Physiological recovery from firefighting activities in rehabilitation and beyond

Details

• Personal Author:
  Fahey GC ; Fahs CA ; Fernhall B ; Goldstein E ; Gutzmer S ; Horn, Gavin P. ; Petruzzello SJ ; Smith, Denise L.
• Description:
  OBJECTIVES: The primary objective of this study was to document the timeline of physiologic recovery from firefighting activities in order to inform emergency medical services (EMS) of vital sign values that might be expected during incident rehabilitation and in developing rehabilitation protocols to make decisions about when to return personnel to the fireground. Secondarily, we compared two different incident rehabilitation strategies to determine effectiveness in reducing physiologic strain following firefighting. METHODS: A repeated-measures randomized crossover design was utilized in which firefighters conducted a controlled set of firefighting activities, after which they completed incident rehabilitation in one of two conditions: 1) similar to currently used rehabilitation protocols and 2) with active cooling and nutritional intervention. Following 15 minutes of rehabilitation, each firefighter was asked to perform a simulated rescue "dummy drag" and then recover for 120 minutes in a quiet area. Core temperature and heart rate were recorded throughout the study. Blood pressures and subendocardial viability ratios were obtained before firefighting, after firefighting, and at standardized times during rehabilitation and recovery. RESULTS: Heart rate and core temperature increased during firefighting, and core temperature continued to increase for 7 minutes after completion of firefighting activities. These values did not return to baseline until at least 50 minutes after firefighting activity. Systolic blood pressures were significantly reduced during rehabilitation (15.2 percent), and recovered 7.7 percent during the first 30 minutes of recovery, but remained significantly lower than before firefighting for at least 120 minutes. An index of subendocardial perfusion was also significantly depressed for up to 110 minutes after firefighters. Differences between rehabilitation protocols were minimal. CONCLUSIONS: The timeline for recovery from firefighting activities is significantly longer than the typical 10-20-minute rehabilitation period that often is provided on the fireground. Modifications from the current rehabilitation protocol do not appear to improve the recovery timeline when rehabilitation is conducted in a cool room. While firefighters often are concerned about elevated blood pressures, this study suggests that firefighters and EMS personnel should also be cognizant of the potential dangers of hypotension. [Description provided by NIOSH]
• Subjects:
  Blood Body Temperature Cardiovascular System Cold Temperature Delivery Of Health Care Emergencies Emergency Responders Fatigue Firefighters Hot Temperature Occupational Health Safety Stress, Psychological Temperature Workload

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• Keywords:
  Author Keywords: Rehabilitation Biological-effects Blood-pressure Blood Pressure Body-temperature Body Temperature Cardiac-function Cold-environments Cryotherapy Emergency-care Emergency-responders Emergency-response Emergency-treatment Fire-fighters Fire-fighting Firefighter Heart-rate Heart Rate Hot-environments Job-stress Medical-care Medical-treatment Myocardium Nutrition Physiological-effects Physiological-fatigue Physiological-measurements Physiological-response Physiological-stress Physiological-testing Rescue-measures Rescue-workers Rest-periods Systolic-pressure Task-performance Temperature-effects Tension Vital-capacity Work-capability Work-capacity Work-intervals Work-performance

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• ISSN:
  1090-3127
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Illinois ; New York ; Oklahoma ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 6
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  214-225
• Volume:
  15
• Issue:
  2
• NIOSHTIC Number:
  nn:20039115
• Citation:
  Prehosp Emerg Care 2011 Apr-Jun; 15(2):214-225
• Contact Point Address:
  Gavin Horn, PhD, University of Illinois Fire Service Institute, 11 Gerty Drive, Champaign, IL 61820
• Email:
  ghorn@fsi.illinois.edu
• Federal Fiscal Year:
  2011
• Performing Organization:
  University of Illinois at Urbana-Champaign
• Peer Reviewed:
  True
• Start Date:
  20070901
• Source Full Name:
  Prehospital Emergency Care
• End Date:
  20100831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:436618d9b0313dd464bbaccfa5a8717f1eb661be6074425ad4c897db5c55c8eac6136d75d23ad4cf47c034da3d866dc1d6fe1ea3709d5c5df933f6f460fb413d
• Download URL:
  https://stacks.cdc.gov/view/cdc/192589/cdc_192589_DS1.pdf
• File Type:
  [PDF - 579.48 KB ]