Lightning Injuries: Electrical, Medical, and Legal Aspects

by National Wildfire Coordinating Group (Author)

In 2010, the Incident Emergency Medical Subcommittee (IEMS), operating under the authority of the National Wildfire Coordinating Group (NWCG) - Risk Management Committee, completed the document, Interim Minimum Standards for Medical Units Managed By NWCG Member Agencies. The document was the first of several to be developed that will address the need for uniform standards and safe delivery of medical care provided by Emergency Medical Services (EMS) personnel at wildland fire. It focused on recognizing current practices and recommending standards to medical units for; promoting the use of licensed personnel within their scope of practice, state EMS office notification, applicable rules and jurisdictions, medical direction, communications, patient transportation and medical equipment, medication and supplies used. The IEMS also committed to developing wildland fire specific protocols and this document, Clinical Treatment Guidelines for Wildland Fire Medical Units, PMS 551, is the finished product. A task group of physicians with diverse backgrounds in wildland fire medicine, wilderness medicine and emergency/ clinical backgrounds reviewed this document and provided valuable input. These guidelines where developed with the expectation that the typical appropriate Basic Life Support (BLS) or Advanced Life Support (ALS) EMS interventions will be provided as needed so we did not include detailed protocols for EMS medical or trauma patient care, which already exists. Rather, we focused on guidance for the unique differences and challenges associated with remote sites and expanded evaluation skills needed for patient care issues such as: 1) assisting a patient with first aid and self-care health management; 2) triaging conditions for recognition of appropriate self-care assistance vs. need for transport to clinical medical care; and 3) initiating urgent/EMS care using appropriate and predetermined transport modes.