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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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NWCG Latest Announcements

Incident Position Standards and the Next Generation Position Task Books Now Available for UASD, UASM, UASL and UASP

Date: July 31, 2025
Questions?  Please contact:
Interagency Fire Unmanned Aircraft Systems Subcommittee
 

NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Books are now available for all four Unmanned Aircraft Systems positions:

  • Unmanned Aircraft Systems, Data Specialist (UASD)
  • Unmanned Aircraft Systems, Manager (UASM)
  • Unmanned Aircraft Systems, Module Leader (UASL)
  • Unmanned Aircraft Systems Pilot (UASP)

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization 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 Unmanned Aircraft Systems, Data Specialist Position Page

NWCG Unmanned Aircraft Systems, Manager Position Page

NWCG Unmanned Aircraft Systems, Module Leader Position Page

NWCG Unmanned Aircraft Systems Pilot Position Page

Incident Position Standards and the Next Generation Position Task Books Now Available for RADO and INCM

Date: July 30, 2025
Questions?  Please contact:
Incident Logistics Subcommittee
 

NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Books are now available for Radio Operator (RADO) and Incident Communications Center Manager (INCM).

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization 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 Radio Operator Position Page

NWCG Incident Communications Center Manager Position Page

ETC Equipment Bulletin: 25-004 NEW Aquatic Invasive Species – Golden Mussels

Date: July 29, 2025
Questions?  Please contact:
Equipment Technology Committee
 

The Equipment Technology Committee (ETC) issued Equipment Bulletin: 25-004, notifying the wildland fire community about a newly discovered invasive species and actions to take if found. Golden mussels, a highly invasive species recently identified in California, pose a significant risk to native ecosystems, infrastructure, and fire equipment. These mussels rapidly colonize hard and soft surfaces, including aquatic plants and fire equipment, clogging pipes, fouling motors, disrupting water systems, and impacting native species.

To help prevent their spread, fire personnel must follow the decontamination procedures outlined in the NWCG Guide to Preventing Aquatic Invasive Species Transport by Wildland Fire Operations, PMS 444. Additionally, report any sightings immediately to your Lead Resource Advisor and include clear, close-up photos and location details.

Read the complete ETC Equipment Bulletin: 25-004 to learn more. 

References:

NWCG Alerts

ETC Equipment Bulletin: 25-004

NWCG Guide to Preventing Aquatic Invasive Species Transport by Wildland Fire Operations, PMS 444

Incident Position Standards and the Next Generation Position Task Books Now Available for ICT5 and FFT1

Date: July 29, 2025
Questions?  Please contact:
Incident Command Subcommittee
Incident Operations Subcommittee

NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Books are now available for Incident Commander Type 5 (ICT5) and Firefighter Type 1 Squad Boss (FFT1).

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization 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 Incident Commander Type 5 Position Page

NWCG Firefighter Type 1 Squad Boss Position Page