# SWP - Rehabilitation at Incidents and Training > Fire Service Safety Management System, version 0.3.3 (2026-10-25). The Human Factor. Document FSSMS-SWP-11. > > Canonical: https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training > > Licence: CC BY-NC-SA 4.0 with the Adopting Agency Grant (https://creativecommons.org/licenses/by-nc-sa/4.0/) > > General information only, not legal, medical or other professional advice. Verify every requirement against the current official text of the law, standards and manufacturer instructions that apply to you. Obtain your own legal review and consult your joint health and safety committee before adopting anything. You adopt, adapt, implement and rely on this material entirely at your own risk and on your own responsibility. Full terms: Terms of Use, thehumanfactor.ca. > **Warning: Adoption without implementation increases legal exposure** > > Adopting this procedure without the training, equipment, supervision, verification and resources to carry it out as written increases municipal and command liability in a regulatory investigation or a fatality inquiry. See [00a Copyright, Licence and Legal Notices](https://thehumanfactor.ca/library/fire-service-safety/copyright-licence-and-legal-notices). > **Speak up: Speak up** > > Anyone can stop this task, or send anyone to it, if it looks wrong. Say the hazard, then the action: “Stop, that crew is on their third cylinder, they go to rehab now.” “Hold, the pump operator has been in the wind for two hours, rotate him.” The officer acknowledges, acts, and reviews it later for learning, never for blame. The one debrief question for this task: **“Who was due for rehab and did not get there, and what was in the way?”** ## 1. Task and when this applies Setting up and running rehabilitation (rehab) for members at incidents and training, and going to it. This procedure applies at every working structure fire and every incident where SCBA is used in the hazard zone; every incident expected to last longer than one SCBA cylinder per crew or 45 minutes of physical work; every incident or training activity in heat or cold at or beyond the thresholds in the [Heat, Cold and Weather Program](https://thehumanfactor.ca/library/fire-service-safety/heat-cold-and-weather-program); every live-fire evolution, physical ability test, strenuous drill, extended technical rescue, hazmat entry in chemical protective clothing, and wildland or interface operation; and any other time the incident commander, the incident safety officer or any officer calls for it [(NFPA 1580, 2025, legacy NFPA 1584)](https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training#ref-nfpa-1580). Full program: [Firefighter Rehabilitation Program](https://thehumanfactor.ca/library/fire-service-safety/firefighter-rehabilitation-program). ## 2. Hazards - Heat strain and heat illness, from work, PPE and weather (ACGIH, n.d.). - Cardiac events during and up to 24 hours after exertion; overexertion is the largest single cause of on-duty firefighter death in the US data ([NFPA 1580, 2025](https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training#ref-nfpa-1580); [USFA, 2025](https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training#ref-usfa-2025)). - Dehydration; electrolyte loss; low blood sugar at long incidents. - Cold stress, hypothermia and frostbite for wet members standing still in wind. - Carbon monoxide and hydrogen cyanide absorbed during the work, showing up as fatigue, headache or nausea in rehab. - Contaminated PPE brought into the rest area; eating and drinking with contaminated hands. - Members hiding symptoms or self-releasing to get back to work. - Rehab sited in exhaust, smoke, the collapse zone or traffic. ## 3. Controls in hierarchy order | Level | Control | |:---|:---| | Elimination | Call enough resources early that crews can be rotated instead of pushed; schedule strenuous training out of the hottest hours. | | Substitution | Lighter tasks for crews released after a second rehab cycle; defensive or exterior operations where the risk assessment allows. | | Engineering | Shade, shelter, seating, cooling devices (forearm immersion, misting fan), heated shelter and dry clothing in winter, pulse CO-oximeter and vital-sign equipment; rehab sited upwind of smoke and exhaust. | | Administrative | Fixed work-cycle triggers; mandatory entry and release vital signs; release criteria approved by the medical director; no self-release; rehab inside the accountability system; the rehab log; trained sector officers and monitors; the fatigue rules. | | PPE | PPE doffed and bagged at the rehab entry; hand and face wipes before eating or drinking; dry gloves and hoods issued in cold. | ## 4. Required PPE and equipment Apparatus rehab kit (water, electrolyte, seats, wipes, blood pressure cuff, pulse CO-oximeter, thermometer, log and monitoring cards, vest, cooling towels or dry gloves by season); district cooling and warming kit; rehab unit or canopy at larger incidents; accountability tags or board. Full list: [Firefighter Rehabilitation Program](https://thehumanfactor.ca/library/fire-service-safety/firefighter-rehabilitation-program) section 17.2. ## 5. Minimum staffing and competencies - A rehab sector officer, trained to the program’s four-hour course, assigned by the incident commander. Any officer may start rehab until the trained sector officer arrives. - A medical monitor: EMS under the department’s agreement, or a department member trained in vital signs, pulse CO-oximetry and the release thresholds (medical first responder or higher). - At large incidents: one monitor per 10 members in rehab at once; a second sector officer to run the entry and doffing point. ## 6. Step-by-step procedure **A. Establish (incident commander and sector officer)** 1. **Decision point: does any trigger in section 1 apply?** If yes, the incident commander assigns a rehab sector officer and a radio designation in the first 10 minutes of a working incident; at training, before the evolution starts. 2. The sector officer picks the site: upwind and uphill of smoke and exhaust; outside the hot and warm zones and the collapse zone; away from traffic; shade or shelter; a short walk from the work; EMS access; out of sight of the fire where possible. 3. Set up: entry point with bags and tags for PPE and SCBA; wipes; seating; fluids; monitoring station; cooling or warming; accountability board. Put on the vest. 4. Tell command and accountability: “Rehab established, location, ready for crews.” **B. Send crews (company officers, command, incident safety officer)** 5. Track work cycles by cylinder and by time. **Decision point: has the crew used one 30- or 45-minute cylinder or worked 20 minutes hard without SCBA?** Send them for at least 10 minutes. **Two cylinders, one 60-minute cylinder, or 40 minutes hard?** Send them for at least 20 minutes [(NFPA 1580, 2025)](https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training#ref-nfpa-1580). 6. **Any member with symptoms (chest pain, shortness of breath, dizziness, nausea, confusion, cramps, unusual fatigue) goes to rehab now, with the monitor told.** The symptom overrides the cycle. 7. The crew reports to rehab together; the officer tells accountability. The crew is not available for assignment while in rehab. > **Warning: Stop-work triggers** > > Stop and act immediately if: a member collapses, is confused, has chest pain or cannot catch their breath (EMS now, treat as cardiac or heat emergency); a member’s temperature is 39 °C or higher or they stop sweating in heat (aggressive cooling and transport); a member is shivering uncontrollably, slurring or confused in cold (warm and transport); SpCO is above the transport threshold (oxygen, EMS, transport); rehab is in smoke or exhaust (move it); crews are being held on the line past the trigger because there is no relief (command calls more resources; the ISO may halt the evolution or reduce the work). **C. In rehab (sector officer and monitor)** 8. Entry: tag in; doff and bag or stage PPE and SCBA; wipes to hands, face and neck; seat; fluids (water or electrolyte, roughly 250 mL per 20 minutes of work, more in heat; no caffeine or energy drinks). 9. Entry vital signs within five minutes: heart rate, blood pressure, respiratory rate, temperature where a device is available, oxygen saturation, SpCO if smoke exposure was possible, symptoms. Record on the monitoring card. 10. Cooling in heat: coat, hood, helmet off, bunker pants opened, shade and air movement; forearm immersion, misting, cold towels when the WBGT or humidex is at the program threshold or the member is hot. Warming in cold: heated shelter, dry gloves and hood, blanket, warm fluids, out of the wind. 11. Food at any incident over three hours and at all-day training; wipes first. 12. Hold the clock: the minimum period from step 5, longer if vitals or symptoms require. **D. Release (sector officer on the monitor’s recommendation)** 13. Release vital signs. **Decision point: does the member meet every release criterion?** Defaults, to be confirmed by the medical director: rest completed; heart rate 100 or less (some protocols 110); blood pressure below 160/100; temperature below 38 °C; oxygen saturation normal for the member; SpCO below 5 per cent for a non-smoker; no symptoms; fluids taken. 14. If not met: rest a further 10 minutes and reassess; if still not met after 20 further minutes, or if any symptom, EMS assessment. Treat or transport as EMS directs. A transported member does not return to duty at that incident. 15. If met: tag out; tell accountability; the member returns to command for reassignment, lighter work where possible after a second cycle. **No self-release.** If command needs a crew, command asks the sector officer whether they are releasable. 16. Record time out and disposition on the log. **E. Demobilize** 17. Log complete, signed by the sector officer; every transport or refusal has an injury or exposure report number and the incident commander and the HSO have been told. 18. Restock the kit; decon rehab equipment that touched contaminated PPE; return the log with the incident or training record. **F. Training ground** 19. The training safety officer or lead instructor establishes rehab before the evolution, briefs the cycle and the no-self-release rule to the students, and keeps the log [(NFPA 1403, 2024)](https://thehumanfactor.ca/library/fire-service-safety/swp-rehabilitation-at-incidents-and-training#ref-nfpa-1403). Recruits are at higher risk and less likely to speak up; instructors watch for it. ## 7. Emergency and contingency - **Collapse, chest pain, altered mentation, heat stroke signs, severe cold stress:** EMS and transport; AED and oxygen from the apparatus; incident commander told; the member’s officer stays with them; injury report started before the end of the incident. - **EMS not on scene or committed:** the department monitor runs rehab; a second EMS unit is requested at any working fire; the incident commander does not wait for EMS to establish rehab. - **No trained sector officer available:** any officer runs rehab by this procedure and the pocket card until relieved. - **Mass casualty or large incident:** rehab is split into entry, rest and monitoring, and re-equipment areas; a canteen or support association is requested; relief for the monitors every two hours. - **Rehab contaminated (smoke shift, exhaust, hazard expansion):** move it; tell accountability. - **A member refuses assessment or transport:** the sector officer records the refusal, tells the incident commander, and the member is not reassigned to the hazard zone; an injury or exposure report is filed and the member is followed up the next day by their officer. ## 8. Documentation and reporting - [Form - Rehabilitation Log](https://thehumanfactor.ca/library/fire-service-safety/form-rehabilitation-log) for every rehab period, attached to the incident or training record; retained with the exposure records. - Medical monitoring card per member per cycle, attached to the log. - Any transport, refusal, heat or cold illness or cardiac symptom: injury or exposure report the same day; the reporting clocks the applicable law sets may apply ([J08 Incident Reporting and Investigation](https://thehumanfactor.ca/library/fire-service-safety/j08-incident-reporting-and-investigation)). - Rehab in and out times in the accountability record. - The Tier 1 after-action review notes when rehab was set up, who went, and what got in the way. ## 9. Training and review - All members: heat and cold illness recognition, the triggers and the no-self-release rule at recruit level and annually before summer. - Officers: sending crews on the trigger, requesting rehab, the AAR question. - Sector officers: four-hour course and annual refresher; monitors: skills check annually. - Sign-off by the training officer in the training record; the Health, Wellness and Rehab Program Improvement Team reviews this SWP annually, after any transport from rehab, after any cardiac event, and after any learning team finds it is not being followed as written. ## 10. Related - Program: [Firefighter Rehabilitation Program](https://thehumanfactor.ca/library/fire-service-safety/firefighter-rehabilitation-program) - Policy: [Policy - Emergency Operations Safety](https://thehumanfactor.ca/library/fire-service-safety/policy-emergency-operations-safety); [Policy - Occupational Medical, Fitness and Wellness](https://thehumanfactor.ca/library/fire-service-safety/policy-occupational-medical-fitness-and-wellness) - Forms: [Form - Rehabilitation Log](https://thehumanfactor.ca/library/fire-service-safety/form-rehabilitation-log); [Form - Exposure Report](https://thehumanfactor.ca/library/fire-service-safety/form-exposure-report) - Programs: [Heat, Cold and Weather Program](https://thehumanfactor.ca/library/fire-service-safety/heat-cold-and-weather-program); [Emergency Operations Safety Program](https://thehumanfactor.ca/library/fire-service-safety/emergency-operations-safety-program); [Training Safety and Live Fire Program](https://thehumanfactor.ca/library/fire-service-safety/training-safety-and-live-fire-program); [Decontamination and Contamination Control Program](https://thehumanfactor.ca/library/fire-service-safety/decontamination-and-contamination-control-program) - Learning: [Incident Investigation and Learning Program](https://thehumanfactor.ca/library/fire-service-safety/incident-investigation-and-learning-program) ## Jurisdiction requirements This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it. | Topic | What to check in your jurisdiction | Page | |:---|:---|:---| | Incident Reporting and Investigation | Which serious injuries must be reported to the regulator and how fast, and the deadline for the employer’s injury report to the compensation board | [J08 Incident Reporting and Investigation](https://thehumanfactor.ca/library/fire-service-safety/j08-incident-reporting-and-investigation) | | Exposure Limits, Heat and Cold Stress | The basis of the heat and cold stress limits (such as the ACGIH TLVs) that the rehab triggers and work and rest cycles must meet | [J22 Exposure Limits, Heat and Cold Stress](https://thehumanfactor.ca/library/fire-service-safety/j22-exposure-limits-heat-and-cold-stress) | | First Aid | First aid requirements that reach incident and training sites | [J24 First Aid](https://thehumanfactor.ca/library/fire-service-safety/j24-first-aid) | | Workers’ Compensation and Firefighter Presumptions | Whether a heart injury presumption covers events after an emergency response, and the time window it uses | [J32 Workers' Compensation and Firefighter Presumptions](https://thehumanfactor.ca/library/fire-service-safety/j32-workers-compensation-and-firefighter-presumptions) | ## References American Conference of Governmental Industrial Hygienists \[ACGIH\]. (n.d.). *Threshold limit values for chemical substances and physical agents and biological exposure indices* (current edition). National Fire Protection Association. (2024). *NFPA 1403, Standard on live fire training evolutions* (last standalone edition; now part of NFPA 1400). National Fire Protection Association. (2025). *NFPA 1580, Standard for emergency responder occupational health and wellness* (consolidates NFPA 1581, 1582, 1583 and 1584). United States Fire Administration \[USFA\]. (2025). *Firefighter fatalities in the United States in 2024*. Federal Emergency Management Agency.