Monday Morning Medical Director’s Message
The term “prehabilitation” refers to proactive measures responders can take to ready their bodies and minds before facing the challenges of emergency operations. It involves hydration, nutrition, physical conditioning, and sufficient rest. All of these elements impact how effectively first responders perform under stress.
NFPA 1582 specifies the medical and physical examinations candidates must pass to ensure they can safely perform essential job tasks. NFPA 1583 emphasizes the importance of maintaining a physical fitness program for emergency responders. Regular exercise, cardiovascular conditioning, and strength training are vital to meet the physical demands of the job. All first responders should maintain their fitness and readiness throughout their careers and are required to meet the standards in NFPA 1582. In fact, NFPA 1582 mandates an annual fitness evaluation, with restrictions on essential job tasks if personnel do not meet the specified aerobic capacity. | 
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Just as athletes warm up before competition, responders should engage in pre-event stretching and preparation to lower the risk of injury during drills or live operations. Hydration and nutrition also significantly impact performance and recovery. Responders should begin each shift well-hydrated and sustain proper electrolyte levels throughout their activities. Remember, the thirst mechanism is a delayed response; by the time you feel thirsty, you are already dehydrated by about one liter. Dehydration can reduce work capacity by up to 30%. Lastly, don’t forget the importance of sleep. Sleep deprivation and fatigue can impair decision-making as much as alcohol, making rest a vital part of readiness.
Fire, EMS, and Police Departments can implement prehabilitation by scheduling active warm-ups at the start of the shift, before training, establishing hydration policies, and monitoring crew readiness. Supervisors should recognize signs of fatigue and ensure personnel are recovered before returning to service. Prehabilitation helps ensure that when the call comes, responders already have the physical and mental reserves needed to perform safely and effectively.
Until next week,
John B. Hill, MD
Emergency Medicine Physician
UH EMS Medical Director
UH Portage ED Associate Medical Director
NEOMED Clinical Assistant Professor