Just the Numbers: Here is all the analyzed data from the first 2,000 recorded rescues. Thanks for everyone that has made a grab(s), filled out a survey(s), posted rescues to the page, added context to the posts, shared your thoughts with us, offered ideas on how to enhance the survey/website, shared this information with their members, supported our website/upcoming app by buying stickers/water bottles/shirts, challenged us intellectually, and all of the other ways you've helped us out over the past five plus years...we all really appreciate it. Also, as we are all huge proponents of transparency, all of the raw data is available for anyone to see on our website (FirefighterRescueSurvey.com). We are also advocates of accuracy above all, and are fallible human, so if anyone finds any mistakes in the raw or analyzed data, please just let us know. Lastly, please read the preamble for this document and take it to heart, as information is more important than affirmation. Thanks and enjoy.
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Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop .....Exterior Conditions Upon Arrival v Survival Rate Below is data showing the rescue survival rate relative to the exterior conditions upon arrival of the first due. Exterior conditions were defined on a spectrum ranging from nothing showing, to smoke only showing, all the way to >75% fire involvement. Not surprisingly, there seems to be an inverse relationship between the amount of fire involvement and the survival rate, meaning that as the percent of fire involvement increases, the survival rate decreases. Even when the building was >75% involved (aka “fully involved” to many firefighters), there has been a 33% survival rate. While an exterior size up is essential for effective and efficient operations, the view from the outside is only part of the picture and should be combined with the imperative, and for some reason much less championed, interior size up. There’s absolutely a lot of important information to glean from outside the building (building construction and condition, vent profile, fire conditions, etc.), although there’s a lot we could be missing too (closed doors, burning regime, location of possible victims, etc.). Thus, we must marry our exterior size up with our interior size up (as conditions allow) to improve our decision-making ability. Like in all things, the more we learn about something, the more questions arise.
Search Culture“Nothing showing”, means we must further investigate, make the interior and get a more educated size-up. Nothing showing had a 22% fatality rate, how would you feel or a family member react after you slowed a box to code 1 or didn’t assign a search early or at all and then a civilian came up injured or dead? 33% survival rate when a building is involved greater than 75% . We are always looking for searchable spaces and if they aren’t, then make them searchable, occupy it and complete the primary. Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop.....TIC Use v Total Recorded Rescues and Survival Rate The analyzed data and graph below show us that of the recorded rescues to date, 65% of the time a TIC was not used by the crew that located the victim; or if you prefer, a TIC was used by the crew locating the victim 35% of time. We can also see that the survival rate of victims located without the use of a TIC (67%) was slightly higher than when a TIC was used (54%). This may likely seem counterintuitive to most of us, but remember that this is a singular data set, and as always, a singular data set needs more context to be truly understood. A quick example of adding context to this data set, would be to parce out rescues made when the victim was located in low or no viz...would this change the numbers? Like in all things, the more we learn about something, the more questions arise.
Yes - 35% (624/1778) No – 65% (1154/1778) Was a Thermal Imaging Camera Used to Assist Search v Survival Rate: Yes - 54% (333/617) No – 67% (769/1145) Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop.....Victim Condition v Survival Rate. If you've been doing this job long enough, you've probably come to the realization that at times, life can be incredibly resilient. The data indicates that victims have survived 56% of the recorded rescues when they were unconscious upon removal (when CPR was not performed), 41% of the time they had severe burns (when CPR was not performed), and 31% of the time when they were in cardiac arrest at some point in their rescue, treatment, or transport. A 31% survival rate for prehospital cardiac arrest is incredibly high, and for a type of traumatic arrest this is simply off the charts. For clarification, survival in this context means that the victim was alive as of the most current information when the survey was filled out. At the risk of repeating ourselves, these data demonstrate that we should not be so quick to write off people or areas of the building, for even in the most hostile of environments, with severe injuries, life can find a way to survive. Rather, if we can occupy the space, we should…it is literally our prime directive. Like in all things, the more we learn about something, the more questions arise.
Search Culture 31% survival rate when our victims are being pulled out of a fire in cardiac arrest. The AHA states that the national average survival rate is 10% in the outside of hospital setting. What’s the TIME? CPR alive vs deceased - Air brake to locating these civilians - Locating them to bring rescued We need to compare the above times to the 69% of victims that did not survive. Was TIME a factor? For every minute in cardiac arrest, their survival chances decrease by 10%. What are we doing to decrease the TIME to the interior? - Do you, your crew or department have a mask up TIME standard that supports rescues? If not, we have work to do Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop.....Assignment v Total Recorded Rescues. When we look at who is rescuing victims, we see from the graph below that primary search is locating the majority of victims (58%), followed by attack (25%). Primary search and attack combined have found 84% of victims, with the rest, in order, coming from ‘other’ (e.g., IC, backup/on-deck, RIT, etc.), secondary search, salvage and overhaul, PD, and ventilation. It’s likely no surprise that primary and attack are finding the most victims, since they are typically the first crews inside these buildings. Although the fact that one in four victims are being found by the Attack Group might be surprising. This proves that attack IS search, and we must therefore act and train accordingly. Like in all things, the more we learn about something, the more questions arise.
Search Culture 25% of our victims are being located by Fire Attack. I wonder how many of these are because of departments assigning two assignments to one crew Fire Attack/Search? Of those departments that do the above, is it because they have a lack of manpower or is it because they have a lack of Search Culture? What is the survival rate of Fire Attack vs Search locating our civilians? What is the TIME difference between Fire Attack vs Search rescues? - Air brake to locating victim - Locating victim to removal Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop.....Fire Conditions Upon Entry v Survival Rate The graph below compared fire conditions upon FD entry to recorded victim survival rate. We instinctively would have estimated that incipient stage fires would have the highest survival rate while structural fires would have the lowest survival rate, and our instincts would have been correct. These data seem to affirm our intuitive understanding of the inverse relationship between fire size and survival rate. Incipient stage fires have a survival rate of 83%, quite a bit higher than any of the other categories. Although even in buildings with structural involvement, arguably the most advanced fires, there is a recorded survival rate of 46%. The data also reveals that in 52% of recorded rescues to date, the fire has involved multiple rooms or the structural members. What all this tells us is that we shouldn’t be so quick to write off a building or areas of a building, but instead we should have a bias for action when conditions allow. Like in all things, the more we learn about something, the more questions arise.
Incipient – 8% (161/1975) Room and Contents – 40% (791/1975) Multiple Rooms – 22% (426/1975) Structure – 30% (597/1975) Fire Conditions Upon Entry v Survival Rate: Incipient – 83% (131/158) Room and Contents – 67% (526/782) Multiple Rooms – 59% (251/424) Structure – 46% (275/594) Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop....Initial Mode of Operation v Survival Rate Not surprisingly, the vast majority of all recorded rescues to date happen on a fireground where the initial mode of operations is offensive. What might be surprising is that in 68 recorded rescues (6% since this question was not initially asked but was added during the first large update to the survey) so far, the fire department started in a defensive posture. As you can see in the raw data and in the graph below 46% of these recorded rescues resulted in a successful save. Like in all things, the more we learn about something, the more questions arise.
Initial Mode of Operation v Total Recorded Rescues: Offensive – 94% (1014/1082) Defensive – 6% (68/1082) Initial Mode of Operation v Survival Rate: Offensive – 68% (692/1011) Defensive – 46% (31/68) Data from the first 2,000 recorded rescues (you read that right) has been collected, calculated, and collated for all you nerds.
Data Drop....Visibility at Victim v Total Recorded Rescues. From the data below, we can see that 72% of recorded rescues happened in low and zero visibility. The data also shows that, not surprisingly, the survival rate decreases as visibility decreases (High Viz – 84%, Moderate Viz – 76%, Low Viz – 60%, and Zero Viz – 47%), so we need to make sure our training environment mirrors this apparent experiential truth. With the visual density and volume of smoke produced from most synthetic materials, operating in low and zero visibility is our reality. Like in all things, the more we learn about something, the more questions arise.
Search Culture 72% of our victims have been located in low to zero visibility. We should all hold ourselves, our crews and our departments accountable in these conditions and keep on the ground in these elements. Being low in low/zero visibility is where we can see/hear the farthest and feel for our victims the best. If a firefighter is walking during a low/zero viz search, grab them and tell them to get down and then ask “can you see better now?” Correcting this during an active fire will take a few seconds but will pay dividends for a career. Tripoding is great in larger open areas, hallways, areas where there may be stairs that lead down and when fire is below but in hoarder conditions and in close quarters such as bedrooms it really just isn’t always feasible and crawling or alike may be warranted. What’s best for our victims is not always what is comfortable to us but when we get over our ego, we can make our comfort level match that of what is best for our civilians. Data Drop.....When was Search Initiated v Survival Rate.
Data from the recorded rescues so far show that survival rates are higher when search was initiated before fire knockdown, and also when search was initiated before RIT was assigned. The data also shows that the vast majority of recorded rescues had search initiated before knockdown (83%) and before RIT was assigned (95%). These facts, when combined lead to early search (pre-knockdown and pre-RIT assignment) accounting for the lion's share of all successful rescues (89% pre-knockdown; 96% pre-RIT assignment). As always, the more we learn, the more questions that arise: How early in your operations does your department prioritize search? How many members are typically assigned to search on your firegrounds? How often are we supplementing search by sending multiple crews to search different areas? Is there ever a fireground where one could justify triaging RIT before search? If so, can you given an example? When Was Search Initiated v Survival Rate: Pre Knockdown – 65% (1069/1653) Post Knockdown – 40% (129/322) * 89% (1069/1198) of all successful rescues were made when search was initiated before the fire was knocked down When Was Search Initiated v Survival Rate: Pre RIT/RIC Assignment – 66% (725/1091) Post RIT/RIC Assignment – 47% (27/58) * 96% (725/752) of all successful rescues were made when search was initiated before the RIT was assigned Data Drop...Cyanokit Use and Victim Burns v Survival Rate.
While the sample size of victims given hydroxocobalamin (Cyanokit) is relatively small (n = 204 total), the numbers are definitely intriguing (this is obviously not a double-blind, peer reviewed, empirical study that meets the standard of the medical community). As you can see in the raw data and graph below, the survival rate for all three burn categories is higher when hydroxocobalamin is given to the vicitm. As always there are multiple variables at play, but we'll be keeping an eye on these numbers in future iterations for sure. As always, the more we learn, the more questions that arise: Does your department/local transporting agency carry hydroxocobalamin? If not, why (price, shelf-life, etc.)? Could you/they work with a local hospital/burn center to stock the medication? What are your/their indications for giving hydroxocobalamin? Victim Burns v Cyanokit v Survival Rate: None – (no Cyanokit) 72% (654/910) ; (Cyanokit) 77% (82/106) Mild - (no Cyanokit) 57% (230/407) ; (Cyanokit) 64% (42/66) Severe - (no Cyanokit) 37% (151/409) ; (Cyanokit) 53% (17/32) A big thanks to Robert McClelland for all his work on this topic. |
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