Medical Incident Report (MIR) (HB)

The Medical Incident Report is one of the cornerstones of the Medical Incident Technician program. This report has gone through several iterations over the past few years and has become a standard format for communicating information about a medical problem in the field.

The Medical Incident Report has four sections:

• Initial Contact,
• Patient Assessment and Transport Plan,
• Additional Resources
• (optional) MIST Reports for Red Patients

First Transmission: Initial Contact

During the initial contact, you will contact appropriate resources by radio and declare “Medical Incident within an Incident” and then declare EITHER: “Medical Emergency” for RED patients or “Non-Emergency Medical Transport” for patients that are yellow or green.

Second Transmission: Patient Assessment and Transport Plan

Next, you will provide the following information in order:

• Incident summary. You must give a name for the overall incident, the name of the on-scene incident commander, and the person providing care to the patient. It is best to name the incident using a geographic name followed by the term “Medical.” Avoid the use of names that are already in use to prevent any confusion. Give the last name of IC and the level of care, and last name of the medical provider.
• Number of patients and their priority. Use the color-coded severity system (Red, Yellow, Green). An example is: “I have two red patients, zero yellow, and three green.”
• Brief summary of injuries and illnesses. Keep this high level and list the most significant injuries. Give a concise description of what is wrong with the patient and how it happened.  Say what you see–remember the other side of the communications does not see the patient, they see a radio. We are not trying to give a MIST report or full Patient Assessment here.
• Transport request. State what you need for transport for the patient and where you will need it. Ask for what you need for the situation that will get the patient to the last, best place they need to be. The request could be an agency vehicle at a trailhead for a ride to the local hospital (for a stable ankle injury). The other end is the use of helicopters, be it agency based for short-haul or hoist or the need for a medical helicopter. Remember that no matter what we are planning on using, we still need to have a backup plan, especially if aviation resources are requested.
• Location. Give your current location as coordinates. We need to identify the patient’s location and not where the ambulance should be or where the LZ is. The best way to describe the location is to give the distance and direction from a know geographic position and lats and longs.  Also give the evacuation location, The estimated time of arrival of the patient (or patients) to the evacuation location, and the extraction site details.

Third Transmission: Additional Resources

The third transmission is to request any other equipment and or manpower that may be needed and where and when it is needed. Confirm communication with any other agency or units involved—state contingency plans. Remember PACE: Primary, Alternate, Contingency, Emergency. Ensure that all involved know what the plan is.

If you need additional resources, you will transmit that last. If you do not need any additional resources, you can say “no additional resources needed.” In addition to that information, you should also provide your communication frequencies (or how to get a hold of you), any contingency plans, and any updates from the beginning of the communications.

Fourth Transmission (Optional): MIST for RED Patients

The fourth transmission is a patient assessment for a red patient. This should be done after patient severity has already been communicated and transport initiated. This could be delegated from the IC to the on-site medical provider and might be done on an alternate frequency or phone call if appropriate.

Example Medical Incident Report