Wildland Fire EMS 2006

1. Wildland Fire EMS 2006 Gene Madden Division Safety Officer, Florida Division of Forestry Chair, NWCG Safety & Health Working Team Member, NWCG EMS Group

2. Wildland Fire EMS 2006 • National Wildfire Coordinating Group • Safety & Health Working Team Changes • Emergency Medical Support Group Changes • Medical Unit Protocols Established • Vitamins & Mineral Supplements • New Developments • Fireline EMT • AEDs in Cache • Review of EMS Equipment/Supplies in Fire Cache

3. National Wildfire Coordinating Group Safety & Health Working Team 2006

4. Gene Madden (FL), Chair, SE States Michelle Ryerson, Vice Chair, BLM John Gould, BIA Rod Blum, USF&WS Bob Ashworth (NV), Western States Al King, NPS Ron Hanks, USFS Vacant, NE States Tim Lynch, MTDC Karin Nichols, Executive Secretary Mike Long, NWCG Liaison Safety & Health Working Team 2006

5. National Wildfire Coordinating Group Emergency Medical Support Group Changes

6. Wildland Fire EMS 2005 NWCG Safety & Health Working TeamEmergency Medical Services Group • Established Emergency Medical Support Group (EMSG) Feb. 2003 after Reno Wildfire EMS Summit (Jan. ’03) • Original Membership: • Gene Madden, Chair, SE Rep-NASF/SHWT (FL) • Jeff Hatch, USDA/USFS Rep (WY) • Sherrie Collins, DOI/NPS Rep (AZ) • Kim Christensen, DOI/BLM Rep (ID) • Jeff Scussel, USDA/USFS Rep (MT) • Dia Gainor, NASEMSD Rep (ID) • Fergus Laughridge, NASEMSD Rep (NV) • Bobby Golden, Executive Secretary, USDA/USFS (MT)

7. Wildland Fire EMS 2006 • EMS Group • Kim Christensen, Chair, DOI/BLM Rep (ID) • Gene Madden, SE Rep-NASF/SHWT (FL) • Jeff Hatch, USDA/USFS Rep (WY) • Don Pontbriand, DOI/NPS Rep (WO) • Jeff Scussel, USDA/USFS Rep (MT) • Dia Gainor, NASEMSD Rep (ID) • Fergus Laughridge, NASEMSD Rep (NV) • Dr. David Cone, NAEMSP Rep • Mary Jo Lommen, Executive Secretary, USDA/USFS (MT)

8. NWCG Medical Unit Operating Standards for Integration with State EMS Approved January 2005 by NWCG Parent Group

9. NWCG Medical Unit Operating Standards for Integration with State EMS • On Web@: • www.nwcg.gov/teams/shwt/emsg/resources.htm

10. Limited Request for Recognition Form* * There is a very similar but different form for deployment in Montana

11. LIMITED REQUEST FOR RECOGNITION (Print or type all information. Use additional forms as necessary. MEDLs are responsible for reporting arriving AND demobing resources within 24 hours to the designated state EMS office. See http://nasemsd.org/member list.html for contact information) Authorization for recognition is requested for the following emergency medical personnel assigned to the _______________________________incident. The identified personnel will provide emergency medical and health care services for incident personnel. It is anticipated that they may be providing these services for up to 21 days from the date of this notification. ______________________________ __________ ______ ______ Full name Cert/Lic. Level State NREMT# ______________________________ __________ _____ ______ Full name Cert/Lic. Level State NREMT# The above individual(s) will be assigned starting on ________________________________ The location of the incident is: ________________________________________________ __________________________________________________________________________ The primary wildfire jurisdictional authority is: ____________________________________ I attest that I have physically examined the certifications/licenses of the above individuals. ____________________________________ (_______)_____________________ Medical Unit Leader-Print Telephone Number (_______)_____________________ Fax Number ____________________________________ _________ Medical Unit Leader-Signature Date

12. Completing the Request for Recognition Form The purpose of the “Request for Recognition” form is to advise the state EMS office (where your incident is) that you have established a medical unit within their jurisdiction, and you are identifying out-of-jurisdiction (the state’s) EMS personnel who are going to be rendering care for a limited period of time. This form does not provide certification/licensure reciprocity. It only notifies authorities of the presence of EMS resources. A new form must be completed for each resource as they move from incident to incident within that state or if they travel to another state. Remember too, that advanced life support (ALS) care rendered requires in-jurisdiction Medical Direction. The state EMS Office may be able to help you with this. To locate the State EMS office, simply click on the NWCG Emergency Medical Support Group website (www.nwcg.gov/teams/shwt/emsg/index.htm) and go to the National Association of State EMS Directors (NASEMSD) website link. The NASEMSD web address is: www.nasemsd.com Click on the state where your incident is located. You will go immediately to the appropriate state contact number. The National Registry of Emergency Medical Technicians also has a website that will provide you with the correct state EMS contact information. The NREMT web address is: www.nremt.com Both websites may offer additional important and helpful information to you about the area EMS facilities and services in completing the Medical Unit Plan (ICS 206). Additional links are expected to be added. REMEMBER TO VERIFIY ALL INFORMATION TAKEN FROM WEBSITES e.g. telephone numbers, services, etc. It cannot be overly stressed that it is the responsibility of the Medical Unit Leader (or the Incident Medical Specialist Manager or Firemedic manager, if so designated) to complete the Request for Recognition form. Remember, there are a multitude of statutory and administrative regulations from state to state. You may be required to provide additional information and proof of certification/licensure to the State EMS Office. Contact them for specific information and assistance.

13. Vitamins & Mineral Supplements • SHWT asked by IBPWT • >>SHWT>>EMSG>>Drs. Cone, Sharkey and Cox researched data. • Accepted by EMSG and SHWT • Forwarded to IBPWT Feb 2, 2005

15. “The assumption is firefighters will receive all the proper vitamins and minerals by eating the meals, food and liquids they require to do their job safely on the incident.”Madden, Feb 2, 2005 SHWT Memo to IPBWT

16. “In examining the reputable literature and studies, no definitive evidence can be located at this time that a daily multi-vitamin and mineral supplementation provided is effective for firefighter health or increasing their performance. However, certain cases and situations may arise on specific incidents (e.g. all risk, medical direction, etc) that a limited number/type/kind of vitamins may be permitted. Consequently, in most common situations, without outstanding warrant, the use of vitamins should be a personal preference.”Madden, Feb. 2, 2005 SHWT memo to IPBWT

17. Vitamin & Mineral Supplements • Policy of NWCG Parent Group “Based upon their review of ongoing nutritional work and that of the scientific community, it was concluded that vitamin and mineral supplements are not recommended to prevent or reduce the risk of disease. Such supplements are not a substitute for a balanced and nutritious diet.” Kirk Rowdabaugh, NWCG Chair 3/22/06

18. Is Emergen-C Acceptable? Yes, as an electrolyte replacement fluid. The added vitamins and minerals are secondary in nature

20. Fireline EMTs • What are they? • What’s happening? • What should my IMT do when they need an EMT up on the fireline?

21. NWCG/SHWT FEMT Current EMT certification Moderate fitness level FF2 Would define a national level fireline EMT(310-1) To IOSWT for approval November 2005 IOSWT denied request November 2005 FIRESCOPE FEMT Current EMT certification Arduous fitness level FF1 Sets the guidelines for a CA fireline EMT Approved by FIRESCOPE Accepted SHWT position Fireline EMT Proposals

22. AEDs • SHWT recommended (Sept. ‘05) to FEWT the inclusion of sufficient bi-phasic AEDs including supplemental 02 and companion airway kits into fire cache system. It was suggested that initially the number of AEDs should be sufficient for all Type I & Type II IMT/MEDLs in a phase in process. • Parent Group has requested additional guidance as to the “level of care.” • When should an AED be present? • IA? • EA? • Type 2? • Type 1?

24. Review of EMS Equipment/Supplies in Fire Cache • SHWT members offered to FEWT to serve as SMEs to assist in the review of FA kit equipment and supplies. • Dia Gainor, ID EMS Director • Scott McKinney, MEDL/EMTP, Sacramento FD

25. Other Wildland Fire EMS Issues • Continual updates to EMSG website • http://www.nwcg.gov/teams/shwt/emsg/index.htm • http://www.nwcg.gov/teams/shwt/emsg/resources.htm • Medical protocols & the effect from the National Scope of Practice Model • Continued development of the Standard Medical Unit Protocol modeled from: • Florida Regional Common EMS Protocols (BLS only) • IMS Protocols • National Park service (Chapter 51) Emergency Medical protocols

26. What Can the LOGS Do? • Order a MEDL/IMSM — when you need it • Good ordering data — printed/type (“portion control” quantities) with call back #’s & substitution info • Copy the EMSG with a copy of your incident medical treatments & send me the email address of your MEDLs • Discourage: • Preordering of personnel and supplies • Orders not based upon current and expected conditions • Over ordering and inappropriate ordering—especially from the Cache • Failure to return FA kits back to fire cache in a timely manner • Medical Unit problems • Personnel? Treatment? Ordering? • Contact Kim Christensen or me

27. What Can the Buying Teams Do? • Do everything you can to satisfy the order from the MEDL. Call the MEDL/IMSM back when you are substituting or have questions • Don’t make medical decisions • It’s “OK” to have oxygen in the fire camp medical unit • Let us (EMSG/SHWT) know what kind of problems you encounter to help mitigate them

28. Questions? Thank You!