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1 WFU / Baptist Medical Center Trauma Center (Level 1) Medical Center Blvd, Winston-Salem, NC (336) 713-9100 2 Forsyth Medical Center Community Hospital 3333 Silas Creek Parkway, Winston-Salem, NC (336) 3 Helicopter Plan Primary aircraft: AirCare Landing Zone Contact no: (336) 716-3669 Alternate aircraft: MedCenter Air (Charlotte) 800-421-9195 Address: Latitude: Longitude: LZ Type: Obstructions / Debris: Weather Temp Hi: Precip ( ): Heat Index: Temp Lo: Sunrise AM Cold Risk Yes / No Wind (mph): Sunset PM Uniform Adjustments Humidity ( ): Night Ops Yes / No Hydration Rest Guide (for operations 4 hrs) Yes / No Recs: WB Temp 60 60-78 78-82 82-85 85-88 88-90 90 H20 Qt/hr 0.5 0.5 0.5 0.75 1.0 1.5 2.0 0 0 0 10 15 30 40 Rest min/hr Animal Threats Domestic Animals Yes / No : Types: Poisonous Snakes Yes / No : Types: Wild Animals Yes / No : Types: Police Dogs Yes / No : Police Vet: Dr. Poisonous plant exposure likely Yes / No Types: Uniform Adjustments needed Yes / No Recommendations: Ignition risks or NFDD use anticipated Yes / No Types: Clandestine Lab Yes / No Types: Industrial chemicals Yes / No Types: Other HazMats Yes / No Types: Animal Control: (999) 999-9999 (vs “Obtain via dispatch”) Vet contact no: (999) 999-9999 After hrs contact no: (999) 999-9999 Police Vet address: Plant Threats Poison Control: (800) 222-1222 Hazardous Materials Recommendations HazMat Team: Nomex Yes / No Other special PPE Yes / No List: Public Works Street Closings Yes / No Location: Gate Access Yes / No Location / Code: Road Hazards Yes / No Location: EMS Staging Yes / No Location: Extended Operations Work cycles determined Yes / No List: Restroom facilities determined: Yes / No List: Nutrition secured / checked Yes / No List: Sleep area determined: Yes / No List: Other MTA Template provided by NCTMA – the North Carolina Tactical Medical Association (999) 999-9999 (vs “Obtain via dispatch”) Rest and Hydration Guideline Notes Wet Bulb Temperature Information The wet bulb tem
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