Post Incident Analysis Medical

Post Incident Analysis Medical
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
Total Patients
Form will calculate for you
Green Patients
Yellow Patients
Red Patients
YesNo
Number of Fatalities
Incident Description
ProceduresDispatchResponseApparatusTrainingEquipmentOperationsCommandPPE
Please Explain Checked Items
Incident Command
Established by First ArrivingAssign and Announced Ops ChannelDeveloped IAP and Communicated to Incoming Crews
Face to FaceAnnounced on Ops to Operating CrewsDispatch Notified Transfer of CommandCommand Not Transferred
Size Up
Communicated360 CompletedAssignments Given to Incoming Crews
On Scene Operations
YesNo
YesNo
Resources
YesNo
Safety Concerns
Communications
No IssuesIssues
Describe Issues
No IssuesIssues
Describe Issues
No IssuesIssues
Describe Issues
Landing Zone
YesNo
LZ Used (Location)
Support Functions
Power CompanyWater AuthorityGas Company
Accountability
YesNo
Training
CommandSize UpCommunicationsArea FamiliarizationPump OpsHose Deployment/AdvancementTacticsEquipmentGearTool Work
Please Explain Checked Items
NOB HazmatSOB HazmatBCSOSLEDATFFBIOther Fire DepartmentOther Agency
FrippBeaufort
Beaufort FDFripp FDBurton FDAir Station MCASParris Island MCRDSheldon FDOther
What Went Well
Lessons Learned
Should be Empty:

Incident Command