Form
Form - Heat and Cold Stress Monitoring Log
Document FSSMS-FRM-43Stage 1Revision 4Version 0.3.3
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One log per extended incident or training evolution in heat or cold, kept by the rehab officer or the training safety officer. It records the environment and the controls applied; the member-level vitals live on the rehab log (Firefighter Rehabilitation Program). Filed with the incident or training record (Heat, Cold and Weather Program).
| Field | Entry |
|---|---|
| Incident or training number; date; location | |
| Event type (structural, wildland, extended incident, live fire, physical training, water or ice, other) | |
| Rehab officer or training safety officer (role); incident safety officer assigned (Y/N) | |
| Action level broadcast at start of duty period (Heat or Cold: Green / Yellow / Orange / Red) and time received | |
| Instrument used (WBGT model / humidex card / wind chill card); calibration or function check date | |
| Clothing worn by the working crews (structural ensemble / wildland / station wear); clothing adjustment applied | |
| Work-rest cycle in force (percent work per hour, or minutes work and rest) | |
| Rehab trigger in force (cylinders or minutes) | |
| Heated or cooled shelter location; carbon monoxide alarm in shelter (Y/N) | |
| Generators and heaters placed downwind and away from rehab and command (Y/N) |
| Time | WBGT (°C) or humidex | Air temperature (°C) | Wind (km/h) and wind chill | Action level now | Carbon monoxide at rehab and command (ppm) | Hydrogen cyanide at overhaul (ppm) | Controls changed (Y/N; what) | Initials |
|---|---|---|---|---|---|---|---|---|
| Member ID | Time in | Reason (trigger / symptoms / member’s own call / officer’s call) | Signs (cramps, dizziness, confusion, no sweating, shivering, numb skin, other) | Cooling or warming applied | SpCO (percent) | Released (time) / held / transported | Initials |
|---|---|---|---|---|---|---|---|
Release criteria per the medical director (heart rate at or below 100 beats per minute, blood pressure below 160/100, temperature below 38 °C, SpCO below 5 percent for non-smokers, no symptoms after at least 20 minutes’ rest) (NFPA 1580, 2025).
| Field | Entry |
|---|---|
| Stop level reached (Y/N); work or training stopped (time); decision maker (role) | |
| Lightning inside 30/30 (Y/N); aerial lowered (time); work resumed (time) | |
| Wind at or above an aerial limit (Y/N); action | |
| Heat or cold illness cases (count); injury report numbers | |
| Carbon monoxide above the action level in rehab or command (Y/N); action; near-miss report number | |
| Hydration and food provided (Y/N); shortfalls | |
| Hot debrief question answered: “Who was running on empty, and did anyone know?” | |
| Signature (rehab officer or training safety officer, role); incident commander or training officer review (role, date) |
| Field | Type | Required | Who completes |
|---|---|---|---|
| Incident or training number, date, location, event type | Text, date, list | Yes | Rehab officer or training safety officer |
| Roles present | Text, Y/N | Yes | Rehab officer |
| Action level and time received | List, time | Yes | Rehab officer |
| Instrument and check date | Text, date | Yes | Rehab officer |
| Clothing and adjustment | List, number | Yes | Rehab officer |
| Work-rest cycle and rehab trigger in force | Text | Yes | Rehab officer with the incident commander |
| Shelter and carbon monoxide alarm; generator placement | Text, Y/N | Yes | Rehab officer |
| Readings rows | Time, numbers, list, Y/N, initials | Yes, at least hourly | Rehab officer or designated member |
| Members monitored rows | Member ID, time, list, text, percent, outcome, initials | For each member in rehab for heat or cold | Rehab officer |
| Close fields | Y/N, time, counts, report numbers, text | Yes | Rehab officer |
| Signatures | Role, date | Yes | Rehab officer; incident commander or training officer |
National Fire Protection Association. (2025). NFPA 1580, Standard for emergency responder occupational health and wellness (consolidates NFPA 1581, 1582, 1583 and 1584). https://www.nfpa.org/codes-and-standards/nfpa-1580-standard-development/1580