National Wildfire Coordinating Group

2018 WOR Day 2: Medical Incident Response

Ribbon symbol for survivor next to the Wildland Fire Leadership logoWeek of Remembrance June 30-July 6

This Week of Remembrance is dedicated to all those who have fallen in the line of duty and is intended to serve as an opportunity to renew our commitment to the health, wellness and safety of wildland firefighters.

On July 25, 2008 a falling module from an engine company was assigned to mitigate hazard trees along a fireline in Northern California to enable crews to safely work in the area. At approximately 1350, a firefighter called ICP for medical assistance for a severely injured crew member—18-year-old Andy Palmer. Emergency medical personnel responded and treated the injured firefighter for severe bleeding. Due to heavy smoke conditions requiring Instrument Flight Rules (IFR) capability, primary helicopter resources were unable to respond to the injured firefighter’s location. Firefighters carried the injured party by litter to a location where he was eventually hoisted into a U.S. Coast Guard helicopter (USCG) at approximately 1630. The USCG Helicopter carrying the injured firefighter arrived at Redding Municipal Airport, where Andy was pronounced dead at 1710. This was Andy Palmer’s first fire assignment. This line of duty death would later be referred to as the Dutch Creek Incident.

“We honor and remember through learning”

Brit Rosso
Director, LLC

This incident and the loss of Andy shocked and saddened the wildland fire service. Many wondered how it could take more than three hours to get a severely injured firefighter off the line and to a hospital. After all, this fire was being managed by a Type 1 Incident Management Team. There were line EMTs assigned to the fire. There was a medical plan in place. Yet with everything in place, we still lost a young firefighter.

Everyone on scene and in a supporting role that day did everything they could do to help Andy Palmer. The questions and discussions that emerged in the aftermath were about reducing the chance of this happening again. What do we need to change in our systems? Where are the holes and gaps that allowed this to happen? What new tools do we need to provide to our firefighters, fire managers, dispatchers and IMTs when it comes to planning for a medical response and evacuation to a hospital?

In July of 2009, the Dutch Creek Accident Review Board (ARB) recommended eight corrective measures to “…help prevent similar accidents from occurring in the future”. In May of 2010, NWCG released a memo titled “Dutch Creek Serious Accident Investigation Report Response: Three (3) New Incident Management Team (IMT) Daily Operation Protocols/Procedures”. This memo later became known as the “Dutch Creek Protocol”.

One of the recommendations in the Dutch Creek Protocol memo was to add some standard language to the ICS-206 Medical Plan, Block 8 titled “Emergency Medical Procedures”. These procedures were printed on adhesive pink stickers by the Wildland Fire Lessons Learned Center (LLC), and could then be added to the Incident Response Pocket Guide (IRPG) medical section. More than 100,000 stickers were sent out to the field. Over time, the pink sticker protocol was tested, refined, and is now referred to as the Medical Incident Report (MIR), which was first included in the IRPG in 2014. It was recently updated and improved for the 2018 IRPG.


Action: Watch this video and then do the following:

  • On page 2 in your IRPG, review and discuss the value of “Planning for Medical Emergencies”.
  • On page 118 & 119 in your IRPG, review and discuss how to use the “Medical Incident Report”.

The topics, review, and resources for the NWCG “Wildland Firefighter Week of Remembrance” have been contributed by the Wildland Fire Lessons Learned Center, the Wildland Fire Leadership Subcommittee, the Interagency Helicopter Operations Subcommittee, interagency dispatchers, and many other field SMEs.


Week of Remembrance
Page Last Modified / Reviewed: 
Aug 2023

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