2018 WOR: Ground-based Medevac

Week 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.

There are many examples of firefighters being carried out from the fireline due to a medical emergency. The reports often include lessons learned and suggestions from the firefighters involved that may be very helpful to you and your crew when a medevac situation becomes a reality on your piece of the fireline. Below are just a few for you and your crew to review for training purposes.

“We honor and remember through learning”

Brit Rosso
Director, LLC

1. “The crews who had trained with medical evac simulations—when faced with the real thing on the fireline—performed in an orderly and comfortable manner, saving precious time. Those who had not practiced wished they had. This holds true for everyone involved—including dispatch and administrators. Do this! If you get hit by a tree, I’m sure you would prefer the folks around you were not at their first rodeo.” Quote from Travis Dotson Fire Management Specialist, Two More Chains Spring 2011 Vol 1 Issue 1 Digging Through Incident Reviews.
    
2. “Knowing whether or not the injury to a firefighter is life threatening is critical information that needs to be relayed to decision makers early in emergency response scenarios. Pre-planned decisions as to whether to use air or ground transport, or to mobilize an incident helicopter instead of an air ambulance, depend on having a good patient assessment. When this information is not clearly communicated by EMTs on scene attending to the medical emergency, the managing organization needs to take the necessary actions to obtain it.”  Pyramid Butte Fire 2010 Facilitated Learning Analysis.
    
3. When a hotshot got pinned by a burning log, a Rapid Extraction Module (REM) team joined the effort to pack him out. REMs are a relatively new, emerging resource, which many fireline resources/IMTs have not yet had the opportunity to work with. The speed at which the low-angle rescue mission was performed on this incident was slower than expected by the ground resources.  What is your definition of rapid? One hour? Four hours? Are we expecting more from this “tool” than the tool can provide? IMTs and crews need to talk with these teams and get an understanding of their capabilities and SOPs. “We need to train together” was one recommendation from a REM team member on this incident. Learn about REM teams by reading this RLS. Rough Fire Medical Extraction Lessons Learned Review 2015.
    
4. At the beginning of the season, this hotshot crew practiced building a backcountry litter during training. During the July 20 medical emergency, when Foreman requested backcountry litter, “everyone on the crew had a solid image of what needed to be done and what it would look like when ready. Later in the season, the crew was involved in a carryout involving cardiac arrest . Based on this experience, crewmembers were able to be decisive in finding the best way to help during this medical incident. Whether it was building the stretcher/splint, controlling the fire’s edge, or clearing a path out to the trail, everyone found a way to contribute. Check out this 1 ½ minute video on how this crew trained for this emergency—and how that training paid off in a real situation. Rapid Lessons Shared (RLS) – Non-emergency carryout of Hotshot crewmember 2013 IHC Packout.

Action: Train and drill with other resources from your home unit on ground-based medevac simulations.

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.