Rapidly cooling firefighters post emergency response is likely to increase the operational effectiveness of fire services during prolonged incidents. Ice vests, misting fans, iced towels, cool intravenous fluids, forearm water immersion, immersion of multiple body segments and crushed ice ingestion are among the firefighter cooling modes tested to date. Currently, forearm immersion in cold water is a recommended cooling modality for use in firefighting settings by the National Fire and Protection Association (NFPA). 

The NFPA recommendation appears based upon the research of Selkirk et al. (2004)¹, that reported core temperature cooling by forearm immersion as superior to that conferred by seated rest or a misting fan. A number of fire services in Australasia have subsequently implemented post-incident cooling protocols that include forearm immersion. Interestingly, this cooling modality does not extend beyond the fire and rescue services into the similarly high pressure, time sensitive environments of elite sport and emergency medical settings, likely due to the unacceptably slow core temperature cooling rates (0.01-0.05^oC/min). In comparison, the core temperature cooling rates produced by multi segment immersion are generally classified as acceptable or ideal (0.03-0.35^oC/min).

Based upon the extensive field of research supporting multi segment immersion and comparable logistics of establishing forearm or multi segment immersion, we recommend fire and rescue management reassess their approach to firefighter rehabilitation. Specifically, we question the use of forearm immersion as the recommended cooling method to rapidly lower firefighter core temperature during rest periods. By utilising multi segment immersion to dissipate excess body heat, fire and rescue services would adopt an evidence based approach, likely to assist the maintenance of operational capability during arduous, sustained responses.