OSH PROCESS Code:

PHYSICAL FITNESS Version:

EVALUATION FOR THE
BRIGADE Date:

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Date PERSONAL INFORMATION

Names) Surname Second surname

Identity document No. Date of Birth (dd/mm/yy) Age:

Residence address, Neighborhood and City Landline and Cell Phone

Email
Blood Type: RH: EPS AFP ARL
Height (m): Weight (kg): BMI:
AREA: COLLECTIVE ACTIVITY:

DATA OF THE GUARDIAN OR RESPONSIBLE

Names) Surname Second surname

Identity document No. Relationship Landline and Cell Phone

EXPERIENCE

Relief groups and/or industrial brigades to which you have belonged.

ORGANISM YE NO CITY OR COMPANY POST TIME

AH
Firefighters
Civil defense
Red Cross
Brigades

TRAINING

Courses you have taken

COURSE YE NO HOURLYINTENSITY CERTIFICATE (YES/NO)

AH
Fire prevention and control
Evacuation and rescue
techniques
First aid
Emergency care
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PHYSICAL CONDITIONING

SPORT ACTIVITY
Frequency of sports activity: YEA NO
H
a. Not done
b. 1 time per week
c. 2 or more times a week

BECAUSE YOU WANT TO BELONG TO THE BRIGADE

GENERAL STATE OF HEALTH

DO YOU SUFFER OR HAVE ANY OF THE FOLLOWING CONDITIONS?

YEA NO NA WHAT TYPE
H
Are you hypertensive?
If you are hypertensive, is it controlled?
Do you use permanent glasses?
Heart diseases
Epilepsy, seizures
Asthma, suffocation
Diabetes or Hypoglycemia
Allergies
Hernias
Spine problems
Sequela of fractures that limit mobility
Muscle problems
Use some type of prosthesis
Fears or phobias
Have any physical limitations
Have any medical restrictions
Take some medication regularly
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EVALUATION FOR THE
BRIGADE Date:

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DO YOU SUFFER OR HAVE ANY OF THE FOLLOWING CONDITIONS?

YEA NO NA WHAT TYPE
H
Have taken medications for long periods of
time

ENTRY MEDICAL EXAMS

TYPE OF EXAM YE NO SUITABLE

AH
Laboratories
Medical exam

INCOME CONCEPT

POST CONCEPT Vo Bo
IMMEDIATE BOSS
SST
BRIGADE LEADER

FITNESS RESULT
SUITABLE: NOT SUITABLE: POSTPONED:

BRIGADIST SIGNATURE: ________________________________________

IDENTIFICATION CARD:
DATE:
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PHYSICAL FITNESS Version:
EVALUATION FOR THE
BRIGADE Date:

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ANNEXES

RUFFIER TEST TO MEASURE AEROBIC RESISTANCE

A simple and quick way to calculate heart recovery capacity and aerobic endurance is the Ruffier test, which
gives an idea of your physical fitness. The most accurate way to do this is with a pulse meter, although you can
get an idea by taking the pulses in the carotid artery (next to the apple) or in the radial artery (in the wrist, at the
base of the thumb), but There is a certain error due to the time it takes to count them.
1. Take your heart rate at rest, sitting in a chair, and write it down (FC1).
2. Do at least 30 deep leg bends (squats), so that the thighs are just below the horizontal, in a time of 45
seconds and take the pulses as soon as you finish (FC2). If you finish the squats before 45 seconds,
continue doing them until the time is complete.
3. Take pulses again just one minute after finishing (FC3)

Apply the formula: Rating: (FC1+FC2+FC3)-200/10

ASSESSMENT INTERPRETATION
0 Excellent
0.5 Very good
5.1-10 Well
10.1-15 Acceptable
15.1-20 Deficient
>20.1 Very weak

CONDITION OF UNFITNESS FOR EMERGENCY BRIGADEIST:

Initially validate the survey information and discard:
1. BMI greater than 30
2. Uncontrolled hypertension
3. Uncontrolled diabetic
4. Epileptic
5. Use of permanent glasses
6. Sequelae of musculoskeletal injuries mentioned above.
7. Ruffier test: with acceptable result, poor, very weak.
8. Suffering from claustrophobia, vertigo or other impairment.

BRIGADIST PROFILE
 The brigadier in a company must have the following basic characteristics:
 Have permanence within the company.
 Physically healthy, suitable for emergency work.
 Calm, sensible.
 Excellent work performance.
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 You must be of legal age.

 Not older than 60 years.
 Be in adequate physical and mental condition.
 Know the company and its processes
 Discipline, responsibility and commitment to the company.
 Dynamic, serene and strong people
 Possess leadership that allows the participation and creativity of other members.
 Good personal relationships
 Willingness to work as a team
 Willingness and willingness to work in this type of activity.
 Arrangement for training and training sessions

It is necessary to carry out medical examinations of fitness for the position of brigade members to
determine adaptability conditions and phobias Specifically.