quickly leave the rehabilitat ion center to maintain accountability.
lead to hypothermia. When brigade members are ready to be released, the team
should be released as a un it.
How Does Rehabilitation Work? The first function of emergency incident rehabilitation is
physical assessment. A brigade member's vital signs, including
One way to understand an emergency incident rehabilitation pulse, respiration, blood pressure, and temperature, should be
center is to look at the functions it is designed to perform. taken and recorded by assigned medical personnel when the
The most co mmo n mo del h as seven d ifferent fu nct ions (T b rig ad e me mb er a rr iv es at t h e reh ab ilit at io n cen t er (A
Tab le 20-f); Figure 20-11 ). Many signs and symptoms of fatigue will
1. Physical Assessment indicate the need for rehabilitation and are a function of many
2. Revitalization factors, including poor nutrition and mental, physical, and
3. Medical Evaluat ion and Treat ment emotional exhaustion. Each team member should be ques -
4. Regular Monitoring of Vital Signs tioned and observed for indications of emotional stress. From
5. Transportation to a Hospital here, the brigad e member may be referred for med ical
6. Crit ical Incident Stress Management treatment or sent for rest, retrydration, and food before being
7. Reassignment reassigned to operational activities.

Revitalization
Table 20-1 Seven Functions of Rehabilitation Revitalization is the main part o f the rehabilitation p rocess.
1. Physical Assessm ent 2. Revitalization The four co mponents of rev italizat ion are ( T Table 20-2 );
3. Medical Evaluation and Treatment 4.
Regular M onit oring of Vital Signs 5. Table 20-2 Four Components of Revitalization
Transportation to a Hospital 6. Critical 1. Rest
Incident Stress Managem ent 7. 2. Fluid replac ement 3.
Reassignment Nutrition 4. Temperature
stabilization
804 I N D U S T R I A L F I R E B R I G A D E :
(Figure 20-12) In the rehabilit ation center, brigade mem bers should be
able to remove personal protective clothing and get some rest before returning to
action.
1. Rest
2. Flu id rep lacement
3. Nutrit ion
4. Temperature stabilizat ion
Rest
Rest begins as soon as the brigade member arrives for reha-
bilitation. Rehabilitation should be located away fro m the
central activity of the emergency, so the brigade member can
disengage fro m all other stressful act iv ities and remove
personal protective clothing (Figure 20-12). Many times
brigade personnel who are in rehabilitation do not remove all
of their gear, including bunker pants. Doing so achieves max-
imu m cooling and facilitates rest and rehydration. Rest con -
tinues as the brigade member goes through the other parts of
revitalization. Rehabilitation centers are equipped with chairs
or cots so b rigade members can s it o r lie do wn and relax.
Fluid Replacement
When the body becomes overheated, it sweats so that evap -
orat ive cooling can reduce body temp eratu re. Perspirat ion
is co mposed of water and other d issolved substances such
as salt. During fire suppression activities, a b rigade member
can perspire enough to lose 2 quarts of water in the time it
takes to go through 2 bottles of air. Because 1 p int of water
weighs 1 pound, losing 2 quarts of water is equivalent to a
2% loss in body weight for a 200-pound b rigade member.
The loss o f that mu ch body flu id can resu lt in imp aired
body temperatu re regu lation .
Fu rther dehyd rat ion can resu lt in redu ced muscu lar
endurance, reduced strength, and heat cramps. Severe cases
o f deh yd rat io n can cont ribut e to heat st ro ke. Becaus e a
P R I N C I P L E S A N D P R A C T I C E
(Figure 20-13) The rehabilit ation center should hav e plenty of fluids to
rehydrate brigade members. Plain water or diluted sports drinks are preferred.
brigade member can lose so much water during fire sup -
pression activit ies, it is impo rtant to replace flu ids before
severe dehydration takes place ( Figure 20-13 ).
When the body perspires, it loses electrol ytes (certain
salts and other chemicals that are dissolved in body flu ids
and cells) as well as water. If a brigade member loses large
amounts of water through perspiration, the electro lytes must
be rep lenished as well as the water. Th is is why sport-type
drin ks are o ften used in rehab ilitat ion. Sport drin ks supply
water, balanced electro lytes, and some sugars. These drinks
can be mixed with twice the reco mmended amount of water
to dilute the sugars.
Rehydrating your body is not as easy as just drinking lots
of fluids quickly. Drinks like co las, coffee, and tea should be
avoided because they contain caffeine. Caffeine acts as a
diuret ic that causes the body to excrete more water.
Sugar-rich carbonated beverages are not tolerated o r
absorbed as well as straight water o r d iluted sports drin ks.
Too much sugar is d ifficu lt to digest and causes swings in the
body's energy levels. Drin ks that are too co ld o r too hot may
be hard to consu me and may p reven t you fro m ingest ing
enough liquids.
 Briga de M e mber Re ha bilita tion
605

Brigade Member Tips

The s ensation of thirst is not a reliable indicator of t he amount of wat er
the body has lost. Thirst develops only after the body is already
dehy drated. Do not wait until you feel thirsty to be concerned with your
hydration. Start to drink before you get thirsty. Remember to drink
early and often. Try t o drink enough fluids to k eep the body properly
hydrat ed at all times, particularly during hot w eat her. T his will
decrease the risk of dehydrat ion when an emergency incident
occurs. Adequate hydration also ens ures peak physic al and mental
performance. The best indicator of proper hy dration is the color of
urine. If urine is dark or am ber in color, the body is dehydrated. If urine
is light or clear, the body is properly hydrated. Fatigue and heat
sensitivity are also signs of dehydration. Brigade mem bers should
strive to drink a quart of w ater an hour during periods of work.

An additional concern is the rate at which flu ids can be

absorbed from the stomach. Drinking too much too quickly
can cause b loating, a condit ion in which air fills the stomach.
This causes a feeling of fu llness and can lead to disco mfo rt,
nausea, and even vomit ing.
Studies demonstrate that the stomach can absorb 1 to 1.5
quarts of flu id per hour. Ho wever, th e body can lose up to 2 (Figure 20-14) Carbohy drates are a major source of fuel for the body.
quarts of flu id per hour. Thus, the body loses fluids much
mo re rap id ly than they can b e rep laced . Once th e in it ial 2
quarts of water are lost, the body will requ ire 1 to 2 hours to (Figure 20-15) Proteins perform m any vital functions in the body.
recover.

Nutrition
A brigade memb er performs more physical tasks and exerts
mo re energy than the average wo rker. Like an engine that
runs on d iesel fuel, t he body runs o n gl ucose . Glucose,
also known as blood sugar, is carried th roughout the body „;'
by the b loodstream and is needed to bu rn fat efficient ly and
release energy.
In o rder fo r the body t o work p rop erly , the g lu cose
(blood sugar) levels need to be in balance. If b lood sugar
drops too low, the body beco mes weak and shaky. If b lood
sugar is too high, the body becomes sluggish. Blood sugar
levels can be balanced by eating a proper diet of carbohy -
drates, proteins, and fats.
Carbohydrates are a major source of fuel for the body and can readily use during h igh-intensity physical activ ities such
can be found in grains, vegetables, and fruits (Figure 20-14). The as fighting fires.
body converts carbohyd rates into g lucose, making "carbs" Proteins p erfo rm many v ital funct ions with in th e body
an excellent energy source. A common dietary myth is that (Figure 20-15). Most protein comes fro m meats and dairy
carbohydrates are fatten ing and should be avo ided. In fact, products. Smaller amounts of protein are found in g rains,
carbohydrates should make up 55% to 65% of calo ries in a nuts, legu mes, and vegetab les. Pro teins (amino acids) are
balanced diet. Carbohydrates have the same number of calories
per gram as proteins and fewer calories than fat. Addit ionally
carbohydrates are the on ly fuel that the body
 VOICES OF EXPERIENCE
"Our facility is located on the Gulf Coast, and
the training usually takes place during hot
humid weather."

A t our facility, we train all new process operation hires for

emergency response roles. In fact, our emergency
response brigade consists mainly of process operators.
With each class of new hires, we conduct approximately 120 hours of emergency
response training. Our facility is located on the Gulf Coast, and the training usually takes
place during hot humid weather.
One July, as we were planning the brigade training for August, we were discussing past
training classes. The discussion quickly turned to a familiar topic: "We spend a lot of
time dealing with the effects of the weather on the brigade rather than the actual emer-
gency response training procedures and techniques." With that, we decided to undertake
a proactive approach to responder safety and rehabilitation.
We now include the subject of rehabilitation in our safety classes at the start of each
day. In the field during physical training activities, we ensure that everyone stays
hydrated. In addition to providing fluids, we provide nutritious foods, scheduled periods
of rest, and means of body temperature stabilization.
Managing the four components of revitalization is very important. The one
component that has shown to be the greatest benefit to our program is body
temperature stabiliza tion. We provide cold or cool neck wraps to be used during
training activities. Our goal is to keep body temperature near normal levels during
physical exertion. By controlling body temperature, the rest periods can be more
manageable, allowing more t ime to train.
We also realized we were having trouble with the same issues during incidents at the
plant, so we now practice the same procedures during emergency response activities.
Recognizing the importance of rehabilitation to protect our greatest resource has
improved the safety, capability, and functions of our brigade.

Roy Robichaux, Jr.

ConocoPhillips—Alliance Refinery
Belle Chasse, Louisiana
 Briga de M e mber Re ha bilita tion 607

Brigade Member Safety Tips where their body temperatu re can return to normal levels
before resuming further activities.
PPE is designed to provide protection from hazards encountered in As mentioned previously, fighting fires in full turnout gear
emergency operations. Brigade mem bers who are overheated should can result in some degree of heat stress ( Figure 20-16). The heat
remove their PPE as soon as possible to permit evaporative cooling. generated by the body during the intense physical exer tion,
PPE must only be rem oved in a saf e place, outside the hazard area. coupled with the increased temperature fro m the fire, can
The Incident Commander or a s afety officer may approve working without increase the body's internal temperature and p roduce profuse
full PPE in situations where the risks have been fully evaluated. sweating. In most situations, turnout gear should be
completely removed as soon as possible to allow the body to
cool. If necessary, additional steps such as the use of cold
co mpresses should be taken to reduce body temperature.
When ambient temperatures are low, damp clothes should be
used by the body to g ro w and repair t issues and are on ly remov ed and b lan kets should be used to s tabilize body
used as a primary fuel source in ext reme condit ions such as temperature.
starvat ion . Like oth er nut rients , excess p ro teins are Stabilizing body temperature is further complicated during
converted and stored in the body as fat. A balanced diet has periods of hot weather o r h igh hu midity . At these t imes,
10% to 12% of calo ries fro m proteins. brigade members cannot cool off even when they take a break
Fats are also essential for life. Fats are used for energy, for and remove their turnout gear. For this reason, rehabilitation
insulating and protecting organs, and for breaking down cer- centers need to be climate-controlled so that brigade members
tain vitamins. Some fats, such as those found in fish and nuts, can achieve a normal body temperature before resuming active
are health ier and more beneficial to the body than others, duties. Some organizations have air-conditioned vehicles for
such as the fats found in margarine. Ho wever, no more than rehabilitation. Others use buses or establish rehabilitation cen-
25% to 30% of the diet should come from fats. Excess fat con- ters in an already cooled area such as a control room.
sumption, particularly of saturated fats (which come mostly
fro m an imal products), is lin ked to h igh cho lesterol, h igh
blood pressure, and cardiovascular disease.
Candy and so ft drin ks contain sug ar. The body can
quickly absorb and convert these foods to fuel. But simple
sugars also st imu late the p rodu ct ion o f insu lin , wh ich
reduces blood glucose levels. That's why eating a lot of sugar
can actually result in lo wer energy levels.
For a brigade member to sustain peak perfo rmance lev -
els, it is necessary to refuel during rehab ilitation . During
short incidents, lo w-sugar, h igh-p rotein sports bars can be
used to keep the g lucose balance steady. Du ring extended
incidents, a b rigade member should eat a mo re co mp lete
meal. The p roper balance o f carbohyd rates, p roteins, and
fats will maintain energy levels throughout the emergency.
To ensure peak performance, the meal should include co m-
plex carbohydrates such as whole grain breads, whole grain
pasta, rice, and vegetables. It is also better to eat s maller
meals; larger meals can increase g lucose levels and slo w
down the body.
Healthy, balanced eat ing should be a lifestyle. Proper
nutrition reduces stress, imp roves health, and provides more
energy. It is just as important to keep blood sugar levels bal-
anced throughout the day as it is to remain hydrated . Then,
you will be ready to react to an emergency at any t ime.

Temperature Stabilization
The fourth part of revitalizat ion is stabilizing body tempera-
ture. Body temperature must return to a normal range before a
brigade member resumes strenuous activities. Brigade mem- (Figure 20-16) Fighting fires in com plete turnout gear can result in
bers exposed to hot or cold temperatures need to have a place varying degrees of heat stress.
608 I N D U S T R I A L F I R E B R I G A D E : P R I N C I P L E S A N D P R A C T I C E

Industrial fire fighters, whether at the incip ient, advanced

exterior, or interio r structural level, may be subject to
heat-related disorders. This kind of situation may evolve
rapidly as temperatures in the firefighting environ ment rise or
when barriers to the body's ability to cool itself are used, such as
fire fighters' turnout gear. Addit ional physiolog ical activ it ies,
including increased work rates or breathing against a resist-
ance (e.g., in SCBA), increase the chance that one of these
thermal d isord ers will occu r. Old er b rigad e members or
those with circulatory system problems are particularly sus -
ceptible to heat-related concerns. All fire brigade members
must be cognizant of the two heat-related events described
next, recognize their signs and sympto ms, and take appro-
priate actions if they occur.
The symptoms of heat stress, sometimes known as heat
cramps or heat exhaustion, include profuse sweating, weak-
ness, nausea, headache, and fainting associated with loss of (Figure 20-17) Prolonged ex posure to freez ing weather can result in severe
flu ids. During heat stress events, the body continues to try to frostbit e.
cool itself, but sy mptoms are p resent. Indiv iduals who pres ent
with these sympto ms should immed iately be removed fro m
firefighting activities and placed in a cool atmosphere to rest.
Water or electrolyte fluids should be provided.
Heat stroke is a true medical emergency. It can occur if heat
stress is not properly treated and can lead to brain damage or
death. Symptoms include red/blue dry skin (because sweating
has ceased), confusion, and loss of consciousness. In heat
stroke, the body loses its ability to cool itself and typically the
core body temperature exceeds 104°E First aid for heat stroke
requires dosing the body continually with cool liqu id and
summon ing emergency med ical assistance immed iately .
Brigade members who are experiencing heat stroke need to be
taken to a medical facility as soon as possible.
Cold temperatures cause problems as well. Brigade mem-
bers responding to incidents during cold weather are subject
to hypothermia and frostbite (damage to tissues resulting
fro m prolonged exposure to cold) ( Figure 20-17). In these
(Figure 20-18) A medical team should be part of rehabilit ation to check vital
cases, the rehabilitation center needs to be warm enough so
signs and treat any injuries that occur.
they can get warmed up before return ing to the chilly envi-
ronment. Brigade members who are wet or severely chilled
should be wrapped in warming b lan kets and moved into a
well-heated area before they remove their turnout gear. As Regular Monitoring of Vital Signs
soon as possible, all wet cloth ing should be removed and Pulse, respirat ion, b lood p ressure, and temperatu re should
replaced with warm, dry clothing. be mon ito red at regu lar int ervals du ring rehab ilitat ion.
These read ings shou ld b e co mpared with read ings taken
Medical Evaluation and Treatment when the brigade member first enters the rehabilitat ion cen -
A brigade member who has abnormal v ital signs, is suffering ter. Vital signs must be taken repeatedly to ensure that they
pain, or is injured needs to have further medical evaluation. A return to normal limits before the brigade member is reas -
medical evaluation and treatment team should be assigned to signed. If v ital signs do not return to normal levels, a brigade
the rehabilitation center ( Figure 20-18). Signs of illness or member may need to spend mo re t ime in the rehab ilitat ion
inju ry should be checked in the rehabilitation center before center o r be further evaluated by medical personnel.
the brigade member resumes activit ies. Identify ing problems
in the rehabilitation center can p revent later disruption on the Transportation to a Hospital
fire scene. A brigade member who collapses or becomes inca- Another function of the rehabilitation center is to transport ill
pacitated while in act ion endangers the entire team. or injured brigade members to the hospital ( Figure 20-19).

(Figure 20-19) An ambulance s hould always be ready near the rehabilita -
tion center to transport an ill or injured brigade member to a hospital.
An ambulance should be available to ensure that ill or injured
brigade members receive the best possible care.
Critic al Incid ent Stre ss Man age ment
When emergencies involve stressful situations, particu larly
mass casualty incidents or brigade member fatalities, reha -
bilitat ion should include staff trained in cri tical inci dent
stress management (CIS M). CISM is a process that con-
fronts the responses to crit ical incidents, defuses them, and
directs the brigade member toward physical and emotional
balance. The CISM team members should talk to each team in
rehabilitation to assess the emotional state of brigade
members. Talking with a CISM member in the rehabilitation
center is the first step in the CISM system. After the incident,
CISM team members may meet with brigades or individual
brigade members to d iscuss the event and work through it .
CISM is discussed further in Chapter 18, Brigade Member
Survival.
Reas sign ment
Once rested, rehydrated, refueled, and rechecked to make
certain that they are fit for duty brigade members can be
released fro m rehab ilitation and reassigned to active duty.
Reassign ments may be to the same job performed before o r
to a different task, depending on the decis ion o f the officer in
charge. Generally, teams stay together during the rehabil-
itat ion p rocess because th is creates a more effect ive wo rk
u n it and helps t o ensu re accou nt ab ility at all t imes .
However, it is somet imes necessary to tempor arily reassign
Brigade Member R e ha bi l i ta ti on
609
Brigade Member Safety Tips
Stress managem ent skills are crucial for high -quality perf orm ance,
regardless of the type of stressor involved or what role the person plays
in em ergency assist anc e. A brigade m ember needs to know basic
stress management skills to deliver high -quality perf ormance. Ex ercis e,
proper nutrition, and em otional support are all helpf ul in managing
stress.
Brigade Member Tips
You m ust take care of yourself first to be able to help others.
members to different co mpanies. This allows brigade mem-
bers who require add it ional rest o r med ical t reat ment to
remain in rehabilitation and releases fully staffed teams for
additional duty.
Personal Responsibility in Rehabilitation
The goal of an industrial fire brigade is to save lives first and
property second. To achieve this goal, however, you need to
take care of yourself first, take care of the rest of your team
second, and then take care of the people involved in the inci-
dent. Another way o f loo king at th is is to remember that
safety begins with you. The other members of your team
depend on you to bear you r share o f the load . To do th is,
you need to maintain you r body in peak cond it ion.
Part o f your responsibility is to know your o wn limits.
No one else can know what you ate, whether you are light -
headed or dehyd rated , wh ether yo u are feeling ill, o r
whether you need a breather. You are the only person who
knows these things. Therefore, you may be the only person
who kno ws when you need to request rehabilitation. It may
be difficult to say "I need a break" while your team members
are still hard at work. But it is better to break when you need it
than to push yourself too far and have to be rescued by other
members of your brigade.
Regu lar rehab ilitat ion enab les b rigade memb ers to
accomp lish more work during a major incident. It decreases
the ris k of stress-related in juries and illness. Remember,
safety begins and ends with you.
• Rehabilit ation is a s pec ially designated area w here em ergency
pers onnel c an rest, rec eiv e fluids and nourishm ent, and be ev al
uated f or medical and CI SM problem s.
• Rehabilit ation c enters help prevent injuries and illnes ses, enable
brigade m embers to ac com plish m ore during an em ergency
inc ident, and reduc e the need f or resc uing ex hausted or col
laps ed brigade mem bers from t he fire s cene.
• Types of inc idents that m ay n ec ess itat e rehabilitation cent ers
inc lude major struct ure fires, st orage t ank fires, and flam m able
liquid and gas fires. Rehabilit ation is also needed f or hazardous
mat erials inc idents, s earc h -and-resc ue operations and t raining
activities.
• The sev en parts of rehabilitat ion are: physic al ass ess ment, revi -
talizat ion, medical evaluat ion and t reat m ent, regular m onit oring
of vital signs, trans port, critic al inc ident stress m anagem ent, and
reassignm ent. Revitaliz ation c onsists of rest, fluid replac em ent,
nutrit ion, and t em perat ure st abiliz ation.
• Your res ponsibilities in rehabilitat ion are t o k now y our lim its, to
list en t o y our body, and to us e t he rehabilit ation f acilities w hen
needed.
Critical incident stress management (CISM)
A s yst em t o help pers onnel deal wit h c ritical inc ident st ress in a
positiv e m anner; its aim is to prom ote long -t erm m ent al and em o tional
healt h after a critic al incident.
Dehy drati o n A st at e in w hic h fluid loss es are great er t han fluid
int ak e into t he body, leading to s hock and ev en deat h if unt reat ed.
Electrolytes C ert ain s alt s and ot her c hemic als t hat are dis solved
in body fluids and c ells.
Emer genc y incide nt re ha bilitation A function on the
em ergency sc ene t hat c ares for the w ell-being of t he brigade m em -
bers. It includes phys ical ass ess m ent, revit alization, m edic al evalua-
tion and treatm ent, and regular m onit oring of vit al s igns.
Frost bit e D am age t o t is s ues as the res ult of ex pos ure t o c old;
froz en or partially froz en body parts.
F ul ly e nc a ps ul ate d s uit s A prot ec t iv e s uit t hat c om plet ely
covers the brigade m em ber, including the breathing apparat us, and
does not let any vapor or fluids ent er t he s uit.
Gl ucose T he s ourc e of energy f or t he body. One of t he basic
sugars, it is t he primary f uel, along w it h oxy gen.
Hy pot her mia A c ondition in w hic h t he int ernal body t em pera ture
falls below 95°F, us ually a res ult of prolonged ex pos ure t o c old or
freez ing temperatures.
Persona l pr otective e quipme nt (PPE) Gea r worn b y
brigade mem bers that includes helm et, glov es, hood, coat, pants,
SC BA, and boots. The pers onal prot ectiv e equipm ent provides a
thermal barrier for brigade m em bers against int ense heat.
Reha bilitate T o rest ore to a c ondition of healt h or to a st at e of
us eful and c onstructive activity.
 Yo ur in d ustr ial fir e b ri ga de tea m is dis patc he d t o a fire in t he ca ntee n. It
is a hot, h u mid aftern o o n i n J uly. T he te mpe ratu re is 94 ° F (35 ° C), a nd
relative h u mi dity is 98 %. W he n y o u ar rive, the struct ure is c o mp letely
inv olve d a n d the fire has exten de d i nto a near by gar age sto rage facility.
The Inci de nt C o mma nd er or ders y ou r tea m l eade r to esta blis h a
reha bil itatio n ce nter. Yo ur te a m le ade r t ells y o u to establ ish re ha b at the
desi g nate d sta gi n g a rea , whi ch is at the e ntra nce of t he pl ant .

1. W hat equipm ent w ould y ou N OT bring wit h y ou? 3. Should t he brigade m em bers go back into t he
A. M edic al equipm ent bag building aft er rehabilit ation?

B. Drink ing wat er and ic e A. Yes — the f ire is still burning and t hey are
needed urgently.
C. Self-cont ained breat hing apparat us
B. Yes —t hey s hould be fine for another w ork
D. Clipboards and pens
period aft er a quic k drink.
C. No— t hey c annot leav e rehabilitat ion until y ou
2. Your brigade leader tells y ou and y our partner t o hav e written dow n all of their names.
check in t he brigade mem bers as t hey report to
D. No— they need m ore tim e to c ool dow n and
rehabilit ation. T his m eans t hat y ou will:
rehy drat e.
A. writ e dow n the identity of eac h team reporting
to rehabilitat ion.
4. W hat s hould they do to revit aliz e?
B. writ e dow n the tim e each t eam reports to
rehabilit ation. A. Remov e prot ective clothing, drink a carbonat ed
soda, and eat a donut.
C. rec ord the nam e of eac h individual brigade
m em ber reporting t o rehabilit ation. B. Keep prot ectiv e c lot hing on and drink c old
wat er or s ports bev erage.
D. determ ine if any one report ing t o rehabilit ation
is injured. C. Rem ove prot ectiv e clot hing, eat a protein bar,
and drink c old w at er or dilut ed sports bev erage.
E. All of t he abov e
D. Rem ove prot ectiv e clot hing, drink c offee, and
eat a donut.