What the NFPA Says About Firefighter Rehab in 2025

The National Fire Protection Association (NFPA) sets the recommended standards for fire departments and other related agencies across the country on just about every aspect of operations. NFPA 1580* deals specifically with firefighter rehabilitation, so you'd think that fire departments would follow it carefully.

Most agencies miss out on literally the first SOP/SOG recommendation in the NFPA standards in 2025:

"The fire department shall develop standard operating procedures/guidelines (SOP/Gs) that outline a systematic approach for the rehabilitation of members operating at incidents and training exercises."

So many agencies have (or think they have) SOPs or SOGs that map out firefighter rehab, but that aren't feasible, realistic, enforced, or haven't been updated in a generation. The key phrase is "systematic approach which recommends that departments and agencies have a firefighter rehab system that's repeatable, scalable, sustainable, and works on any incident regardless of size.

Get access to our guide to NFPA 1580 here!

Is what you have good enough? Probably not...

In our classes we have people take 2 minutes and, in as much detail as possible, write down their firefighter rehab system. Most of the time we get two reactions: complete confusion (from the newer members usually) and overconfident list-making. When asked to read them out, most people who wrote anything read out a list of supplies/equipment ending with "Then we do rehab..." But what IS that?

That'd be like us asking "Do you have a cake recipe?" only for people to tell you a list of ingredients.

Materials are important, yes, but an equipment or supply list isn't a system; a system is how you IMPLEMENT those materials. THAT is what your SOPs/SOGs describe: your firefighter rehab system. In fact, the NFPA (20.2.1.1.2) spells out a list of exactly what needs to be included in SOPs/SOGs:

1. Relief from climatic conditions
2. Processes for contamination reduction prior to rehabilitation
3. Active and/or passive cooling or warming as needed for incident type and climate conditions
4. Rehydration (fluid replacement)
5. Calorie and electrolyte replacement
6. Medical assessment
7. Emergency medical services (EMS) treatment in accordance with local protocol
8. Member accountability
9. Member release disposition from rehabilitation (reassignment, EMS evaluation, or post-incident recovery)

What we've done at WearARMR is organize these 9 things into four categories that are easy to remember, ARMR:  Accountability (in and out), Rest (from climate and duties), Medical (evaluation and treatment), Replenishment (of fluids and nutrients).

We've excluded HAZMAT considerations from the list (#2), in part because it's supposed to take place prior to rehabilitation, but also because there are plenty of specialized HAZMAT courses out there that will cover it in more detail than we ever could! The NFPA guidelines did strengthen their explanation of decontamination procedures, personal hygiene, and even added new terms like "No-Entry Zone" (21.2.5). Section 21 in NFPA 1580 deals heavily with HAZMAT topics.

See how WearARMR stacks up with firefighter rehab recommendations from the NFPA!

What're the highlights?

The NFPA has, in the last few years, clarified training requirements for firefighters on hot and cold risks and injuries (20.3). They now require firefighters are trained on how to recognize signs and symptoms, how to control heat and cold stress, and how hydration/nutrition/rest relate to stress. This is why our WearARMR 400 class, "Heat Kills" is so popular: it covers all of these topics and more!

There is a huge emphasis now on "prehabilitation" (20.4) which extended from 3 or 4 sections in 2022 to 7 in 2025. It also includes more information on sleep & fatigue management (like circadian rhythm disruption), fitness readiness (including rhabdomyolysis), and required training about both.

Section 22 was expanded in several key ways. First let's talk about what triggers rehabilitation. According to 22.7.1.1, "Members shall rest for a minimum of 20 minutes following the use of a single SCBA cylinder with intensive work or after 40 minutes of intensive work without SCBA." Although the 40 minutes of intense activity is not changed, the standard used to recommend rehab after one 45- or 60-min cylinder or two 30-min cylinders.

22.9.1 now requires that during training and operations, "the highest level pre-hospital care, transport-capable, AED-equipped EMS shall be available on-site as part of the incident scene rehabilitation for the evaluation and treatment of symptomatic members." Rehabilitation operations are absolutely required for training exercises (at the discretion of the instructor-in-charge), and if they're available then MICU/ALS units should be staffing rehab areas ready and able to transport patients.

We've been saying that accountability is critical in rehab areas for years, and the NFPA has finally updated recommendations that explicitly require that accountability must be maintained in a rehab area (22.4.7), the rehab manager must be notified when members enter or exit rehab (22.10.2), and that a rehab documentation report must be created with the following information: company/unit ,name, time in & out, and their disposition (Were they referred to treatment? Released to duty?). WearARMR helps rehab managers prepare the report with all the necessary information on scene with accountability trackers, and helps evaluators track individual members as they move through the rehab process.

In 22.1.3 (and in 22.9.3), the NFPA clarifies that, as delegated by the IC, EMS providers have the authority to keep members in rehab or transport them for further medical evaluation and treatment. Furthermore, in 22.7.1.3, the NFPA makes it clear that if "EMS or supervisory staff... see evidence of medical, psychological, or emotional distress" then "the member shall not return to operations." While this has been the case in the past, the addition of psychological/emotional distress as reasons to hold members from operations is indicative of the trend towards mental health in fire and EMS.

They've also added a dedicated chapter on post-incident recovery and demobiliation (23) including information on warmth, clothing changes, traumatic event considerations, and PPE cleaning protocols.

How can you make sure you're NFPA compliant?

1. Download the NFPA 1580 standards through NFPA Link (or purchase it outright) and cross-reference all of your SOPs/SOGs to ensure they're in accordance with the recommendations.
2. Get a system like WearARMR which takes care of every training and rehab-specific implementation requirement that exists in 1580 outside of HAZMAT.

It's our mission to protect firefighters from their #1 cause of death, and we appreciate your commitment to them as well. By adopting and implementing the NFPA standards, you are helping to decrease the number of Line of Duty Deaths every year.

* The standard for firefighter rehab used to be 1584, but as part of a consolidation effort the rehab standards are now a part of 1580.