Providing Firefighter Rehab with Limited Staffing

Running head: PROVIDING FIREFIGHTER REHAB WITH LIMITED STAFFING 1

Providing Firefighter Rehab with Limited Staffing

Paul C. Bearce

Rio Rancho Fire

Rio Rancho, New Mexico

PROVIDING FIREFIGHTER REHAB WITH LIMITED STAFFING 2

Certification Statement

I hereby certify that this paper constitutes my own product, that where the language of others is set forth, quotation marks so indicate, and that appropriate credit is given where I have used the language, ideas, expression, or writings of another.

Signed: _____________________________________________


Abstract

Cardiovascular stress is the cause of firefighter deaths in over half of the cases reported, due

to the fact that fire personnel perform arduous physical tasks in stressful environments. Providing

incident rehabilitation services and medical monitoring has been shown to reduce the effects of

physiological and emotional stress which creates a safer work environment for firefighters. The

problem is the Rio Rancho Fire Rescue Department (RRFRD) has not been able to provide

sufficient trained personnel to meet the national standards for firefighter’s rehabilitation and

medical monitoring during active fire suppression incidents.

The purpose of this research project is to gain perspective on the options for providing this

critical service to fire personnel, especially during difficult economic times. To address this issue,

descriptive research was used to answer the following questions: (a. What criteria are fire

departments using to create a firefighter rehabilitation system, (b. How do fire departments of

similar size to RRFRD provide personnel and training to deliver critical rehabilitation services to

firefighters on active fire scenes? (c. Among fire departments experiencing limited staffing

levels, what volunteer resources are utilized to provide rehabilitation services on active fire

scenes? (d. Are mutual aid resources from neighboring fire departments utilized to provide

firefighter rehabilitation and medical monitoring to fire departments which have limited staffing

levels?

A review of contemporary literature, as well as original research incorporating surveys,

interviews, and other correspondence were employed to investigate how other agencies coped

with similar staffing challenges. It was determined that the utilization of call-back personnel,

volunteer resources, and mutual aid agencies were common among fire departments needing


additional support services. Based on these findings, it is recommended that RRFRD develop a

volunteer program using the existing Citizens Emergency Response Teams Program.


Table of Contents

Abstract 3

Introduction 6

Background and Significance 7

Literature Review 14

Procedures 29

Results 31

Discussion 41

Recommendations 46

References 51

Appendices: A B C D E F G H I

Organizational chart Fire department survey list Survey questionnaire Survey cover letter Regional fire department list Regional fire department questions RRFRD survey questionnaire CERT survey questionnaire Proposed volunteer organizational chart

55 56 59 64 65 66 68 69 72


Providing Firefighter Rehab with Limited Staffing

Introduction

Fire departments with limited staffing levels are held to many of the same standards as larger

metropolitan departments. These standards, which are set by the National Fire Protection

Association (NFPA), include the ability to provide rehabilitation and medical monitoring

services to firefighters who are performing tasks associated with firefighting or other physically

demanding tasks.

The problem is the Rio Rancho Fire Rescue Department (RRFRD) has not been able to

provide sufficient trained personnel to meet the national standards for firefighters’ rehabilitation

and medical monitoring during active fire suppression incidents.

The purpose of this project is to identify the means for providing staffing and the necessary

training to deliver critical rehabilitation and medical monitoring services to firefighters who are

involved in fire incidents, in accordance with these national standards.

To address this problem facing RRFRD, research was conducted utilizing descriptive

methodology with the goal of answering the following questions: (a. What criteria are fire

departments using to create a firefighter rehabilitation system, (b. How do fire departments of

similar size to RRFRD provide personnel and training to deliver critical rehabilitation services to

firefighters on active fire scenes? (c. Among fire departments experiencing limited staffing

levels, what volunteer resources are utilized to provide rehabilitation services on active fire

scenes? (d. Are mutual aid resources utilized to provide firefighter rehabilitation and medical

monitoring to fire departments which have limited staffing levels?


Background and Significance

Fire Department History

Rio Rancho Fire Rescue Department is an all-hazards response agency which serves the

residents, visitors, and businesses of a medium-sized suburban area, located along the northwest

border of Albuquerque, New Mexico. The results of the latest U.S. Census shows that Rio

Rancho and the surrounding county has the largest percentage of population growth in the state,

making it the fastest growing city in New Mexico (Rio Rancho Observe, 2011). RRFRD is a

relatively small fire department with limited staffing. This shortage of personnel has created

challenges in providing adequate resources to meet the increasing demands of nearly 88,000

residents who reside within the city’s borders.

According to Bassi (2008), in the early 1960’s, the arid desert northwest of Albuquerque

consisted of vacant land and scrub brush. American Realty Petroleum Company (AMREP) had a

vision to create a community on 103 square miles of sandy soil. They began to market residential

lots to retirees who resided mainly on the east coast. Many of these retirees moved their families

and furniture west to take advantage of the warm southwest climate. Population growth during

the first decade of building homes was rather slow. It was not until 1981 that Rio Rancho

celebrated the 10,000th resident. However, during the early days of development, the need for a

fire department became evident and the citizens formed the Rio Rancho Estates Volunteer Fire

Department. With a donated 19-year-old fire engine and a former career firefighter at the helm,

the volunteer fire department began to serve the fire suppression and emergency medical services

(EMS) needs of the residents. The department quickly began to add to the fleet of vehicles and

more volunteers signed up to help staff the apparatus. Funding was provided through state grants

and the generous giving of the residents. Fundraisers were prevalent, including a department

ladies' auxiliary who raised donations for the department to purchase a used ambulance. Calls for


service for these volunteers grew as the population increased. In 1970 the department responded

to 62 calls and nearly a decade and a half later, the call volume had increased to over 1,000 calls

in a year.

As the calls began to burden the volunteer system, a petition began to circulate through the

community asking the city council to adopt a paid firefighter system. In September of 1984,

citing a need for increased fire and emergency medical personnel, the governing body came to

the conclusion that the city had simply outgrown the volunteer fire department. Through an

emergency ordinance the Rio Rancho Department of Public Safety (RRDPS) was created. With

this new public safety model, the design called for law enforcement officers to be cross-trained

as emergency medical technicians and firefighters. At this point, a small number of the fire

department volunteers remained in their former position and continued to answer calls for

service through a reserve program. Their positions were still unpaid. It was the hope of the city

leaders that the new department would provide an increased level of service to the citizens by

boosting law enforcement’s presence on the street while making more productive use of a

firefighter’s time, all at a reduced personnel cost. The department continued to grow slowly over

the next two decades, and the burden of being cross-trained in police and firefighter duties began

to take its toll on the personnel. A larger population and the subsequent increase in the request for

fire suppression and EMS resources led to the decision to split the police and fire into two

separate divisions, while still remaining under the administrative direction of RRDPS leadership.

Under this model minimal numbers of firefighters, usually one or two, were housed in four fire

stations across the city and were required to respond to emergency incidents and meet cross-

trained police officers who would fill the remaining positions in a fire company. However, it


became increasingly difficult for these responders to maintain critical certifications in

firefighting and EMS while performing law enforcement duties every day.

With a promise of inexpensive housing and good schools, young families flocked to Rio

Rancho and the city began to experience explosive growth. It became evident that the public

safety system would no longer be able to answer the calls generated by the residents. By 2007, it

was estimated that the population of Rio Rancho reached 80,000, making it the third largest city

in New Mexico. Change was on the horizon again for the fire department after the city

councilors determined that the public safety system that had served the citizens and the budget

for so many years was being overwhelmed. By a unanimous vote, the split of the police and fire

departments became official. In July of 2007 the city formed two new departments from RRDPS

system. Rio Rancho Police Department and Rio Rancho Fire Rescue Department were the two

separate and independent agencies under the new city charter. However, the young fire

department, which was tasked with protecting lives and property, started at a distinct

disadvantage with limited staffing levels and minimal stations. A total of 62 fire personnel staffed

the same four fire stations which had existed since 1998 (Bassi, 2008).

Current Fire Department Status

RRFRD provides fire suppression, technical rescue, and fire prevention educational and

regulatory services, and is the sole provider of EMS to the residents, visitors, and businesses in

Rio Rancho. All department rescue ambulances provide advanced life support care and are

staffed with at least one licensed paramedic. Being a single-tiered EMS system requires that

RRFRD rescue ambulances first respond to provide medical treatment and transport of the sick

and injured. With limited hospital services within the city limits, department ambulances are

often forced to transport patients to Albuquerque hospitals to receive a higher level of care. This


can take the ambulance and the personnel out of service for up to two hours. Additionally,

several of the department’s five staffed ambulances could be transporting patients at the same

time. Effectively, this potentially removes them from being an available resource in the event of

a fire, technical rescue incident, or other emergency which requires a multiple-apparatus

response.

In 2007, RRFRD had applied for a federal grant to help boost the on-duty presence of cross-

trained firefighter/EMTs through the Staffing for Adequate Fire and Emergency Grant (SAFER)

program, offered by the Federal Emergency Management Agency (FEMA). The City of Rio

Rancho was awarded the funding for 24 new firefighters, who were trained through an on-site

academy. Additionally, the city’s governing body added several more positions in the budget to

bring the department’s total personnel roster to 98. This, however, included administration, fire

prevention, and training staff. Also during this time, the department opened the city’s fifth fire

station in a new sub-division. Department leaders soon began to realize that the boost in

personnel would be sufficient in the short term only. There were a number of large commercial

projects on the city’s horizon which would only add to the work load of the fire department. A

year later, Rio Rancho, along with other municipalities across the country, began to feel the

effects of an economic slow-down. Decreasing retail tax revenue, new housing starts, and

commercial projects all began to negatively affect the city’s financial stability. Hiring freezes,

layoffs, pay-cuts, and furlough days for government workers began to be commonplace in

government. The fire department was not immune to these economic woes. Although there was

no loss of personnel positions, RRFRD leadership was forced to cut their operational budget by

nearly $600,000.


Many areas across the United States are still suffering from decreased budgets due to the poor

economic climate, high unemployment, and declining home sales. Rio Rancho is among

communities which are still feeling this pinch. Although the city’s population has continued to

grow, RRFRD has remained stagnant with only 98 personnel on their roster despite an increase

in the calls for fire suppression, rescue, and EMS. In 2011, economic stimulus grant money was

used to construct the city’s sixth fire station in a high-call-volume area. However, no additional

personnel were forecast into the department’s annual budget, leaving the staffing for the new

station a controversial subject at City Council meetings. Department leadership was faced with

the possibility of utilizing existing staffing levels, spread across a wider area and more stations.

There was fear and anxiety among fire personnel that they would face the additional burden of

more calls for service with no help from the city in the near future.

Current staffing levels at RRFRD require a minimum of 27 personnel on duty 24 hours each

day to staff the six current stations. These positions are filled by an on-duty battalion chief, six

captains, two driver/engineers, six firefighter/paramedics, and 12 firefighter/EMTs. Most fire

apparatus and rescue ambulances are staffed with a minimum of two personnel. Operational

personnel work a 48/96 hour schedule with two days on duty and four days off. Several

administrative positions are filled during normal business hours. These include a training

battalion chief, an EMS battalion chief, two administrative captains, fire prevention personnel,

the deputy chief, and the fire chief (Appendix A). At any given time, one large incident can

deplete the department’s limited resources. In a consistent approach to meet national response

standards, RRFRD attempts to utilize on duty personnel, as well as call-back administrative staff

to fill the required positions at the scene of an emergency incident. However, only critical staff

assignments, such as command, safety, accountability, operations, as well as fire suppression,


ventilation, search and rescue, and a rapid intervention crew (RIC) are filled. Often, support

roles, like firefighter rehabilitation and the light and air unit remain unfilled due to personnel

shortages.

National Standards

RRFRD, like the majority of fire departments across the United States, has protocols and

procedures in place to follow recommendations and guidelines set by the NFPA. Many of these

guidelines provide goals for the department aimed at protecting the health and safety of

firefighters involved in active emergency scenes and training classes. Other standards set goals

for response to emergencies. RRFRD attempts to meet most of the standards set by the NFPA,

although limited staffing levels often affect the department’s ability to meet or exceed standards

with consistency.

Some of the stated purposes of the NFPA 1710 Standard are to define the minimum

requirement for the management of resources, and to provide for the health and safety of fire

personnel, and to allow for efficient incident management for fire departments. According to the

NFPA (2001), the standard can be utilized to address the effectiveness of fire department

personnel when they respond to fire incidents, EMS calls, and special operations emergencies,

and to accomplish necessary tasks in a timely fashion while maintaining the occupational safety

of department employees. Additionally, 1710 sets minimum requirements of fire department

personnel to meet the necessary deployment criteria (NFPA 2001). RRFR attempts to meet the

1710 Standards on all structure fires and other incidents which may require extended scene time

operations. However, due to a limited staffing model, meeting these requirements has proven to

be a challenge on a consistent basis. NFPA’s minimum standard for a residential structure fire is

to have 14 firefighters on scene within a nine-minute response time. In order to meet this, RRFR


would have to initiate a second-alarm assignment. This, in effect, would deploy four of the city’s

six engine companies, as well as three of the city’s five rescue/ambulances for a single incident.

Hence, fulfilling additional support roles has become problematic.

NFPA has also defined standards for fire departments to provide for firefighter rehabilitation

(rehab) and medical monitoring when they are deployed to an incident that requires sustained

strenuous physical activity, often in austere conditions. According Ludwig (2009), providing for

the well-being, safety, and health of firefighters is one of the most important responsibilities that

a chief officer faces during an emergency incident. Following the NFPA 1584 Standard for the

rehabilitation of firefighters should be a priority on these scenes in an effort to decrease the

number of firefighter deaths (Ludwig, 2009). Rehab for firefighters can range from a formal

approach with a specialized vehicle, equipment and supplies, to giving firefighters a short water

break under the shade of a tree. Typically, RRFDR’s approach to rehab on an incident consists of

two cases of bottled water stored on the floorboard of the command truck driven to the scene by

the on-duty operational battalion chief.

The goal of this research project is to define creative and alternative methods for a department

with limited staffing, such as RRFRD, to provide for the critical incident task of firefighter

rehabilitation and medical monitoring without having to increase the financial burden of

additional personnel. Additionally, the project will allow the researcher to utilize the adaptive

challenge knowledge and skills acquired through the Executive Development course as part of

the National Fire Academy’s (NFA) Executive Fire Officer Program. To meet these objectives,

the five stages of innovation and creativity (Federal Emergency Management Agency, 2011, pp.

SM6-7, 6-8) were used to research the answers to the questions posed by this project. In addition,

the project addresses several safety issues which align with one of the United States Fire


Administration’s (USFA) operational objectives of reducing the number of line-of-duty deaths

and injuries suffered by firefighters by implementing the reduction of risk at the local level

through prevention and mitigation (Federal Emergency Management Agency [FEMA], n.d., p.

18).

Literature Review

It can be assumed that government administrators, fire service officers, and firefighters agree

that firefighting is inherently dangerous and involves heavy physical activity in austere

conditions. This intense exertion can lead to a negative impact on the health and safety of

firefighters involved in these scenarios. When the effects of strenuous activity are combined with

existing medical conditions, the toll on a firefighter can be dramatic and may lead to disability or

even death. To combat the physical and emotional effects of firefighting, fire department leaders

have the responsibility of providing rehabilitation services and medical monitoring for their

personnel operating on an emergency incident. Additionally, this service is defined by NFPA

standards as a recommended practice for fire departments. This task, however, can often prove to

be difficult, especially for smaller fire departments.

When developing a system to address firefighter rehabilitation and medical monitoring, as

well as providing the staffing of this program, there appears to be a significant number of

considerations that fire departments must take into account. During a review of contemporary

literature and research on this subject, it was discovered that numerous fire departments from

across the United States have encountered many challenges to providing for firefighter

rehabilitation and other support services to personnel on an emergency scene. Limited staffing,

budget cuts, and shrinking volunteer resources are common barriers facing departments


attempting to provide adequate support services. This inability to provide for firefighter

rehabilitation, medical monitoring, and other support services can lead to decreased levels of

firefighter safety, and has contributed to an increase in the line-of-duty deaths of firefighters

during active incidents.

When a firefighter dies in the line of duty, the U.S. government investigates the cause of the

fatality and will make recommendations to fire services across the nation on how to prevent

future incidents. The USFA (2006) has tracked and monitored firefighter fatalities in an effort to

find solutions to reduce the number of deaths. In addition, the data collected on these incidents

help to establish the effectiveness of health and safety programs aimed at keeping firefighters

safe. Ultimately, the goal is to reduce the number of fire ground deaths by 50% in the next ten

years. During the evaluation of firefighter deaths, incidents involving accidental or intentional

injury, as well as any occupational related fatal illnesses, were considered for inclusion (U.S. Fire

Administration [USFA], 2006, pp. 1-4). Many of these reports have several common themes; the

investigators often name physical stress combined with lack of health/fitness as contributing

factors to these deaths, and the addition of an incident rehabilitation program as a

recommendation for future management during an emergency incident. In July of 2006, a 43-

year-old male firefighter responded to a fire and provided various physically demanding tasks on

scene. It was a warm evening with high humidity and the firefighter, along with several others,

was treated for heat stress on scene. He was later found unconscious and without a pulse at his

home. Efforts to revive him were unsuccessful. Contributing factors to his death were reported as

heat and physical stress, which triggered a heart attack. Institution of an on-scene rehabilitation

program during structure fires was the top recommendation of the investigating agency

(Baldwin, 2007). In November of 2005, a similar incident claimed the life of another 43-year-old


male who had performed exterior firefighting tasks at the scene of a residential structure fire.

During an on-scene debriefing of the incident, the firefighter walked to the fire engine and

collapsed. He was transported to the hospital, but later died. The National Institute for

Occupational Safety and Health (NIOSH) report concluded that the physical exertion associated

with firefighting contributed to his cardiac arrest. The addition of an on-scene rehabilitation

program was among the six recommendations of the NIOSH investigator (Baldwin, 2006).

During a training exercise, a 50-year-old male firefighter was assisting a recruit class during live

fire burn training evolutions. He began to feel ill, sat down to rest, and was found collapsed and

unconscious a few minutes later. He did not survive after efforts to revive him were unsuccessful.

Stressful environmental conditions and the high levels of physical activities triggered his heart

attack. Among the NIOSH recommendations was to create a wellness and fitness program for all

firefighters involved in these intense physical activities (Baldwin & Hales, 2009). In another

training incident, a 42-year-old female firefighter collapsed and was found not breathing during a

physically demanding training exercise. She was pronounced dead after arrival at the hospital.

Physical exertion which triggered her cardiac condition was the finding of the NIOSH

investigator. Incorporating medical monitoring into a rehab program was the second listed

recommendation from the report (Baldwin, Miles, & Hales, 2009).

Despite the findings and recommendations of the investigators of firefighter deaths, fire

departments across the United States are still experiencing about 100 deaths on the fire ground

annually. According to Schaeffer (2011), firefighter work cycles, the limited air supply that

firefighters’ carry on their back, dehydration, and fatigue are large contributors to firefighter

injuries and deaths during fire suppression activities. The latter two factors have been shown to

increase as the incident progresses, especially during the overhaul phase of the incident


(Schaeffer, 2011). During the overhaul phase, which involves firefighters searching for fire

extension and continued burning in concealed spaces, they are often exposed to dangerous gases

and other products of combustion.

Firefighter rehabilitation, referred to commonly as rehab, is described by Bledsoe (2009) as:

The means to restore to a condition of good health, to restore the ability to work, or the

like. In the fire service, rehabilitation is an intervention designed to mitigate the effects of

physical, psychological, and emotional stress of firefighting in order to sustain a

member’s ability to work, improve performance, and decrease the likelihood of an on-

scene injury or death. (Bledsoe, 2009, p. 3)

According to Dobesh (2011), rehab has also been simply defined as firefighters taking care of

firefighters in an effort to send them home as healthy as they were when they arrived. However,

rehab is necessary for this to occur with any consistency. Some departments have an elaborate

rehab protocol, while others have nothing (Dobesh, 2011). McEvoy describes firefighter rehab as

containing nine key components: Relief from climatic conditions, rest and recovery, cooling or

re-warming, re-hydration, calorie and electrolyte replacement, medical monitoring, medical care

according to local EMS protocols, member accountability, and release from rehab (McEvoy,

n.d.). The USFA further defines the need for firefighter rehab to include extended operations at

the scene of a structure fire, as well as providing for the health and safety of wild-land

firefighters, which also involves arduous physical labor. No matter the incident, the USFA

recommends that firefighters have a process in place to receive rehab services when they have

become injured, exhausted, exposed to extreme climate conditions, or are in need of fluid or food

replenishment (Federal Emergency Management Agency [FEMA], 2009, p. SM 5-32).


Verfuss (2004) wrote that fire departments across the U.S. are giving firefighters all of the

tools necessary to perform their job in the safest possible environment. This includes health and

wellness programs to assist them combating he physical stressors experienced on the fire ground.

However, he contends that the fire service has failed to recognize the importance of providing

on-scene incident rehab for firefighters, leading to increased incidents involving on-duty injuries

and deaths. Cardiac-related incidents account for nearly half of these deaths. “It is not burns or

falls or collapse that is killing responders, it is a combination of heat and cardiac stress” (Verfuss,

2004, p. 43).

In August of 2011, the volunteer firefighters from River Oaks (TX) Fire Department were

dispatched to nearby Parker County to help with a grass fire which was uncontrolled due to

extreme weather conditions. Texas had been experiencing an unprecedented drought and on that

day, temperatures reached 112 degrees with humidity levels of under 10%. Volunteer firefighter

David Bearce (personal communications, December 8, 2011) was among the responders who

were given the task of breaking down bales of hay which were burning in the field. After 20

minutes of work, his crew reported to rehab, which consisted of bottled water for rehydration and

wet towels placed around their necks. After another 20 minute work cycle, he again reported to

rehab and had his vital signs monitored. His heart rate was elevated and he began to feel

lightheaded. He had also stopped sweating. He was later transported to the hospital and after

receiving intravenous fluids was told by the physician attending to him that he was on the verge

of heat stroke, which is potentially life threatening. In retrospect of his experience, he felt that

the lack of a more formal rehab procedure in his department, lack of adequate fluid replacement,

the absence of medical monitoring, along with improper personal protective equipment,

contributed to his medical issue.


Firefighter rehab has been shown to improve the health and safety of firefighters who are

involved in physically demanding emergency scene tasks, or when the incident occurs during

extreme weather conditions. Although the NFPA has set a standard for fire departments to follow

in an effort to create a more consistent approach to rehab, many departments are providing this

critical task through a minimalist approach. Or, the use of rehab has not been deployed on a

regular basis and firefighters and incident commanders have been reluctant to realize the benefits

of rehab during emergency responses. According to Evans (2008), the Norfolk Fire Department’s

(NFD) use of rehab was chaotic and unplanned. Providing this service was inconsistently applied

and sometimes even forgotten. Additionally, firefighters in Norfolk did not accept the process of

rehab, possibly due to cultural reasons. NFD firefighters even stated that they perceived rehab as

being only for the weak, with some going as far as creating stickers that read ‘rehab is for

quitters.’ Staff officers who filled the role of incident commander often stated that the reason

they did not create a rehab sector was the lack of personnel to fill the positions necessary to

provide rehab services. NFD has a department trailer that is specifically designed and equipped

to provide rehab on scenes, however, it is not utilized often for its intended purpose (Evans,

2008, pp. 6-7).

Bledsoe (2009) wrote that there are several steps to creating rehab services on the scene of a

fire incident. Firstly the incident commander must recognize the need for rehab and establish a

rehab sector. The decision must be based on the incident type, weather, working conditions, or

established guidelines. Next, those staffing the rehab sector must know what is expected of them

and these tasks must be clearly defined by protocols. He notes that this is especially important

when non-fire department personnel are providing the rehab services. There must also be a

system of accountability of the firefighters who are entering and exiting the rehab sector. Safety


of firefighters should be the main focus of the rehab sector. In other words, the personnel who

are providing staffing for rehab must assure that firefighters are being properly cared for and are

rested and ready to return to duty prior to being released from the rehab sector (Bledsoe, 2009,

pp. 3-4). After rehab has been established at an emergency scene, it then becomes a priority of

the incident command staff to determine how and when a firefighter must cease performing

operational tasks and report to the rehab sector to rest and rejuvenate. According to Schaeffer

(2011), firefighters who are involved in strenuous scene situations must share the heavy

workload through the rotation of personnel through the various work tasks and through the rehab

sector. The use of personal protective equipment (PPE) and the wearing of self-contained

breathing apparatus (SCBA) can take a heavy toll on the firefighter through additional

cardiovascular stress and increased body temperatures. This creates significant risks on the health

and safety of fire personnel which rehab can address. It then becomes necessary to provide this

critical period of rest and recovery. He contends that most fire departments adhere to the two-

bottle-rule, which requires a firefighter receive some form of rehab after having exhausted the

compressed breathing air available in the SCBA cylinders. It would be at the change-out of the

second bottle/cylinder that the firefighter should be required to rest for at least 10-minutes and

have a quick mental awareness check and ask if they are prepared to re-enter the scene.

Additionally, they should receive rehydration fluids and food if necessary (Schaeffer, 2011, pp.

42-44).

With the release and update of the NFPA 1584 Standard in 2008, many fire department

leaders became acutely aware of the importance of and the need to provide rehab and medical

monitoring for their personnel involved in active incidents. The question that many had was how

to accomplish this goal. The resources involved in providing this service to fire personnel can


include a vehicle, personnel, equipment, and supplies. Depending on the size of the incident and

the number of firefighters involved in the active scene tasks, Bledsoe (2009) states that some

departments opt for having an apparatus dedicated to this purpose. The personnel necessary to

provide staffing for any rehab services may require department administration to pre-plan for

their resource needs. This may include the use of personnel from the Salvation Army, the

American Red Cross, or even a fire department auxiliary. He warns, however, that agreements

must be in place for the type of food and hydration fluids that these agencies provide as

“doughnuts and coffee are not appropriate for rehab,” (Bledsoe, 2009, p. 12). Evans (2008) wrote

that 70% of the departments he queried acknowledged that they participated in some form of

rehab for firefighters. Of those, there were only 20% were completely compliant with the NFPA

Standard. Slightly more than 10% of these departments did not have any formal rehab program

in place. Within the departments which were actively providing rehab, most utilized personnel

and apparatus from the local ambulance provider, while 40% of the departments had a dedicated

rehab vehicle to transport personnel and supplies to the scene (Evans, 2008, pp. 19-20). In

another survey of fire departments and their approach to firefighter rehab, Irr (2008) discovered

that 56% of the departments involved in his research stated that they had a dedicated rehab

apparatus, while 31% utilized an available on-scene department apparatus to provide the rehab

services; fewer still relied on private ambulance providers to staff the rehab sector (Irr, 2008, p.

17).

Schaeffer (2011) suggests that rehab may be approached through a two-tier system. “In a

quick residential fire, rehab may only consist of hydration and removing PPE for active cooling.

A more complex fatality fire, however, may necessitate additional support teams, including

mental health professionals,” (Schaeffer, 2011, p. 47). The contention by fire department leaders


tends to lean towards the necessity of providing their personnel with these rehab services,

especially since it has been shown as a contributing factor in maintaining the health and safety of

firefighters during the active phase of emergency operations.

However, one of the questions that remains unanswered by many departments across the

United States is how to find dedicated personnel resources to provide this critical service. Many

fire departments, when responding to a reported fire, are utilizing their on-duty personnel to fill

roles necessary to meet the demands of NFPA 1710. The NFPA standard defines response time

criteria, and also creates a template for assigning firefighters to tasks associated with providing

fire suppression, search and rescue, incident command, and other fire-ground priorities (NFPA,

2001, pp. 7-8). However, for smaller, minimally-staffed departments, meeting these criteria for

firefighting operations can tax their personnel, leaving no unassigned firefighters to perform

support services such as rehab and medical monitoring. The challenge then becomes how to staff

for these fire-ground support functions, when sufficient resources are unavailable. Even

considering a minimalist approach of providing just rehydration fluids and a cooling station

would require an employee to staff it. Tight budgets, reduced personnel, and increased calls for

service have been facing fire department leaders for the past several years. Requests for

additional personnel are likely to address staffing levels on apparatus or boost manning level in

the firehouse, leaving ancillary functions unmanned. Even though rehab may be considered a

critical fire-ground task, it has taken a back seat to the more pressing needs of daily department

operations.

The sluggish economy in the United States has created difficult times for fire departments

across the nation. Governing bodies are looking at fire department budgets with closer scrutiny

and fire chiefs are being asked to justify their staffing levels. An unfortunate result of the


economic downturn is that many low-income residents are increasingly relying on fire

departments to provide them with basic medical care due to a loss of adequate primary

healthcare. This places an additional burden on an already taxed system (Lewis, 2010). Hrustich

(2009) stated that the Endicott Fire Department has lost one-third of its uniformed personnel due

to the city’s financial shortfalls. The loss of firefighters to answer calls for service has placed the

residents in that city at an increased risk of losing their property to fire and has potentially placed

firefighters in danger of injury. Additionally, there is no agreement between the city and the labor

union to provide the citizens with minimum staffing levels of firefighters to respond to fires and

medical emergencies. Monetary limitations imposed by the city have disallowed the use of

overtime to staff apparatus and stations. Unfortunately, staffing cuts, budget restraints, and

negotiated union contracts have created a large variance in the staffing of fire departments,

despite the recommendations of NFPA 1710 (Hrustich, 2009). In 2004, the International

Association of Fire Chiefs (IAFC) conducted a survey of over 7,000 members, asking them to

identify the problems facing their departments. Overwhelmingly, the majority of respondents

stated that budget cuts and staffing issues were creating significant challenges in their

departments. Many of those who responded to the survey stated that they had experienced

layoffs, compounded by the increase in calls for service and growth of their communities (IAFC,

2004). The current economic climate across the U.S. has forced many fire departments to look at

creative solutions in an effort to provide for the increasing needs of their customers. These

resources are also being utilized to help fulfill roles that benefit firefighters’ health and safety

through rehab.

The NFPA 1710 Standard defines automatic aid as identifying personnel and equipment

resources which are predetermined to be deployed to a neighboring community when an


emergency incident is reported and dispatched simultaneously to each agency. A further

definition of mutual aid states that the personnel and equipment would respond to the emergency

in a neighboring community based solely on a formal request funneled through the dispatch

center (NFPA, 2001, p. 13). To meet the demands of providing for emergency response under

limited resources, Lewis (2010) stated that almost all fire department jurisdictions rely on mutual

aid resources from surrounding departments, even if it occurs only on a limited basis. However,

some departments use mutual aid assistance on routine calls and to provide for support services.

“Staffing can be problematic,” and emergency response agencies cannot provide adequate

staffing levels to meet the potential surge of emergency calls that face departments daily (Cahill,

2011, p. 16). With shrinking staffing levels to meet this surge capacity, fire chiefs are

increasingly relying on these creative sources, such as mutual aid, to provide for personnel to

perform the demands of emergency response and to provide for the safety of their personnel.

Larger fire departments usually have greater depth in which to absorb the impacts of personnel

reductions, but smaller agencies tend to feel the effects of tight financial restraints and are more

likely to resort to finding alternative methods to maintain services. Verfuss (2004) writes that

large metropolitan fire departments, such as Phoenix, Arizona, provide rehab to firefighters

during extended incidents by utilizing paramedics rescue trucks and fire personnel assigned to a

dedicated department rehab apparatus which was designed specifically for that purpose.

Conversely, smaller, rural fire departments may not have sufficient personnel for support

services, so they rely on mutual aid compacts with neighboring communities to provide rehab

services by using volunteers to staff a shared apparatus. Departments within Yates County (NY)

have even offered the use of their personnel and rehab trailer to the county sheriff’s department

when they have an extended operation (Verfuss, 2004, p. 46).


Adequate staffing at the scene of a structure fire allows department leaders to utilize proven

tactics aimed at mitigation of the emergency. It has been shown that these tactics increase the

likelihood of firefighter safety and survival. In an analysis of on-duty firefighter deaths, Parker

(2010) found that 43% of these incidents showed that lack of adequate staffing was considered a

factor in the poor outcome and that there were not enough firefighters to accomplish the

necessary tasks. The lack of properly trained personnel often forces fire departments to overly

depend on mutual aid resources (Parker, 2010). Although effective fire suppression, life safety,

and property conservation are among the priorities of any firefighter, fire departments are also

faced with a legal obligation to provide sufficient staffing levels to accomplish these tasks while

maintaining safety for their personnel. “It is the responsibility of the locality or fire department to

ensure staffing at safe levels. This can be accomplished through minimum staffing of apparatus,

having extra apparatus respond, requesting mutual aid, or requesting aid from bystanders for

exterior activities away from fire hazards.” Additionally, there is a certain amount of liability that

a department assumes if it can be proven that lack of staffing contributed to the occurrence of an

accident (Reeves, 2006, p. 106). Although, asking a bystander to help with fire-ground

operations may be an unnecessary risk, fire departments have considered the use of volunteer

resources and internship programs to help them augment their firefighters’ efforts.

When faced with a personnel shortage that affects the efficiency of firefighters working at the

scene of an emergency incident, fire department leaders may have to look for resources beyond

the neighboring fire agencies to help with these tasks. This may involve employing volunteers to

the response protocol to augment career firefighters’ efforts. With the prospect of having

volunteers arriving on a fire incident, safety, training, and reliability are concerns that are

immediately brought forth. However, there are many volunteer personnel across the United


States that assist career fire departments through a combination system that can be an effective

method of creating additional manning with little or no increase in funding. It then becomes the

responsibility of the sponsoring agency to provide the training and oversight for these personnel

in order to create a useful resource that contributes to the safety of the incident, rather than cause

concern for injuries or accidents. Scott and Windisch (2006), contend that although training and

qualifications of volunteer resources can be a concern, the management of the relationship

between career staff and volunteers can be a difficult task for department leadership (Scott &

Windisch, 2006). Additionally, it could prove to be a difficult to recruit volunteer resources to

fulfill these critical task roles. With the current economic climate in the U.S., many families are

struggling to pay their bills and keep their children clothed and fed. This can create situations in

which the principal money earner in the home may have to hold down several jobs in an effort to

earn wages sufficient to provide for the family’s needs. As a volunteer for a fire department,

Simpson (1996) states that members must have the ability to leave work or home to answer an

alarm that is received by the department. In rural areas, volunteerism in the local volunteer fire

department has become a tradition for many families and it is somewhat expected to be active in

the community. However, middle class suburban neighborhoods may find the availability of

volunteers to be scarce (Simpson, 1996).

The Community Emergency Response Team (CERT) is a national program aimed at training

residents in the basic tasks of taking care of themselves and their neighbors in times of a natural

or man-made disaster. According to the CERT website, the training program is delivered in two-

to three-hour blocks over a seven-week period, and involves teaching disaster preparedness,

basic fire suppression, first aid medical care, light search and rescue operations, and team

organization and management. One of the tenets of the CERT program is “people helping


people,” and aims at training citizen responders to help make a positive impact during the initial

phase of a disaster, when local first responders are likely busy. Additionally, CERT recommends

that these trained citizens can partner with their local response agencies to take an active role in

disaster preparedness and emergency response (Citizens Emergency Response Teams, n.d.).

Dean (2003) wrote that any fire department can experience a natural or man-made disaster which

can deplete their resources. During these times, it may become necessary to consider the use of

volunteer resources, such as a CERT program. He contends that people have an inherent desire to

help out when their community is in need during an emergency incident, and this desire to help

out can provide a benefit to fire departments (Dean, 2003). However, this volunteer assistance

does not necessarily require a disaster to become useful for the fire department, as there are more

routine incidents in which CERT resources can be beneficial. The Los Angeles City Fire

Department utilizes CERT volunteers to help them provide necessary emergency response on a

regular basis. The Los Angeles program follows the national CERT program of presenting the

training curriculum in a seven-week format to their students. They teach classes throughout the

year and allow graduates of their program to sign up for call-out team status. This program

allows those who pre-register through the fire department to be notified of official requests for

assistance from CERT responders. In order to qualify for this program, the CERT graduate must

be pre-qualified, be a sworn in as a disaster service worker, attend regular training sessions, and

follow the fire department’s CERT Code of Conduct. Members of the call out team are strictly

prohibited from self-dispatching, and agree to stay only within their scope of training. The Code

of Conduct also states that members of the CERT response are not firefighters and are not to

present themselves as such. There are also rules that regulate members' conduct and

professionalism while deployed to an emergency (CERT Los Angeles, n.d.). In addition to CERT,


there are other national volunteer programs available for consideration as a fire department

resource, including U.S. Fire Corps. Departments with minimal staffing have also considered

creating an internship program through the fire department that may also provide additional

resources for fire ground operations and support services.

College students can be considered a valuable resource for smaller fire departments as they

can be integrated into the emergency response model in a way that they can become

indistinguishable from regular response personnel. Successful internship programs have been

developed in Davis, California, and Fairbanks, Alaska. By providing free dorm housing and

firefighter training, these programs have been shown to reduce the need for paid staff by

supplementing the department’s resources. Additional benefits include the students' ability to

gain valuable experience working with trained fire personnel, while providing motivated

responders who can provide emergency response at a greatly reduced cost (Bliss, 2010). This can

also help students with the overall cost of education by reducing their housing costs during the

school terms. However, a drawback to consider is that during semester breaks, students will be

unable to provide a response service to the department and lose valuable training time when they

return to their homes while school is not in session (Hrustich, 2009).

It has been shown through research and common fire department practice that firefighter

rehab and medical monitoring of personnel who are working at the scene of an emergency is a

valuable tool to help prevent fire ground injuries and deaths. The reduction in physical and

emotional stress has been a proven factor in the overall health and safety of firefighters. As many

fire departments are facing difficult economic times and staff shortages, many fire chiefs and city

administrators are looking at the valuable alternatives of mutual aid compacts, volunteerism, and

even college internship programs to help augment their systems.


Procedures

This project was specifically targeted at addressing how to provide staffing for a sustained

and consistent firefighter rehab program for RRFRD without affecting the minimal staffing

profile of fire incidents and other emergencies. In an effort to answer the research questions

posed in this project, literature that addressed fire department staffing issues, especially for

departments which had a similar staffing profile to RRFRD, was searched out. In addition,

literature on the use of volunteer resources to augment staffing for fire departments and how the

fire service viewed the importance of firefighter rehabilitation and medical monitoring was

sought. The search for this literature began at the National Fire Academy by utilizing the

Learning Resource Center’s (LRC) electronic card catalog system. A continuation of the

literature search was accomplished through the use of standard and academic search engines

through the Internet, which also included additional use of the LRC’s system.

Original research was also conducted to answer specific questions on how other fire

departments of similar size to RRFRD addressed creative approaches to staffing challenges in

their departments. The first step in this process was to identify fire departments across the United

States which fit a staffing and size profile similar to RRFRD. A copy of Firehouse Magazine,

which contained their National Run Survey and Fire Department Profiles, was used ("Fire

Department Profiles," 2011). Although this published survey is not encompassing of every fire

department across the country, it represented a cross-section of the American fire services. Since

RRFRD employs 98 firefighters and serves a population of 88,000 residents, fire departments

listed in the survey which either served a population base of between 50,000 and 150,000, or had

a staffing profile of between 50 and 150 career firefighters, or both were chosen. This list


consisted of 50 fire departments (Appendix B). An online survey service titled Survey Monkey

(www.surveymonkey.com) was used for this project. A survey was created to address 10 targeted

questions concerning their department’s use and staffing of firefighter rehab during fires and

other significant incidents (Appendix C). An Internet link to this survey was sent via email to the

fire chief or other representative of each fire department with an email message requesting their

participation in the survey (Appendix D).

In order to further narrow down specific fire department procedures, an Internet directory of

fire departments located in proximity to the City of Rio Rancho, NM, which included southern

Colorado, and Arizona through firefighting news’ website was used (www.firefighting

news.com/fdDirectory). This was done in an effort to identify departments of similar size to

RRFRD, which tend have similar climate, social makeup, and fire department culture. Two fire

departments were identified in southern Colorado, and seven were located in Arizona (Appendix

E). These departments all fit the same population and staffing profile listed above. Several

members of the fire department leadership from these departments were contacted either through

personal email, by telephone, or through face-to-face interviews. A similar set of questions were

utilized for each contact in an effort to obtain consistent data on their use of firefighter rehab and

how they accomplish staffing to provide this service for their personnel (Appendix F).

Survey Monkey was used to create two additional surveys to gather data for this project. A 10

question survey (Appendix G) was sent to the 98 career firefighters from RRFRD through the

city’s email system. Since the recommendations of this project may be implemented by the

department’s administration, it was determined to solicit their opinions on which resources they

would prefer to have providing rehab on an emergency scene. Additionally, RRFRD has a very

aggressive CERT program, and after contacting the program coordinator, another survey was


sent to former students through their leadership (Appendix H) via an email to every member on

their contact list. This was done to accumulate data on CERT members' ability and willingness to

complete additional training and be involved in a call-out program in the future.

Lastly, the brother of this researcher was contacted through several telephone calls and

through email communications to obtain a first-person account of how the lack of firefighter

rehab and medical monitoring can create an emergent medical condition and endanger the lives

of firefighters. David Bearce is a volunteer firefighter with the River Oaks Fire Department in

the Fort Worth metropolitan area, and he was transported to the hospital after suffering from heat

exhaustion during the efforts to fight a field fire in the summer of 2011. It is believed that his

account would provide beneficial information by showing the need for fire departments to

consider finding resources to staff for firefighter rehab services.

Results

Recognizing the need for firefighter rehab and medical monitoring is an important step to

developing a program with the operational guidelines of a fire department. In Yuma, Arizona, the

fire department has taken a very proactive approach to providing rehab to firefighters on

emergency incidents. According to Battalion Chief Stephen Irr (personal communication,

November 25, 2011), the Fire Chief has taken the process of rehab very seriously due to the

climate extremes that Yuma experiences during the summer months. As part of their response

protocol and standard operating guidelines (SOG), Yuma Fire Department (YFD) assigns the

second-due engine company to the task of the initial fire attack crew. This allows the first

arriving engine company to set all of the processes in place prior to the arrival of the second

company. After the attack crew has consumed all of the air in their SCBA tanks, they

immediately report to rehab, then they are released from the scene. This process prevents


firefighters from reentering fire ground operations after experiencing heat and physical exertion

during their fire attack. YFD leadership has also realized the importance of firefighter fitness as

it relates to their abilities to work more efficiently and safely on emergency incidents. As noted

in their department procedures, Flagstaff Fire Department in Arizona also recognized the need

for providing rehab to their personnel when dispatched to an incident. According to Battalion

Chief Pat Staskey (personal communications, December 17, 2011), their process for establishing

firefighter rehab starts through training individual firefighters on their familiarity with the signs

and symptoms of heat and cold stress. Additionally, the incident commander has the ability to

designate incident rehabilitation when an emergency scene is likely to last longer than 30-

minutes. In Flagstaff, as in Yuma, the first crew to be actively involved in mitigating the

emergency is the first crew to report to rehab.

Of the 50 fire department administration personnel sent the firefighter rehab survey through

SurveyMonkey.com, 29 responded with answers to the 10 questions posed about their

department’s use and staffing of rehabilitation and medical monitoring services for their

personnel. This accounts for a 58% participation in the research for this project. When asked if

their department currently has a formal program for providing firefighters with rehab, 28

(96.6%) indicated that they did have one. One respondent (3.4%) stated that they did not

currently have a program, but would like to start one. When asked about the reason and need for

firefighter rehab and medical monitoring, the overwhelming majority indicated that they felt that

it was critical to firefighter safety. With 18 respondents (62.1%) agreeing with this concept, nine

(31%) stated that they felt it was very important. Only one felt it was important, and one stated it

was only somewhat important (see Figure A).


After a fire department has decided that an incident rehab program could provide benefit to

their personnel, they must then create a protocol as to when informal or formal rehab is

established on emergency scenes. When asked which incidents they feel would require the need

for firefighter rehab and medical monitoring, 100% of the respondents indicated that a fire

suppression scene would be an appropriate incident for requiring rehab. Those completing the

survey were given the opportunity to choose multiple responses when indicating which incidents

which would require rehab. Among the incidents (see Figure B) which the respondents indicated

the need for rehab were ranked as follows: fire suppression, 100%; hazardous materials response,

90%; technical rescue, 76%; fire department training, 62%; wild land fire, 57%; multiple

casualty incident, 55%; vehicle extrication, 14%; and public education event, 14%.


Response to the scenes described in the table above may or may not require the need for

firefighter rehab; often the decision is based on the extent of the incident operation and possibly

weather conditions which personnel are exposed to during the emergency. Another variable to

providing rehab services is the level in which they are provided to firefighters during their work

cycles. Some departments have opted for a two-tiered approach in which smaller incidents would

only require informal rehab, where larger, more complicated scenes would indicate a need for

more formal rehab that would require additional personnel. The Green Valley Fire District (AZ)

assigns rehab to the first arriving paramedic ambulance companies which arrive at the scene of a

fire. According to the Green Valley Fire District’s Operations Chief, Chuck Wunder (personal

communications, December 14, 2011), their rehab protocol provides rest and recovery at the

scene of a fire; however, personnel are allowed to reenter active operations after having their

vital signs checked and they are cleared to resume fire ground tasks. Chief Wunder indicated that

their procedures do not completely follow the NFPA standards and therefore, he feels that their

process is more informal. Battalion Chief Stephen Irr (personal communications, November 25,

2011) from the Yuma Fire Department stated that YFD utilizes the two-tiered system in which

the process at smaller incidents utilizes equipment and supplies carried by the on-duty battalion

chief in his/her response truck. The process allows for firefighters to rehydrate, rest, and have the

opportunity to sit and cool down during breaks in their work cycle. Irr added that on more

complicated incidents, a more formal approach is used. When a higher level of rehab is required,

additional department personnel are called back to duty to assist with these services. Usually, one

of the off-duty battalion chiefs will respond to the scene with a department trailer which is

equipped with enough rehab supplies to provide for extended scene times and numerous

personnel. This system requires the need for extra staffing, which could tax available resources.


At YFD, the utilization of call back fire personnel and assistance from their mutual aid partners

help to provide for these resources.

The survey was sent to fire department leadership which represented departments which had a

similar staffing model and size of RRFRD. When asked to qualify their staffing levels, 18 (62%)

indicated that they had limited staffing, but are able to provide all aspects involved in active fire

suppression. Nine (31%) stated that their staffing only covered tasks considered critical, while

two (7%) felt that their staffing levels did not allow them the ability to complete all tasks

necessary. The respondents were then asked to describe their ability to provide staffing for

firefighter rehab; the majority of 12 departments (41.4%) indicated that they utilize whatever

resources are available at the time they need rehab. Another nine (31%) indicated that they have

adequate personnel to provide for rehab, three (10%) stated that they are unable to utilize on-duty

personnel due to their limited staffing, three (10%) said that they would not use on-duty

personnel due to the lack of a program. One respondent (3.5%) felt that the use of on-duty

personnel to staff for the rehab function was done so at the expense of other critical on-scene

tasks. One person (3.5%) skipped the question.

Of the departments that participated in the online survey, 11 (38%) stated that they utilize a

local EMS agency to provide their on-scene rehab services to firefighters, while ten (35%) have

the ability to use on-duty fire department personnel to provide rehab to their own department

members. Four departments (13.8%) rely on volunteer resources, and another three (10.4%) have

mutual aid resources assist them with the rehab task. Only one (3.5%) stated that the department

does not have a formal policy on who will fill this role. Five departments (17.2%) answered

‘other’ when asked how staffing of the rehab sector was accomplished. When asked to explain

their answers, one stated that a regional Explorer program is used, which involves the use of


scout-aged teens who volunteer to learn about fire and police departments while providing

support services at times. Others indicated that they use a combination of resources, including

staff officers, EMS resources combined with fire personnel, and a rehab-specific volunteer

agency (see Figure C).

In addition to providing the resources to staff for rehab services to firefighters, department

leaders must also consider the ability to train those personnel in an effort to meet the NFPA 1584

Standard for firefighter rehab. Battalion Chief Staskey from Flagstaff (AZ) Fire Department

(personal communications, December 17, 2011), stated that all members of the department are

trained to the Emergency Medical Technician (EMT) standard at minimum and everyone must

formally review the standard operating procedure (SOP) as established by the department. A

more formal approach to training is accomplished in partnership with the local EMS provider on

the rehab process. This is due to the reliance of the private ambulance company’s ability to

provide rehab services. Green Valley Fire District (AZ) also uses a formal training session when

it comes to preparing volunteers to become a rehab provider. Operations Chief Wunder (personal

communications, December 14, 2011) stated that they rely on on-the-job-training to train their

own personnel. When surveyed on their standards for training staff members, other agency


personnel, or volunteers, the majority of the departments (25, or 86.2%) indicated that they use

in-house training sessions or rely on departmental EMS training to deliver rehab curriculum.

Three departments (10.4%) stated that their training met the NFPA 1584 Standard in their

training, and one department (3.4%) said that they do not provide any formal training. When

prompted to provide additional information regarding their training, one respondent said that all

of their staff officers have attended the NFA Safety Officer class, and one indicated that their

training must comply with state regulations. The amount of time spent in rehab training was

asked through the survey process and 13 (44.8%) of the 29 respondents stated that their initial

rehab training lasted between one to five hours. Three (10.4%) departments’ training lasted up to

10 hours. One (3.4%) had training which was 11-24 hours long, and another (3.4%) lasted up to

36 hours in length. Eleven of those surveyed (38%) stated that the question was not applicable.

An equal number of surveyed departments (13 or 44.8%), each indicated that they required

annual refreshers, or did not retrain their personnel after the initial curriculum delivery. Two

respondents (7%) stated that their crews receive re-training every two years, and one (3.4%)

skipped the question.

Twenty two of the 29 departments surveyed (75.9%) indicated that they would utilize

volunteer resources if their on-duty personnel were inadequate for providing firefighter rehab to

their crews. When asked which agencies they would consider, even if they had the ability to

choose multiple agencies, seven respondents (31.8%) indicated they would use CERT volunteers,

while five (22.7%) prefer the Red Cross, and three (13.6) would consider the Salvation Army as

a resource. An additional three (13.6%) would rather ask a fire department auxiliary and one

(4.5%) indicated that U.S. Fire Corps would be their preference. Other responses of volunteer

resources included; the Fire Explorers program, Medical Reserves Corps group, and two


unnamed volunteer groups who provide rehab services. Of the departments surveyed, ten

(34.5%) stated that they do not use volunteer resources by choosing ‘not applicable,’ and seven

(24.1%) skipped the question. Among career fire departments, introducing volunteer resources

into their response model can be a challenge, and some firefighters are reluctant to accept

volunteers on their emergency scenes. Battalion Chief Irr (personal communications, November,

25, 2011), said that their experience with utilizing CERT volunteers for support tasks was not

very successful. He added that these resources were difficult to control and had very little

direction when it came to accomplishing focused tasks needed by fire department leadership.

Chief Wunder (personal communications, December 14, 2011) said that his department utilizes a

volunteer group to perform a multitude of non-emergency functions, which would include rehab

if needed. However, the volunteers are scheduled for duty during business hours only and are not

for on-call services.

Fire personnel from RRFRD received an email survey asking them which resource they

would prefer to respond to emergency incidents to provide them with rehab services and medical

monitoring of firefighters. Thirty members (31%) responded to the online questionnaire which

asked them to rate each agency from being ‘highly recommended,’ to ‘do not use this resource.’

They were also given the option to state that they did not know enough about a certain agency.

Among the available resources who may provide rehab at emergency scenes, RRFR personnel

overwhelmingly indicated that they would prefer call-back firefighters. Twenty-two (75.9%)

stated that this option would be ‘highly recommended.’ Fifteen (55.6%) indicated that the least

likely agency they would use is asking another city agency, such as parks and recreation. All of

the RRFR responses can be viewed below (see Table A).


Table A

RRFD firefighters’ choice for utilizing outside resources to provide for firefighter rehab

Resource Highly recommended

Recommended with

reservations

If nobody else

available

Do not use this

resource

Don’t know enough

C.E.R.T 6 (20.7%) 6 (20.7%) 9 (31%) 7 (24.1%) 1 (3.4%)

Fire Corps 2 (7.4%) 2 (7.4%) 5 (18.5%) 4 (14.8%) 14 (51.9%)

Red Cross 7 (25.9%) 9 (33.3%) 6 (22.2%) 3 (11.1%) 2 (7.4%)

Mutual aid 7 (24.1%) 14 (48.3%) 5 (17.2%) 3 (10.3%) 0 (0%)

Private ambulance

2 (7.4%) 9 (33.3%) 11 (40.7%) 5 (18.5%) 0 (0%)

RRFRD volunteers

4 (14.8%) 7 (25.9%) 4 (14.8%) 10 (37%) 2 (7.4%)

College intern 1 (3.7%) 8 (29.6%) 8 (29.6%) 7 (25.9%) 3 (11.1%)

Private contractor

0 (0%) 6 (22.2%) 5 (18.5%) 12 (44.4%) 4 (14.8%)

Call back RRFRD

firefighter

22 (75.9%) 5 (17.2%) 0 (0%) 1 (3.4%) 1 (3.4%)

Other city department

0 (0%) 0 (0%) 8 (29.6%) 15 (55.6%) 4 (14.8%)

RRFRD, through the Emergency Management division, has a very active CERT training

program which sponsors several classes each year for citizens and workers in the city and from

surrounding communities. The department has been involved in CERT training since 2003 and

has graduated 511 people. In recent years, they have added Cardio-Pulmonary-Resuscitation

(CPR) and first aid into the curriculum. Additionally, 86 of those who attended have sought

traffic control training as a separate class. Among those who have attended the training, there is a

small contingent of people who have volunteered for various tasks and duties as part of the


Emergency Management team. They have worked as assistants for scenario-based training in the

city’s Emergency Operations Center (EOC) and have helped to patrol areas deemed to be

vulnerable to fires during the July Fourth weekend. There appears to be the desire to provide

community service after attending the CERT class. Due to the fact that this system is already in

place, it appeared that the CERT program in Rio Rancho was the most likely resource to consider

for willing volunteers who already possessed basic emergency scene training. A survey to gauge

the ability and willingness to attend additional training and become a possible resource for the

fire department was sent to 150 former CERT trainees. A total of 67 (44.7 %) people responded

to the survey. The majority of the respondents ( 56 or 83.6%), had received their training in

classes that were held in the past three years, and 44 people (66.7%) felt that the initial training

adequately prepared them to perform vital functions on the scene of an emergency. Of the 67

trained individuals, 63 (96.9%) stated that they would be willing to receive additional training in

order to help provide support functions to assist first responders in an emergency. Of those, 61

(93.8%) indicated that they feel that they could provide basic first aid medical care. Providing

traffic control (54 or 83.1%), assistance with communications, safety patrols, assistance at large

public events (all were 51 or 78.5%), shuttling of vehicles (48 or 73.8%), and public education

(45 or 69.2%), were all considered appropriate duties by these potential volunteers. Second only

to first aid was their willingness to provide rehab services to firefighters and other first

responders. Fifty five (84.6%) stated that this was a potential role that they would fill if needed

during emergency operations (see Figure D).


When asked if they would be willing to become a member of a CERT response team to

provide support for fire department personnel, 44 (66.7%) indicated they would be willing to

volunteer for these duties. However, several respondents said that their comfort level would be in

question due to several factors. Thirty one (63.3%) had concerns over their own safety, while 7

(14.3%) felt that they would feel out of place, and 7 (14.3%) stated that they feel that volunteers

are never appreciated. One of the survey participants sent additional comments via email. Carol

Salucka (personal communications, December, 1, 2011), wrote “I would very much like to see

CERT become a much more essential and recognized for community welfare and emergency

response, and I am willing to devote time and effort to help make this happen.”

Discussion

It is apparent from the literature, the accepted national standards, and the research that fire

department leadership has recognized the need for firefighter rehab and that providing this

critical support service to their personnel on the scene of emergency incidents provides safety

benefits for their staff. Line of duty firefighter injuries and deaths are often caused by

physiological conditions created by physical exertion, stress, and overheating. It has been shown


that providing ample rest, rehydration, calorie replacement, an opportunity to cool down, and

time to take a mental break from the action can decrease the risk of these injuries or deaths.

McEvoy (n.d.), Schaeffer (2011), and Bledsoe (2009), all agree that proper rehab involves

relief from adverse weather elements, allows for firefighters to rest and recover from intense

physical activity, creates a method to rehydrate personnel and allow them to replace spent

calories. Additionally, these authors state that the use of rehab allows for firefighters to combat

the adverse physiological effects on firefighters. The surveys conducted for this project provided

data that concurred with contention that rehab was necessary for firefighter safety. Over 90% of

those who responded to the survey agreed that the need for including rehab in their incident

operations stated that it was either critical or very important to safety for their personnel.

Most fire department leaders are also in agreement that firefighting is inherently dangerous and

that any extended emergency scene is an appropriate opportunity to utilize rehab for firefighters.

Both Bledsoe (2009), and Shaeffer (2011), stated that in ideal circumstances, firefighters should

be released from the tasks on an incident and report to for rehab after a 20-minute work cycle.

Evans (2008) agrees that having a consistent approach to rehab may not completely eliminate on-

duty injuries or deaths, but the use of rehab should reduce these incidents that are caused by

overexertion and fatigue. The survey respondents overwhelmingly contend that fire suppression,

technical rescue incidents, and fire department training are all situations in which rehab would be

required.

The current economic situation facing fire department administrators across the United States

has created significant challenges for fire chiefs who are faced with increased calls for service

and decreased budgets and staffing levels. Additionally, increasing regulations and governmental

expectations for fire departments add to the stresses of daily operations. Although the standards


and guidelines issued by the NFPA are not legally binding, they tend to be the industry standard

to which the fire services are held accountable when incidents go bad and firefighters are injured

or even killed in the line of duty. In their attempt to meet the standards for fire and EMS

response, fire department leaders are often faced with the decision of utilizing the personnel they

have available to provide critical fire ground tasks like suppression, ventilation, or search and

rescue. Support services such as firefighter rehab and medical monitoring are often relegated to

an afterthought or performed inconsistently.

The NFPA 1710 Standard establishes minimum staffing recommendations for fire

departments to meet when they respond to a fire incident. The ability to meet the goal of 14

personnel arriving at the scene of a structure fire within an eight-minute response time is difficult

for many smaller departments to achieve. Lewis (2010) is in agreement with the International

Association of Fire Chiefs (2004) that the lack of staffing has been presenting fire departments

with a significant challenge for several years. In order to provide personnel to staff for rehab

services, many fire departments are looking at other agencies for this resource, or finding

creative alternatives to fill this role. Chris Harner, training officer for the City of Pueblo (CO)

Fire Department (personal communications, December 15, 2011), stated that they have 132 total

staff manning 10 stations and that they rely on either the third-party EMS provider, or the

American Red Cross to provide formal rehab to their firefighters involved in active incidents.

Flagstaff (AZ) Fire Department also uses the American Red Cross and the local EMS provider to

staff the rehab sector. Thirty-eight percent of the survey respondents stated that they too utilize a

local EMS provider to fill the firefighter rehab task, while the majority (62%) of those surveyed

felt that their departments were unable to meet the demands of a complicated incident due to


minimum staffing. It appears that many fire departments which have a similar staffing model as

RRFRD utilize personnel from sources other than on-duty fire personnel to provide rehab.

The use of volunteers to augment a career fire department can be controversial, even if the

volunteer resources are utilized for support services such as rehab. Close to half (44.8%) of those

who responded to the research questions said that their departments do not use volunteers to

provide rehab. Personnel from RRFRD, when asked who they preferred as a resource to provide

rehab services to them on incidents, reacted as expected by indicating that they would rather

have this service provided by call-back RRFRD firefighters (75.9%). Yet the use of volunteers

seem to be an alternative being considered by fire departments across the United States as many

agencies are experiencing significant staffing shortages. Wunder (personal communications,

December 14, 2011), stated that the Green Valley Fire District has a volunteer contingent from

U.S. Fire Corps to provide their rehab. Dean (2003) stated that using volunteers from the CERT

program would provide valuable resources to fire departments during large disasters, while Trick

(2009) contends that it is becoming increasingly difficult to recruit volunteers due to the

significant time commitments (Trick, 2009).

Although time constraints caused by family and work may have an effect on the ability of a

person to devote time to a volunteer effort, Dean (2003) stated that there is an inherent desire for

people to want to help out their community through volunteerism. This sentiment is mirrored by

Salucka (personal communications, December 1, 2011), when she said that it was her hope to

become a more valued and active volunteer in her community. Her view is shared by many of her

colleagues who have attended CERT training through RRFRD. With the exception of a few, the

majority (96.9%) said that they would be willing to provide support services for the fire


department, which included the commitment to attend additional training in order to perform this

critical function.

The use of mutual aid fire departments to provide support services at the scene of an

emergency is another alternative for fire department leadership to consider if they are minimally

staffed. This approach appears to be an acceptable alternative to the responders of the RRFRD

survey. Of those who answered the survey question, the third most popular response (24.1%),

behind call-back RRFRD firefighters and the American Red Cross was mutual aid resources. The

response moved to first (48.3%) when the choice of using mutual aid resources was

recommended with reservations. Irr (personal communications, November 25, 2011), indicated

that Yuma Fire Department increases their abilities on larger structure fires by relying on mutual

aid engine companies from the nearby U.S. Marine Corps Air Base. By utilizing the mutual aid

resources for the coverage of calls in the city, YFD personnel are then allowed to concentrate on

the tasks at hand on the fire ground, which includes rehab services. However, only a small

percentage of survey respondents (10.4%) rely exclusively on mutual aid fire personnel to

provide incident rehab. Lewis (2010) uses the theory that all fire departments utilize mutual aid

resources on routine calls and complicated incidents. In a 2008 survey of 500 fire chiefs,

conducted by the Opinion Research Corporation, it was discovered that the majority of the fire

departments (54%) stated that they always or almost always relied on neighboring communities

to provide them with personnel to respond to emergency scenes. Of those, most (74%) stated that

the reason they relied on mutual aid resources was the lack of adequate responders available

(Kenney & Malinowski, 2008).Whether the rehab sector is staffed by on-duty or off-duty

firefighters, filled by volunteers, or provided by mutual aid resources, most agree that finding a

means to accomplish this task is important.


Recommendations

Firefighting and other emergency services provided by fire departments are inherently

dangerous and removing or reducing the risks associated with overexertion or cardiovascular

stress can decrease the chance that a firefighter will suffer an injury or death on the fire ground.

Providing rehabilitation and medical monitoring services for firefighters involved in active

emergency scenes needs to be a priority at RRFRD in order to protect the health and safety of

personnel. Given the current economic situation facing most municipalities in the United States,

finding a method to provide additional support services such as rehab has proven to be a difficult

task. Using a creative approach to finding staffing alternatives without adding to the payroll

budget has been a priority for RRFRD and Rio Rancho city administrators. Additionally,

utilizing an existing resource, such as the CERT volunteer system appears to be a viable

alternative to other solutions presented in the research. It is therefore recommended that RRFRD

administration begin the process of developing a volunteer-based system to provide support

service tasks to the fire department using the current CERT program.

Based on the literature and research, there are several issues to be considered in the planning

and implementation of a program involving volunteers who would be assuming an active role in

a career fire department. Although the designing of a program should include these provisions,

consideration of other issues that may arise should be included. Among the issues are draft

policies, response protocols and guidelines, identifying volunteers interested in participating,

developing and implementing a training program, creating an organizational chart for the

volunteer system, and providing accountability and leadership for the volunteers. To accomplish


these goals, it will be necessary to create a timeline and set up stages for each task with the goal

of implementing the system within one year.

The first step in moving forward would be to research and draft a set of policies, response

protocols and guidelines for the CERT volunteers to follow. In order to allow for input from all

personnel who would be ultimately affected by the new system, it is recommended to create a

policy committee comprised of a member of RRFRD administration, the Emergency Programs

Manager, a member of the current CERT system, and a firefighter. By allowing input from all

parties, a realistic set of rules can be created. In creating the support documentation for the CERT

program, utilizing the Code of Conduct contract similar to the one used by the Los Angeles

CERT program will give the volunteers strict guidelines for how they identify themselves, while

allowing RRFRD to limit volunteer activity to non-emergency tasks only. It will also be

necessary to create response protocols and a call-out procedure for the volunteer personnel.

In order to find suitable volunteers to create a cadre of personnel willing and able to respond

with RRFRD personnel, using the existing email database for current and former CERT students

would allow the request to be widely distributed. Additionally, the proposal for RRFRD support

services can be included in future CERT curriculum. However, in an effort to create a system of

obtaining the most motivated and qualified candidates, it will be necessary and recommended to

require the use of an application, list of personal and professional references, and background

check including driving record inquiry. Each volunteer employed to accomplish these support

services tasks have the potential of driving city-owned apparatus and could possibly be providing

first-aid in a mass-care scenario. Having a candidate pass these initial screening tests would be a

minimum in an effort to protect the safety of the volunteers, the public, and fire department

personnel.


Developing a training curriculum will be multi-faceted in order to provide the volunteers with

all of the tools necessary to perform the tasks allowed within their policies and guidelines. The

training could also be tailored to each volunteer based on the jobs they are willing to accomplish

within the system. A training class specifically aimed at providing firefighter rehab and medical

monitoring currently exists in the RRFRD Training Division. This curriculum provides

information on the stresses involved in active operations on an emergency scene and how these

stresses can create negative impacts on the health and safety of firefighters. The two-hour class

also addresses the need for rest, protection from environmental conditions, rehydration and

calorie replacement, and how to monitor the vital signs in an effort to identify firefighters at risk.

Each subsequent CERT class could also include a block on this subject matter and the class could

be offered on an annual basis as a refresher to those who have already attended an initial session.

In addition, it is recommended that CERT volunteers interested in providing support to RRFRD

personnel would be required to attend a class on basic fire ground management and scene safety

so they would be able use the proper personal protective equipment and have knowledge on the

hot, warm and cold zones. This would allow them to realize where they are able to operate in a

safe manner and remain in areas established for support functions. All CERT volunteers should

also complete training on the Incident Command System (ICS), such as ICS 100, ICS 200, and

ICS 300. These online components to FEMA training will give the volunteers a basic knowledge

in working within the scene ICS and the National Incident Management System (NIMS) for

larger disasters. Select volunteers should be targeted to be a resource for driving city-owned

apparatus, such as the Extended Operations Vehicle (EOV), which carries RRFRD rehab

supplies. This 16-hour Emergency Vehicle Operators Course (EVOC) will meet the city and state

insurance requirements for safe operations of a government vehicle. The EVOC course for fire


department vehicles involves eight hours of classroom work and an additional eight hour slow-

speed driving course. This class has been created and is sponsored by the Volunteer Firemen’s

Insurance Services Inc. (VFIS). Volunteers participating in the CERT volunteer system would

also be required to obtain and maintain certification in CPR and first aid through the American

Heart Association (AHA). These classes can be sponsored and delivered to the volunteers

through RRFRD’s training division as an official AHA training site.

Fire departments generally have an organizational chart similar to that of RRFRD (see

Appendix A) which has the ability to expand or contract, depending on the number of personnel

who are represented by the chart structure and the span of control for each officer represented. A

similar chart would need to be established for the volunteer CERT system (See Appendix I).

Officers should be developed in the organization in order to give the volunteers a chain of

command. It is recommended that officers in the CERT organizational chart obtain additional

training, such as a basic leadership and management curriculum, to give them the knowledge

base to handle the stresses of scene operations and risk management. Currently there are several

volunteers within the CERT cadre that have experience, education and backgrounds in volunteer

fire departments, EMS, and emergency management. These individuals would be the likely

resource to provide leadership with the ranks of the CERT volunteer program.

In the operations plan for the system, it would also be necessary to create a method to hold

volunteer personnel accountable for training hours, maintenance of certifications, attendance of

meetings and briefings, adherence of policies, protocols, and guidelines set forth by RRFRD

administration. In order to accomplish this, a member of the fire department’s command staff

would be assigned responsibility to manage the volunteer ranks. Additionally, procedures for

removing volunteers who are in violation of policies or guidelines should be established in order


to maintain system and department integrity. RRFRD administration is currently entertaining a

reorganization proposal which would establish a new Deputy Chief of Support Services position.

If this position is added into the fire department command structure, providing leadership to the

CERT cadre of volunteers would allow for the volunteer system to have an advocate, mentor, and

leader within the higher ranks of the organization.

As noted in the literature and research, developing a firefighter rehab program is on the

minds of many fire chiefs, whether they are from large metropolitan organizations, combination

departments, or smaller suburban agencies, such as RRFRD. Utilizing volunteer resources has

been shown to be a useful resource, especially during tough economic times. Creating a system

where well-meaning and dedicated citizens can be utilized for firefighter rehab allows for them

to exercise their community involvement and give value to the fire department. In addition, if the

rehab program proves to be successful, an expansion of the volunteer system could be used to

provide other support services to RRFRD. This could involve volunteers providing staffing for

the apparatus providing compressed breathing air refill services, additional scene lighting, traffic

control, and even welfare and vital sign checks for senior citizens or the at-risk population.

Organization, training, and leadership will be the keys to establishing a sustainable and

consistent approach to incorporating volunteers into the RRFRD operations model.


References

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Prevention: www.cdc.gov/niosh/fire/pdfs/face200713.pdf

Baldwin, T., & Hales, T. (2009). Firefighter suffers sudden cardiac death during live fire training -

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introduction to NFPA 1584 (2008 standards). Midlothian, Texas: Cielo Azul Publications,

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Bliss, S. (2010, June). Using college students as supplemental emergency response staffing

(Applied Research Project). Retrieved from U.S. Fire Administration:

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(FEMA P-738). Washington, DC: U.S. Government Printing Office.

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1

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Appendix A: RRFRD organizational chart

Current organizational chart for Rio Rancho Fire Rescue Department, 2011


Appendix B: Fire department survey list

FIRE DEPARTMENT STATE POPULATION STAFFING

Compton Fire Department CA 99,769 107

Davis Fire Department CA 68,894 49

Hemet Fire Department CA 74,000 45

Modesto Fire Department CA 220,000 133

Palm Springs Fire Department CA 46,800 50

Redding Fire Department CA 100,000 75

Redlands Fire Department CA 73,000 61

Longmont Fire Department CO 86,720 unk

Meriden Fire Department CT 59,255 99

Lauderhill Fire Department FL 70,824 96

Melbourne Fire Department FL 78,427 134

Stanford Fire Department FL 53,000 81

The Villages Fire Department FL 82,000 67

Rome Fire Department GA 95,000 unk

Sandy Springs Fire Department GA 99,700 139

Sioux City Fire Department IA 85,013 115

Champaign Fire Department IL 78,000 117

Decatur Fire Department IL 76,200 118

Glenview Fire Department IL 65,000 82

Mount Prospect Fire Department IL 54,000 97


Bloomington Fire Department IN 75,000 unk

Elkhart Fire Department IN 52,000 124

Lawrence Fire Department KS 92,048 139

Monroe Fire Department LA 51,682 unk

Sterling Heights Fire Department MI 128,000 unk

St. Joseph Fire Department MO 74,000 130

Billings Fire Department MT 120,000 115

Missoula Fire Department MT 68,876 95

Schenectady Fire Department NY 61,871 unk

Springfield Fire Department OH 62,060 127

Lawton Fire Department OK 110,000 unk

Hilton Head Is. Fire Department SC 50,000 148

Mount Pleasant Fire Department SC 67,000 118

Bryan Fire Department TX 75,000 114

Cedar Park Fire Department TX 79,848 74

College Station Fire Department TX 94,643 116

Euless Fire Department TX 54,700 69

Harlingen Fire Department TX 67,300 109

Lewisville Fire Department TX 95,250 127

Longview Fire Department TX 75,800 unk

Mansfield Fire Department TX 58,949 81

Port Arthur Fire Department TX 57,000 105


Ogden Fire Department UT 83,000 123

Renton Fire Department WA 118,800 133

Yakima Fire Department WA 85,000 87

Kenosha Fire Department WI 102,000 152

Waukesha Fire Department WI 68,000 106

Casper Fire Department WY 54,874 76

Cheyenne Fire Department WY 57,000 88


Appendix C: Survey questionnaire


Appendix D: Survey cover letter

Good Day Chief ___________, I am the EMS Operations Battalion Chief for a small metropolitan fire department in New Mexico. We are a suburb of Albuquerque. I am currently involved in the Executive Fire Officer Program through the National Fire Academy and am working on my first Applied Research Project. I am asking for about 15-minutes of your time to complete a very short (10 question) survey. As I had mentioned, we are small and minimally staffed and have found that meeting the NFPA 1584 requirements for providing for firefighter rehab and medical monitoring is difficult as the majority of our resources are tasked with critical fire-ground operations. We are looking for creative staffing models to meet this standard. I am approaching fire departments with staffing and population bases that fall close to our city to fill out this short survey to give me some research data for my paper. Any assistance would be very helpful. Here is the link to the survey. It will be open until the end of November. http://www.surveymonkey.com/s/CLVB3W5 Again, thank you for your time. Paul Bearce Battalion Chief of EMS Rio Rancho Fire Rescue 2810 Southern Blvd. Rio Rancho, NM 87124 Office: 505-891-5283 Fax: 505-896-8036 "Protecting Your Family"

http://www.surveymonkey.com/s/CLVB3W5�


Appendix E: Regional fire department list

Avondale Fire Department

Arizona fire departments:

Buckeye Fire Department

Flagstaff Fire Department

Green Valley Fire District

Lake Havasu City Fire Department

Surprise Fire Department

Grand Junction Fire Department

Colorado fire departments:

Pueblo Fire Department


Appendix F: Regional fire department questions

Good Day Chief _______,

I am in the process of doing some research for my first Applied Research Project for the

Executive Development class as part of my EFO Program. I am looking into how fire

departments in smaller communities are able to provide firefighter rehab for their

personnel who are involved in active fire and rescue incidents. My intention is to look at

the parameters for establishing either formal or informal rehab, and how fire

departments are providing staffing to provide this necessary service.

If you have a few spare moments, would it be possible to answer the short questions

listed below. I do not want to take up a lot of your time, so brief answers are fine. I am

just looking for a consensus among fire departments in the southwestern U.S.

Thank you so much for your time.

1. Name:

2. Name of Department:

3. Rank/Title:

4. Number of fire personnel/stations:


5. EMS as first response, or first response and transport:

6. When personnel from your department are dispatched to a structure fire, or

extended scene operation, do you provide a formal or informal method of firefighter

rehab and medical monitoring per the NFPA 1584 Standard. If so, give a brief

description of that program:

7. If you provide rehab services, are your personnel formally trained on how to

provide rehab? If so, briefly describe the training:

8. How do you provide staffing for formal rehab situations (i.e. on-duty personnel,

call-back firefighters, third-service agency, or other)? Please describe:

9. Have you ever had to rely on volunteer resources to provide formal rehab to your

firefighters during extended operations (i.e. CERT, Fire Corps, Red Cross, others)?

Please describe:

10. Do you have equipment and supplies dedicated to provide formal or informal

rehab to your firefighters on emergency incidents? If so, give a brief description:


Appendix G: RRFRD personnel survey questions

1. It has become increasingly difficult for RRFD to provide personnel to attend to the rehabilitation and medical monitoring needs of firefighters who are actively involved in fire suppression. If given a choice of agencies/personnel that could assist with these tasks, which resources would, you prefer to provide these critical services? (Please rank each selection by choosing the following: Highly Recommended – Recommended with Reservations – If Nobody Else Available – Do Not Use This Resource – Don’t Know Enough About This Resource).

C.E.R.T.

Fire Corps

Red Cross

Mutual Aid agency (Fire Department)

Private ambulance company

RRFRD volunteers (similar to the old Reserves program)

College student intern program

Call-back RRFRD firefighters

Other city agency (Parks and Recreation, etc.)


Appendix H: CERT survey questions


Appendix I: Proposed volunteer organizational chart

Proposed CERT Volunteer Support System

Providing Firefighter Rehab with Limited Staffing

Documents

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