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Incident Report – 09/18/2022
164 Main St, Jackson, CA 95642

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Summary

On September 18, 2022, Jackson Fire Department responded to an EMS call at 164 Main St, Jackson, CA 95642, a business and residential use, 1-or-2 family dwelling.

The alarm was received at 4:35 AM, 3 suppression personnel arrived at 4:49 AM, and the last unit was cleared at 5:54 AM. The time to arrive was 14 minutes and the total incident time was 1 hour, 19 minutes.

The following actions were taken during the incident: provide basic life support (BLS) and emergency medical services/other.

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Location

Type Street address
Address 164 Main St, Jackson, CA 95642
County Amador County
State CA
City Jackson
Zip Code 95642
Mixed Use Business and residential use
Property Use 1 or 2 family dwelling

Timeline

  • Alarm

    Alarm received at

  • Arrived

    Arrived at

    Alarm to arrival: 14 minutes

  • Last Unit Cleared

    Last unit cleared at

    Alarm to last unit cleared: 1 hour, 19 minutes

Response

Incident Type EMS call, excluding vehicle accident with injury
Department Station 132
Mutual Aid Given/Received Automatic aid received
Resources Include Mutual Aid Yes
Shift A
Alarms M3
District JKS

Personnel

Support Personnel 3
EMS Personnel 0
Other Personnel 0

Fire Department

Name Jackson Fire Department
Department Type Mostly volunteer
Address 33 Broadway
Jackson, CA 95642-2354
Phone (209) 256-4499
Website https://www.ci.jackson.ca.us/fire_department.php

Actions Taken

First Action Taken Provide basic life support (BLS)
Second Action Taken Emergency medical services, other

Metadata

Incident Key CA_03020_09182022_0001272_0
State California
Fire Department ID 03020
Incident Date 09/18/2022
Incident Number 0001272
Exposure Number 0
NFIRS Version 5.0

EMS Report

Patient Description

Provider Impression/Assessment Cardiac arrest
Patient Age 34
Patient Gender Female
Patient Race White
Patient Ethnicity Other

Timeline

  • Arrived

    Arrived at

  • Transported

    Transported at

    Arrival to transport: 1 minute

Human Factors

Human Factor Possibly impaired by alcohol

Procedures Used

Procedure Used Airway Insertion
Procedure Used CPR
Procedure Used EKG monitoring
Procedure Used Intubation (ET)
Procedure Used IO/IV Therapy
Procedure Used Medications therapy
Procedure Used Oxygen therapy
Procedure Used Suction/aspirate

Cardiac Arrest

Pre or Post Arrival Arrest Pre-arrival arrest
Pre-Arrival Arrest Descriptor Bystander CPR
Initial Arrest Rhythm Undetermined
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