Post Incident Analysis MVA

Post Incident Analysis MVA
Shift
Completed By
Incident Commander
Date of Incident

MonthDayYear
Date
Incident Number
Response Time

Tone Out

AM/PM Option

until
Arrival

AM/PM Option
Total 0.0
Incident Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Vehicles Involved
Number of Patients Involved
Required Extrication

YesNo
Number of Occupants Entrapped
Fatalities

YesNo
Number of Fatalities
Incident Description
EV Vehicle Involved

YesNo
Items Requiring Attention

ProceduresDispatchResponseApparatusTrainingWater SupplyEquipmentOperationsCommandPPE
Explain Each Checked Item Above
Incident Command
Command

Established by First ArrivingAssign and Announced Ops ChannelDeveloped IAP and Communicated to Incoming Crews
Transfer of Command

Face to FaceAnnounced on Ops to Operating CrewsDispatch Notified Transfer of CommandCommand Not Transferred
Size Up
Size Up

Communicated360 CompletedAssignments Given to Incoming Crews
Plan A
Plan B
On Scene Operations
Vehicle 1 Disposition

Up RightSitting On Driver's SideSitting On Passenger SideOverturnedOn Another VehicleOn FireAgainst ObjectIn Water
Vehicle 2 Disposition

Up RightSitting On Driver's SideSitting On Passenger SideOverturnedOn Another VehicleOn FireAgainst ObjectIn WaterN/A
Vehicle 3 Disposition

Up RightSitting On Driver's SideSitting On Passenger SideOverturnedOn Another VehicleOn FireAgainst ObjectIn WaterN/A
Vehicle 4 Disposition

Up RightSitting On Driver's SideSitting On Passenger SideOverturnedOn Another VehicleOn FireAgainst ObjectIn WaterN/A
Type of Vehicle

CommercialSedanSUVPickupSchool BusMotorcycleATVBoatElectric Vehicle
Mechanism of Injury

RolloverFront InpactRear ImpactSide Impact
Damage

LightModerateHeavy
First Due Apparatus Properly Positioned

YesNo
Second Due Apparatus Properly Positioned

YesNo
Command Properly Positioned

YesNo
Extrication Tactics

Door PopDoor RemovalB Post FlapB Post BlowoutDash PushPedal RemovalSteering Wheel removalRoof FlapRoof RemovalTunnelOther
Glass Management was Coordinated with Patient and Rescuers Protected

YesNoNo Glass Management
Tools Used

Hydraulic CutterHydraulic SpreadersHydraulic RamElectric CutterElectric SpreadersConfined Space CuttersReciprocating SawRotary SawOther
All Tools were Operated Effectively

YesNo
Describe any Issues with Tools or Tool Operation
Hard Protection was Used to Protect Patients and Rescuer

YesNo
Patient Care Inside Vehicle

Performed by LISHFD PersonnelPerformed by EMS PersonnelPerformed by Other AgencyPatient Care was Not Provided Inside Vehicle
Vehicle Stabilization

StruttsCribbingRopesStrapsWinchMarried VehiclesNo Stabilization Performed
Scene Safety Provided

Apparatus Blocked Roadway to Protect PersonnelCones DeployedAll Personnel in Proper PPE for AssignmentHose Line Deployed
Safety Concerns
Hazards

Down Power LinesDown TreePower to Vehicle(s) SecuredFuel/Oil Leak or SpillHazardous Cargo
Please explain any issues with securing power, like an odd battery location or a hard to access power source. Also describe any hazards caused by what the vehicle was transporting.
Communications
Communications with Dispatch (if issues describe below)

No IssuesIssues
Describe Issues
Communications with Crews Enroute (if issues describe below)

No IssuesIssues
Describe Issues
Communications On Scene (if issues describe below)

No IssuesIssues
Describe Issues
Landing Zone
Was LZ Used

YesNo
LZ Used (Location)
Support Functions
Utility Agencies

Power CompanyWater AuthorityGas Company
Accountability
LISHFD Accountability Procedures Followed Throughout Incident

YesNo
Training
Training Deficiencies

CommandSize UpCommunicationsArea FamiliarizationPump OpsHose Deployment/AdvancementTacticsEquipmentGearTool Work
Explain Checked Item
Assisting Agencies

NOB HazmatSOB HazmatBCSOSLEDATFFBIOther Fire DepartmentOther AgencyBCEMS
Auto Aid

FrippBeaufort
Mutual Aid

Beaufort FDFripp FDBurton FDAir Station MCASParris Island MCRDSheldon FDOther
What Went Well
Lessons Learned
Should be Empty:

Post Incident Analysis MVA

Incident Command

Size Up

On Scene Operations

Communications

Landing Zone

Support Functions

Accountability

Training