nfirs 4 - civilian fire casualty module captures data regarding civilian casualties resulting from a...
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NFIRS 4 - Civilian Fire Casualty
Module
Captures data regarding civilian casualties resulting from a fire
Civilian Fire Casualty Module
Captures data regarding civilian and/or non-fire service casualties
The injury must be the result of a fire
A - Header
Header information is repeated on all modules . . .
In an automated system, this information is entered once and imported into all modules
Delete NFIRS - 4
Civilian Fire Casualty
AChange Station FDID Exposure Incident Date
MM DD YYYY
State Incident Number
B - Injured Person
Identifies the name and gender
of the person
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether 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 PersonB Male Female 1
MI
2
C - Casualty Number
Assign a specific consecutive number to each casualty beginning with 1 usethree digits: 001, 002, etc
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
Casualty Number
CasualtyNumberC
D - Age or Date of Birth
Identifies the age or date of birth of the casualty use months for infants
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
Months (for infants) Age
OR
Date of Birth
Age or Date of BirthD
Month Day Year
E1 - Race / E2 - Ethnicity
E1 Identifies race of casualty Based upon US Census
categories,
Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
White Black Am. Indian, Eskimo Asian Multi-racialUndetermined
RaceE112345 U
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
E2 Identifies the ethnicity of the victim
Currently the only Census Bureau classification for ethnicity is Hispanic
E2Ethnicity
Hispanic
F - Affiliation
Identifies if the casualty was a civilian or a non-fire service emergency responder
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
Affiliation
Civilian EMS, not fire department Police Other
F1230
G - Date and Time of Injury
Captures the casualty date Captures the time using a
24 hour clock
midnight is 0000
D
Area of fire origin
Heat source
Item first ignited
Type of material first ignited
D1
D2
D3
D4
Ignition
Check box if fire spread was confined to object of origin
Required only if item first ignited code is 00 or < 70
1
2 1 Bedroom
Time of Injury Date of Injury
Date & Time of InjuryG
Month
Midnight is 0000.
Day Year Hour Minutes
H - Severity
Identifies the relative severity of the
casualty
,Acres burned (outside fires)
Not Residential
Number of buildings involved
Estimated number of residential living units in building of origin whether or not all units became involved
B2
B3
Buildings not involved
Less than one acre
None
Property Details
B1
B
1
2
Severity H
Minor Moderate Severe Life threatening Death
1 2 3 4 5
I - Cause of Injury
Identifies the physical event that caused the injury
Additional codes can be found in the handbook or QRG
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1Cause of Ignition
Check box if this is an exposure report.
12345U
Skip to Section G
x
Cause of InjuryIExposed to fire products including flame heat, smoke, & gas Exposed to toxic fumes other than smoke Jumped in escape attempt Fell, slipped, or tripped Caught or trapped Structural collapse Struck by/or contact with object Overexertion Multiple causes Other Undetermined
1
234567890 U
J - Human Factors Contributing to Injury
Identifies the physical or mental state of the person that may have contributed to the injury
Intentional Unintentional Failure of equipment or heat source Act of nature Cause under investigation Cause undetermined after investigation
E1Cause of Ignition
Check box if this is an exposure report.
12345U
Skip to Section G
x
Human Factors Contributing to Injury
J
Asleep Unconscious Possibly impaired by alcohol Possibly impaired by other drug Possibly mentally disabled Physically disabled Physically restrained Unattended person
Check all applicable boxes
None
K - Factors Contributing to Injury
Identifies the most significant factors that contributed to the injury Can identify up to three factors
Factors Contributing to InjuryK
Contributing factor (1)
Contributing factor (2)
Contributing factor (3)
None Enter up to three contributing factors
L - Activity When Injured
Identifies the activity in which the person was engaged at the time of the injury
None
Equipment Involved In Ignition
Equipment Involved
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
Activity When Injured L
Escaping Rescue attempt Fire control Return to fire before control Return to fire after control Sleeping Unable to act Irrational act Other Undetermined
123456780U
M1 - Location at Time of Incident
Identifies the location of the victim in relation to fire origin
None
Equipment Involved In Ignition
Equipment Involved
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
Location at Time of Incident M11234U
In area of origin and not involved Not in area of origin & not involved Not in area of origin, but involved In area of origin and involved Undetermined
M2 - General Location at
Time of Injury
Identifies the location of the victim at time of injury If casualty was in area of fire origin, skip
to section N If casualty was outside of the building
and not in area of origin, go to M5
None
Equipment Involved In Ignition
Equipment Involved
Brand
Year
F1
Model
Serial #
If equipment was not involved, skip to Section G
6 3 2 Hot Plate
XRS 130
34345
1 9 8 5
M2 General Location at Time of Injury
In area of fire origin In building, but not in area Outside, but not in area
Check ONE box. If undetermined, leave blank and skip to Section N.
Skip to Section N
Skip to Section M 5
123
M3 - Story at Start of Incident
Complete only if the injury occurred inside of building
Identifies the floor level where the victim was at the start of the incident
below grade
M3
Story at START of incident
Story at Start of Incident Complete ONLY if injury occurred INSIDE
M4 - Story Where Injury Occurred
Identifies the story (floor level) where the casualty was located at the time of the injury
F3Equipment Portability
Portable
Stationary
Portable equipment normally can be moved by one person, is designed to be used in multiple locations, and requires no tools to install.
1
2
X
Story where injury occurred, if different from M 3
below grade
M4 Story Where Injury Occurred
M5 - Specific Location at
Time of Injury
Identifies the specific location at the time of injury Codes can be found in the
Handbook
F3Equipment Portability
Portable
Stationary
Portable equipment normally can be moved by one person, is designed to be used in multiple locations, and requires no tools to install.
1
2
X
Specific location at time of injury
M5 Specific Location at Time of Injury
Complete ONLY if casualty NOT in area of origin
N - Primary Apparent Symptom
The casualty’s most serious injury other codes can
be found in the Handbook
None
Equipment Involved In Ignition
Equipment Involved
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 5Primary apparent symptom
Look up a code only if the symptom is NOT found above
Smoke only, asphyxiation Burns & smoke inhalation Burns only Cut, laceration Strain or sprain Shock Pain only
01111221339698
N Primary Apparent Symptom
N - Primary Apparent Symptom
The casualty’s most serious injury other codes can be found in the Handbook
None
Equipment Involved In Ignition
Equipment Involved
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 5Primary apparent symptom
Look up a code only if the symptom is NOT found above
Smoke only, asphyxiation Burns & smoke inhalation Burns only Cut, laceration Strain or sprain Shock Pain only
01111221339698
N Primary Apparent Symptom
O - Primary Area of Body Injured
Describes the part of the body that sustained the most serious injury
None
Equipment Involved In Ignition
Equipment Involved
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
Primary Area of Body Injured O
Head Neck & shoulder Thorax Abdomen Spine Upper extremities Lower extremities Internal Multiple body parts
123456789
P - Disposition
Identifies if the casualty was transported to an emergency care facility
F3Equipment Portability
Portable
Stationary
Portable equipment normally can be moved by one person, is designed to be used in multiple locations, and requires no tools to install.
1
2
X
Transported to emergency care facility
Disposition P
Remarks
The 'remarks' section is an area for any other remarks that might be made concerning the incident. A narrative description of the incident may be written in this block.
F3Equipment Portability
Portable
Stationary
Portable equipment normally can be moved by one person, is designed to be used in multiple locations, and requires no tools to install.
1
2
X
Remarks Local option
Summary
The Civilian Fire Casualty Module (NFIRS 4) captures data regarding any civilian casualty associated with fire-related incidents
Civilian Fire Casualty: private citizen, emergency medical
responder (not fire department), or police
dies or is physically injured as a result of a fire-related incident