Woodbury Blair, Merrill Stefan A.
Midwestern Un - Arizona College of OM
Kingman Regional Medical Center
Historically, firefighting has been a hazardous profession and in response, many departments and national organizations have adopted rehabilitation protocols to minimize excess risk. Fire rehab is a coordinated plan to ensure firefighters, who encounter extremes of temperature, exposure, and exertion, do not develop significant illnesses related to exertion or exposure. Fire rehab can vary from simple temperature management and oral rehydration to aggressive medical treatments and transport to a higher level of care. Fire rehab is continually evolving as our understanding of physiologic responses to exertion and exposure change, technologies evolve, and risk tolerance adjusts. Fire rehab services have a varying structure, depending on the service and the region. Small, rural fire services may have few responders with medical training and coordinate with local EMS agencies to assist or oversee rehab. Some fire services have a sufficient number of trained EMS providers and coordinate their own rehab, including transport to health care facilities. Large services may have highly scalable rehab plans that include multiple rehabilitation units operating under a coordinating officer. Over the years, a group of central resources has been created that provides education and guidance on fire rehab. In 1987, the National Fire Protection Association (NFPA) released its , which comprehensively addressed common dangers and protective measures for firefighters. In 1992, the U.S. Fire Administration (USFA) published the short report FA-114, , which included a sample standard operating procedure (SOP) for fire rehab. A textbook bearing the same title was released in 1997, providing further details of the science and reasoning for the fire rehab protocols. USFA published an updated SOP, and much more comprehensive, report on in 2008. was issued in 2003, establishing guidelines for fire services. These recommendations were upgraded to standards in a 2008 update and again updated in 2015, with carbon monoxide monitoring added to recommended practices. It is important to delineate that fire rehabilitation, when discussed in the context of wildfires, relates to the ecological recovery of an affected area, not the physiological recovery of humans working to contain fires. The subject of the ecological recovery after a wildfire is addressed in other literature and will not be covered in this article.
从历史上看，消防工作一直是一项危险的职业，作为应对措施，许多部门和国家组织都采用了康复方案，以尽量减少额外风险。消防康复是一项协调计划，旨在确保身处极端温度、暴露环境和高强度体力消耗中的消防员不会患上与体力消耗或暴露相关的重大疾病。消防康复的形式多样，从简单的温度管理和口服补液到积极的医疗治疗以及转送至更高水平的医疗机构。随着我们对体力消耗和暴露的生理反应的理解不断变化、技术不断发展以及风险承受能力不断调整，消防康复也在持续演变。消防康复服务的结构各不相同，这取决于服务内容和地区。小型农村消防部门可能只有少数接受过医疗培训的响应人员，并与当地紧急医疗服务机构协调以协助或监督康复工作。一些消防部门有足够数量的训练有素的紧急医疗服务人员，并自行协调康复工作，包括将人员转运至医疗机构。大型消防部门可能有高度可扩展的康复计划，其中包括在一名协调官员指挥下运作的多个康复单元。多年来，已经形成了一批核心资源，为消防康复提供教育和指导。1987年，美国国家消防协会（NFPA）发布了其《》，全面阐述了消防员面临的常见危险和防护措施。1992年，美国消防管理局（USFA）发布了简短报告FA - 114《》，其中包括一份消防康复的标准操作程序（SOP）样本。1997年出版了一本同名教科书，进一步详细介绍了消防康复方案的科学依据和推理过程。2008年，USFA发布了一份更新的、更为全面的SOP报告《》。《》于2003年发布，为消防部门制定了指导方针。这些建议在2008年的更新中升级为标准，并于2015年再次更新，在推荐做法中增加了一氧化碳监测。需要明确的是，在野火背景下讨论的消防康复是指受影响地区的生态恢复，而非参与灭火工作的人员的生理恢复。野火后的生态恢复主题在其他文献中有论述，本文将不再涉及。
