MPDS Supervisor 0.0.5

• Protocol 1: Abdominal Pain/Problems
  • 1-D-1 Not alert
  • 1-C-1 Suspected aortic aneurysm (tearing/ripping pain) ≥50 years old
  • 1-C-2 Known aortic aneurysm
  • 1-C-3 Fainting or near fainting ≥50 years old
  • 1-C-4 Females with fainting or near fainting 12-50 years old
  • 1-C-5 Males with pain above navel ≥35 years old
  • 1-C-6 Females with pain above navel ≥ 45 years old
  • 1-A-1 Abdominal pain

• Protocol 2: Allergies (Reactions)/Envenomations (Stings/Bites)
  • 2-E-1 Ineffective breathing
  • 2-D-1 Not alert
  • 2-D-2 Difficulty speaking between breaths
  • 2-D-3 Swarming attack (bee, wasp, hornet)
  • 2-D-4 Snakebite
  • 2-C-1 Difficulty breathing or swallowing
  • 2-C-2 History of severe allergic reaction
  • 2-B-1 Unknown status/other codes not applicable
  • 2-A-1 No difficulty breathing or swallowing (rash, hives or itching may be present)
  • 2-A-2 Spider bite
    • Suffixes: I=Injection administered or advised, M=Medication administered or advised

• Protocol 3: Animal Bites/Attacks
  • 3-D-1 Unconscious or arrest
  • 3-D-2 Not alert
  • 3-D-3 Chest or neck injury (with difficulty breathing)
  • 3-D-4 Dangerous body area
  • 3-D-5 Large animal
  • 3-D-6 Exotic animal
  • 3-D-7 Attack of multiple animals
  • 3-B-1 Possibly dangerous body area
  • 3-B-2 Serious hemorrhage
  • 3-B-3 Unknown status/other codes not applicable
  • 3-A-1 Not dangerous body area
  • 3-A-2 Non-recent (≥6 hours) injuries (without priority symptoms)
  • 3-A-3 Superficial bites

• Protocol 4: Assault/Sexual Assault
  • 4-D-1 Unconscious or arrest
  • 4-D-2 Not alert
  • 4-D-3 Chest or neck injury (with difficulty breathing)
  • 4-D-4 Multiple victims
  • 4-B-1 Possibly dangerous body area
  • 4-B-2 Serious hemorrhage
  • 4-B-3 Unknown status/other codes not applicable
  • 4-A-1 Not dangerous body area
  • 4-A-2 Non-recent (≥6 hours) injuries (without priority symptoms)
    • Suffixes: A=Assault, S=Sexual assault

• Protocol 5: Back Pain (Non-Traumatic or Non-Recent Trauma)
  • 5-D-1 Not alert
  • 5-C-1 Suspected aortic aneurysm (tearing/ripping pain) ≥50 years old
  • 5-C-2 Known aortic aneurysm
  • 5-C-3 Fainting or nearly fainting ≥50 years old
  • 5-A-1 Non-traumatic back pain
  • 5-A-2 Non-recent (≥6 hours) traumatic back pain (without priority symptoms)

• Protocol 6: Breathing Problems
  • 6-E-1 Ineffective breathing
  • 6-D-1 Not alert
  • 6-D-2 Difficulty speaking between breaths
  • 6-D-3 Changing color
  • 6-D-4 Clammy
  • 6-C-1 Abnormal breathing
    • Suffixes: A=Asthma history

• Protocol 7: Burns (Scalds)/Explosion (Blast)
  • 7-E-1 Person on fire
  • 7-D-1 Multiple victims
  • 7-D-2 Unconscious or arrest
  • 7-D-3 Not alert
  • 7-D-4 Difficulty speaking between breaths
  • 7-C-1 Building fire with persons reported inside
  • 7-C-2 Difficulty breathing
  • 7-C-3 Burns ≥18% body area
  • 7-C-4 Significant facial burns
  • 7-B-1 Blast injuries (without priority symptoms)
  • 7-B-2 Unknown status/other codes not applicable
  • 7-A-1 Burns <18% body area
  • 7-A-2 Fire alarm (unknown situation)
  • 7-A-3 Sunburn or minor burns (≤ hand size)
    • Suffixes: E=Explosion, F=Fire present, W=Fireworks

• Protocol 8: Carbon Monoxide/Inhalation/HAZMAT/CBRN
  • 8-D-1 Unconscious or arrest
  • 8-D-2 Not alert
  • 8-D-3 Difficulty speaking between breaths
  • 8-D-4 Multiple victims
  • 8-D-5 Unknown status/other codes not applicable
  • 8-C-1 Alert with difficulty breathing
  • 8-B-1 Alert without difficulty breathing
  • 8-Ω-1 Carbon monoxide detector alarm (without priority symptoms)
    • Suffixes: B=Biological, C=Chemical, G=Smell of gas/fumes, M=Carbon Monoxide, N=Nuclear, R=Radiological, S=Suicide attempt (carbon monoxide), U=Unknown

• Protocol 9: Cardiac or Respiratory Arrest/Death
  • 9-E-1 Not breathing at all
  • 9-E-2 Breathing uncertain (agonal)
  • 9-E-3 Hanging
  • 9-E-4 Strangulation
  • 9-E-5 Suffocation
  • 9-E-6 Underwater
  • 9-D-1 Ineffective breathing
  • 9-D-2 Obvious or expected death questionable
  • 9-B-1 Obvious death unquestionable (a through k)
  • 9-Ω-1 Expected death unquestionable (x through z)
    • Suffixes: a=Cold and stiff in a warm environment, b=Decapitation, c=Decomposition, d=Incineration, e=Non-recent death, f=Injuries obviously incompatible with life, g=Submersion (>6 hours), x=Terminal illness, y=DNR (Do Not Resuscitate) order

Note: Local medical direction may permit additional suffixes for 9-B-1 (designated with letters h through k) and an additional suffix for 9-Ω-1 (designated letter z) specifying indicators determined by the medical director.

• Protocol 10: Chest Pain (Non-Traumatic)
  • 10-D-1 Not alert
  • 10-D-2 Difficulty speaking between breaths
  • 10-D-3 Changing color
  • 10-D-4 Clammy
  • 10-C-1 Abnormal breathing
  • 10-C-2 Heart attack or angina history
  • 10-C-3 Cocaine
  • 10-C-4 Breathing normally ≥35 years old
  • 10-A-1 Breathing normally <35 years old

• Protocol 11: Choking
  • 11-E-1 Complete obstruction/ineffective breathing
  • 11-D-1 Abnormal breathing (partial obstruction)
  • 11-D-2 Not alert
  • 11-A-1 Not choking now (can talk or cry, is alert and breathing normally)

• Protocol 12: Convulsions/Seizures
  • 12-D-1 Not breathing
  • 12-D-2 Continuous or multiple seizures
  • 12-D-3 Agonal/ineffective breathing
  • 12-D-4 Effective breathing not verified, patient ≥35 years old
  • 12-C-1 Focal seizure (not alert)
  • 12-C-2 Pregnancy
  • 12-C-3 Diabetic
  • 12-C-4 Not seizing now and effective breathing verified (>6 years old, confirmed no seizure disorder)
  • 12-C-5 History of stroke or brain tumor
  • 12-C-6 Overdose/poisoning (ingestion)
  • 12-C-7 Atypical seizure
  • 12-B-1 Effective breathing not verified <35 years old
  • 12-A-1 Not seizing now and effective breathing verified (known seizure disorder)
  • 12-A-2 Not seizing now and effective breathing verified (seizure disorder unknown)
  • 12-A-3 Not seizing now and effective breathing verified (≤6 years old, confirmed no seizure disorder)
  • 12-A-4 Focal seizure (alert)
  • 12-A-5 Impending seizure (aura)
    • Suffixes: E=Epileptic or previous seizure diagnosis

• Protocol 13: Diabetic Problems
  • 13-D-1 Unconscious
  • 13-C-1 Not alert
  • 13-C-2 Abnormal behavior
  • 13-C-3 Abnormal breathing
  • 13-A-1 Alert and behaving normally
    • Suffixes: C=Combative or aggressive

• Protocol 14: Drowning (near)/Diving/SCUBA Accident
  • 14-D-1 Unconscious or arrest
  • 14-D-2 Not alert
  • 14-D-3 Diving or suspected neck injury
  • 14-D-4 SCUBA accident
  • 14-C-1 Alert with abnormal breathing
  • 14-B-1 Alert and breathing normally (injuries or in water)
  • 14-B-2 Unknown status/other codes not applicable
  • 14-A-1 Alert and breathing normally (no injuries and out of water)

• Protocol 15: Electrocution/Lightning
  • 15-E-1 Not breathing/ineffective breathing
  • 15-D-1 Unconscious
  • 15-D-2 Not disconnected from power
  • 15-D-3 Power not off or hazard present
  • 15-D-4 Extreme fall (≥30 ft/10 m)
  • 15-D-5 Long fall
  • 15-D-6 Not alert
  • 15-D-7 Abnormal breathing
  • 15-D-8 Unknown status/other codes not applicable
  • 15-C-1 Alert and breathing normally
    • Suffixes: E=Electrocution, L=Lightning

• Protocol 16: Eye Problems/Injuries
  • 16-D-1 Not alert
  • 16-B-1 Severe eye injuries
  • 16-A-1 Moderate eye injuries
  • 16-A-2 Minor eye injuries
  • 16-A-3 Medical eye problems

• Protocol 17: Falls
  • 17-D-1 Extreme fall (≥30 ft/10 m)
  • 17-D-2 Unconscious or arrest
  • 17-D-3 Not alert
  • 17-D-4 Chest or neck injury (with difficulty breathing)
  • 17-D-5 Long fall
  • 17-B-1 Possibly dangerous body area
  • 17-B-2 Serious hemorrhage
  • 17-B-3 Unknown status/other codes not applicable
  • 17-A-1 Not dangerous body area
  • 17-A-2 Non-recent (≥6 hours) injuries (without priority symptoms)
  • 17-A-3 Public assist (no injuries and no priority symptoms)
    • Suffixes: G=On the ground or floor, J=Jumper (suicide attempt)

• Protocol 18: Headache
  • 18-C-1 Not alert
  • 18-C-2 Abnormal breathing
  • 18-C-3 Speech problems
  • 18-C-4 Sudden onset of severe pain
  • 18-C-5 Numbness
  • 18-C-6 Paralysis
  • 18-C-7 Change in behavior (≤3 hours)
  • 18-B-1 Unknown status/other codes not applicable
  • 18-A-1 Breathing normally

• Protocol 19: Heart Problems/AICD
  • 19-D-1 Not alert
  • 19-D-2 Difficulty speaking between breaths
  • 19-D-3 Changing color
  • 19-D-4 Clammy
  • 19-D-5 Just resuscitated and/or defibrillated (external)
  • 19-C-1 Firing of AICD
  • 19-C-2 Abnormal breathing
  • 19-C-3 Chest pain ≥35 years old
  • 19-C-4 Cardiac history
  • 19-C-5 Cocaine
  • 19-C-6 Heart rate <50 bpm or ≥130 bpm (without priority symptoms)
  • 19-C-7 Unknown status/other codes not applicable
  • 19-A-1 Heart rate ≥50 bpm and <130 bpm (without priority symptoms)
  • 19-A-2 Chest pain <35 years old (without priority symptoms)

• Protocol 20: Heat/Cold Exposure
  • 20-D-1 Not alert
  • 20-D-2 Multiple victims (with priority symptoms)
  • 20-C-1 Heart attack or angina history
  • 20-B-1 Change in skin color
  • 20-B-2 Unknown status/other codes not applicable
  • 20-A-1 Alert
    • Suffixes: C=Cold exposure, H=Heat exposure

• Protocol 21: Hemorrhage/Laceration
  • 21-D-1 Unconscious or arrest
  • 21-D-2 Not alert
  • 21-D-3 Dangerous hemorrhage
  • 21-D-4 Abnormal breathing
  • 21-C-1 Hemorrhage through tubes
  • 21-C-2 Hemorrhage of dialysis fistula
  • 21-B-1 Possibly dangerous hemorrhage
  • 21-B-2 Serious hemorrhage
  • 21-B-3 Bleeding disorder
  • 21-B-4 Blood thinners
  • 21-A-1 Not dangerous hemorrhage
  • 21-A-2 Minor hemorrhage

• Protocol 22: Inaccessible Incident/Other Entrapments (Non-Vehicle)
  • 22-D-1 Mechanical/machinery entrapment
  • 22-D-2 Trench collapse
  • 22-D-3 Structure collapse
  • 22-D-4 Confined space rescue
  • 22-D-5 Inaccessible terrain situation
  • 22-D-6 Mudslide/avalanche
  • 22-B-1 No longer trapped (unknown injuries)
  • 22-B-2 Peripheral entrapment only
  • 22-B-3 Unknown status (investigation)/other codes not applicable
  • 22-A-1 No longer trapped (no injuries)
    • Suffixes: A=Above ground (≥6 ft/2 m), B=Below ground (≥6 ft/2 m), M=Multiple victims, X=Above ground and multiple victims, Y=Below ground and multiple victims

• Protocol 23: Overdose/Poisoning (Ingestion)
  • 23-D-1 Unconscious
  • 23-D-2 Changing color
  • 23-C-1 Not alert
  • 23-C-2 Abnormal breathing
  • 23-C-3 Antidepressants (tricyclic)
  • 23-C-4 Cocaine, methamphetamine (or derivatives)
  • 23-C-5 Narcotics (heroin)
  • 23-C-6 Acid or alkali (lye)
  • 23-C-7 Unknown status/other codes not applicable
  • 23-C-8 Poison Control request for response
  • 23-B-1 Overdose (without priority symptoms)
  • 23-Ω-1 Poisoning (without priority symptoms)
    • Suffixes: A=Accidental, I=Intentional, V=Violent or combative

• Protocol 24: Pregnancy/Childbirth/Miscarriage
  • 24-D-1 Breech or cord
  • 24-D-2 Head visible/out
  • 24-D-3 Imminent delivery (≥5 months/20 weeks)
  • 24-D-4 3^rd trimester hemorrhage
  • 24-D-5 High risk complications
  • 24-D-6 Baby born (complications with baby)
  • 24-D-7 Baby born (complications with mother)
  • 24-C-1 2^nd trimester hemorrhage or miscarriage
  • 24-C-2 1^st trimester serious hemorrhage
  • 24-C-3 Baby born (no complications)
  • 24-B-1 Labor (delivery not imminent, ≥5 months/20 weeks)
  • 24-B-2 Unknown status/other codes not applicable
  • 24-A-1 1^st trimester hemorrhage or miscarriage
  • 24-Ω-1 Waters broken (no contractions or presenting parts)

• Protocol 25: Psychiatric/Abnormal Behavior/Suicide Attempt
  • 25-D-1 Not alert
  • 25-D-2 Dangerous hemorrhage
  • 25-B-1 Serious hemorrhage
  • 25-B-2 Non-serious or minor hemorrhage
  • 25-B-3 Threatening suicide
  • 25-B-4 Jumper (threatening)
  • 25-B-5 Near hanging, strangulation or suffocation (alert)
  • 25-B-6 Unknown status/other codes not applicable
  • 25-A-1 Non-suicidal and alert
  • 25-A-2 Suicidal (not threatening) and alert
    • Suffixes: B=Both violent and weapons, V=Violent, W=Weapons

• Protocol 26: Sick Person (Specific Diagnosis)
  • 26-D-1 Not alert
  • 26-C-1 Altered level of consciousness
  • 26-C-2 Abnormal breathing
  • 26-C-3 Sickle cell crisis/thalassemia
  • 26-B-1 Unknown status/other codes not applicable
  • 26-A-1 No priority symptoms (complaint conditions 2-11 not identified)
  • 26-A-2 Blood pressure abnormality
  • 26-A-3 Dizziness/vertigo
  • 26-A-4 Fever/chills
  • 26-A-5 General weakness
  • 26-A-6 Nausea
  • 26-A-7 New onset of immobility
  • 26-A-8 Other pain
  • 26-A-9 Transportation only
  • 26-A-10 Unwell/ill
  • 26-A-11 Vomiting
  • 26-Ω-1 CODE NOT IN USE
  • 26-Ω-2 Boils
  • 26-Ω-3 Bumps (non-traumatic)
  • 26-Ω-4 Can't sleep
  • 26-Ω-5 Can't urinate (without abdominal pain)
  • 26-Ω-6 Catheter (in/out without hemorrhaging)
  • 26-Ω-7 Constipation
  • 26-Ω-8 Cramps/spasms/joint pain (in extremities and non-traumatic)
  • 26-Ω-9 Cut-off ring request
  • 26-Ω-10 Deafness
  • 26-Ω-11 Defecation/diarrhea
  • 26-Ω-12 Earache
  • 26-Ω-13 Enema
  • 26-Ω-14 Gout
  • 26-Ω-15 Hemorrhoids/piles
  • 26-Ω-16 Hepatitis
  • 26-Ω-17 Hiccups
  • 26-Ω-18 Itching
  • 26-Ω-19 Nervous
  • 26-Ω-20 Object stuck (nose, ear, vagina, rectum, penis)
  • 26-Ω-21 Object swallowed (without choking or difficulty breathing, can talk)
  • 26-Ω-22 Painful urination
  • 26-Ω-23 Penis problems/pain
  • 26-Ω-24 Rash/skin disorder (without difficulty breathing or swallowing)
  • 26-Ω-25 Sexually Transmitted Disease (STD)
  • 26-Ω-26 Sore throat (without difficulty breathing or swallowing
  • 26-Ω-27 Toothache (without jaw pain)
  • 26-Ω-28 Wound infected (focal or surface)

• Protocol 27: Stab/Gunshot/Penetrating Trauma
  • 27-D-1 Unconscious or arrest
  • 27-D-2 Not alert
  • 27-D-3 Central wounds
  • 27-D-4 Multiple wounds
  • 27-D-5 Multiple victims
  • 27-B-1 Non-recent (≥6 hours) single central wound
  • 27-B-2 Known single peripheral wound
  • 27-B-3 Serious hemorrhage
  • 27-B-4 Unknown status/other codes not applicable
  • 27-B-5 Obvious death (explosive GSW to head)
  • 27-A-1 Non-recent (≥6 hours peripheral wounds (without priority symptoms)
    • Suffixes: G=Gunshot, P=Penetrating trauma, S=Stab, X=Self-inflicted GSW, Y=Self-inflicted stab

• Protocol 28: Stroke (CVA)/Transient Ischemic Attack (TIA)
  • 28-C-1 Not alert
  • 28-C-2 Abnormal breathing
  • 28-C-3 Sudden speech problems
  • 28-C-4 Sudden weakness or numbness (one side)
  • 28-C-5 Sudden paralysis or facial droop (one side)
  • 28-C-6 Sudden loss of balance or coordination)
  • 28-C-7 Sudden vision problems
  • 28-C-8 Sudden onset of severe headache
  • 28-C-9 Stroke history
  • 28-C-10 TIA (mini-stroke) history
  • 28-C-11 Breathing normally ≥35 years old
  • 28-C-12 Unknown status/other codes not applicable
  • 28-A-1 Breathing normally <35 years old
    • Suffixes: C=Partial evidence of stroke (less than _ hours), D=Partial evidence of stroke (greater than _ hours), E=Partial evidence of stroke (unknown time frame), F=Strong evidence of stroke (less than _ hours), G=Greater than _ hours since symptoms started (stroke diagnostic not completed), H=Strong evidence of stroke (greater than _ hours), I=Strong evidence of stroke (unknown time frame), J=Clear evidence of stroke (less than _ hours), K=Clear evidence of stroke (greater than _ hours), L=Less than _ hours since symptom onset (stroke diagnostic not completed), M=Clear evidence of stroke (unknown time frame), U=Unknown when symptoms started (stroke diagnostic not completed), X=No test evidence of stroke (less than _ hours), Y=No test evidence of stroke (greater than _ hours), Z=No test evidence of stroke (unknown time frame)

Note: Local medical direction will determine the time duration indicated in the suffixes.

• Protocol 29: Traffic/Transportation Incidents
  • 29-D-1 Major incident (a through f)
  • 29-D-2 High mechanism (k through s)
  • 29-D-3 Hazmat
  • 29-D-4 Pinned (trapped victim)
  • 29-D-5 Not alert
  • 29-B-1 Injuries
  • 29-B-2 Serious hemorrhage
  • 29-B-3 Other hazards
  • 29-B-4 Unknown status/other codes not applicable
  • 29-A-1 1^st party caller with injury to not dangerous body area
  • 29-Ω-1 No injuries (confirmed)
    • Suffixes: A=Multiple patients and additional response required, a=Aircraft, b=Bus, c=Subway/metro, d=Train, e=Watercraft, f=Multi-vehicle (≥10) pile-up, k=All-terrain/snowmobile, l=Auto vs. bicycle/motorcycle, M=Multiple patients, m=Auto vs. pedestrian, n=Ejection, o=Personal watercraft, p=Rollovers, q=Vehicle off bridge/height, r=Possible death at scene, s=Sinking vehicle, U=Unknown number of patients, X=Unknown number of patients and additional response required

• Protocol 30: Traumatic Injuries (Specific)
  • 30-D-1 Unconscious or arrest
  • 30-D-2 Not alert
  • 30-D-3 Chest or neck injury (with difficulty breathing)
  • 30-B-1 Possibly dangerous body area
  • 30-B-2 Serious hemorrhage
  • 30-A-1 Not dangerous body area
  • 30-A-2 Non-recent (≥6 hours) injuries (without priority symptoms)

• Protocol 31: Unconscious/Fainting (Near)
  • 31-E-1 Ineffective breathing
  • 31-D-1 Unconscious - agonal/ineffective breathing
  • 31-D-2 Unconscious - effective breathing
  • 31-D-3 Not alert
  • 31-D-4 Changing color
  • 31-C-1 Alert with abnormal breathing
  • 31-C-2 Fainting episode(s) and alert ≥35 years old (with cardiac history)
  • 31-C-3 Females 12-50 years old with abdominal pain
  • 31-A-1 Fainting episode(s) and alert ≥35 years old (without cardiac history)
  • 31-A-2 Fainting episode(s) and alert <35 years old (with cardiac history)
  • 31-A-3 Fainting episode(s) and alert <35 years old (without cardiac history)

• Protocol 32: Unknown Problem (Man Down)
  • 32-D-1 Life status questionable
  • 32-B-1 Standing, sitting, moving or talking
  • 32-B-2 Medical alarm (alert) notifications (no patient information)
  • 32-B-3 Unknown status/other codes not applicable
  • 32-B-4 Caller's language not understood (no interpreter in center)

• Protocol 33: Transfer/Interfacility/Palliative Care
  • 33-D-1 Suspected cardiac or respiratory arrest
  • 33-D-2 Just resuscitated and/or defibrillated (external)
  • 33-C-1 Not alert (acute change)
  • 33-C-2 Abnormal breathing (acute onset)
  • 33-C-3 Significant hemorrhage or shock
  • 33-C-4 Possible acute heart problems or MI (heart attack)
  • 33-C-5 Acute severe pain
  • 33-C-6 Emergency response requested
  • 33-A-1 Acuity I (no priority symptoms)
  • 33-A-2 Acuity II (no priority symptoms)
  • 33-A-3 Acuity III (no priority symptoms)
    • Suffixes: P=Palliative care, T=Transfer/interfacility

Fire

• Protocol 51: Aircraft Emergency
  • 51-D-1 Aircraft crash on land (Alert III)
  • 51-D-2 Aircraft crash involving structure (Alert III)
  • 51-D-3 Aircraft fire/recovery on ground (Alert III)
  • 51-D-4 Coastal water aircraft emergency
  • 51-D-5 Inland water aircraft emergency
  • 51-D-6 Oceanic water aircraft emergency
  • 51-C-1 Aircraft incoming - full emergency (Alert II)
  • 51-C-2 Aircraft incoming - minor emergency (Alert II)
  • 51-B-1 Unknown situation (investigation)
  • 51-A-1 Stand by
  • 51-Ω-1 Airborne aircraft
    • Suffixes: L=Large aircraft, M=Military aircraft, S=Small aircraft, U=Unknown

• Protocol 52: Alarms

• Protocol 53: Citizen Assist/Service Call

• Protocol 54: Confined Space/Structure Collapse

• Protocol 55: Electrical Hazard

• Protocol 56: Elevator/Escalator Rescue

• Protocol 57: Explosion

• Protocol 58: Extrication/Entrapped (Machinery, Vehicle)

• Protocol 59: Fuel Spill

• Protocol 60: Gas Leak/Gas Odor (Natural and LP Gases)

• Protocol 61: HAZMAT

• Protocol 62: High Angle Rescue

• Protocol 63: Lightning Strike (Investigation)

• Protocol 64: Marine Fire

• Protocol 65: Mutual Aid/Assist Outside Agency

• Protocol 66: Odor (Strange/Unknown)

• Protocol 67: Outside Fire

• Protocol 68: Smoke Investigation (Outside)