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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.

 

Category
Fire Communication
References
NWCG Emergency Medical Committee (EMC)

6MFS Suggestion Form


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NEW! S-271, Helicopter Crewmember (Blended) Now Available

Date: Aug 14, 2025
Questions? Please contact:
Interagency Helicopter Operations Subcommittee

The S-271, Helicopter Crewmember (Blended) is now available. Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Helicopter Crewmember (HECM) incident qualifications. 

S-271, Helicopter Crewmember (Blended) training combines online training and instructor-led training components. This course is designed to provide students with the knowledge and skills necessary to perform the duties of the HECM position, as described in the NWCG Incident Position Standards for Helicopter Crewmember, PMS 350-22.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

S-271, Helicopter Crewmember (Blended)

NWCG Helicopter Crewmember (HECM) Position Page

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Incident Position Standards and Next Generation Position Task Books Now Available for FBAN and LTAN

Date: Aug 13, 2025
Questions? Please contact:
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NWCG is excited to announce that Incident Position Standards and Next Generation Position Task Books are now available for Fire Behavior Analyst (FBAN) and Long Term Fire Analyst (LTAN).

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization (IPTM) effort. These resources support trainees, qualified personnel, and evaluators in their respective roles.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

NWCG Fire Behavior Analyst Position Page

NWCG Long Term Fire Analyst Page

ETC/RMC Safety Bulletin: 25-001 New Guidance on Laundering Wildland Fire Clothing to Reduce Contamination

Date: Aug 8, 2025
Questions? Please contact:
Equipment Technology Committee
 Risk Management Committee

The Equipment Technology Committee (ETC) and the Risk Management Committee (RMC) have issued Safety Bulletin 25-001: Laundering to Decontaminate Wildland Fire Clothing. Recent research revealed that wildland fire flame-resistant pants and shirts can be contaminated with chemicals from combustion byproducts, including carcinogens, and that common laundering practices can effectively remove these harmful contaminants from wildland firefighter clothing more effectively than previously understood. It is recommended to decontaminate wildland fire clothing as frequently as possible. 

Frequently Asked Questions about this new information and how to implement recommendations can be found on the NWCG Alerts page. Read the complete ETC/RMC Safety Bulletin: 25-001 to learn more. 

References:

NWCG Alerts

ETC Safety Bulletin: 25-001

Frequently Asked Questions (FAQ) on Laundering to Decontaminate Wildland Fire Clothing

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FAQ Now Available for Archiving Type 1 and Type 2 Incident Positions

Date: Aug 6, 2025
Questions? Please contact:
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To support the transition to Complex Incident Management (CIM), NWCG will archive all Type 1 and Type 2 Command and General Staff (C&G) position qualifications in January 2026, as outlined in NWCG Executive Board Memo 25-002. To assist with this transition, a new Frequently Asked Questions (FAQ) document is now available.

This resource answers common questions about the status of Type 1 and Type 2 qualifications, impacts to incident qualification management, training requirements, and resource ordering considerations. Review the full FAQ to learn more.

For additional information on CIM and the transition of C&G positions, see NWCG Executive Board Memos 23-005, 24-005, and 25-002, as well as the Incident Workforce and Development Group webpage.

References:

NWCG Type 1 & Type 2 Position Archiving FAQ

NWCG Executive Board Correspondence

Incident Workforce Development Group

Incident and Position Standards Committee