Thursday, September 30, 2010

Some things are complicated, Rehab AIN'T one of them.

Many Thanks to EMS Chick who jogged me out of my stupor and reminded me of a valuable subject worthy of sharing on this blog in the hope that somebody somewhere might learn something to enable them to make a difference at a critical point. She mentions, in this post, about a recent rehab experience. Her experience should be familiar to most who work in a Fire and EMS service. Rehab is (should be) part of the job. The problem has always been in the execution.
 I could (and have) easily deliver an 8 hour classroom session on this subject but that's not the point I want to make here, and I'm sure you don't want to do all that reading. I have however, done a lot of study on this subject which continues to this day. Part of my research includes a subscription to the NFA LODD announcements which come in far too often to my inbox. I read and study the circumstances of each report. At the end of the year I summarize these for my own understanding as well as my students. As you watch these things, you begin to recognize patterns. 2009 showed a decrease in fatalities for the first time in a long time and we dropped below 100 for the year. Up until the last few weeks, it looked like this year would be even lower, but the last 10 days have shown a dramatic increase in the numbers. We'll see what fate, and other influences, provide for the statistics at the end of the year.
 I attend a fair amount of fires, and serve in either a fire officer's position, or engineer, or rehab sector.  I used to do a lot more rehab before I got involved and trained on the Fire side and in those days we all knew that the rehab folks were just a pain in the ass and didn't have a clue that they were keeping the Firefighters from doing there job. The rehab folks knew that the Firefighters didn't want to deal with EMS and they had to find a way to make it happen. That was then.
 Then we had a few close calls where EMS would not allow a Firefighter to return to duty because of his/her presentation. In one case we probably saved a man's life, because it turned out that just a few hours after EMS 'took him down' he was in a cath lab and got the treatment he needed. It was a wake-up call for all of us. Then we had a 'save' at a live burn training evolution and we knew we had to focus on this issue.
 Today, we have regular rotations through rehab, two bottles and you're in the tent. Anyone who skirts or refuses rehab is dismissed from the scene, anyone who refuses to stand down when rehab deems he/she needs to is not permitted back into the fight by the IC. The IC system steadfastly respects the recommendations of the rehab Officer. Rehab is part of the system and stands on its own with it's own responsibilities to the incident operation. There is no question of whether or not rehab counts, it is a given. But I digress.
  Read the reports, all the reports, over a period of several years. Read them over and over and over again. Look for a pattern or a common thread. It's in there, and you can find it. You don't even really need to look very hard. You will see it in the fire scene fatalities, the after action fatalities, and the training fatalities.
 Give up?
 It's the LOOK TEST stupid!
 In a vast majority of the LODD cases, the victim would have stood a chance of survival if someone had just done a look test on them and said "Hey man, you look like shit, somethings wrong, let's get you checked out". That's it. That's all it would take. Don't believe me? You don't have to. Just go read a dozen or so reports and put them to the test in your head.
 So here, at last, is my point: you don't need to be a Paramedic performing assessments every 10 minutes on every firefighter on an incident. You need to be a partner, or a friend, and LOOK at those you are working with and have the courage to make them get checked out and admit they are possibly in a bit of trouble. You don't need to be EMS trained to make that happen, you just need to take a good look at your crew.
 Have some courage, grow a set if you need to, keep them alive. If it doesn't seem right, it probably isn't. It sure won't cost much to check it out.
 This Sunday is the Fallen Firefighter's Memorial Service. I invite you to watch as much of this service as you can. The next time your are working rehab, or have your crew in a fire, think about the service and whether or not you want to be there next year because you have a fallen Brother on the 'list'.
 I have 2 Brothers on the list this year, neither of which fit into my 'look test theory', but I can tell you this: I would give anything to not hear the bell rung in their Honor.

1 comment:

  1. Thanks for the input!

    I stopped a firefighter from going back in a few years ago on a fire, he actually refused to talk to me for a month. I'm okay with that, because he didn't look/present like he should go back in and if I was wrong, well at least he's still alive.