FILLTOLINE4andFaxtoCOIDC541-316-7775orsaveandsendtoorcoc@firenet.govPRIORTOSTARTINGPROJECTPROJECTMEDICALEVACUATION[MEDEVAC]PLAN1.PROJECTNAME&TYPE:STARTDATE:FIELDCONTACT:PHONENUMBER:RADIOCHANNEL:PROJECTLOCATION:TRSec¼2.LZLOCATION:Latitude:°Longitude:°3.TRAVELROUTETOPROJECTAREA:(Fromclosestmainroute)4.SPECIALINFORMATION/FLIGHTHAZARDS:(powerlines,towers,etc…)EMERGENCYMEDICALNOTIFICATIONPROCEDURESIntheeventofamedicalemergency:Designateanon-scenepointofcontactandnotify911and/orDispatchwiththefollowinginformation:1.Relaypatientinformation,location,identifyanyon-scenemedicalpersonnelandwhoisinchargeofthemedicalincident.•Follow8-LINEMedicalPlanonthesecondpageofthisdocumentoronpage118intheIRPG(PinkPages)2.Documentallinformationreceivedandtransmittedontheradioorphone.3.Identifyanychangesintheon-scenePointofContactormedicalpersonnelastheyoccur.4.ContinuePatientAssessmentandprovideupdates.AirLinkandLifeFlight(fromtheRedmondBase)willuseAirtoGround61(A2G61)forgroundcommunicationwhenrespondingtoanincidentwithFS/BLMemployeesasthegroundcontact.MEDICALPLAN(8-LINE)ControlledUnclassifiedInformation//BasicICS206WF(03/18)ControlledUnclassifiedInformation//BasicMedicalIncidentReportFORANON-EMERGENCYINCIDENT,WORKTHROUGHCHAINOFCOMMANDTOREPORTANDTRANSPORTINJUREDPERSONNELASNECESSARY.FORAMEDICALEMERGENCY:IDENTIFYONSCENEINCIDENTCOMMANDERBYNAMEANDPOSITIONANDANNOUNCE"MEDICALEMERGENCY"TOINITIATERESPONSEFROMIMTCOMMUNICATIONS/DISPATCH.Usethefollowingitemstocommunicatesituationtocommunications/dispatch.1.CONTACTCOMMUNICATIONS/DISPATCH(Verifycorrectfrequencypriortostartingreport)Ex:"Communications,Div.Alpha.Stand-byforEmergencyTraffic."2.INCIDENTSTATUS:Provideincidentsummary(includingnumberofpatients)andcommandstructure.Ex:“Communications,IhaveaRedprioritypatient,unconscious,struckbyafallingtree.RequestingairambulancetoForestRoad1at(Lat./Long.)ThiswillbetheTroutMeadowMedical,ICisTFLDJones.EMTSmithisprovidingmedicalcare.”3.INITIALPATIENTASSESSMENT:Completethissectionforeachpatientasapplicable(startwiththemostseverepatient)PatientAssessment:SeeIRPGpage106Treatment:4.TRANSPORTPLAN:EvacuationLocation(ifdifferent):(DescriptiveLocation(droppoint,intersection,etc.)orLat./Long.)Patient'sETAtoEvacuationLocation:Helispot/ExtractionSiteSizeandHazards:5.ADDITIONALRESOURCES/EQUIPMENTNEEDS:Example:Paramedic/EMT,Crews,ImmobilizationDevices,AED,Oxygen,TraumaBag,IV/Fluid(s),Splints,Roperescue,Wheeledlitter,HAZMAT,Extrication6.COMMUNICATIONS:IdentifyStateAir/GroundEMSFrequenciesandHospitalContactsasapplicableFunctionChannelName/NumberReceive(RX)Tone/NAC*Transmit(TX)Tone/NAC*COMMANDAIR-TO-GRNDTACTICALSeverityofEmergency/TransportPriority☐RED/PRIORITY1Lifeorlimbthreateninginjuryorillness.EvacuationneedisIMMEDIATEEx:Unconscious,difficultybreathing,bleedingseverely,2o–3oburnsmorethan4palmsizes,heatstroke,disoriented.☐YELLOW/PRIORITY2SeriousInjuryorillness.EvacuationmaybeDELAYEDifnecessary.Ex:Significanttrauma,unabletowalk,2o–3oburnsnotmorethan1-3palmsizes.☐GREEN/PRIORITY3MinorInjuryorillness.Non-EmergencytransportEx:Sprains,strains,minorheat-relatedillness.NatureofInjuryorIllness&MechanismofInjuryBriefSummaryofInjuryorIllness(Ex:Unconscious,StruckbyFallingTree)TransportRequestAirAmbulance/ShortHaul/HoistGroundAmbulance/OtherPatientLocationDescriptiveLocation&Lat./Long.(WGS84)IncidentNameGeographicName+"Medical"(Ex:TroutMeadowMedical)On-SceneIncidentCommanderNameofon-sceneICofIncidentwithinanIncident(Ex:TFLDJones)PatientCareNameofCareProvider(Ex:EMTSmith)7.CONTINGENCY:Considerations:Ifprimaryoptionsfail,whatactionscanbeimplementedinconjunctionwithprimaryevacuationmethod?Bethinkingahead.8.ADDITIONALINFORMATION:Updates/Changes,etc.REMEMBER:ConfirmETA'sofresourcesordered.Actaccordingtoyourleveloftraining.BeAlert.KeepCalm.ThinkClearly.ActDecisively.
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