Water immersion for post incident cooling of firefighters; a review of practical fire ground cooling modalities

Extreme Physiology & Medicine

Anthony Walker¹  Matt Brearley² 

[1] Australian Capital Territory Fire and Rescue, Amberley Avenue, Fairbairn Business Park, Majura 2609, ACT, Australia;National Critical Care and Trauma Response Centre, Level 8 Royal Darwin Hospital, Rocklands Drive, Tiwi 0810, NT, Australia

关键词: Water;    Immersion;    Heat;    Forearm;    Firefighter;    Core body temperature;    Cooling;   

Others  :  1231862
DOI  :  10.1186/s13728-015-0034-9

 received in 2015-06-27, accepted in 2015-09-17,  发布年份 2015

【 摘 要 】

Rapidly cooling firefighters post emergency response is likely to increase the operational effectiveness of fire services during prolonged incidents. A variety of techniques have therefore been examined to return firefighters core body temperature to safe levels prior to fire scene re-entry or redeployment. The recommendation of forearm immersion (HFI) in cold water by the National Fire and Protection Association preceded implementation of this active cooling modality by a number of fire services in North America, South East Asia and Australia. The vascularity of the hands and forearms may expedite body heat removal, however, immersion of the torso, pelvis and/or lower body, otherwise known as multi-segment immersion (MSI), exposes a greater proportion of the body surface to water than HFI, potentially increasing the rates of cooling conferred. Therefore, this review sought to establish the efficacy of HFI and MSI to rapidly reduce firefighters core body temperature to safe working levels during rest periods. A total of 38 studies with 55 treatments (43 MSI, 12 HFI) were reviewed. The core body temperature cooling rates conferred by MSI were generally classified as ideal (n = 23) with a range of ~0.01 to 0.35 °C min ⁻¹ . In contrast, all HFI treatments resulted in unacceptably slow core body temperature cooling rates (~0.01 to 0.05 °C min ⁻¹ ). Based upon the extensive field of research supporting immersion of large body surface areas and comparable logistics of establishing HFI or MSI, it is recommended that fire and rescue management reassess their approach to fireground rehabilitation of responders. Specifically, we question the use of HFI to rapidly lower firefighter core body temperature during rest periods. By utilising MSI to restore firefighter T _cto safe working levels, fire and rescue services would adopt an evidence based approach to maintaining operational capability during arduous, sustained responses. While the optimal MSI protocol will be determined by the specifics of an individual response, maximising the body surface area immersed in circulated water of up to 26 °C for 15 min is likely to return firefighter T _cto safe working levels during rest periods. Utilising cooler water temperatures will expedite T _ccooling and minimise immersion duration.

【 授权许可】

   
2015 Brearley and Walker.

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