Firefighters and Dehydration

Charles E. Truthan, D.O., F.A.C.O.F.P.
President & Medical Director, F.D. Doc®
Copyright 1999 by FD Doc®

In 1996, a firefighter died in the line of duty from dehydration at the scene of a fire. This Line of Duty Death, unlike the other several hundred that have occurred since then, and unlike that of the Worcester 6 or Keokuk 3, was completely preventable. All that was required was proper on-scene Rehab and for the firefighter to admit (he) required Rehab. Rehab as simple as a drink of water might have saved his life.

The United States Fire Administration (USFA) has an excellent guide "Emergency Incident Rehabilitation" FA-114/July 1992 that not only provides detailed information on why Rehab is necessary, it also provides a model program for Rehab. It includes easy to use tables for heat index and wind chill factors, forms for tracking the Rehab of firefighters and other practical, useful information. This can be ordered from the USFA: "Customers can use our online catalog to order from over 200 publications. In addition to ordering through the online catalog, publications may be ordered by calling USFA's 24-hour publications line at (301) 447-1660 or the Publications Center at (301) 447-1189 between 8:30a - 5:00p EST/EDT. To order publications by mail, write to:

Publications Center
United States Fire Administration
16825 South Seton Avenue
Emmitsburg, MD 21727

Please include your name, mailing address, daytime telephone number, date required, title(s) of the publication, and the quantity you need when ordering by phone or mail." (from USFA website).

The knights of old "suited up" in heavy armor to protect him from some of the dangers of battle. Heavy chain and iron where his clothing with lance and sword his weapons. He rode a horse with banner and trumpet to do battle with the mythical dragon. Today’s firefighters "suit-up" in armor made of Nomex ®. Boots, pants, coats, gloves and helmets are his clothing with a deuce-and-a-half nozzle and axe his weapons. He rides into battle with lights and sirens blaring to do battle with the dragon. Technology of old allowed the knight to penetrate deeper into the battle scene with heavier armor. Technology of today allows the firefighter to penetrate deeper into the dragon’s lair. Eventually the knight’s armor became so heavy and cumbersome, he had to be hoisted onto his steed.

Fortunately, today’s technology makes the firefighter’s gear lighter. Unfortunately, we take those weight savings and we add more and more PPE to the firefighter, thereby losing the weight savings. We now have cooling vests that can be added to hold body core temperatures down and they also "wick away" perspiration. One of our "alarms" is the production of sweat. If we "wick away" this sweat, we may lose that external reminder that we need to replenish our fluids. Unfortunately, the body has a very small "booster tank" of fluids it can safely lose. These body fluids MUST be replaced. This is only accomplished by on-scene Rehab.