INCIDENT EMERGENCY MEDICAL TASK GROUP
|Table of Contents|
|Program of Work and Action Items|
|Develop a process that ensures
proper notification is made to
State and local EMS authorities when an incident Medical Unit
is to be operated within their jurisdiction
|Review Existing Policy, Guidelines, and Directions|
|Develop a Standard of Care for incident medical operations|
|Identify a common Scope of Practice for incident medical operations|
|Identify standardized medical equipment and supplies to be carried by EMS personnel assigned to incidents managed by NWCG member agencies|
|Make recommendations for identifying Regional/State level Medical Directors/Advisors|
|Standardize the management of
Incident Medical Units, possibly
through creation of an Interagency Incident Medical Unit Standard Operating Guide
|Incorporate industry standards for emergency medical terminology and duties, (e.g., Emergency Medical Technician, Advance Emergency Medical Technician, and Paramedic) into NWCG position standards|
|Develop standards for contracting Emergency Medical Services|
|Develop tools that will enhance
NWCG members’ ability to provide
oversight to Incident Medical Units
|Action Item Summary Table|
|A. IEMTG Charter|
|B. IEMTG Core Member Listing|
|C. IEMTG Introduction Letter|
|D. NASEMSO Resolution 2007-02|
|Resources and References|
|USFS Decision Support Briefing Paper- Wildland Fire Emergency Medical Services issues and recommendations|
|NWCG Medical Unit Operating Standards for Integration with State EMS|
|Handling of Medical Records Created on Incidents|
|Sample of Limited Request for Recognition form|
|Montana Sample of Limited Request for Recognition form|
|Resources & References under Construction|
|NWCG Standards for Burn Injuries|
|NWCG EMS Scope of Practice Model|
|NWCG Standard of Care for Incident Medical Operations|
|NWCG Operating Standards for Incident EMS Support|
|NWCG Contract Incident Medical Equipment & Supply Lists|
|NWCG Incident Medical Equipment & Supply Lists|
|Incident Medical Unit Evaluation Criteria|
|Medical Unit “Cook Book”|
|NWCG Recommendations for providing AEDs at Incident Base Camps|
|back to the top|
Wildland firefighting and all risk incidents require a unique array of support services due to remoteness, terrain, and multiple agencies involved in major responses. Medical support is essential because of the inherent risks found at these and other catastrophic events. The issues of standards of care and legal certification of providers come into play when emergency medical providers from other jurisdictions cross state lines or other geopolitical boundaries to provide medical care. These situations are further complicated in areas where medical control is sometimes nonexistent, or the capabilities of nearby medical facilities may be limited, including the variability of local emergency medical services agency capacities. The National Wildfire Coordination Group (NWCG) Safety and Health Working Team (SHWT) has formed and chartered the Incident Emergency Medical Task Group (IEMTG) to address these issues.
The mission of the IEMTG is to develop national emergency medical and occupational health standards and procedures. The mission purpose is to ensure the health and safety of workers on incidents in an efficient and cost effective manner on wildland incidents. The focus will be to provide information, updates, and guidance, as necessary in the development and ongoing effort for a successful outcome.
The care of the sick and injured on incidents
has expanded over the last thirty years.
A number of well documented issues have been identified in recent years. These issues include the following:
Lack of clarity on these and other issues has led to heightened costs for incident emergency medical services operations, greater exposure to liability for all agencies and employees involved, and concerns about quality of care. This challenge has also created some problems between state and national emergency medical services entities.
Wildland fire agencies in most areas of the nation may lack the organization and standards required to adequately address the host of emergency medical services issues they regularly confront. Incident Management Teams, Medical Unit Leaders, Emergency Medical Technicians, Advanced Emergency Medical Technicians, other intermediate level EMS personnel, and Paramedics are frequently mobilized from one part of the country to another, causing inconsistencies in providing emergency medical services on wildland fire incidents. Some geographic areas and agencies have established programs which provide trained incident medical resources with medical oversight. These programs were implemented to provide a more organized approach to emergency medical services delivery.
The fragmented delivery of emergency medical services and occupational health care on wildland fire incidents has not escaped the notice of the various state authorities charged with overseeing emergency medical practices within their areas. In 2002 and again in 2007, the National Association of State Emergency Medical Services Officials called upon the agencies responding to or arranging staffing for wildland fires to work with them to create standards to be followed when identifying and using resources at the local, state, regional, and national levels. The National Association of State Emergency Medical Services Officials continues to support the development of an organized approach for granting legal recognition for out-of-state personnel for fighting wildland fires.
Delivery of regulated and standardized emergency medical services support on wildland fire incidents is obviously an interagency concern. In 2003 the National Wildland Coordinating Group’s Safety and Health Working Team established an Emergency Medical Standards Group to focus on these issues. The team composition included representatives of federal agencies involved in wildland fire oversight, the National Association of State Foresters, National Association of State Emergency Medical Services Officials, and the National Association of Emergency Medical Services Physicians. In the spring of 2004, the Emergency Medical Standards Group developed “Medical Unit Leader Operating Standards for Integration with State Emergency Medical Services” along with a companion “Limited Request for Recognition” form. These documents were approved by the National Wildland Coordinating Group.
Following the sunset of the Emergency Medical Standards Group, the National Wildland Coordinating Group (NWCG) chartered the Incident Emergency Medical Task Group (IEMTG) to pursue the development of more robust wildland fire standards concerning medical practices and operations on incidents. The scope of the charter also includes:
PROGRAM OF WORK AND ACTION ITEMS
|SUBTASK NAME||Target timelines:|
process that ensures proper notification is made to State and
local EMS authorities when an Incident Medical Unit is to operate
within their jurisdiction
Policy, Guidelines, and Directions
a common Scope of Practice for incident medical operations
Standard of Care for incident medical operations
standardized medical equipment and supplies to be carried by EMS
personnel assigned to incidents managed by NWCG member agencies
for identifying Regional/State level Medical Directors/Advisors
the management of Incident Medical Units, possibly through creation
of an Interagency Incident Medical Unit Standard Operating Guide
industry standards for emergency medical terminology and duties,
(e.g., Emergency Medical Technician, Advance Emergency Medical
Technician, and Paramedic) into NWCG position standards
for contracting Emergency Medical Services
that will enhance NWCG members’ ability to provide oversight
to and evaluation of Incident Medical Units
The National Wildfire Coordinating Group (NWCG) member agencies have been aware of a number of issues related to the delivery of Emergency Medical Services (EMS) on incidents managed by participating agencies. Many ongoing issues have been identified in such areas as the credentialing of EMS providers when moving between jurisdictions; identification of a standard Scope of Practice and Standard of Care on incidents; maintenance of incident medical records; provision of Over-The-Counter (OTC) medications, and others. The Incident Emergency Medical Task Group is being formed to address these issues, working closely with the States in which NWCG member agencies operate.
The name of group is the Incident Emergency Medical Task Group, hereafter referred to as the Task Group.
Work with the appropriate State and National EMS offices and organizations to identify standards for the delivery of EMS and Occupational Health services on incidents managed by NWCG member agencies.
The number of members of this Task Group shall
not exceed eight (8) including the Chair and Executive Secretary.
Members will be skilled and knowledgeable in the area of providing
Emergency Medical Services on wildland fires and other emergency
incidents, or will represent other medical service organizations
such as state EMS boards. Membership will also provide for interagency
input and participation. A SHWT Liaison will be assigned after
selection by consensus vote of the SHWT. Replacement members
will be selected by the Task Group Chair through discussions
and coordination with the SHWT Liaison. The Chair will be selected
by a consensus vote from the SHWT.
This Task Group is established pursuant to the authority granted to the National Wildfire Coordinating Group Safety and Health Working Team.
VII. CHAIR AUTHORITY AND RESPONSIBILITIES
The Task Group Chair will have the following authority and responsibilities:
VIII. MEETINGS AND REPORTS
This Charter is effective as of the date it is approved and signed by the SHWT Chair. The Charter may be revised upon recommendations of a majority of the Task Group members and with the concurrence of the SHWT.
Chair, Safety and Health Working Team
June 16, 2008
Incident Emergency Medical Task Group (IEMTG) Core Member Listing
||Chair Idaho Safety & Health Manager
|Gene Madden|| NIMO
||Branch Chief of Emergency Service
||Manager Office of Emergency Medical Systems
State of Nevada
|Mary Jo Lommen
|Dia Gainor|| Idaho
State of Idaho
| Fire Chief
North Lake Tahoe Fire Protection District
|Deputy State Forester
| Larry Sutton
| Fire Operations Risk
USFS - WO
The National Wildfire Coordinating Group (NWCG) and those agencies involved in emergency medical services (EMS) deployment and system regulation are aware of a number of issues related to the delivery of EMS on incidents managed by participating agencies. Many unresolved challenges have been identified. Credentialing of EMS personnel and resources moving between jurisdictions, medical unit equipment standards, identification of a standard scope of practice and standard of care on incidents, maintenance of incident medical records, and provision of over-the-counter (OTC) medications are some of the areas of greatest concern.
The Incident Emergency Medical Task Group (IEMTG) has been formed under the direction of the Safety and Health Working Team (SHWT) to address these challenges. The IEMTG will continue the work of the former Emergency Medical Support Group and will coordinate with the appropriate local, state, tribal, federal, and national organizations. The team will develop and recommend standards for the delivery of EMS and occupational health services on incidents managed by NWCG member agencies.
The objectives of the IEMTG include:
The current members of the IEMTG are from the U.S. Forest Service, U.S. National Park Service, Bureau of Land Management, National Association of State Foresters and the National Association of State EMS Officials.
Additional information and resource material can be found at: www.nwcg.gov/teams/shwt/iemtg
Michelle G. Ryerson,
National Association of State EMS Officials
Whereas, states have the legislated authority and responsibility to verify and assure that EMS meets or exceeds minimum standards when provided to people residing and working in their state; and
Whereas, local EMS resources, including personnel and ambulances services, are properly certified or licensed by the appropriate state or local agency, operate under local medical direction, and know the local protocols and capabilities of the area healthcare system, and it is desirable to have a comparable organized national approach for wildland fires; and
Whereas, failure to receive proper state level authorization as EMS personnel or ambulance services may be in violation of state statutes, making individuals and organizations both civilly and criminally liable; and
Whereas, NASEMSO recognizes that the agencies responsible for wildland fire incident command and resource deployment often do so under adverse circumstances and resort to deployment of EMS personnel and ambulances from other states; and
Whereas, the “National Wildfire Coordinating Group (NWCG) Medical Unit Operating Standards for Integration with State EMS” has resulted in limited standardization and the detection of conditions in medical units of great concern or basis for action by state EMS offices, such as the utilization of EMS personnel who have no valid license in any state;
efforts to establish comprehensive standards for medical unit
Whereas, it is desirable to have an organized national approach for granting legal recognition to out-of state emergency medical personnel and transportation services that ensures that such personnel and resources are appropriately credentialed (granted the legal authorization to practice) and operate under appropriate medical direction; and
Whereas, it is not possible for states to develop a system for granting legal recognition to out-of-state EMS resources in the absence of comprehensive standards comparable to those that have been adopted for wildland firefighting operations;
be it resolved that the National Association of State
EMS Officials renews the
be it resolved that the National Association of State
EMS Officials pledges to
Association of State Emergency Medical Services Officials