Recently I have had the opportunity to watch several training evolutions. These have been both single company and multi-company drills. Each involved establishing water supply, deploying handlines, conducting search, victim removal and fire suppression. As soon as the victim was out, the evolution was over and there was no consideration for the care of the victim at all.
In today's fire service most all firefighters are trained at least to the level of medical first responder, many more are EMTs and paramedics. With this in mind I can't help but wonder why the evolution objectives do not require treatment of the victim after successful removal when we train. The short answer is that EMS will be standing by and take over care. This is a good answer except, how about when the incident does not allow them to get that close and the victim has to be taken to EMS? What if rescue is made before EMS arrives? What does your department SOG say about initiating care? Lastly what happens when there is more than one victim? For this reason firefighters need to be practicing care of these patients at their level.
When the victim is removed during training, have your firefighters do a role change and provide care. As they remove a victim from an IDLH environment there must be a rapid transition from rescuer to medical provider until EMS handoff is made. With this in mind, take time to practice the care of victims. This will allow for adequate care for your victim as well as strengthen the patient care skill set that some firefighters don't get to use often.
It is important to build the patient care portion of your simulation as real as possible. Most departments use a rescue manikin to simulate victim removal. Once the victim in this evolution has been removed consider placing a live victim in place of the manikin. Be sure that this person is well coached to play whatever type of victim you choose. If you have a combination department this will be easy as you have fire and EMS personnel on hand, the EMS staff play these roles and provide critique. If it's a volunteer organization or your EMS is third service contact, the EMS training staff they will likely be ready to help out.
One of our primary goals with any operational training or to safely remove victims from the dangerous environment that they are in. Once this has been accomplished we owe that victim the best care they can get. The best way to ensure we accomplish this is to practice and review care procedures and work with EMS as best as possible. In addition, review your department's SOG related to victim care in order to ensure all resources are mobilized in a timely fashion.