REHAB - "What is it & Do I Really Need It?" - SAFETY STAND DOWN 2021

     Yes, I am an old, former firefighter, having served two volunteer departments from 1977-1985. For the first, nearly seven years, we defined "rehab" as having cold water, hot coffee or hot chocolate as the "sum total" of rehab. Whether it was a rollover off the Interstate or a working structure fire, we would head back to the Squad or Rescue, maybe take off our bunker coat and sip away for the next 5-10 minutes.
     That all changed, especially for me personally, in the fall of 1984. I was eating lunch at the firehouse in upstate New York, when a call came in for a van down a deep embankment off of the Interstate in our district, with multiple ejections and fatalities.  Everyone at the firehouse, plus additional volunteers responded.
     It was October and uncannily warm, in the low 80's that afternoon. Upon arrival, we found the van some one-hundred feet down the embankment, with at least two fatal ejections and another seven passengers in the van.  After our initial size-up and due to the steep incline, we set up our rope rescue systems to allow rescuers to both descend with rope tension and ascend with the Stokes, with help from the team by the Rescue.
     I made four descents and climbs in about forty-five minutes. Under my bunker gear, I was wearing a shirt, tie and suit pants, having doffed my suit jacket when I bunkered up. And I was sweating - a lot. After assisting on scene for another half-hour, I had to return to work and got a ride by one of the police cars, back to the firehouse.
     I worked for another four hours or so, but throughout, I was not feeling myself. Sure, I knew I was exhausted from the call, the climbing and the drama, but I did not feel well. So, when it was time for me to leave the office, I called my wife and told her I was going to stop at the firehouse for a quick check.
     When I got there, one of my friends who was a paramedic saw me walk in and told me that he didn't think I looked well. I told him what had happened. He took me into the bunk room, called over another medic and then brought the gear into the bunk room.
     My BP was high, I was dry as the proverbial bone, nauseated and had a slightly abnormal EKG. The medic called the acting chief and explained the situation. The chief asked him, "If he was a civilian that we had responded to, what would you normally do?
     He replied, "We'd package him and transport with the ambulance company."
     The chief said, "Then do it! It makes no difference that he's one of us. Get him to the ER STAT!"
     When I got to the ER, they conducted a battery of labs, EKG's, ultrasound, etc. After about an hour, the doctor came over and explained that both my sodium and potassium levels were dangerously low, probably the cause of irregular EKG. He asked for the details of the afternoon, which I shared. After listening, the doctor explained that with the ambient temperature, being "wrapped in bunker gear" and the physical exertion, I had sweated these important salts out and never replenished them.
     "If you had not come in here, you may have suffered a significant cardiac event!"
     With that, a nurse came in and hung a 1,000ml bag of saline, Ringer's and D5W. Within about twenty minutes, I started feeling better.
     REHAB is no joke and is not an "excuse" if you're a little tired after going through two or three tanks, working overhaul for an hour, etc. As much as we might like to think so, we're not "super heroes," impervious to human health risks! Just as we promote taking care of others, we must take care of ourselves, just to be able to take care of someone else.
     This year's SAFETY STAN DOWN 2021 is all about rehab and how it has evolved over the nearly forty years since my incident. Rehab must be about determining our condition and stamina once we enter, including basic levels, e.g., pulse, pulse-ox, cardiac, replenishment and more. We must break the ethos that spending 15-20 minutes in rehab is a sign of weakness! It is NOT! It is a sign of your professional conduct, training and allowing others to care for you so that you can care for others!
     For more information on this year's Safety Stand Down, please visit www.safetystanddown.org/