Incident Report Incident Report Step 1 of 333%Area*Location*Date* Time* : HH MMDuration* : HH MMALERTED TO INCIDENT BY*LG PaidLG (volunteer)HMCGILBALBPoliceAmbulanceAir AmbulanceFireSAR HeloPublicOtherCOORDINATED BY:*LG PaidLG (volunteer)HMCGILBALBPoliceAmbulanceAir AmbulanceFireSAR HeloPublicOtherOTHER SAR UNITS INVOLVED:*LG PaidLG (volunteer)HMCGILBALBPoliceAmbulanceAir AmbulanceFireSAR HeloPublicOtherLOCATION OF THE INCIDENT:*Craft / Surf ZoneRed & Yellow / Buoyed ZoneNon-zonedOtherDISTANCE FROM SAFETY COVER:*1-10m10-50m50-100m100-500m500-1000m1000+mN/AOPERATIONAL STATE OF THE BEACH:*NormalRed FlagOut of HoursN/ANATURE OF INCIDENT*RescueSearchAssistanceNear MissMajor First AidOtherMale* Child (0-12yrs) Teenager (13-17yrs) Adult (18-59yrs) Senior (60+yrs) N/ANumber of male casualtiesFemale* Child (0-12yrs) Teenager (13-17yrs) Adult (18-59yrs) Senior (60+yrs) N/ANumber of female casualtiesEquipment Used* IRB RWC 4x4 ATV Canoe/Ski Rescue Board Rescue Tube Throw Line First Aid Equipment Public Rescue Equipment Mountain Bike None Other N/AOtherActivity* Swimming Inflatables Ski Paddling Body Boarding Surfing Wind Surfing Kite-surfing Power Craft Sailing Beach/Coastal Running Surf Boat Rowing Climbing Walking Relaxing Paddle Boarding OtherOtherNARRATIVE OF INCIDENT*CAUSE OF INCIDENTENVIRONMENTAL* Rip Currents Estuarial Currents Surging Waves Strong Winds Cliff Fall / Land Slide Undertow Sandbar / Sandbanks Plunging / Dumping Waves Offshore Winds Unsafe Beach Access Littoral Current Tidal Cut Off High Seas / Heavy Surf HAZCHEM Water Quality Other N/AOtherPHYSICAL* Cliffs Promontories Harbour Walls Piers Wave Breaks Jetties Large Rocks Buildings Seawall Groynes OtherOtherEQUIPMENT* Equipment Failure Inappropriate Equipment Misuse of Equipment Inexperienced Hired Eqpt OtherOtherBEHAVIOURAL* Violent / Threatening Behaviour Apparent act of daring Caused by another person Believed to be under the influence of Alcohol Believed to be under the influence of Drugs Self harm Other N/AOtherENVIRONMENTAL CONDITIONSWEATHER Cloudless Partly Cloudy Overcast Rain Sea Fog / MistWAVE HEIGHT <0.5 0.5 - 1.5m 1.6 - 2.5m 2.6 - 3.5m 3.6 - 4.5m N/ASTATE OF TIDE Spring high Spring low Mid Neap high Neap low Ebbing FloodingInland Canal River Lake OtherOtherWIND CONDITIONSDIRECTION*FORCE*WINDSOCK*YesNoNAME*I HAVE PROVIDED INFORMATION AS ACCURATELY AS POSSIBLE*YesNoDo you think a life was saved?*YesNoWas First Aid Administered?*YesNoWas this Major or Minor First Aid?MajorMinorPatient Name First Last GenderMaleFemaleAgePost TownHouse No.PostcodeTelephone No.Minor Wounds Graze Bruise Puncture Cramp Cut Splinter FO in Eye Break/Loss of Nail BlisterBurns Minor Burn SunburnSting/Bite Weever Fish Insect Jellyfish Unknown Bee/Wasp OtherOtherTreatment/Equipment Used Cold Compress Eyewash Plaster Hot Water Cold Water Shade Warmth/Blanket Reassurance Medi-Wipe Tweezers Crepe Scissors Non Absorbent Gauze OtherIs there a chance that you had exposure to blood-borne/saliva contamination?YesNoPlease refer to a doctorDetails of Lifeguards InvlovedNamePaid/Voluntary (P/V) Patient ReportPatient Details First Last D.O.B GenderMaleFemaleAddress Post Code Town Post Code Country PATIENT CONDITION (on initial examination)ListType of injuryLocation of injury Symptoms Disorientated Faint Fitting Hyperventilating In Shock Nauseated Pale Sweating Weak VomitingLevel of Conciousness Alert Voice (responds to) Pain (responds to) UnresponsiveTemperature Hyperthermic Normal HypothermicAirway Clear Partially Obstructed ObstructedBreathing Present AbsentCirculation Strong Normal WeakDetails of Treatment Given Rest Reassurance Warmed Cooled Raised Legs Bag & Mask Manual Suction Cleaned Plaster Ice Applied Dressing Applied AED Oxygen Therapy Spinal Board/Collar None OtherOther please give detailsAllergies/Past Medical HistoryPatient Release No further action Advised to attend a doctorPatient Handover Land Ambulance Air AmbulancePatient declined treatmentYesNoDuty of care handed over toSAR/AmbulanceRelativeFriendOther (please give details)OtherIs there a chance that you had exposure to blood-borne/saliva contamination?YesNoPlease refer to a doctorDetails of Lifeguards InvlovedNamePaid/Voluntary (P/V)