ABSTRACTS
Active Rewarming Is Not Necessary During Cold Weather Firefighting OperationsAuthor: Caitlin Delaney, MS, AEMT, NREMT-B | | Associate Authors: Andrew R. Poreda, MD, FACEP, Kyle J. Kelleran, PhD, EMT-B, Cameron P. DeMott, BS, Brian M. Clemency, DO, MBA, David Hostler, PhD
Introduction Physiologic effects of firefighting work and rehabilitation during warm weather operations have been well-studied; however, current cold weather rehabilitation protocols are based on assumptions adapted from warm weather operations, and active rewarming is often recommended. The purpose of this study was to monitor the physiologic impacts of work in a cold temperature in thermal protective clothing (TPC). We hypothesized that active rewarming is not necessary during cold weather firefighting. We aim to fill the gap in knowledge to help guide best practices for fireground rehabilitation during cold weather operations. Objective To monitor the physiologic impacts of work in a cold temperature in TPC. Methods Seventeen firefighters (3 females, 14 males, 31 ± 7.99 years) participated in both a neutral (20°C) and cold (−8°C) condition, at least 48 hours apart. Each participant was outfitted with a heart rate (HR) monitor, eight surface temperature sensors, and a core temperature pill prior to donning TPC. Participants walked on a graded treadmill in a thermal chamber to simulate the aerobic demand of firefighting activities for two 20-minute sessions with a short rest in between. Firefighters were rehabbed in neutral conditions (20°C) with TPC removed and given room temperature water or Gatorade. Heart rate (HR); respiratory rate (RR); rate of perceived exertion (RPE); and thermal sensation, comfort, and preference were recorded during the exercise and rehab portions. Data were analyzed with a paired t-test. Results After 20 minutes of rehab (RT20), when compared to cold time 0 (CT0), core temperature (CT0 37.35 ± 0.34°C, RT20 37.37 ± 0.63°C, p = 0.98), thermal preference (CT0 2.94 ± 0.52, RT20 2.84 ± 0.37, p = 0.33), mean skin temperature (CT0 32.18 ± 0.76°C, RT20 32.32 ± 0.94°C, p = 0.83), and HR (resting 78 ± 13.66 BPM, RT20 85.1 ± 14.21 BPM, p = 0.25) were not significantly different. Differences in mean hand (CT0 30.11 ± 0.77°C, RT20 31.79 ±1.03°C, p = 0.004) and digit (CT0 26.29 ± 2.91°C, RT20 32.77 ± 1.24°C, p < 0.0001) temperatures, thermal comfort (CT0 0.26 ± 0.45, RT20 0 ± 0, p = 0.04) and sensation (CT0 3.73 ± 0.93, RT20 4.05 ± 0.52, p =0.02) were statistically significant. Conclusion After cold weather exterior firefighting, 20 minutes of rehabilitation in a temperature-controlled environment will allow firefighters to return to their physiologic baseline without active rewarming. Further studies should be performed to determine optimal rehab methods.
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