Adapted by Gerald Poarch from Costa Mesa EMT, LAPM's First Aid, Incident Command System of U.S.Fire Service.

• Designed for one or more persons to handle tasks, depending on type of Emergency.
• One or more teams to be set up at the beginning of each event from qualified people present.

This plan is designed for all Odd Fellow events, such as Conventions, Degree Days, Special Sessions, Receptions, Parties, and Large social gatherings. It can also be used at other "Community activities".

• On the registration forms have a place for
  Present Certification level: First Aid______ CPR______ EMT_____ LVN_____ RN______
  
• Upon arrival at an Odd Fellow or Rebekah meeting, all certified medically trained people are to report to a person in charge. They are to provide certification cards and/or identification of skill level.
  
• The names of the qualified people will be divided into teams. The structure of the teams will be as follows:
  
  • Team Leader - This person is in charge of the entire scene.
    
  • Security -This person is in charge of crowd and traffic control.
    
  • Medical Group Leader - This person is in charge of patient care.
    
  • History/Records - This person works under the direction of the Medical Group Leader and writes down all information obtained about the patient and data taken by "vitals person". Also keep times of incident & vitals.
    
  • Vitals - This person takes all the vital signs - pulse, respirations, blood pressure and etc.
    
  • First Aider - This person provides the "need" care: Talks to the patient, gives C.P.R., bandage wounds, handles warmth/cooling needs, apply splints, etc.
    
• If Team #1 is working and they need more people to perform the tasks. The Team Leader will request the needed number and type of members of Team #2 to assist. Team #2 will immediately begin to replace the members of their team.
  
• One person can perform all of these functions on every small or minor incident. It can take twenty people to handle a major type of incident.

Emergency Medical Report Rationale

• Date and Time - This is primary information along with Name
  
• Patient's Name - First (or Nickname) and Last Name (or any portion thereof)
  
• Address - Home Address of Patient (make note of hotel & room number if known)
  
• Lodge/Unit Name - Enter Lodge, Canton, LAPM, Encampment, Auxiliary, Theta Rho Club, or Junior Lodge Name and Number. Helps in finding others to provide information. Helps at the time of emergency as well as in future planning.
  
• Rank/Title - Helpful especially if patient is an Officer (such as Marshal or Past President) of one of the Branches.
  
• Male(_) Female(_) - Check box to indicate sex of patient.
  
• Age - If it can be obtained (remember some people do not like it known).
  
• Weight - Same as above
  
• D.O.B. - "Date of Birth" - Used to legally identify people of the same or similar name. This is a must for Medical records.
  
• Chief Complaint - Problem expressed by patient or observed by First Aid Team. Such as "Pain in right arm" or "Blood coming from nose".
  
• Status - Check the box that best describes the patient's condition:
  • Stable - normal and not changing.
  • Mild - not normal but doing okay. Medical attention should be obtained
  • Moderate - not normal and medical attention needed
  • Acute Distress - immediate medical attention required
• Vital Signs - These are things that the provider can see or detect.
  • <Mental State ul>
  • conscious - the state of knowing what goes on around oneself.
  • lethargic - the state of lacking energy or interest.
  • confused - to fail to distinguish between facts.
  • unconscious - lack of consciousness for a period of time. Enter the duration in minutes.
• Speech
  • coherent - consistent in sequence of thought.
  • incoherent - unable to speak clearly and with continuity.
  • silent - making no sound.
  • hysterical - excessive excitability and anxiety.
  • crying - to weep.
• Skin Color
  • normal - regular color for the patient's skin.
  • pale/ashen - lacking intensity of color/deathly pale.
  • cyanotic - the skin acquires a blue tinge.
  • flushed - the skin is reddened
• Skin Moisture
  • normal - regular amount of moisture.
  • dry - lacking moisture.
  • moist - slightly wet.
• Skin Temperature
  • normal - 98.6 degrees Fahrenheit is a normal oral thermometer reading.
  • hot - higher body temperature than normal.
  • cold - very low body temperature.
  • cool - slightly low temperature.
• Enter the time and rate each time you take:
  • Pulse - the Patient's pulse (heart beat rate)
  • Respirations - a count of Patient's breathing rate.
  • Blood Pressure - the patient's blood pressure. (Note if it was obtained by palpation).
• Pupils - Check both eyes for their condition (usually with a light source).
  • P.E.R.L - P E R L stands for Pupils Equally Reactive to Light.
  • pinpoint - the pupil very small.
  • sluggish - slow to react to light.
  • unequal - both eyes do not react the same.
  • dilated or fixed - pupil enlarged or remains the same.
  • responds - eyes respond to light.
• Time of first symptom - Note the time when the patient was first identified as one in need of assistance, such as they fell, fainted, or asked for help.
  
• Treatment before arrival - What care had been given before the First Aid Team got on the scene. You can also make note of any care you provide that is not entered on this form.
  
• Medical History - Enter any information you can obtain on the patient's past medical problems.
  
• Allergies to Medication - This is very important to obtain information if the patient has had any bad reaction to any drugs, if you can.
  
• Medications - List all drugs that the patient is presently taking.
  
• Patient's Physician - If possible, obtain the name of the patient's Doctor and his address and/or telephone number.
  
• Medical Personnel arrival time and departure time - Note when the Paramedics or Ambulance get on the scene and when they leave.
  
• Signature of Provider and Provider's Lodge Name & Number - This would generally be the Record keeper but could be any member of the team.

Medical Release Form Rationale

In order to protect our members and our Organization, this form has been developed for the patient to sign. You can fill out the information and have the patient just sign it.

• Refusal of service: Select one of the three statements that best fits your situation or mark "other" and explain.
  
• Release from responsibility: Have the patient read and sign, or you read the statement to the patient and have him/her sign.
  If patient is under 18 years old, have a person who is responsible for the patient, such as Club Advisor, sign under the patient's signature.
  
• Witness: The person who has the patient sign the release form should be the witness. But anyone can witness it.