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Incident Report – 12/20/2022
5662 Blackhawk Rd, Rockford, IL 61109

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Summary

On December 20, 2022, Cherry Valley Fire Protection District responded to an EMS call at 5662 Blackhawk Rd, Rockford, IL 61109, a 1-or-2 family dwelling.

The alarm was received at 1:18 PM, 4 suppression, 2 EMS, and 2 other personnel arrived at 1:22 PM, and the last unit was cleared at 1:48 PM. The time to arrive was 4 minutes and the total incident time was 30 minutes.

The following actions were taken during the incident: provide advanced life support (ALS) and transport person.

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Location

Type Street address
Address 5662 Blackhawk Rd, Rockford, IL 61109
County Winnebago County
State IL
City Rockford
Zip Code 61109
Property Use 1 or 2 family dwelling

Timeline

  • Alarm

    Alarm received at

  • Arrived

    Arrived at

    Alarm to arrival: 4 minutes

  • Last Unit Cleared

    Last unit cleared at

    Alarm to last unit cleared: 30 minutes

Response

Incident Type EMS call, excluding vehicle accident with injury
Department Station 2
Mutual Aid Given/Received None
Resources Include Mutual Aid No
Shift R
District Cou

Personnel

Support Personnel 4
EMS Personnel 2
Other Personnel 2

Fire Department

Name Cherry Valley Fire Protection District
Department Type Mostly volunteer
Address 4919 Blackhawk Rd
Rockford, IL 61109
Phone (815) 332-5382
Website https://www.cvfpd.com/

Actions Taken

First Action Taken Provide advanced life support (ALS)
Second Action Taken Transport person

Metadata

Incident Key IL_WJ124_12202022_222221_0
State Illinois
Fire Department ID WJ124
Incident Date 12/20/2022
Incident Number 222221
Exposure Number 0
NFIRS Version 5.0

EMS Report

Patient Description

Provider Impression/Assessment Other impression/assessment
Patient Age 66
Patient Gender Male
Patient Race White

Timeline

  • Arrived

    Arrived at

  • Transported

    Transported at

    Arrival to transport: 43 minutes

Procedures Used

Procedure Used EKG monitoring
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