Medical Incident Report

The Medical Incident Report (MIR) can be found in the following documents: in the NWCG Incident Response Pocket Guide (IRPG), PMS 461, under Emergency Medical Care (pink); in the Medical Plan ICS-206 WF; and in many Incident Action Plans (IAPs). The MIR evolved from and has replaced the 9 Line Form and Pink sticker.

The MIR is not always tasked to the Emergency Medical Technician (EMT) or Paramedic in Patient Care. The intent of the form is to:

1. establish control of the incident, whether routine or life-threatening, by initiating a new Incident Command System,
2. standardize a systematic process for reporting medical incidents/injuries, similar to a fire size-up for initial attack, and
3. enable any firefighter, with prior training and direction, to fill it out and transmit the information.

• Treat it like any incident. If the incident is overwhelming, ask for a more qualified Incident Commander (IC) to assume command. Expand/contract the organization’s size depending on the needs of the incident.
• Fill this report out completely prior to transmitting to dispatch/communications. If the incident is life threatening, do not let documentation delay patient care.
• When transmitting the report, state the number and title of each section, and say “break” and pause between the sections (e.g., “Dispatch, Task Force Leader (TFLD) Jones. Standby for Priority Medical Incident Report. 1. All other radio traffic please hold, break” (pause/wait for response). “2. Incident Status: Nature of Illness is chest pain. Incident Name is Tank Medical. IC will be TFLD Jones. Patient Care will be Paramedic Smith. Break (pause again). 3. Initial Patient Assessment is…”).
• When using the MIR during a Multi-Casualty Incident (MCI), state the number injured and their severity (Section 3: e.g., “3. Initial Patient Assessment, I have five patients. three Reds, one Yellow, and one Green. Mechanism of Injury is...”).
• Use the terms Paramedic or EMT with the provider’s last name in “Patient Care.” Do not use EMT to describe a Paramedic or the ambiguous term Medic. All those roles need to be clearly identified to understand the level of care and treatment the patient(s) will receive.
• Enact more than one transport plan and clear more than one frequency if needed for Sections 5 and 6.
• Always be ready for the first plan to fail and be flexible enough to move into an alternate plan. Use the acronym PACE (Primary, Alternate, Contingency, and Emergency) for planning purposes.

Action Items:

• Consider developing medical emergency tabletop scenarios as part of morning briefings or field scenarios on project work to be become familiar with the process. The more comfortable with the MIR you are, the more it will be second nature under stress.
• Ensure dispatchers and radio operators are aware of their roles and responsibilities pertaining to the MIR.
• Review your local unit emergency plans.

This topic was submitted by Assistant Fire Management Officer (AFMO) Miles Ellis and Asst. State Fire Management Officer (FMO) Paul Hohn with Wyoming Bureau of Land Management (BLM), and expanded upon by Eric Graff, of Grand Canyon Helitack.