202.08 Rehabilitation Sector

Rehabilitation Sector Policy

• The Phoenix Fire Department's policy is to prevent injuries resulting from extended field operations under adverse conditions.
• No member will be permitted to continue emergency operations beyond safe levels of physical or mental exertion.

Rehabilitation Sector Procedure

• The Rehabilitation Sector (radio designation REHAB) is used to evaluate and assist personnel suffering from the effects of sustained physical or mental exertion during emergency operations.
• The sector provides a specific area for personnel to assemble and receive:
• Assessment of vital signs
• Revitalization (rest, hydration, refreshments, and temperature regulation)
• Medical evaluation and treatment of injuries, if needed
• Transportation for those requiring treatment at medical facilities
• Reassignment as needed

Rehabilitation Sector Team

• A Rehab Team concept will be used to establish and manage the Rehab Sector.
• The team consists of:
• Rehab Truck
• Utility Truck
• Rescue
• ALS Company
• Designated Sector Officer
• C959, as needed
• Health Center officer, as needed

Incident Commander Responsibilities

• The Incident Commander makes an early determination of incidents requiring Rehab Sector.
• The commander determines the need for multiple Rehab Sectors, and each sector assumes a geographic designation consistent with the location at the incident site.

Rehabilitation Sector Location and Boundaries

• The Rehab Sector is located in a functional location for crew access.
• City buses may be called to the incident scene to provide cooling or shelter.
• The sector has a defined boundary with only one entry point.
• The sector is divided into four functions: Assessment, Hydration and Replenishment, Medical Treatment and Transport, and Documentation.

Function A: Assessment

• The initial entry point and assessment area where members remove their Personal Protective Equipment prior to entry.
• Rehab Sector Officer assigns a member to collect passports from crews and take a pulse rate on all crew members.
• The purpose of this area is to identify members who may be in need of more attention than just a recovery period.

Function B: Hydration and Replenishment

• Rehab personnel provide supplemental cooling devices, fluid and electrolyte replacement, and nourishment.
• Members rest and rehydrate with their crew members and are re-evaluated for pulse rate after 20 minutes.

Function C: Medical Treatment and Transport

• ALS crews and Rescue manage this function.
• Members receive evaluation and treatment for overexertion and injuries.
• Crews follow standard ALS Protocol and advise the Rehab Sector Officer of the need for medical treatment and/or transportation requirements of personnel due to physical condition.

Function D: Documentation

• Time-in and time-out for members/crews entering or leaving the rehabilitation area are tracked with vitals.
• Any member requiring further evaluation beyond 20 minutes is documented on an EMS patient care report.
• Where emergency medical care is provided, an EMS Patient Care Report is generated and a copy is placed in the member's employee health record.

Function E: Reassignment

• The Health Center staff officer may be available in this section.
• This section determines a crew's readiness for reassignment.
• Diligent efforts and face-to-face communication with the Rehab Sector Officer are required.
• Rehab crews advise the Rehab Sector Officer of all companies' status for reassignment and crews that are running short or without a company officer.

Vital Signs and Assessment Standards for REHAB

• ALS crew in Function C pay close attention to members' physical observations, including:
• Chest pain, dizziness, shortness of breath, weakness, nausea, or headache
• General complaints such as cramps, aches, and pains, rate of perceived exertion
• Symptoms of heat or cold-related stress
• Changes in gait, speech, or behavior
• Alertness and orientation to person, place, and time
• Skin color
• Obvious injuries

Reassignment Criteria

• Members must meet the following criteria to be reassigned:
• Heart rate below 100 bpm with no irregular beats
• Systolic BP below 160
• Diastolic BP below 100
• Respiratory rate between 12-20 per minute
• No abnormal neurological findings
• No complaints