Version 3.20.14E

FILL TO LINE 4 and centraloregondispatch@gmail.comFax to COIDC 541-316-7775 or save and send to PRIOR TO STARTING PROJECT

PROJECT MEDICAL EVACUATION [MEDEVAC] PLAN

1. PROJECT NAME & TYPE:

START DATE:

FIELD CONTACT: PHONE NUMBER:

RADIO CHANNEL:

PROJECT LOCATION: T R Sec ¼

2. LZ LOCATION: Latitude: ° Longitude: °3. TRAVEL ROUTE TO PROJECT AREA: (From closest main route)

4. SPECIAL INFORMATION/ FLIGHT HAZARDS: (power lines, towers, etc…)

§§ Scene Safety, PPE, remove patient from danger, rapid assessment (ABC’s), thorough examination, stabilize, document §§5. NUMBER OF PATIENTS:

6. MECHANISM/NATURE OF INJURY:

7. PRIORITY: RED - ALS (Difficulty breathing, Cardiac chest pain, Major blood loss, Burns > 2x palm size)

YELLOW - (Closed fracture, Bleeding not controlled by pressure, Burns > 1 palm size)

GREEN - BLS (Walking wounded, General sickness, Sprains and strains)

8. SPECIAL EQUIPMENT NEEDS:

C-spine precautions (back or neck injury known or suspected)

Extrication-specify (rope rescue, hoist, stokes and carry team, other)

Other: _________________________________________________

9. PATIENT ASSESMENT/ Age________ Gender M F INJURIES AND TREATMENT:

Alert and Oriented? Y N

Difficulty Breathing? Y N

Rapid or Shallow Pulse? Y N

Continue patient care documentation on reverse…

§§ Scene Safety, PPE, remove patient from danger, rapid assessment (ABC’s), thorough examination, stabilize, document §§

EMERGENCY MEDICAL NOTIFICATION PROCEDURES

In the event of a medical emergency: Designate an on-scene point of contact and notify 911 and/or Dispatch with the following information:

1. Relay patient information and location information.

2. Identify any on-scene medical personnel and who is in charge of the medical incident.

3. Document all information received and transmitted on the radio or phone.

4. Identify any changes in the on-scene Point of Contact or medical personnel as they occur.

5. Continue Patient Assessment and provide updates.

Air transport can be communicated with on radio.

AirLink and Life Flight (from the Redmond Base) will use Air to Ground 61 (A2G 61) for ground communication when responding to

an incident with FS/BLM employees as the ground contact.

Patient Assessment

Initial Patient Assessment

• General impression of patient • Airway • Breathing • Circulation • Wrist or Neck pulse • Major Bleeding

Patient Information

• Chief Complaint • Age and Weight • Known Allergies • Past Medical History

Level of Consciousness

• Alert and oriented • Verbal (responds to voice) • Pain (responds to painful stimuli) • Unresponsive

Breathing

• Normal • Difficult/labored breathing • Not breathing-Start rescue breathing

Pulse

• Present • Very fast • Weak • Absent- Start CPR

Skin color

• Normal • Pale • Bluish • Flushed/Red

Skin Moisture

• Normal • Dry • Moist/clammy • Profuse sweating

Skin Temperature

• Normal/warm • Hot • Cool • Cold

Pupils

• Equal and reactive to light • Fixed • Slow response • Unequal • Dilated • Constricted