| MEDICAL PLAN | 1. Incident Name :nam: |
2. Date Prepared
:dat:
|
3. Time Prepared :tim: |
4. Operational Period :opp: |
||
| 5. Incident Medical Aid Station |
||
| Medical Aid Stations |
Location |
Paramedics |
| :msta0: |
:mloc0: |
:mpar0: |
| :msta1: |
:mloc1: |
:mpar1: |
| :msta2: |
:mloc2: |
:mpar2: |
| :msta3: |
:mloc3: |
:mpar3: |
| :msta4: |
:mloc4: |
:mpar4: |
| 6. Transportation |
|||
| A. Ambulance Services |
|||
| Name | Address |
Phone |
Paramedics |
| :tname0: |
:taddr0: |
:tphon0: |
:tpara0: |
| :tname1: |
:taddr1: |
:tphon1: |
:tpara1: |
| :tname2: |
:taddr2: |
:tphon2: |
:tpara2: |
| :tname3: |
:taddr3: |
:tphon3: |
:tpara3: |
| :tname4: |
:taddr4: |
:tphon4: |
:tpara4: |
| B. Incident Ambulances |
||
| Name |
Location |
Paramedics |
| :aname0: |
:aloca0: |
:apara0: |
| :aname1: |
:aloca1: |
:apara1: |
| :aname2: |
:aloca2: |
:apara2: |
| :aname3: |
:aloca3: |
:apara3: |
| :aname4: |
:aloca4: |
:apara4: |
| 7. Hospitals |
||||||
| Name |
Address |
Travel Time Air Grnd |
Phone |
Helipad |
Burn Center |
|
| :hname0: |
:haddr0: |
:hatim0: |
:hgtim0: |
:hphon0: |
:hheli0: |
:hburn0: |
| :hname1: |
:haddr1: |
:hatim1: |
:hgtim1: |
:hphon1: |
:hheli1: |
:hburn1: |
| :hname2: |
:haddr2: |
:hatim2: |
:hgtim2: |
:hphon2: |
:hheli2: |
:hburn2: |
| :hname3: |
:haddr3: |
:hatim3: |
:hgtim3: |
:hphon3: |
:hheli3: |
:hburn3: |
| :hname4: |
:haddr4: |
:hatim4: |
:hgtim4: |
:hphon4: |
:hheli4: |
:hburn4: |
| 8. Medical Emergency Procedures |
|
| :proc: |
|
| 9. Prepared by (Medical Unit Leader) :prep: |
10.Reviewed by (Safety Officer) :rvwr: |