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SINGAPORE: Singapore Civil Defense Force (SCDF) firefighters fighting a raging industrial fire can spend hours doing grueling work while enduring intense heat. Their body temperature skyrockets, without the help of the bulky protective gear they have to wear.
These first responders work shifts for 30 to 40 minutes before rotating with another team. This is when they take off their equipment, have a drink and rest in the shade. But because they are so acclimated to the heat, they may not realize that their body temperature has reached alarming levels.
Some can exceed 39.5 degrees Celsius, putting them at greater risk for heat stroke. Left unchecked, heat injuries can have serious consequences, including multiple organ failure and death. The key is to lower your body temperature as quickly as possible.
The SCDF wants to accomplish this by deploying a specially designed new vehicle that can be deployed to the scene to rehabilitate and treat first responders showing signs of heat injuries. The Responders’ High Performance Vehicle (RPV) was unveiled to the media on Wednesday (Aug 26).
The responders’ high-performance vehicle combines three custom cooling methods on a single platform to assist SCDF first responders with heat injuries. (Photo: Sutrisno Foo Test)
“The RPV takes advantage of science and technology and we would really like to have this vehicle to improve our operations, as well as the well-being and standards of our first responders,” said RPV project officer Capt. Edrick Lim.
The RPV comes with three types of cooling equipment for first responders to immerse their forearm or body in cold water. Studies have shown that this technique is the fastest way to lower temperatures, compared to body cooling units, cooling packs, and ice packs.
“They clearly indicate that in the case of heat stroke, where cold water immersion is available, it is the preferred mode of treatment,” said Major Dr. Luke Tay, a SCDF National Service (NSman) operative member and consultant surgeon who participated in the RPV project.
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Responders are sent to three sections based on body temperature: rapid cooling zone (below 37.9 degrees Celsius), deep cooling zone (37.9 degrees Celsius and above), and cold water immersion (38, 5 degrees Celsius and above).
Based on the research, Cpt Lim believes the vehicle is “the first in the world” to combine three custom cooling methods on a single platform.
The SCDF has an RPV ready for deployment during prolonged incidents or those that carry a higher risk of heat exhaustion, including massive factory fires or chemical leaks. The latter require personnel to wear bulkier hazmat suits.
SCDF medical director Col. Dr. Shalini Arulanandam said the force could obtain a second RPV depending on its future training and operational needs, including how often the first RPV is used in the coming years.
The SCDF has an RPV ready for deployment during prolonged incidents or those that carry a higher risk of heat exhaustion, including massive factory fires or chemical leaks. (Photo: Sutrisno Foo Test)
The RPV, manned by a pair of paramedics and EMTs, is an enhancement to SCDF’s responder performance module. The latter, launched in 2013, is a 20-foot container with similar capacities that had to be towed.
The module took 45 minutes to set up and was able to treat 20 people at a time, compared to the RPV’s 20-minute deployment time and the treatment capacity of 37 first responders. The SCDF generally sends a first wave of 28 to 32 staff members to an incident.
QUICK REFRIGERATION ZONE
In one scene, the temperatures of the first responders are taken before they are dispatched to the three zones of the RPV. The vehicle is connected to a fire hydrant to fill an internal tank that cools the water.
The blast chill zone is outside the RPV under retractable shade. Fourteen folding chairs, with hollow armrests containing 15 degrees Celsius of water, unfold on both sides of the vehicle. Responders dip their forearms and sit under a vent that blows cold air.
The RPV comes with folding chairs, each with hollow armrests that hold 15 degree Celsius water to help cool off first responders on scene. (Photo: Sutrisno Foo Test)
This is a step up from the responder performance module, which could only deploy eight chairs with no immersion capabilities on both sides. Fans were used instead of cold air.
Respondents sit in these chairs for 20 minutes before their temperature is taken again. Those measuring below 37.9 degrees Celsius can be redeployed into operation.
Cpt Lim said science shows that water at 15 degrees Celsius strikes the best balance between comfort and cooling speed, while body temperature drops the most in the first 20 minutes.
Responders can dip their forearms in 15-degree C water and sit under a vent that blows cool air. (Photo: Sutrisno Foo Test)
DEEP REFRIGERATION ZONE
The highest risk deep cooling zone is within the air-conditioned RPV, designed with darker colors and dimmer lighting to promote mental recovery.
There are two rows of four aluminum seats for optimal heat conduction. Respondents again immerse their forearms in 15 degree Celsius water for 20 minutes.
The deep cooling zone is inside the air-conditioned RPV. (Photo: Sutrisno Foo Test)
The difference is that these armrests automatically fill with water, with the ability to maintain their temperature regardless of how much heat is dissipated. The machines continuously monitor the response personnel’s temperature, heart rate, and oxygen level.
The water temperature in the hollow armrests in the deep cooling zone is maintained at 15 degrees Celsius. (Photo: Sutrisno Foo Test)
COLD WATER IMMERSION
First responders most at risk for heat injury, including those showing symptoms such as disorientation, are sent to cold water immersion in a single fiberglass tub located outside the vehicle. The responders are found inside the tub in 5 degree Celsius water.
The tub circulates and regulates the water at a constant temperature at all times and directs the jets of water to different parts of the body to accelerate the elimination of heat. Responders are only submerged for five minutes due to the freezing temperature.
Responders with a temperature of 38.5 degrees Celsius or higher will be asked to lie down in a tub filled with five degrees Celsius water. (Photo: Sutrisno Foo Test)
The bathtub is also portable enough to be deployed in the field and in medical facilities. First responders who undergo cold water immersion should be sent to the hospital for further evaluation for heat injuries.
CONCEPTUALIZATION
The RPV was conceptualized in 2016 after the response personnel performance module was demonstrated to work during operations. It was also based on an earlier predecessor called the Mobile Body Cooling Unit, which is an ambulance equipped with ventilators and pressurized water mist.
Over the next several years, SCDF studied the latest academic research, engineering solutions, and medical science to develop the RPV. The process involved doctors from the SCDF NSmen, researchers from the National University of Singapore and the local engineering firm HOPE Technik.
SCDF said the RPV was designed and field tested with ergonomics and user experience in mind. First responders, including paramedics and EMTs, tested a prototype and provided feedback on its features.
“For example, things like the dimensions and height of the cold water tub (and) making sure its corners aren’t sharp,” said Cpt Dr. Arif Uzair Mohamad Roslan, a member of the SCDF NSman who also participated in the project.
“They are small things, but they did play an important role in the eventual design of the bathtub.”
The cold soak tub directs the jets to different parts of the body to accelerate the elimination of heat. (Photo: Sutrisno Foo Test)
Overall, Col. Dr. Shalini said the RPV data could be used to further study how responders physically react during operations.
“For vital sign collection, we can deploy this RPV during training when they are doing live fire,” he said.
“We can control the body temperature of the students when they go out and after they cool down. It is very unique data that is not easily collected in a real situation without this vehicle. “
