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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! Incident Performance and Training Modernization Story Map Now Available

Date: Aug 26, 2025
Questions? Please contact:
National Wildfire Coordinating Group

NWCG is excited to announce the launch of the Incident Performance and Training Modernization (IPTM) Story Map, a new interactive resource that showcases how NWCG is transforming wildland fire training and qualifications through a performance-based system.

Since its launch in 2023, IPTM has made major strides in updating how we manage incident positions:

  • 36 incident positions now have new Incident Position Standards and Next Generation Position Task Books available for field use
  • 6 more incident positions are nearing completion
  • 111 total incident positions are being analyzed through the IPTM initiative

The Story Map guides you through the IPTM process, highlights key accomplishments, and outlines what’s ahead. Whether you are a trainer or a trainee, this tool offers valuable insight into the modernization effort shaping the future of wildland fire training and qualifications.

This effort would not be possible without the contributions of NWCG staff, NWCG committees, and hundreds of subject matter experts across the wildland fire community.

References:

IPTM Story Map

Incident Performance and Training Modernization Webpage

NEW! S-290, Intermediate Wildland Fire Behavior (Blended) Available Now

Date: Aug 15, 2025
Questions? Please contact:
Fire Behavior Subcommittee

NWCG is excited to announce that the S-290, Intermediate Wildland Fire Behavior (Blended) training is now available on the Wildland Fire Learning Portal. S-290 (Blended) training combines online training and instructor-led training components that support individuals working towards any Single Resource Boss or Fire Effects Monitor incident qualifications.

This second course in the series collectively serves to develop fire behavior prediction knowledge and skills, and provides more detailed information on fuels, weather, and topography that affect wildland fire behavior for safety purposes.

Students are required to finish the prerequisite S-190, Introduction to Wildland Fire Behavior, before enrolling in S-290, Intermediate Wildland Fire Behavior (Blended).

References:

S-290, Intermediate Wildland Fire Behavior (Blended)

S-190, Introduction to Wildland Fire Behavior

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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

Wildland Fire Learning Portal

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

Date: Aug 13, 2025
Questions? Please contact:
Fire Behavior Subcommittee

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