1. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION Date Location

2. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) DEHYDRATION & Firefighters Our overlooked condition

3. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) OBJECTIVES  To define dehydration as it applies to firefighters  To identify common hydration issues for firefighters  To describe how hydration impacts firefighter health- including heart attack and stroke

4. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)  To identify the signs and symptoms of dehydration  To discuss what can be done to prevent and reduce dehydration conditions  To identify and describe four main types of heat injuries  Describe the five methods of fire ground rehabilitation.  Discuss cooling methods of fire ground REHAB OBJECTIVES

5. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) FIREFIGHTER INJURIES IN THE U.S.

6. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION  Is a bigger problem than we realize  Has a significant impact on our cardiovascular system  Heat stroke deaths are 2% of the LODD’s

7. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) FIREFIGHTER DEATHS

8. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) IS Heat Stroke LODD preventable?

9. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)

10. 50% OF LODD’S ARE ATTRIBUTED TO SCD  Of 440 deaths over a 10 year period, 308 (43.5%) had a known heart condition  If you start with the number of deaths attributed to firefighters with a known heart condition, add in age, other health conditions and smoking, that number accounts for roughly 75% of all firefighter deaths

11. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) SUDDEN CARDIAC DEATH STUDY Between 1995-2004 440 LODDs were due to SCD

12. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WHAT WE NEED TO DO TO PREVENT SCD LODD (it is related to dehydration prevention) 1.Purposeful Standards 2.Policy 3.PPE/Safety Equipment 4.Training/Education 5.Changing Our Culture

13. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) NFPA 1584  Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises Purposeful Standards

14. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WELLNESS-FITNESS INITIATIVE LABOR AND MANAGEMENT WORKING TOGETHER  Medical Evaluation  Fitness  Rehabilitation  Injury Prevention  Behavioral Health  Data Collection Purposeful Standards

15. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) PREVENTING  Education  Physical Fitness  Nutrition  Fluid Intake Purposeful Standards

16. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) PREVENTING  Medical Screening  Rehabilitation  We need to care about our families Purposeful Standards

17. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Purposeful Standards

18. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WHY WE BECOME DEHYDRATED Firefighters are at extreme risk because:  We do extremely strenuous emergency activity  Are exposed to extremely high temperatures  Are wrapped in heavy, non-ventilated PPE Purposeful Standards

19. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WHY WE BECOME DEHYDRATED Firefighters are at extreme risk because:  We often start our shift already dehydrated  We do not drink enough water  We are not physically fit  ITS hot out Purposeful Standards

20. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WHY WE BECOME DEHYDRATED Firefighters are at extreme risk because:  We have excessive body weight (muscle?)  We do not understand the impact of dehydration on increased heart stress Purposeful Standards

21. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION  We need to have a policy  Multiple policies are available through an internet search  The important point is to have an accepted policy POLICY

22. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION PPE/SAFETY EQUIPMENT  Increases thermal impact on the body  Reduces heat dissipation  Must allow perspiration to be evaporated  Full PPE must be worn at emergency scenes PPE

23. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION We need to know:  Where heat comes from  The impact of long term exposure to heat  The effects of heat stress TRAINING EDUCATION

24. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION We need to know:  Physiological Effects of Heat Stress  Increased Risk Factors  Symptoms of the Effects of Heat Stress TRAINING EDUCATION

25. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION We need to know:  The Risk Factors ‒ Medical Issues ‒ Medications ‒ Alcohol/Caffeine TRAINING EDUCATION

26. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION We need to know:  The Risk Factors ‒ Dehydration ‒ Fitness ‒ Heat Acclimation TRAINING EDUCATION

27. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HYDRATION  Fluids  Nutrition  Fitness  Medical Conditions CULTURE CHANGE

28. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURIES  Miliaria (Prickly Heat)  Cramps  Heat Exhaustion  Heat Stroke HEAT

29. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Miliaria (Prickly Heat) ‒Acute inflammation of the skin ‒Results from clogged sweat ducts ‒More annoying than anything ‒PPE or tight clothing ‒wet clothing HEAT

30. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Cramps Excessive sweating results in the loss of electrolytes Rubbing and stretching helps Fluid replacement Sign of a potentially more serious situation HEAT

31. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Heat Exhaustion Fainting Profuse sweating Headache Tingling in extremities Pale, ashen facial color Shortness of breath Vomiting HEAT

32. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Heat Exhaustion Treatment Move victim to a cool, shaded area Water replacement of intravenous fluid replacement Continual monitoring for deterioration of status May require medical intervention HEAT

33. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Heat Stroke ‒High probability of severe injury or death ‒Body cooling systems are not functioning ‒Skin is hot, flushed and dry, may later be wet and clammy ‒May be rapid onset with loss of consciousness, convulsions and delirium HEAT

34. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Heat Stroke ‒Rapid, strong pulse ‒Rapid, deep respirations ‒Shock symptoms are a sign of deterioration ‒Incontinence, vomiting, kidney failure, pulmonary edema and cardiac arrest may result HEAT

35. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) HEAT INJURY  Treatment for Heat Stroke ‒Lower the body temperature a quickly as possible ‒Apply cold packs to carotid arteries ‒Elevate legs ‒Transport to a medical facility HEAT

36. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)

37. REHABILITATION IN THE OLD DAYS  Firefighter rehab is absolutely necessary  Did we really rehab

38. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) REHABILITATION  Firefighter rehab is absolutely necessary  Improvements in concept of rehab  Two bottle theory  Latest rehab theory

39. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) REHABILITATION  Rest  Hydration  Active Cooling  Medical Monitoring  Refueling

40. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) COOLING METHODS  Ambient Air  Wet Towels

41. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) COOLING METHODS  Misting Fans  Cooling Chairs

42. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) FLUIDS  Juice  Caffeinated Drinks  Soda  Water  Sports Drinks

43. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) ACTIVE REHABILITATION  Latest Rehabilitation Theory wrap up

44. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) STUDIES  Orange County Fire Authority, California  U.S. Department of Agriculture  United States Fire Administration/FEMA  Indiana University  Other available on-line sites

45. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)

46. Chief Owens FF Safety Video 1.avi dailydispatch.com firefighterclosecalls.com The Secret List firefighternearmiss.com firerescue1.com fireengineering.com firefighternation.com firefighterspot.com Resources

47. Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)