Monday Morning Medical Director’s Message
Rehabilitation is not the end of the incident; it’s the bridge to recovery and preparedness for the next call. A well-organized rehab operation ensures responders are safe to return to duty and allows early detection of illness or injury.
Rehab should start whenever incident conditions or workload pose safety or health risks. For small incidents, this likely means crew-based self-rehab; for larger incidents, a formal rehabilitation team should be established. The Incident Commander (IC) bears the ultimate responsibility but can delegate management tasks to a Rehabilitation Manager, who handles site setup, accountability, and medical assessments.
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University Hospitals recommends at least 20 minutes of rest after a single SCBA bottle or 40 minutes of strenuous activity. Vital signs should be checked every 10 minutes if normal, or every 5 minutes if abnormal. Release criteria include stable vitals, a minimum of 20 minutes of rest, proper hydration, and no signs of medical or psychological distress.
Post-incident recovery extends beyond the scene. Personnel must perform hygiene decontamination, report exposures, and address behavioral health needs. Supervisors and officers play a vital role in recognizing signs of post-incident stress and connecting personnel to support resources. Rehab is responder medicine, the intersection of operations, health, and leadership. By embedding structured rehab into every incident, we turn responder safety from a reaction into a routine.
Until next week,
John B. Hill, MD
Emergency Medicine Physician
UH EMS Medical Director
UH Portage ED Associate Medical Director
NEOMED Clinical Assistant Professor