there is inherent risk in wildland firefighting and accidents or injuries can occur at initial attack
your crew members and other agency firefighters may have to depend on you
to make life-saving decisions if an accident occurs understanding and
practicing the standard operating procedures for a medical emergency on an incident is essential
the varieties of players in the range of expertise and experience of those involved
the uncertain timing and inherent dangers of wildland firefighting make knowing and practicing
the standard operating procedures for a medical emergency on an incident essential
On July 25th 2008 18 year old national park service wildland firefighter Andy Palmer was fatally injured in a
tree falling accident on the eagle fire burning on the Shasta-Trinity National Forest in California
three hours and 26 minutes after he was injured emergency medical personnel pronounced Andy dead
at the Redding airport he never made it to a hospital Andy's death was a jarring wake-up call
for many in the wildland firefighting community out of Andy's fatality a new focus was given to
wildland fire emergency incident response the Dutch Creek Protocols were created and
later updated to include standard procedures for reporting a medical emergency this set
of standardized procedures can be found in the incident response pocket guide IRPG in the pink
pages within the emergency medical care section officially known as a medical incident report it
is commonly referred to as the eight-line to help you effectively report a medical incident from
the field the eight-line focuses on the required information needed to mobilize emergency resources
when an accident occurs on your fire first identify who will be in charge of the incident
within an incident you'll want this individual to be able to focus solely on the medical emergency
in common wildfire terminology this person will act as the incident commander
of the medical emergency the person in charge of the incident should gather all essential
information and prepare to report the accident to dispatch following the eight-line
line one declare an emergency incident request the channel be cleared for emergency traffic
dispatch incident 316 standby for medical emergency report clear channel for emergency traffic
line two incident status provide a summary of the medical emergency
including the number of patients along with the command structure dispatch i have a red priority
patient unconscious struck by falling tree requesting ambulance to forest road at 45 degrees
two three decimal four five three by one one nine degrees three one decimal two two
one this will be the eagle meadow medical IC is Jones EMT Smith is providing medical care
line three initial patient assessment complete an assessment for each patient if there is more
than one patient start with the most severe first you can find guidance on the medical assessments
in your IRPG document the assessment and treatment administered to the patient
number four your transport plan if needed identify an evacuation location if different
from the patient location you can identify this location by latitude and longitude coordinates
a drop point a road intersection etc it will be important to communicate the patient's
estimated time of arrival to the evacuation spot if applicable
line 5 additional resources and equipment needs
identify and communicate additional needs to dispatch for example a paramedic
an EMT oxygen a trauma bag IV fluid splints etc remember it's very difficult to carry an
injured person on a litter over difficult terrain consider additional manpower if the patient has
to be moved to an evacuation location
line six communications identify and confirm with dispatch your command tactical
air-to-ground and ems frequencies dispatch can confirm hospital contacts as applicable
line seven contingency develop a contingency plan you don't know if your primary
option can be executed or will be successful what actions can be implemented together with
your primary evacuation method
line eight additional information communicate updates
and changes as they occur dispatch will confirm estimated time of arrivals of resources ordered
the most important thing an initial attack crew can do to be prepared for successfully
managing a medical emergency on a wildfire is to practice together
knowing where to find the eight line in your IRPG is not enough besides the stress created
by an actual life-threatening medical emergency multiple layers of coordination have to occur to
successfully manage an incident within an incident this requires teamwork to be effective teams must
practice together under the conditions and in the environments where they are likely to encounter
a medical emergency practice sessions are an easy way to do this flag a fire in your response area
assign a person on the crew to be the injured person explain to them the mechanism of injury
they will have on the designated day have the players respond to the flag fire it's
recommended that you involve your local dispatch so they receive the benefit of the training also
but if dispatch is unavailable the role of dispatch can be played by one of the crew members
as well instruct the participants to respond just as they would on a fire with a size-up and
implementation of the IC's tactical plan hazard mitigation etc once the scenario has progressed
a bit the instructor can signal to the designated person to begin role-playing their injury
at this point the incident within an incident part of the training can begin
allow the scenario to progress through the eight-line until the medical emergency is
resolved through the patient's transport to advanced medical care after the training
scenario conduct and after-action review focus on what went well what was learned and areas for
improvement give each of the participants an opportunity to provide input on the training
share lessons learned with those that did not participate practicing the eight-line for medical
emergencies very well may be the most important training you do it will make the difference
in getting a seriously injured firefighter quickly to the advanced medical care they need