Section 6 - Post-Incident Rehab Considerations Describe the procedures for terminating a rehab operation. Explain the elements of a critical incident stress management program that apply to rehab operations. Explain how to monitor postincident hydration and nutrition. Describe the procedures for terminating a rehab operation. Explain the elements of a critical incident stress management program that apply to rehab operations. Explain how to monitor postincident hydration and nutrition.

Objective 6-1 Describe the procedures for terminating a rehab operation.

Decreasing the Rehab Function at an Incident Remember: Some of the hardest work is done by the small numbers of responders at the end of the incident. Rehab resources can be scaled back as responders leave the scene. All rehab functions must be able to be carried out until the end of the incident. Remember: Some of the hardest work is done by the small numbers of responders at the end of the incident. Rehab resources can be scaled back as responders leave the scene. All rehab functions must be able to be carried out until the end of the incident.

Objective 6-2 Explain the elements of a critical incident stress management program that apply to rehab operations.

CISM Goals Minimize the emotional impact of critical incidents on emergency responders. Increase fire fighters’ resistance and resilience to this type of stress. Prevent harmful effects following critical incidents by working with response personnel at or near the time of such incidents. Prevent any chronic effects, such as post- traumatic stress disorder, through the use of follow-up care and employee assistance programs. Minimize the emotional impact of critical incidents on emergency responders. Increase fire fighters’ resistance and resilience to this type of stress. Prevent harmful effects following critical incidents by working with response personnel at or near the time of such incidents. Prevent any chronic effects, such as post- traumatic stress disorder, through the use of follow-up care and employee assistance programs.

CISM Benefits to the Department Decreased absenteeism Decreased physical ailments Increased morale Improved decision making ability from reduced stress Reduction of poor coping strategies (e.g., substance abuse) Longer retention of qualified personnel Reduction of psychological problems Decreased absenteeism Decreased physical ailments Increased morale Improved decision making ability from reduced stress Reduction of poor coping strategies (e.g., substance abuse) Longer retention of qualified personnel Reduction of psychological problems

CISM Approaches Assistance should always be offered informally. Interventions near the time of the incident include the following. –Informal discussion/support at the company level –Defusing with a behavioral health professional or other CISM team member –Formal debriefing with a behavioral health professional and other CISM team members Long-term care will be done by licensed mental health professionals. Only the earliest portions of the CISM program might be carried out in a rehab setting Assistance should always be offered informally. Interventions near the time of the incident include the following. –Informal discussion/support at the company level –Defusing with a behavioral health professional or other CISM team member –Formal debriefing with a behavioral health professional and other CISM team members Long-term care will be done by licensed mental health professionals. Only the earliest portions of the CISM program might be carried out in a rehab setting

Defusing in Rehab An informal process to reduce immediately the pressure and anxiety surrounding a critical incident. Not intended to encourage venting feelings. Must be guided by the needs of the emergency response personnel. Often, reliable information about the outcome of an unknown event, such as the condition of an injured fire fighter, is sufficient to reduce anxiety. An informal process to reduce immediately the pressure and anxiety surrounding a critical incident. Not intended to encourage venting feelings. Must be guided by the needs of the emergency response personnel. Often, reliable information about the outcome of an unknown event, such as the condition of an injured fire fighter, is sufficient to reduce anxiety.

Objective 6-3 Explain how to monitor postincident hydration and nutrition.

Post-Incident Rehab Functions Drink an additional 12 to 32 ounces more within the 2 hours. A properly hydrated person should have a reasonable volume of urine output and that urine should be relatively clear and odor-free. Firefighters should also monitor themselves and their fellow firefighters for delayed problems. Serious medical conditions can occur as long as 24 hours following the activity. Drink an additional 12 to 32 ounces more within the 2 hours. A properly hydrated person should have a reasonable volume of urine output and that urine should be relatively clear and odor-free. Firefighters should also monitor themselves and their fellow firefighters for delayed problems. Serious medical conditions can occur as long as 24 hours following the activity.