Emergency Medical Technician – Fireline

Introduction

The EMTF provides emergency medical services (EMS) on an active fireline, division or other physically challenging assignment.  This position may also assist at the medical unit and/or other incident location as requested by the Incident Commander or representative.

Duties

• Performs non-invasive lifesaving procedures focused on the initial management of injured and sick person. 
• EMTFs are not independent practitioners and therefore must be supervised by a physician medical director.  Although many of the procedures that an EMTF is allowed to perform do not require real-time oversight by the supervising medical director, the EMTF makes destination decisions in collaboration with medical oversight.
• While all EMTFs receive essentially the same training, the specific procedures that each individual EMTF is authorized to perform vary depending on the EMTF’s scope of practice.  An EMTF’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform.  Therefore, the scope of practice of an EMTF will vary by individual.
• EMTFs will be required to work on the fireline or other remote areas of an incident.  The EMTF would be expected to participate in and/or lead the evacuation of a sick or injured person from this environment.  The EMTF would also be expected to perform these lifesaving skills with the equipment available to them on the fireline, which is significantly less than those EMT in the medical unit or typical urban EMS system.  The EMTF may be the only medical provider on scene for an extended period of time in less than ideal conditions.

Position Knowledge and/or Requirements

The following is a list of the typical skills than EMTF can perform:

• Airway and Breathing
  • Insertion of airway adjuncts intended to go into the oropharynx or nasopharynx.
  • Use of positive pressure ventilation devices such as manually triggered ventilators and automatic transport ventilators.
• Pharmacological Interventions
  • Assist patients in taking their own prescribed medications.
  • Provide lifesaving medications with an auto injector.
  • Administration of the following over-the-counter medications with appropriate medical oversight including the following:
    • Oral glucose for suspected hypoglycemia.
    • Aspirin for chest pain of suspected ischemic origin.
• Use of an automated external defibrillator.
• Trauma Care:
  • Stabilizing suspected spinal injuries and extremity fractures.
  • Controlling bleeding.
  • Evacuation of a sick or injured patient using purpose made and improvised litters.
  • Appropriate triage of sick or injured patients in order to assist with the formulation of an evacuation plan.
  • Application and inflation of the pneumatic anti-shock garment (PASG) for fracture stabilization.

Position Knowledge and/or Requirements

• Current EMT license (must be issued by the EMTs home-state EMS licensing authority)
• Introduction to ICS (I-100)
• Firefighter Training (S-130)
• Introduction to Wildland Fire (S-190)
• NIMS:  An Introduction (IS-700)
• Annual Fireline Safety Refresher (RT-130)
• Human Factors in the Wildland Fire Service (L-180)
• An arduous physical fitness level has been established for this position

Other Training Supporting Development of Knowledge and Skills

• Intermediate Wildland Fire Behavior (S-290)
• Basic Air Operations (S-270)
• Helicopter Crewmember (S-271)
• Wilderness Emergency Medical Technician