fire service casualty module
DESCRIPTION
Fire Service Casualty Module. Objectives. The participants will be able to: describe when the Fire Service Casualty Module is to be used. demonstrate how to correctly complete the Fire Service Casualty Module. Fire Service Casualty Module. - PowerPoint PPT PresentationTRANSCRIPT
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Fire Service Casualty Fire Service Casualty ModuleModule
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ObjectivesObjectives
The participants will be able to:– describe when the Fire Service
Casualty Module is to be used.– demonstrate how to correctly
complete the Fire Service Casualty Module.
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Fire Service Casualty Fire Service Casualty ModuleModule
Used to report injuries, deaths or exposures to fire service personnel.– Exposure of fire service personnel to toxic
substances or harmful physical agents should be reported, even if no signs or symptoms are present.
One module is completed for each fire service individual.
For any incident type or on-duty injury. All fields need to be completed in MA.
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A - HeaderA - Header
Header information is repeated on all modules . . . In an automated system, this
information is entered once and imported into all modules
Delete A Change
NFIRS - 5Fire Service
Casualty Station FDID Incident Date
MM DD YYYY
State Incident Number
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B - Injured Person B - Injured Person
Identifies personal information– name– gender (sex)
Department type– volunteer (include paid-on-call)– career
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2First Name Last Name Suffix
Injured PersonBIdentification Number
MI
Male Female
12
Career Volunteer
12
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C - Casualty Number C - Casualty Number
Each fire service casualty is assigned a number.– begin with 001.– Separate from Civilian
Fire Casualties.
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2
Casualty NumberC
Casualty Number
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D - Age or Date of Birth D - Age or Date of Birth
Identifies the age or date of birth of the fire service casualty.
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2
InyearsOR
Date of Birth
Age or Date of BirthD
DayMonth Year
Age
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E - Date and Time E - Date and Time
Identifies the date and time of injury.– midnight is 0000.
Time of Injury Date of Injury
Date & Time of InjuryE Midnightis0000.
Month Day Year Hour Minutes
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F - Responses F - Responses
Identifies the number of responses that the firefighter made during the previous 24 hours.
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2
ResponsesF
Numberofpriorresponsesduringpast24hours
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GG11 - Usual Assignment - Usual Assignment
Identifies the usual assignment of the injured fire service personnel.– this might not be
the same as the individual’s activity at the time of injury.
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1 Cause of IgnitionCheckboxifthisisanexposurereport.
12345U
Skip to Section G
x
G1 Usual Assignment
Suppression EMS Prevention Training Maintenance Communications Administration Fire investigation Other
123456780
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GG22 - Physical Condition - Physical Condition
Identifies the condition of the firefighter prior to the injury.
D
Areaoffireorigin
Heatsource
Itemfirstignited
Typeofmaterialfirstignited
D1
D2
D3
D4
Ignition
Checkboxiffirespreadwasconfinedtoobjectoforigin
Requiredonlyifitemfirstignitedcodeis00or<70
1
2 1 BedroomG2 Physical Condition Just Prior To Injury
RestedFatiguedIll or injuredOther
1230
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GG33 - Severity - Severity
Identifies the severity of the injury.
Used to report injuries, deaths or exposures to fire service personnel.– Exposure of fire service personnel
to toxic substances or harmful physical agents may be reported.
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2
Report only, including exposure First aid onlyTreated by physician (no lost time) Moderate (lost time) Severe (lost time) Life threatening (lost time) Death
SeverityG31234567
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GG44 - Taken To - Taken To
Identifies where the fire service casualty was taken after the injury occurred.
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1 Cause of IgnitionCheckboxifthisisanexposurereport.
12345U
Skip to Section G
x
G4 Taken ToHospital Doctor’s office Morgue/funeral home Residence Station or quarters Other Not transported
1 4 5 6 7 0 N
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GG55 - Activity at Time of - Activity at Time of Injury Injury
Identifies what the firefighter was doing at the time of injury.– codes are found in the Handbook
or QRG.
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1 Cause of IgnitionCheckboxifthisisanexposurereport.
12345U
Skip to Section G
x
Activity at Time of InjuryG5
Activityattimeofinjury
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HH11 - Primary Apparent - Primary Apparent Symptom Symptom
Block H1: Primary Apparent Symptom. – describe most serious apparent injury.
Coded Field.– codes are found in Handbook and QRG.
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1 Cause of IgnitionCheckboxifthisisanexposurereport.
12345U
Skip to Section G
x
H1
Primaryapparentsymptom
Primary Apparent Symptom
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HH2 2 - Area of Body Injured - Area of Body Injured
Identifies the part of the body which sustained the most serious injury.
Primaryinjuredbodypartorarea
H2 Primary Area of Body Injured
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II11 - Cause of Injury - Cause of Injury
Identifies the cause of the firefighter injury.– codes can be found in the
Handbook or QRG.
Cause of Firefighter Injury
Causeofinjury
I1
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II22 - Contributing Factors - Contributing Factors
Identifies the most significant factor contributing to the injury.
Contributingfactor
Factor Contributing to InjuryI2
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II33 - Object Involved in - Object Involved in Injury Injury
Is used to clarify what object contributed to the injury.
None
Equipment Involved In Ignition
EquipmentInvolved
Brand
Year
F1
Model
Serial#
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 130
34-2345
1 9 8 5Objectinvolvedininjury
Object Involved in InjuryI3
None
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JJ11 - Where Injury Occurred - Where Injury Occurred
Describes the location of the fire service casualty at the time of injury.
None
Equipment Involved In Ignition
EquipmentInvolved
Brand
Year
F1
Model
Serial#
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 130
34-2345
1 9 8 5
Where Injury Occurred J1
Enroute to FD location At FD location Enroute to incident scene Enroute to medical facility At scene in structure At scene outside At medical facility Returning from incident Returning from med facility Other
1234567890
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JJ22 - Story Where Injury - Story Where Injury Occurred Occurred
Identifies the story above or below grade where the injury occurred. – Complete only for structures.
None
Equipment Involved In Ignition
EquipmentInvolved
Brand
Year
F1
Model
Serial#
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 13034-2345
1 9 8 5
J2 Story Where Injury Occurred Complete for structures only.
Below grade
Story of injury
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JJ33 - Specific Location - Specific Location
Provides additional details on the specific location of the casualty at the time of injury.
Complete J4 if casualty was in a vehicle when injured.
None
Equipment Involved In Ignition
EquipmentInvolved
Brand
Year
F1
Model
Serial#
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 130
34-2345
1 9 8 5
J3 Specific Location Completeasapplicable
656463615453494536353433323128272625242322 00
In aircraft In boat or ship or barge
In rail vehicle In motor vehicle In sewer In tunnel In structure In attic In water In well In ravine In quarry or mine In ditch or trench In open pit On steep grade On fire escape/outside stairs On vertical surface or ledge On ground ladder On aerial ladder or in basket
On roof Outside at grade
Other
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JJ44 - Vehicle Type - Vehicle Type
Complete only if the fire service casualty was in a vehicle at the time of injury.
Suppression vehicle EMS vehicle Other FD vehicle Non-FD vehicle
Vehicle TypeJ41234
CompleteONLYifSpecificLocationcodeis>60
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KK11 - Protective Equipment - Protective Equipment
If protective equipment failed and was a factor in this injury, complete Section K.
If the answer to K1 is “yes” complete equipment sequence field, and the remainder of the Module.
Did protective equipment fail and contribute to the injury? Please complete the remainder of this form ONLY if you answered YES.
K1 Yes
No
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KK11 - Equipment Sequence - Equipment Sequence
A unique number assigned to each piece of equipment that failed and contributed to the injury.– First piece of faulty
equipment is always “001” (consecutively number additional pieces).
,Acresburned(outsidefires)
Not Residential
Numberofbuildingsinvolved
Estimatednumberofresidentiallivingunitsinbuildingoforiginwhether or not all units became involved
B2
B3
Buildings not involved
Less than one acre None
Property Details
B1
B
1
2
Equipment Sequence Number
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KK22 - Protective Equipment - Protective Equipment ItemItem
Identifies each piece of equipment that contributed to the injury of the firefighter.– If more than one piece
of protective equipment was a factor in the firefighter’s injury, use additional sheets.
None
Equipment Involved In Ignition
EquipmentInvolved
Brand
Year
F1
Model
Serial#
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 130
34-2345
1 9 8 5
K2 Protective Equipment Item
1112131415161710
Head or Face Protection
Helmet Full face protector Partial protector Goggles/eye protection Hood Ear protector Neck protector Other
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KK33 - Protective Equipment - Protective Equipment ProblemProblem
Describes the most serious problem with the piece of equipment that failed and contributed to the injury.
(Partial list)
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KK44 - - Equipment Manufacturer, Model, & Serial Number
Provide detailed information on the specific equipment that failed and contributed to the injury.
K4 Equipment Manufacturer, Model & Serial Number
Manufacturer
Model
SerialNumber
.
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SummarySummaryThe Fire Service Casualty Module
(NFIRS 5) is used to report firefighter injuries or deaths related to an incident.– Exposure of fire service personnel to
toxic substances or harmful physical agents should be reported, even if no signs or symptoms are present.
Fire service casualty information can be used by Health and Safety Officers to reduce risks at incidents.
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Scenario – Fire Service CasualtyScenario – Fire Service Casualty
FF Bennett, a 49-yr old, career firefighter received a 2nd degree burn to his left wrist during overhaul.
He ran 7 calls in the previous 24 hours.
He was transported to the local hospital and was sent home when discharged.
He reported that his FF gloves did not fully cover his wrist area. The gloves were manufactured by Redi-fit, model – Fit King 200.
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Questions?Questions?