The fire service has done a great job of emphasizing the need for firefighter safety, especially over the past 25 years. Rapid intervention, two out, the 16 Firefighter Life Safety Initiatives, Project Mayday, and many other efforts have been critical parts of the overall firefighter safety enterprise. These groundbreaking efforts have undoubtedly saved firefighter lives.
The time has come to place an equal emphasis on civilian rescue, including quantitative and qualitative data collection, tactical considerations, and command techniques that can increase our success rate toward civilian rescue. We will look at the latest statistical data regarding civilian rescue and how this awareness may increase emphasis on and a training culture toward the civilian victim.
Webcast on Civilian Rescue with Kastros and Brush
A common mantra of the fire service is that life safety is our highest incident priority. Unfortunately, what is unclear is whose life is the priority—the firefighters or the civilians we are sworn to protect? Unfortunately, the data points collected demonstrate that the fire service has placed a higher priority on firefighter life safety than we have on civilian life saves.
Figure 1. Firefighter Interior Line-of-Duty Deaths Per the National Fire Protection Association (NFPA)
Figure 2. U.S. Fire Administration Number of Fires and Fire Deaths
The firefighter death rate for operating inside a structure fire per 100,000 fires has fallen from 2.5 per 100,000 fires in 1977 to less than 1 per 100,000 fires in 2018. The death rate for American civilians inside residential structure fires has increased from 7 per 1,000 fires in 1977 to almost 8 per 1,000 fires in 2018. “While reported home fires and home fire deaths have been cut roughly in half since 1980, the death rate per 1,000 home fires has remained fairly consistent. It was slightly higher in most recent years than it was in 1980.” (NFPA, Home Structure Fires, 2019) Here in black and white is possibly the greatest fire service tragedy: We have 40 years of information showing that we are risking less and losing more. Although this information is concerning, it is incomplete because it is only one side of the story—what the fire service is losing.
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Search and Rescue by the Numbers
To date, the American fire service has not officially collected the number of civilians rescued at fires or the means by which they are rescued—our wins. Imagine if we had 40 years of data to show how many more or less civilians we were saving from fires. The unfortunate result of our current information gap is a service unable to quantify if or how presence, actions, or operations result in saving lives. For the fire service to deliberately improve outcomes and not just reduce loss, the mission (saving lives) must match the metrics (lives saved).
(1) Single-family dwelling fires accounted for 52% of civilian rescues for First Quarter 2021. (Photos by Brett Conner/Night Owl Media.)
(2) Multifamily dwelling fires accounted for 48% of civilian rescues for First Quarter 2021.
To demonstrate proof of concept and value of a civilian rescue-focused data set, a research project was conducted for the first 90 days of 2021 (and continues) through the Oklahoma State University Fire and Emergency Management Program and the Firefighter Rescue Survey. The research project through Oklahoma State University collected all fireground rescues of civilians by firefighters reported in the U.S. news media and fire department press releases. From those reports, a direct contact was made with the departments that made the rescues to complete a Firefighter Rescue Survey, which collects information on the conditions, operations, and outcome of the rescue.
Preliminary Results
The following information is some of the preliminary results.
2021 First Quarter Report
- 454 residential structure fire incidents with fireground civilian rescues by fire departments reported in U.S. news media or by department press releases.
- 881 civilians rescued from residential structure fires and transferred to emergency medical evaluation by the direct actions of U.S. firefighters during the first quarter of 2021. This represents an average of 9.8 rescues per day.
- 247 follow-up Firefighter Rescue Surveys completed by the firefighters or departments involved in the rescue operation. This is a 28% response rate to the direct contact collection method. For the first quarter of 2020, 59 Firefighter Rescue Surveys were collected under the voluntary system with no direct outreach request. Using the direct method for 2021 yielded more than four times the data over the same time period.
- 74% incident survival rate for civilians who were rescued from residential structure fires and transferred to emergency medical through the direct actions of U.S. firefighters. The survival rate is calculated from the 247 direct follow-up Firefighter Rescue Surveys.
- 652 estimated civilian lives saved from residential structure fires through the direct actions of U.S. firefighters and emergency medical personnel. This is determined by applying the survival rate percentage to the total reported rescue population.
- 293 single-family dwelling and mobile home fire incidents had fireground civilian rescues yielding a total of 461 victims. For single-family dwelling and mobile home fires with rescues, it can be anticipated that there will be more than one potential victim.
- 161 apartment and multifamily dwelling structure fires had fireground civilian rescues yielding a total of 420 victims. For apartment and multifamily dwelling incidents with rescues, the average is 2.6 victims per incident.
Total Recorded Rescues vs. Survival Rate
Alive–74% (183/247)
Deceased–26% (64/247)
Time of Day
00:00-02:59–29 rescues
03:00-05:59–59 rescues
06:00-08:59–13 rescues
09:00-11:59–27 rescues
12:00-14:59–19 rescues
15:00-17:59–31 rescues
18:00-20:59–30 rescues
21:00-23:59–39 rescues
Were There Reports of a Victim vs. Total Recorded Rescues?
Yes–Report of victims–73%
Yes–Report of everyone is out–1%
No–No report of victims–26%
When Was Search Initiated vs. Total Recorded Rescues?
Preknockdown–89%
Postknockdown–11%
When Was Search Initiated vs. Survival Rate?
Preknockdown–77%
Postknockdown–54%
Residential Occupancy Type vs. Total Recorded Rescues
Single-Family Dwelling–49%
Multifamily Dwelling–43%
Mobile Home–6%
Survival Rate by Residential Occupancy Type
Single-Family Dwelling–65%
Multifamily Dwelling–87%
Mobile Home–53%
Fire Conditions on Entry vs. Total Recorded Rescues
Incipient–9%
Room and Contents–33%
Multiple Rooms–40%
Structure–18%
Survival Rate by Fire Conditions on Entry
Incipient–91%
Room and Contents–80%
Multiple Rooms–69%
Structure–62%
Visibility vs. Total Recorded Rescues
High Visibility–13%
Moderate Visibility–23%
Low Visibility–33%
Zero Visibility–30%
Survival Rate based on Visibility Conditions at the Victim
High Visibility–97%
Moderate Visibility–89%
Low Visibility–78%
Zero Visibility–45%
Was the Victim Found Behind a Closed Door/Isolated from Fire vs. Total Recorded Rescues?
Yes–32%
No–68%
Survival Rate for Victims Behind a Closed Door/Isolated from Fire
Yes–92%
No–65%
Victim Age vs. Total Recorded Rescues
0-2–2%
3-5–5%
6-12–6%
13-18–2%
19-64–65%
>65–21%
Survival Rate by Age Group
0-2–80%
3-5–45%
6-12–86%
13-18–75%
19-64 – 75%
>65–75%
Crew Locating Victim vs. Total Recorded Rescue
Primary–51%
Attack–25%
Other–16%
Secondary–2%
Salvage/Overhaul–<1%
Law Enforcement–5%
Ventilation–1%
Did the Primary Search Crew Who Located the Victim Physically Have a Hoseline with Them vs. Total Recorded Rescues?
Yes–23%
No–77%
Did the Primary Search Crew Who Located the Victim Physically Have a Hoseline with Them vs. Survival Rate?
Yes–59% (32/54)
No–77% (142/184)
Search Type vs. Survival Rate
Split–73% (53/73)
Left Hand/Right Hand–53% (17/32)
Oriented–61% (14/23)
Vent-enter-search (VES)–85% (39/46)
Search Line–25% (1/4)
Not Assigned to Search–85% (57/67)
Time from FD Arrival on Scene Until Victim Removed (Total Rescue Time) vs. Total Recorded Rescues
<6 minutes–37%
6-10 minutes–41%
11-15 minutes–11%
16-20 minutes–5%
21–30 minutes–2%
>30 minutes–4%
Time from FD Arrival on Scene Until Victim Removed (Total Rescue Time) vs. Survival Rate
<6 minutes–94% (83/88)
6-10 minutes–72% (71/98)
11-15 minutes–54% (14/26)
16-20 minutes–50% (6/12)
21-30 minutes–20% (1/5)
>30 minutes–0% (0/10)
From this quantitative and qualitative data, we can extrapolate some basic statistical assumptions:
- Victims found and removed within six minutes of fire department arrival have the greatest survivability rate.
- The more we know about the location of the victims, the higher the survivability rate.
- It is more likely that a crew without a hoseline will successfully find and remove a victim who survives.
- Most victims are not found behind closed doors.
- The victims found behind closed doors have a higher survivability rate.
- The highest number of rescues (64%) within a 12-hour window occur between 6:00 p.m. and 6:00 a.m. The highest three-hour window is between 3:00 a.m. and 6:00 a.m. (24%). Our period of longest likely turnout time also is the period of greatest potential for rescue.
- Fires in single-family dwellings with a victim will, on average, have more than one victim.
- Fires in apartments with victims will, on average, have three victims.
- Victims have an eight times higher survivability rate if they are found preknockdown.
- VES as a search tactic has the highest survival rate for the civilian at 86%.
These numbers are compelling, to say the least. How can our command and tactics improve the survivability of victims based on the bullet points and statistics above?
Victim Profiling
The primary objective of victim profiling is to rapidly access the potential presence, status, and location of civilian victims as soon as possible to give them the greatest chance of survival. The additional objective is to give the incident commander (IC) the most up-to-date information on potential civilian lives at risk so he may ensure that the appropriate risk is being taken by firefighters. The risk is firefighter lives; the gain is civilian lives. The IC must constantly balance the two throughout the incident, and both change constantly.
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Survivability Profiling: Are the Victims Savable?
The modern fireground is a battlefield. And, like any battlefield, there exists a fog of war. The fog of war can obscure reality and cause confusion. While the first-arriving officer is trying to don a self-contained breathing apparatus, the crew is stepping off, additional companies are arriving, bystanders may be yelling, the radio is blaring, smoke is everywhere, and the fire is crackling away. In this moment, the officer must make potentially life and death decisions, with limited information, in a compressed timeframe. We cannot hit the pause or do-over button. A means to rapidly assess the victim profile must be trained into our officers and their crews if we are going to give the civilian victim the greatest chance of survival—not removal, survival!
Modern fires increase rapidly. Smoke from these fires spreads infinitely faster than the flames and will likely reach the victim before lethal temperatures. Smoke will kill the victim at an exponentially rapid rate, since the two most common gases in structure fires are also the two most deadly. Carbon monoxide (CO) adheres to hemoglobin 212 times more than oxygen (O2) and simultaneously displaces O2. Hydrogen cyanide (HCN) paralyzes the respiratory system.
Using a fire pump as an analogy, imagine losing water from the hydrant while the pump fails. This is the synergistically lethal effect on the body of O2 and HCN.
As part of our size-up, we must assess the victim profile. Most standard operating procedures (SOPs) require the first-due officer to give building type, size, and level of fire involvement on the arrival report. What if we included a victim profile in the initial size-up and arrival report, during a follow-up report, or after a lap is completed (if possible)? The sooner we know about the potential presence, location, and status of victims, the sooner we can align our incident priorities, command, and tactics to give any potential victims the greatest chance of survival.
En route to the scene, ask dispatch if there is any report of victims or if everyone is reported out of the structure. As the first-arriving officer steps off the apparatus, he AND the crew must assess victim status—ask bystanders and consider the time of day, the occupancy type, and the fire location. Rather than “give the hand” to any bystander approaching, ask questions to obtain the victim profile.
To be very clear, only the fire department determines if a structure is “All clear” of victims. That said, there is a big difference between being told by a credible source that everyone is out vs. “I don’t know” vs. “My dad is inside.”
Victim profiling is also designed to establish the level of risk we are willing to take with our firefighters. Being told by a credible source that everyone is out does not mean we are not searching or that search is a lower priority. When taken into consideration with other factors like level of involvement, occupancy type, fire load, and time of day, it adds to the recipe to determine the incident priorities and tactical objectives and, thus, resource deployment and how the incident will be organized.
For example, if Engine (E) 1 arrives to a hardware store at 2 p.m. on a weekday; 50% of the structure is involved; heavy, black, turbulent smoke is pouring out of the A side; and the manager, who appears sane and sober, says, “Everyone is out,” then we are likely to be in a defensive strategy. If that same manager says, “Bob is still inside!” then we need more information and have some decisions to make very fast.
Conversely, if E1 arrives to an apartment fire with two kids trapped in a room-and-contents fire, what is the best use of E2? Do we really need them to lay out 300 feet to a hydrant, or should they come directly into the scene and do a tank transfer while the crew performs search? How many times have you heard crews set up two out, secure utilities, or lay into an engine with 750 gallons in the tank when victims are trapped in a house fire that can be knocked down with tank water? A victim profile can realign incident priorities and create appropriately aggressive tactics instead of checking boxes out of habit.
The victim profile can be broken down into four categories:
- Low.
- Moderate.
- High.
- Confirmed.
A low victim profile would be when a credible source tells you everyone is out—again, not to be confused with “All clear” or the notion that we are not searching. This also tells us what level of risk we are willing to take with our firefighters. If we have a low victim profile with imminent collapse, then we are likely in a defensive strategy. If we have a low victim profile and a well-involved garage attached to a house, we are still searching as quickly as possible.
A moderate victim profile would be a house fire during the day with no reporting parties or bystanders to give you any information. With other factors in mind, a moderate level of risk will be taken by the firefighters because a moderate gain appears to be present. Again, this is based on other factors like level of involvement, potential for collapse, time of day, cars in the driveway, and so on. It is a judgment call, not an exact science.
A high victim profile would statistically (see data above) be the same house at 3 a.m. with cars in the driveway. We have a high likelihood of victims, so we are willing to push harder and risk more. Based on the statistics, other examples would be multifamily dwellings and apartments between 6 p.m. and 6 a.m.
A confirmed victim profile would be just that—a credible witness, reporting party, or occupant tells you that victims are trapped inside the structure. Rather than spring into action, we must take about 10 seconds and get the SIGNAL (see below) from the party declaring the victims. Rapidly obtain the following:
S-Species: Is the victim human? Many of you reading this article have been to fires where “my baby is trapped” was a dog, cat, bird, or emotional support parakeet.
I-Incapacity: Other than unconsciousness from CO and HCN, what about the victim could make this a more challenging rescue? Is the victim deaf, blind, morbidly obese, mentally challenged, or nonambulatory?
G-Gender: Is the victim male or female? If you enter looking for a female and find a male, you likely have more than one victim, which is statistically probable.
N-Number: How many victims are present? There is a big difference between “My family is inside” and “My husband and two small boys are inside.”
A-Age: Age groups have predictable behavioral patterns. Adults tend to be in the path between the fire and front or back door, unless at night in bed. Teens think the water from the shower will save them and may be found in the bathroom during the day or in their bedroom gaming or napping. Children are hiding under beds, blankets, or toys or in closets. Infants are in cribs. The question is, where is the crib?
L-Location: The more accurate the location, the more you can target a search and reduce precious time. Tactics like VES, window cut downs, or going through an adjacent apartment can be fast and effective. Train on these tactics often.
A Scenario to Illustrate
Your fire department is responding to an apartment fire in a fourplex at 3:30 a.m. You have three engines, one truck, one ambulance, and one battalion chief. All companies are three personnel. You are the company officer of E1. On arrival, you have heavy fire in the lower A/B corner unit. The fire is extending into the unit above, and you can definitely knock it down with your tank to support search, but you do not have a water supply. The closest hydrant is 350 feet away in the opposite direction from where you responded. You are told on arrival by an adult male that his “family is trapped in the apartment above the fire.”
You direct your crew to perform a quick transitional attack on the first-floor fire and give the following arrival report: “Engine 1 is on scene at the dispatched address. Two-story fourplex. Heavy fire on the first floor. Extending into the second. Confirmed victim profile. Engine 1 is initiating attack. Next engine, bring a tank transfer to Engine 1 and be ready for rescue. Third engine, complete the water supply. Dispatch, send two additional ambulances for a total of three. Passing command.”
This is obviously a confirmed victim profile. That alone is not enough information to maximize your resources.
Get the SIGNAL from the dad while your crew performs a transitional attack on the fire. This should take no longer than 10 seconds:
“Sir, tell me who exactly is trapped?”
“My wife and kids!”
“How many boys and girls and how old?”
“Two boys and a girl! 10, 8, and 5! Why are you asking me this? Go get them!”
“Are they in their bedrooms?”
“Yes!”
“Point to their bedrooms and your wife’s bedroom.”
He points to two upstairs windows on the B side for his kids and says his wife is in the bedroom in the back (C side). You tell him to stay in front of the engine bumper and to not go back inside. You quickly check with bystanders to assess any other potential victims in the involved unit. You are told that the couple is out of the involved unit. It was a kitchen fire.
You notice a quick knockdown and transmit the following on arrival. “All units, Engine 1 update. Fire is knocked down but not contained. Report of three children and one adult female in unit above. Dispatch, send a second alarm and two additional ambulances for a total of five [one per fire victim, plus one for any unknown victims and potential firefighters]. Truck, on arrival, set up for VES of C side window for adult female. Engine 1 crew is initiating VES of B side windows for children. Engine 2, assume command, perform a water transfer, and assist with VES and containment.”
This may seem like a lot for E2 to do. Think about it in terms of individuals, not companies. E2’s officer will assume command and can keep the fire contained from the outside to support the rescues. He or the engineer from E1 can direct the hoseline at any fire that continues to flare up until the arrival of E3’s crew. Once E3 arrives, members can contain any fire and search the first-floor fire unit. Known victims are a higher priority than unknown victims. If your victim profile and signal yielded other victims in the involved first-floor apartment, then you would take that into account and deploy resources accordingly.
E2’s engineer should put his engine in pump and step off for rescue. This allows E1’s engineer to immediately get water from his tank. A fire of this size can be contained quickly with two tanks or less, and you will have E2’s crew on scene much faster to perform rescue within the six-minute window to make a save.
E2’s firefighter and engineer can now execute VES of the other B-side window for the other victims. This removes the child victims ASAP who will not be as labor intensive as the adult mother on the C side. This assignment was given to Truck 1, allowing all three personnel to execute the VES of the adult female down the ladder.
The battalion chief (BC) arrives and assumes command. As other units arrive, primary and secondary searches will be completed and the fire completely extinguished. The IC has assigned a Rescue Group supervisor (RGS) to supervise and coordinate the multiple crews performing multiple rescues. E2’s officer is an effective choice since he was in position, had command anyway, and had a tactical plan in place on the BC’s arrival. This reduces radio traffic and maximizes tactical efficiency. The objective of the RGS is to get all victims out and to the Medical Group as soon as possible.
Command also establishes a Medical Group supervisor (MGS). This allows one supervisor to coordinate and ensure rapid treatment and transport of all four victims and other unknown victims. If additional medical resources are required (advanced life support engines or ambulances), they would report to the MGS to minimize radio traffic and maximize efficiency. The sooner the victims get to the hospital, the higher their likelihood of survival.
Finally, a Fire Attack Group supervisor (FGS) is assigned with the objective of extinguishing the fire, checking extension, and ventilating. This may be a second BC or an officer from the second alarm.
Using the above example, the span of control for the IC goes from 13:1 (second alarm and additional medic units called) down to 3:1. This will reduce radio traffic while supervisors communicate with their crews face-to-face. Accountability will be much more accurate, as this is conducted hands on by the tactical supervisors, and tactical supervisors are empowered to make tactical decisions at their level, thus reducing lag time to/from the IC to execute objectives.
As with all operations, the key to success in this type of decentralized command structure is training: Training + Time = Trust. In a known rescue scenario, decentralized incident command can rapidly get resources deployed and accounted for while minimizing radio traffic and lag time.
The fire service has made great strides in firefighter safety and has studied the statistics to drive fireground operations, training, personal protective equipment, and a host of other initiatives. This has saved countless firefighter lives, and the statistics prove it.
We must refocus on civilian rescue with the same verve. Firefighter survival and victim saves are not mutually exclusive goals. Data can help us make more effective and efficient decisions regarding SOPs, training, resource allocation, command, and tactics. In today’s modern fireground, the window to make a successful rescue slams shut rapidly. Details matter. Training saves seconds, seconds save minutes, minutes save lives.
Please visit FirefighterRescueSurvey.com and participate so we can continue to collect the most accurate data to better accomplish our mission: saving civilian lives.
Brian Brush is a 20-plus-year veteran of the fire service. His experience includes rural and metro-sized departments. He is the chief of training for the Midwest City (OK) Fire Department. Brush is a graduate of the National Fire Academy Executive Fire Officer Program, has a master’s degree in fire and emergency management from Oklahoma State University, and has Chief Training Officer designation from the CPSE. He frequently contributes to Fire Engineering and has served as a classroom and H.O.T. instructor at FDIC International for 10 years.
Anthony Kastros is a 33-year fire service veteran. He is the author of the Fire Engineering book and video series Mastering the Fire Service Assessment Center–2nd Edition and Mastering Fireground Command–Calm the Chaos! Kastros is the recipient of the 2019 George D. Post Instructor of the Year Award from the ISFSI and Fire Engineering. He is the founder of Trainfirefighters.com, teaching command, tactics, and officer development throughout America.
Anthony Kastros and Brian Brush will present “Civilian Rescue: The Reason We Exist” at FDIC 2021 in Indianapolis on Thursday, August 5, 3:30 p.m.- 5:15 p.m.
