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

Brearley, Matthew B. and Walker, Anthony (2015). Water immersion for post incident cooling of firefighters; a review of practical fire ground cooling modalities. Extreme Physiology & Medicine,4(Article No. 15).

Document type: Journal Article
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IRMA ID 84278914xPUB16
Title Water immersion for post incident cooling of firefighters; a review of practical fire ground cooling modalities
Author Brearley, Matthew B.
Walker, Anthony
Journal Name Extreme Physiology & Medicine
Publication Date 2015
Volume Number 4
Issue Number Article No. 15
ISSN 2046-7648   (check CDU catalogue open catalogue search in new window)
Total Pages 13
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract 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 Tc to 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 Tc to safe working levels during rest periods. Utilising cooler water temperatures will expedite Tc cooling and minimise immersion duration.
Keywords Cooling
Core body temperature
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Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License

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