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Incident Report – 03/31/2019
3332 Senedo Rd, Forestville, VA 22847

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Summary

On March 31, 2019, Mt. Jackson Rescue and Fire Department (Shenandoah County Fire & Rescue) responded to an EMS call at 3332 Senedo Rd, Forestville, VA 22847, a 1-or-2 family dwelling.

The alarm was received at 8:34 PM, 3 EMS personnel arrived at 8:48 PM, and the last unit was cleared at 9:50 PM. The time to arrive was 14 minutes and the total incident time was 1 hour, 16 minutes.

The following action was taken during the incident: provide advanced life support (ALS).

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Location

Type Street address
Address 3332 Senedo Rd, Forestville, VA 22847
County Shenandoah County
State VA
City Forestville
Zip Code 22847
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, 16 minutes

Response

Incident Type EMS call, excluding vehicle accident with injury
Department Station 21
Mutual Aid Given/Received None
Resources Include Mutual Aid No
District Sou

Personnel

Support Personnel 0
EMS Personnel 3
Other Personnel 0

Fire Department

Name Mt. Jackson Rescue and Fire Department (Shenandoah County Fire & Rescue)
Department Type Volunteer
Address 6155 Main St
Mt. Jackson, VA 22842
Phone (540) 477-2510

Actions Taken

First Action Taken Provide advanced life support (ALS)

Metadata

Incident Key VA_17121_03312019_19196_0
State Virginia
Fire Department ID 17121
Incident Date 03/31/2019
Incident Number 19196
Exposure Number 0
NFIRS Version 5.0

EMS Report

Patient Description

Provider Impression/Assessment Other impression/assessment
Patient Age 44
Patient Gender Male
Patient Race White
Patient Ethnicity Other

Timeline

  • Arrived

    Arrived at

  • Transported

    Transported at

    Arrival to transport: 45 minutes

Human Factors

Human Factor Possibly impaired by alcohol
Human Factor Possibly impaired by other drug or chemical
Other Factors Self-inflicted

Injury Types

Cause of Illness/Injury Drug poisoning

Procedures Used

Procedure Used Airway Insertion
Procedure Used EKG monitoring
Procedure Used IO/IV Therapy
Procedure Used Other procedure
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