Motivated by the circumstances surrounding the death of firefighter Andrew Palmer almost two years ago on the Iron Complex fire July 25, 2008, the National Wildfire Coordinating Group has finally decided on some new procedures for managing medical emergencies on incidents. Their Serious Accident Task Team made recommendations that were accepted by the NWCG in three areas:
- Standardized Medical Emergency Procedures for Incident Management Teams (IMT) to include in their Incident Emergency Plans.
- Standardized Communication Center Protocols.
- An expanded ICS-206 Medical Plan to include emergency medical procedures that will be reviewed each Operational Period at the Planning Meeting.
Specifically, Incident Management Teams must incorporate the following protocols into daily operations:
- Each IMT will include the standard Medical Emergency Procedures in their Incident Emergency Plan. These procedures will help ensure safe and efficient responses to any medical emergency that may occur on an incident.
- Each IMT will follow the Incident Communication Center Protocol – Standard Elements. The Communication Unit Leader will ensure that everyone in the Center is familiar with the protocol.
- Each IMT will complete a 206 Block 8 Attachment (see below) when completing their ICS 206 Medical Plan to provide detailed information regarding communication procedures, and roles and responsibilities during a medical emergency. The 206 Block 8 Attachment will document mitigations to hazards (similar to the ICS 215, Operational Planning Worksheet and 215A, Incident Action Plan Safety Analysis) and be approved at the Planning Meeting for each operational period.
- Each IMT should train to understand and practice the medical emergency procedures outlined in their Incident Emergency Plan. Incident simulations or sand table exercises at IMT workshops will help achieve a clear understanding of how the IMT will respond to a medical emergency.
The text that shall be included in Bock 8 of the Medical Plan, (ICS-206):
In the event of a medical emergency provide the following information to the Communications Unit
- Declare the nature of the emergency. Medical injury/illness? If injury/illness is it Life Threatening?
- If Life Threatening, then request that the designated frequency be cleared for emergency traffic.
- Identify the on-scene Point of Contact (POC) by Resource and Last name (i.e. POC is TFLD Smith),
- Identify nature of incident, number injured, patient assessment(s) and location (geographic and GPS coordinates),
- Identify on-scene medical personnel by position and name(i.e. EMT Jones),
- Identify preferred method of patient transport,
- Request any additional resources and/or equipment needed,
- Document all information received and transmitted on the radio or phone,
- Identify any changes in the on-scene Point of Contact or medical personnel as they occur.
Emergency Medical Procedures (Provide detailed emergency medical procedures by Division/Group.
These procedures are steps in the right direction, but most of them are common sense and part of the Incident Command System, and should have already been standard operating procedures on fires and other incidents. We would like to see the mandate go further and specify some guidelines about how to assess and mitigate the risk of firefighters working in remote locations in relation to the availability of immediate emergency medical care and patient transportation, including time frames, to an appropriate medical facility.
