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EMSWORLD.com | OCTOBER 2015 13 One of the older patients is a man who identifies himself as the owner of the house. He says they had a big family party for New Year's Eve, and many family members were there. He knows some stayed overnight but can't identify how many persons were in the house that morning. He believes the fire started in the basement. He had to break out a first-floor window to escape it, and someone was yelling "fire!" to try to get the others out. The critical patients are moved off the scene, then the yellow triage victims. Firefighters come out with minor burns, a back strain from carrying out a victim and a shoulder strain from helping a victim down a ladder. Several deceased victims are found in a basement room, and the Attack One paramedic is asked to assist in making the decision to leave them in place. So 12 victims are in the tracking system through the first hour of operations, and two are fatalities inside the building. The track- ing supervisor gives a copy of the worksheet to Incident Command so there is an initial accounting for victims. It is so far not pos- sible to identify what the relationships are among the victims and others who were in the house. The hospitals have been noti- fied about the identification problem and that it's not anticipated that more victims will be transported. They are advised that persons may walk in who had been in the house but were not seen by EMS, and they are requested to pass back to the field any information on the confirmed identities of patients and any further persons who show up at the hospitals. EMS resources remain staged as the oper- ation in the house continues, but no further live victims are found. Two more fatalities are located. There is one more moment of crisis when the operations section chief is told by a pan- icked woman arriving on scene that her teen- age daughter (a niece of the homeowner) had been at the house for the party and can't be located. The crews at the scene perform another detailed search of every inch of the house but can't find another vic- tim. At that time the girl contacts her mother and reports that she left to stay at a friend's house and her cell phone died. Case Discussion This incident was managed to produce the best outcomes for the family. Incident Command developed a plan to effect a combined rescue and fire-suppression operation. The Attack One crew organized the resources for emergency medical care and victim identification. Fire and extrica- tion operations proceeded quickly. As with many situations, treatment could be per- formed only as environmental conditions permitted and sufficient transport units could be mobilized. Hospital resources were utilized to produce the best patient outcomes possible. For More Information Circle 16 on Reader Service Card