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Firefighter rehabilitation

David A Barr, Craig A Haigh, Jeannie M Haller, Denise L Smith
OBJECTIVE: The objective of this study was to retrospectively investigate aspects of medical monitoring, including medical complaints, vital signs at entry, and vital sign recovery, in firefighters during rehabilitation following operational firefighting duties. RESULTS: Incident scene rehabilitation logs obtained over a 5-year span that included 53 incidents, approximately 40 fire departments, and more than 530 firefighters were reviewed. Only 13 of 694 cases involved a firefighter reporting a medical complaint...
July 2016: Prehospital Emergency Care
Soman Sen, Tina Palmieri, David Greenhalgh
Management of burn injuries requires treatments and interventions from many disciplines. Worldwide, burn patients suffer from physical and psychological challenges that impact their lives socially and economically. In this review, we will highlight a handful of the numerous articles published in multiple areas of burn care. The areas of burn care addressed in the article are: epidemiology; burn resuscitation, critical care, and infection; nutrition and metabolism; pain and rehabilitation; prevention and firefighter safety; psychology; and reconstruction and wounds...
November 2015: Journal of Burn Care & Research: Official Publication of the American Burn Association
L M Shafran, Iu V Nekhoroshkova
As a result of complex hygienic evaluation of working conditions of various professional groups ofpersonnel of State Emergency Service of Ukraine the labor activity of fire-rescues was found to occur in more hazardous conditions than appeared in fire trucks drivers and fire safety inspectors. The work in the area of fire extinguishing was shown to significantly affect on professionally important physiological functions of firemen, causing a decline in attention, memory, accuracy, reactions, increasing of the level of anxiety...
January 2015: Gigiena i Sanitariia
Denise L Smith, Jeannie M Haller, Ron Benedict, Lori Moore-Merrell
UNLABELLED: The primary objective of this observational study was to document the heart rate (HR) responses of firefighters during incident rehabilitation following firefighting activity in a high-rise building with a simulated fire on the 10th floor. Additionally, the study investigated potential factors, including firefighting workload, ambient temperature, firefighter movement, and individual characteristics, that may have affected HR during recovery. Firefighters (n = 198) were assigned to perform a simulation of fire suppression, search and rescue, or material support during one of six firefighting trials that involved different crew sizes and ascent modes, and were performed in different environmental conditions...
2016: Prehospital Emergency Care
Tae-Young Moon, Jee-Hee Kim, Hak-Ju Gwon, Bang-Sung Hwan, Gyoung-Yong Kim, Neal Smith, Gun-Soo Han, Hyo-Cheol Lee, Byung-Jun Cho
[Purpose] The purpose of this study was to determine how an exercise program focusing on muscular strength could aid firefighters with chronic lower back pain. [Subjects] The research subjects were randomly assigned to two groups, the experimental group (n=8) and the control (n=8). [Methods] The experimental group performed two types of exercise programs four times per week for 8 weeks under supervision. Tests were performed before and after the 8 weeks of exercise in accordance with the Korea Occupational Safety and Health Agency's program...
March 2015: Journal of Physical Therapy Science
Robbie J Savage, Cara Lord, Brianna L Larsen, Teagan L Knight, Peter D Langridge, Brad Aisbett
Monitoring an individual's thermic state in the workplace requires reliable feedback of their core temperature. However, core temperature measurement technology is expensive, invasive and often impractical in operational environments, warranting investigation of surrogate measures which could be used to predict core temperature. This study examines an alternative measure of an individual's thermic state, thermal sensation, which presents a more manageable and practical solution for Australian firefighters operating on the fireground...
December 2014: Journal of Thermal Biology
Jenny Adams, Sandra DeJong, Justin K Arnett, Kathleen Kennedy, Jay O Franklin, Rafic F Berbarie
Firefighters who have received an implantable cardioverter-defibrillator (ICD) are asked to retire or are permanently placed on restricted duty because of concerns about their being incapacitated by an ICD shock during a fire emergency. We present the case of a 40-year-old firefighter who, after surviving sudden cardiac arrest and undergoing ICD implantation, sought to demonstrate his fitness for active duty by completing a high-intensity, occupation-specific cardiac rehabilitation training program. The report details the exercise training, ICD monitoring, and stress testing that he underwent...
July 2014: Proceedings of the Baylor University Medical Center
Tina A Greenlee, Gavin Horn, Denise L Smith, George Fahey, Eric Goldstein, Steven J Petruzzello
This study examined the following: effects of simulated firefighting (FF) activities under heat stress on sustained attention; whether incident rehabilitation (IR) influences performance; and relationships between performance, affect and personality. Firefighters performed ~18 min of FF. Attention, physiological, perceptual and psychological assessments were made before and after FF, IR and recovery. IR had no effects. Self-rated Energy increased, Tiredness decreased and Anxiety increased immediately post-FF; all returned to baseline 120 min post...
2014: Ergonomics
David Hostler, Joe Suyama, Francis X Guyette, Charity G Moore, Riana R Pryor, Priya Khorana, Serina J McEntire, Diane Comer, Steven E Reis
PURPOSE: Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation. METHODS: In a double-blind, placebo-controlled study, 102 firefighters were randomized to receive daily therapy (81 mg aspirin or placebo) for 14 days before and a single dose (325 mg aspirin or placebo) following exercise in TPC resulting in four potential assignments: aspirin before and after exercise (AA), placebo before and after exercise (PP), aspirin before and placebo after exercise (AP), and placebo before and aspirin after exercise (PA)...
July 2014: Prehospital Emergency Care
Cynthia Dowdall-Thomae, John Gilkey, Wanda Larson, Rebecca Arend-Hicks
The present study examined coping strategies used by firefighters, the relationship between appraisals and coping strategies used, and the relationship between transitional coping strategies used and outcome coping efficacy for mental preparedness. Firefighter coping strategies of problem focused coping and seeking social support were found to have positive significant relationships to outcome coping efficacy, after transitioning from one critical incident to a second. The coping strategies of blamed self wishful thinking, and avoidance appear to have a negative significant relationship to outcome coping efficacy...
2012: International Journal of Emergency Mental Health
Jenny Adams, Dunlei Cheng, Rafic F Berbarie
Six male firefighters who were referred to phase II cardiac rehabilitation after coronary revascularization participated in a specialized regimen of high-intensity, occupation-specific training (HIOST) that simulated firefighting tasks. During each session, the electrocardiogram, heart rate, and blood pressure were monitored, and the patients were observed for adverse symptoms. No patient had to discontinue HIOST because of adverse arrhythmias or symptoms. For physicians who must make decisions about return to work, the information collected over multiple HIOST sessions might be more thorough and conclusive than the information gained during a single treadmill exercise stress test (the recommended evaluation method)...
April 2013: Proceedings of the Baylor University Medical Center
Serina J McEntire, Joe Suyama, David Hostler
Most duties performed by firefighters require the use of personal protective equipment, which inhibits normal thermoregulation during exertion, creating an uncompensable heat stress. Structured rest periods are required to correct the effects of uncompensable heat stress and ensure that firefighter safety is maintained and that operations can be continued until their conclusion. While considerable work has been done to optimize firefighter cooling during fireground operations, there is little consensus on when or how cooling should be deployed...
April 2013: Prehospital Emergency Care
Jefferey L Burgess, Michael D Duncan, Chengcheng Hu, Sally R Littau, Delayne Caseman, Margaret Kurzius-Spencer, Grace Davis-Gorman, Paul F McDonagh
OBJECTIVES: To determine the cardiovascular and hemostatic effects of fire suppression and postexposure active cooling. METHODS: Forty-four firefighters were evaluated before and after a 12-minute live-fire drill. Next, 50 firefighters performing the same drill were randomized to undergo postfire forearm immersion in 10 ┬░C water or standard rehabilitation. RESULTS: In the first study, heart rate and core body temperature increased and serum C-reactive protein decreased but there were no significant changes in fibrinogen, sE-selectin, or sL-selectin...
November 2012: Journal of Occupational and Environmental Medicine
Eileen Whalen, Cynthia J Hecker, Steven Butler
Harborview Medical Center in Seattle has been home to the pioneering work of University of Washington (UW) Medicine physicians and staff who have led innovations to improve trauma care for more than 40 years. As the only level I adult and pediatric trauma center and regional burn center for Washington, Alaska, Montana, and Idaho, Harborview provides cares for more than 6500 critically injured trauma and burn patients per year. Our physicians, researchers and staff are recognized as national experts and as collaborative partners with nursing in the delivery of outstanding clinical care, research, and education...
July 2012: Critical Care Nursing Quarterly
Riana R Pryor, Jennifer R Seitz, Julia Morley, Joe Suyama, Francis X Guyette, Steven E Reis, David Hostler
BACKGROUND: Temperature measurement is important for emergency medical services (EMS) providers when identifying and treating heat illness or infection. Direct measures of body core temperature (T(c)) are often expensive (ingestible capsules) or impractical (rectal probes) in the field. Multiple devices for estimating T(c) have been adopted by EMS providers, with little understanding of the agreement between these devices and T(c). OBJECTIVE: To examine the agreement between the results of five external thermometers and T(c) after subjects experienced physical exertion while wearing protective clothing...
January 2012: Prehospital Emergency Care
Gavin P Horn, Steve Gutzmer, Christopher A Fahs, Steve J Petruzzello, Eric Goldstein, George C Fahey, Bo Fernhall, Denise L Smith
OBJECTIVES: The primary objective of this study was to document the timeline of physiologic recovery from firefighting activities in order to inform emergency medical services (EMS) of vital sign values that might be expected during incident rehabilitation and in developing rehabilitation protocols to make decisions about when to return personnel to the fireground. Secondarily, we compared two different incident rehabilitation strategies to determine effectiveness in reducing physiologic strain following firefighting...
April 2011: Prehospital Emergency Care
Raymond V Burke, Melissa N Andersen, Scott L Bowen, Monica R Howard, Keith D Allen
We evaluated the efficacy of a vocational training program including behavioral skills training, and a "performance cue system" (i.e., a proprietary iPhone application adapted for the study) to teach targeted social-vocational skills to six young adults with an Autism Spectrum Disorder. In two separate studies, participants were employed to assist in the delivery of a fire safety education program. Participants were asked to wear an inflatable firefighter WalkAround® mascot costume and to perform 63 scripted behaviors in coordination with a fire prevention specialist who was the lead program presenter...
November 2010: Research in Developmental Disabilities
David Hostler, Steven E Reis, James C Bednez, Sarah Kerin, Joe Suyama
BACKGROUND: Thermal protective clothing (TPC) worn by firefighters provides considerable protection from the external environment during structural fire suppression. However, TPC is associated with physiologic derangements that may have adverse cardiovascular consequences. These derangements should be treated during on-scene rehabilitation periods. OBJECTIVE: To examine heart rate and core temperature responses during the application of four active cooling devices, currently being marketed to the fire service for on-scene rehabilitation, and compare them with passive cooling in a moderate temperature (approximately 24 degrees C) and with an infusion of cold (4 degrees C) saline...
July 2010: Prehospital Emergency Care
David Hostler, James C Bednez, Sarah Kerin, Steven E Reis, Pui Wah Kong, Julia Morley, Michael Gallagher, Joe Suyama
BACKGROUND: Performing fire suppression activities results in cardiovascular stress, hyperthermia, and hypohydration. Fireground rehabilitation (rehab) is recommended to blunt the deleterious effects of these conditions. OBJECTIVE: We tested the hypothesis that three rehydration fluids provided after exercise while wearing thermal protective clothing (TPC) would produce different heart rate or core temperature responses during a second bout of exercise in TPC. METHODS: On three occasions, 18 euhydrated firefighters (16 men, two women) wearing TPC completed a standardized, 50-minute bout of upper and lower body exercise in a hot room that mimicked the National Fire Protection Association (NFPA) rehabilitation guidelines of "two cylinders before rehab" (20 minutes of work, 10 minutes of recovery, 20 minutes of work)...
April 2010: Prehospital Emergency Care
Matthew J Schwab
OBJECTIVE: This case report describes the effect of exercise-based chiropractic treatment on chronic and intractable low back pain complicated by lumbar disk extrusion. CLINICAL FEATURES: A 47-year-old male firefighter experienced chronic, unresponsive low back pain. Pre- and posttreatment outcome analysis was performed on numeric (0-10) pain scale, functional rating index, and the low back pain Oswestry data. Secondary outcome assessments included a 1-rep maximum leg press, balancing times, push-ups and sit-ups the patient performed in 60 seconds, and radiographic analysis...
December 2008: Journal of Chiropractic Medicine
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