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Ics 206

The ICS 206 Medical Plan outlines essential information regarding medical aid stations, transportation services, and hospitals for incident responders. It is prepared by the Medical Unit Leader and reviewed by the Safety Officer, ensuring all necessary details are documented for effective medical response. The form is part of the Incident Action Plan and includes instructions on how to fill it out properly.

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Caryl Hannah Pajarillo
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47 views2 pages

Ics 206

The ICS 206 Medical Plan outlines essential information regarding medical aid stations, transportation services, and hospitals for incident responders. It is prepared by the Medical Unit Leader and reviewed by the Safety Officer, ensuring all necessary details are documented for effective medical response. The form is part of the Incident Action Plan and includes instructions on how to fill it out properly.

Uploaded by

Caryl Hannah Pajarillo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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April 29, 2018

MEDICAL PLAN
ICS 206

1. INCIDENT/EVENT NAME 2. OPERATIONAL PERIOD


From (Date and Time):
To (Date and Time):
3. MEDICAL AID STATIONS
Remarks
Contact With Paramedics?
Name Location Contact Person
Number(s)
Yes No

4. AMBULANCE/ MEDICAL TRANSPORTATION SERVICES


Remarks
Contact Level of Service
Name Location Contact Person
Number(s)
BLS ALS

5. HOSPITALS
With With Burn With
Contact Contact Travel Time Trauma Center? Helipad?
Name Location Center?
Person Number(s)
Yes No Yes No
Air Land Yes No

6. MEDICAL EMERGENCY PROCEDURES

__ Check if aviation assets are utilized for rescue. If assets are used, coordinate with Air Operations Branch.

7. Prepared by MEDL Name and Signature: Date Prepared: Time Prepared:

8. Reviewed by SOFR Name and Signature: Date Reviewed: Time Reviewed:


April 29, 2018
ICS 206: MEDICAL PLAN

PURPOSE: The ICS 206 provides information on incident medical aid stations, transportation
services, hospitals, and medical procedures primarily intended for the responders.

PREPARATION: The ICS 206 is prepared by the Medical Unit Leader (MEDL) and reviewed by
the Safety Officer (SOFR).

DISTRIBUTION: The ICS 206 is duplicated and attached to the ICS 202 and given to all recipients
as part of the Incident Action Plan (IAP). All completed original forms must be given to the
Documentation Unit.

HOW TO FILL-UP THE FORM:

BLOCK BLOCK TITLE INSTRUCTIONS


NO.
1 Incident/Event Name Enter the name assigned to the incident/event
2 Operational Period Enter the start date (mm-dd-yyyy) and time (24 hour
format) and end date and time for the operational period to
which the form applies.

3 Medical Aid Stations Enter the relevant information on the incident/field medical
aid station(s). Indicate the name, location, contact person
and contact number(s). Also specify whether or not
paramedics are provided.

4 Ambulance/Medical Enter the relevant information on the ambulance/medical


Transportation transportation service(s). Indicate the name, location,
Services contact person and contact number(s). Also specify the
level of service if Basic Life Support (BLS) or Advance Life
Support (ALS).

5 Hospitals Enter the relevant information on the hospital(s). Indicate


the name, location, contact person and contact number(s).
Also specify the travel time going to the hospital. Further,
indicate if there are trauma center, burn center, and/or
helipad.

6 Medical Emergency Enter any special emergency instructions for use by


Procedures incident personnel including (1) who should be contacted,
(2) how should they be contacted, and (3) who manages
an incident within an incident due to a rescue, accident,
etc. Include procedures for reporting medical
emergencies.

7 Prepared by MEDL Enter complete name of the MEDL, signature, date (mm-
dd-yyyy), and time (24 hour format) the form was prepared
and completed.

8 Reviewed by SOFR Enter complete name of the SOFR, signature, date (mm-
dd-yyyy), and time (24 hour format) the form was
reviewed.

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