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FOREST SERVICE MANUAL
NORTHERN REGION (REGION 1)
MISSOULA, MT
FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
Supplement No.: 5100-2005-1
Effective Date: June 24, 2005
Duration: This supplement is effective until superseded or removed.
Approved: KATHLEEN A. MCALLISTER (FOR)
ABIGAIL R. KIMBELL
Regional Forester
Date Approved: 6/17/2005
Posting Instructions: Supplements are numbered consecutively by title and calendar year.
Post by document; remove the entire document and replace it with this supplement. Retain this
transmittal as the first page(s) of this document. The last supplement to this title was
5100-2003-3 to FSM 5130.
New Document
5130
9 Pages
Superseded Document(s) by
Issuance Number and
Effective Date
5100-2003-3 (8/22/2003)
10 Pages
Digest:
5133.1 – Revises “Work Capacity Test - Light.” To add, “Note: Only with a red card work
capacity rating of moderate or arduous will IMS personnel be allowed to go to the line.” Makes
other minor technical corrections.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
5133.04c – Forest Supervisors
1. Acting Forest Supervisors may be delegated responsibilities for Widland Fire
Situation Analysis (WFSA) decisions and assignment of appropriate Incident Management
Teams. Minimum requirement for the delegation is successful completion of local or National
Fire Management Leadership training.
2. District Rangers are responsible for ensuring, that during initial or extended attack, a
qualified Incident Commander is designated for each fire on the unit and those assigned to the
fire are aware of this information.
5133.1 – Wildland Fire Management Organization
1. R-1 Incident Medical Specialist Program. Incident Medical Specialist (IMS)
personnel utilize the Region 1 Field First Aid Station (NFES No. 1835), which is a component of
the Northern Regional Fire Cache. The Aid Station Kit is designed for use on project fires and
other disasters to support Forest Service and cooperator programs.
The use of the Aid Station allows for the following:
a. Stabilization and transportation of the seriously injured or ill to medical assistance
or facility.
b. Field treatment for minor injuries and illness.
c. Prevention of serious injuries and illness by monitoring and treating minor
ailments.
On project fires, IMS personnel will function under the chain of command, as listed in Logistic
Section, chapter 10, of the NWCG Fireline Handbook, PMS 410.1.
The protocols for the diagnosis and treatment of clinical illness and injury are developed and
closely regulated under the advice of a medical doctor. For information on liability, physician
and pharmacist advisors, accountability of medications, and qualifications, reference R-1
Incident Medical Specialist Program Manual, NFES No. 1749.
For dispatch information and accountability, reference Northern Rockies Fire Mobilization
Guide and Contingency Plan, chapter 60.
2. Personnel Qualifications.
a. Regional IMS personnel will be qualified per the following criteria, which all IMS
positions must meet:
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
(1) Have current EMT certification.
(2) Be currently active with an emergency medical care providing agency.
(3) Attend annual Fire Safety Refresher Course.
(4) Have documentation of Hepatitis B vaccinations or official declination.
(5) Have completed ICS Basic or equivalent I-200 training.
(6) Have completed Fire Behavior S-110 and S-190.
(7) Pass the Work Capacity Field Test (Light). Note: Only with a red card work
capacity rating of moderate or arduous will IMS personnel be allowed to go to
the line.
(8) Have Agency sponsorship.
Additional requisites for IMS positions include:
Position
Training
Incident Medical Unit
Experience
Approval
Technician (IMST)
IMS course in last 2
years
None
Program Leader, and
completion of IMST
Task Book
Assistant (IMSA)
Annual IMS course
Two qualifying incident
assignments as an IMST
Steering/Qualification
Committee.
Recommended by a
current IMSA or
IMSM, and completion
of IMSA Task Book
Manager (IMSM)
Annual IMS course
Two qualifying incident
assignments as an IMSA
Steering/Qualification
Committee.
Recommended by two
different Managers, and
completion of IMSM
Task Book
With recommendations from a Regional IMS Program Leader, the Steering/Qualifications
Committee can advance a Technician to the Assistant position with less than two fire
assignments.
The Steering/Qualifications Committee shall approve all advancements within the Regional IMS
program; such approval shall be based on performance ratings, recommendations, organizational
needs, completed Task Book, and other current pertinent information.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
b. The Regional IMS Steering/Qualifications Committee may consist of the
following individuals.
(1) Regional Safety Manager - Chairperson.
(2) USDA Forest Service FA&A representative.
(3) Regional IMS Program Manager.
(4) Regional IMS Associate Coordinator.
(5) National Park Service Representative.
(6) Two currently qualified Regional IMS Managers.
This Steering/Qualification Committee shall meet at least annually, prior to the annual
publication of the Fire Mobilization Guide, and determine names of currently qualified Region 1
IMS personnel. This Committee will also establish the overall direction for the IMS program.
Regional IMS personnel usually are dispatched with the Medical Kit (NFES No. 1835). The
protocols permit the exchange of IMS-qualified personnel between Northern Rockies
Geographic Area and the Pacific Northwest Area.
Regional IMS positions
The purpose of the IMS program is to provide minor medical care for common occupational
health-type medical problems on an incident, and provide basic life support of injuries at a
significant cost savings to incidents. The unit usually has enough medical personnel to maintain
the Base Camp for each required shift and spike camps, as needed. Once ensured, place other
medical personnel on the fire line.
The IMS Personnel will be available on a 24-hour basis to respond to accidents and/or injuries
and to provide security for the IMS Medical Station from the time of dispatch until
demobilization.
To meet this goal, it is necessary that IMS personnel meet relatively high-level entry
requirements, receive appropriate training; and only after sufficient experience and proof of
competency will they gain additional responsibilities within the program.
Exercise extreme care at all times to ensure that the medical personnel are operating within the
scope of their assigned responsibilities and duties. This is both an IMS Manager responsibility,
Medical Unit Leader responsibility, and an individual responsibility of all medical personnel
assigned to the incident.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
Order all medical personnel through the normal chain of command.
Incident Commander
Logistics Section Chief
Medical Unit Leader (May work for the Safety Officer)
Incident Medical Specialist Manager (IMSM)
Incident Medical Specialist Assistant (IMSA)
Incident Medical Specialist Technician (IMST)

Very large or complex incidents may have a Medical Unit Leader (MEDL) who will be
responsible for the administrative functions of the Medical Unit and an IMS Manager
who will manage the medical care. On smaller incidents one IMSM that has MEDL
qualifications can provide both functions.

Elements that may affect medical unit staff size are as follows:
1. Potential for traumatic injury.
2. Proximity/distance from other health care resources.
3. Access.
4. Spike Camps.
5. Roving IMS or EMT's (on the line).
6. Duration of incident.

EMTs:
1. Sometimes ordered initially to provide emergency medical support. EMTs do not
have training to provide non-emergency support (for example, occupational health issues) and
are not to distribute/issue over-the-counter medications.
2. Sometimes ordered later to supplement IMS personnel in the field (especially for
providing roving medical support on the line).
3. EMTs that are assigned or may respond to the line must have a red card work capacity
rating of moderate or arduous.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
5133.1 – Exhibit 01
IMS POSITION DESCRIPTIONS
Incident Medical Specialist - Manager
The IMS Manager works directly for the Medical Unit Leader (MEDL), if one is present, and is
responsible for providing medical care to all incident personnel. Although the Medical Unit
Leader is identified as working for the Logistics Section Chief under the Incident Command
System, it should be noted that it may be the team’s protocol to have the unit working for the
Safety Officer; and the MEDL and IMSM should clarify in the beginning for whom they are
working. This IMS Manager manages the Medical Field Unit, the IMS Assistants, IMS
Technicians, and other medical personnel and/or equipment on the incident with the objective of
providing timely high quality medical care to all personnel at any location on the incident.
Any individual assigned to this position will be a currently certified Emergency Medical
Technician and have attended the Geographic Area's Incident Medical Specialist training course.
Major Duties:
1. Provide general oversight, coordination, and supervision of incident medical support
on even the most complex (Type I) incidents.
2. Assess and order staff and resource needs.
3. Assess numbers/capabilities and coordinate with local EMS and other health care
providers.
4. Develop the following Medical Unit plans and procedures:
a. Medical Unit Plan ICS-206.
b. For traumatic injury/illness in the incident area (on the line, in base/camp, and en
route).
c. For infection control.
5. Prepares all medical reports and submits reports as directed.
a. Patient Evaluations.
b. Record of Issues.
c. IMS Daily and Fire Summaries.
d. Summary of Cases Transported to a Medical Facility.
e. Resource Order log for APMC (Agency Provided Medical Care).
f. Area Hospital location and capability.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
5133.1 – Exhibit 01—Continued
g. Helicopter Ambulance information.
h. Unit Log ICS-214.
6. Coordinate emergency medivac utilizing incident and/or local resources.
7. Document all Medical Unit activities.
8. Be proactive in prevention of injury and illness consulting and advising appropriate
ICS personnel to implement.
9. Ensure that all medical personnel follow established protocols for patient evaluation,
treatment, documentation, and use of non-prescription and/or prescription medications.
10. Maintain personal responsibility for the prescription medications (Epi-Pens®) issued
under the authority of the advising physician.
11. Responsible for establishing and organizing the Medical Field Unit to efficiently
provide medical care while maintaining a setting which is inviting to persons needing treatment
and does not discourage visitation.
12. May help provide adjunct services, such as coordination of prescription refills or
dental support items needed by incident personnel.
13. Maintain current knowledge of activities on the incident and is able to respond
quickly to requests for medical assistance, whether emergency or routine.
14. Provide supervision and on-the-job training to IMS Assistants, Technicians, and
other assigned personnel commensurate with their skill levels and experience. Schedules the
assistants' time and duties to ensure there is adequate coverage of all incident medical needs.
15. Coordinate physician/hospital visits for personnel needing additional medical care,
and informs the patient's supervisor of medical status.
16. Anticipate needed supplies or personnel, prepares timely requests for same, reviews
those requests with the MEDL, and works with the Supply Section to insure timely response.
17. Keep MEDL informed of any major injuries or illnesses, emergency responses or
transports, identified trends of injury or illness among crews, and makes recommendations for no
duty/light duty status or medical demob.
18. Work closely with the Compensation/Claims Unit Leader to insure accurate and
timely completion of CA-1, CA-2, CA-16, APMC documentation, and other documents, as
necessary.
19. During those incidents when the IMSM is also the MEDL a close liaison with the
Safety Officer should be encouraged (especially when the unit is not supervised by the LSC). It
is the SOF’s responsibility to be kept aware of trends and issues affecting the health and safety of
incident personnel and the MEDL and IMSM should seek him/her out if not already maintaining
a daily dialogue.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
5133.1 – Exhibit 01—Continued
The position qualifications listed below reflect how the needed knowledge, skills, and abilities
are met.
Incident Medical Specialist - Manager
A. Attend Incident Medical Specialist Training every year.
B. Maintain EMT certification.
C. Attend annual Fire Safety Refresher Course.
D. Complete a minimum of two qualifying assignments as an Assistant.
E. Be recommended for advancement by two current Managers.
F. Be approved by the Steering Committee in R-6 or the Steering/Qualification
Committee in R-1.
G. Pass the Work Capacity Field Test (Light). Note: Only with a red card work capacity
rating of moderate or arduous will IMS personnel be allowed to go to the line.
Incident Medical Specialist -Assistant
This position assists the IMS Manager in providing medical care to all incident personnel on
even the most complex (Type I) incidents. The IMSA may manage a remote camp medical unit
on incidents with multiple camps.
Any individual assigned to this position will be currently certified Emergency Medical
Technicians and have attended the Geographic Area's Incident Medical Specialist training
course.
Major Duties:
1. Provide general oversight, coordination, and supervision of incident medical support
on less complex (Type II) incidents.
2. Provide on-scene management of traumatic injury medivac.
3. Knows and correctly follows all established protocols for patient evaluation,
treatment, documentation, and the use of non-prescription medications. (Dispenses Epi-Pens®
only under the direct supervision of the IMS Manager).
4. Remains current on incident activities, and is able to respond to requests for medical
assistance in a timely and professional manner. This includes always being ready for dispatch to
line for medical emergencies (boots, nomex, and so forth).
5. Works closely with, and fully supports, the IMS Manager in the performance of
duties, and may be delegated additional duties by the IMS Manager.
R1 SUPPLEMENT 5100-2005-1
EFFECTIVE DATE: 06/24/2005
DURATION: This supplement is effective until superseded or removed.
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FSM 5100 – FIRE MANAGEMENT
CHAPTER 5130 – WILDLAND FIRE SUPPRESSION
5133.1 – Exhibit 02
The qualifications listed below for the position reflect the way the needed knowledge, skills, and
abilities are met.
Medical Specialist Assistant
A. Attend Incident Medical Specialist Training every year.
B. Maintain EMT certification.
C. Attend annual Fire Safety Refresher Course.
D. Complete a minimum of two qualifying assignments as a Technician.
E. Be recommended for advancement by a current Assistant or Manager.
F. Be approved by Steering Committee in R-6 or the Steering\Qualifications
committee in R-1.
G. Pass the Work Capacity Field Test (Light). Note: Only with a red card work
capacity rating of moderate or arduous will IMS personnel be allowed to be assigned
to the line.)
5133.1 – Exhibit 03
Incident Medical Specialist - Technician
Major Duties:
Learns and correctly follows all established protocols for patient evaluation, treatment,
documentation, and the use of non-prescription medications under the supervision of the
Manager or Assistant Manager. (Dispenses prescription medications only under the direct
supervision of the IMS Manager).
Keeps current on incident activities, and is able to respond to requests for medical assistance in a
timely and professional manner. This includes always being ready for dispatch to line for
medical emergencies (boots, nomex, and so forth).
(Note: only with a red card work capacity rating of moderate or arduous will IMS personnel be
allowed to be assigned to the line.)