Region 1 Incident Medical Specialist Purpose

The purpose of the IMS program is to provide for minor medical care for the more common occupational health type medical problems on an incident, and provide Basic Life Support of injuries at a significant cost savings to incidents. The IMS team is usually staffed with enough medical personnel to maintain the Base Camp and or spike camps as needed for each required operational period Other medical personnel, i.e. EMT’s can be ordered and placed on the fire line. There are three positional levels in the program, IMS Manager, IMS Assistant, and IMS Technician (trainee level).

Roles that IMS personnel can perform include:

  1. First or second-line responder - assessing and treating injuries and illnesses of an emergent nature.
  2. Assessing and aiding in operational decisions regarding traumatic injuries.
  3. Responding to emergent medevac situations and assisting in coordination of medevacs.
  4. Providing medical care of a clinical nature or the non-emergent care.
  5. Acting to refer or transfer sick or injured personnel to definitive care.
  6. Tracking cases of a more serious nature and aiding in decisions pertaining to a patient's returning to work or medical demobilization.Tracking trends of illness and injury to aid improvement in health and safety on the incident.
  7. Working pro-actively to prevent illness and injury, often thru the Safety Officer
  8. Documentation of illness or injury for an individual's official record.

To meet this goal it is necessary that IMS personnel meet relatively high-level entry requirements to the program, receive appropriate training, and gain additional responsibilities within the program only after sufficient experience and proof of competency. Because, fully 90% of the complaints seen at the incident medical unit are not of an emergent nature the IMS course concentrates on providing the additional training for clinical type care (e.g. blisters, colds, coughs, headaches, upset stomachs, strains/sprains, etc.) The course also covers the indications and contraindications for the over-the-counter medications, the use of specialized equipment such as the Otoscope and Ophthalmoscope, patient confidentiality, cultural issues, and a variety of other topics, It is important to note that typical MEDL, and EMT training does not cover providing medical care of this nature.

Extreme care must be exercised at all times to ensure that the medical personnel are operating within the scope of their assigned responsibilities and duties. (i.e. if you are hired as an EMT then that is the role you are expected to operate at, not at the MEDL level, nor at the IMS level, etc.). This is both an IMS Managers responsibility, Medical Unit Leaders responsibility, AND an individual responsibility of all medical personnel assigned to the incident. Many people seem to believe that being an EMT is interchangeable with being a health care provider (IMS). Being the Chief of a fire department does not automatically qualify someone to be a Branch Director on a wildfire. A person can be both if they are trained in both positions.

  • Very large or complex incidents may have a Medical Unit Leader (MEDL) and an IMS Team. The MEDL will be responsible for the administrative functions of the Medical Unit. The IMS Manager will manage the medical care. On smaller incidents one IMSM that is also MEDL qualified can serve in both functions.

Usually the IMST is the only one that could or should be required to be dispatched to the line for roving medical emergencies. Because of their high level of training it is the IMSM or IMSA’s responsibility to remain in camp to treat patients.

  • EMT's:
  1. Usually ordered to supplement IMS personnel in the field (especially for providing roving medical support on the line)
  1. EMT'S that are assigned to the line must be red-carded, and take the light work capacity test. In the ICS there is no such position defined as “line” qualified EMT.
  1. When getting EMT’s from out of State, a Request for Recognition form must be filled out and faxed to the State EMS Director along with proof of their current licensure in another state and in Montana a current National Registry Certification.
  1. EMT’s from out of state can only function at a “basic life support” level and within the approved State Basic Protocols, regardless of the level authorized by the state in which the EMT is licensed. Out of state EMT-I and EMT-Ps need medical control therefore Functioning at an Advanced Life Support level is stricly prohibited.
  1. EMT's do not have training to provide non-emergency support (e.g. occupational health issues) and should not be handing out over-the-counter medications, etc. EMT’s can be held liable for any action they take that exceeds their scope of training and could lose their EMT license.