This is it—the one we all think about, the one we train for every day but hope never happens: Your department is called out in the early morning for a structure fire. While you are responding, the dispatcher gives you additional information, “Multiple calls with trapped occupants.” You are first on-scene and confirm what you knew in the pit of your stomach to be a reality: On the front lawn, a woman in her nightgown is screaming frantically that her husband and two children are still “in there.”
How many of you have already decided to don your personal protective equipment and enter the structure or commit your crew to doing so? I’ll bet my career that most, if not all, of you have. There may be a minority of you who were unable to make that same decision because important information is lacking: Where is the fire located? Are flames coming out of every door, window, and crack in the structure? What is the smoke condition, and what is it telling us? What is the construction/stability of this building? Is it a private dwelling? A condominium with lightweight construction? Or is it a fire resistive occupancy? Is a rapid intervention team (RIT) in place, and are enough firefighters on-scene to mount an attack? After answering these questions, then and only then can you conclude the probable (vs. possible) survivability of any trapped victims that may be inside. Yet, most of you were willing to run in based on the initial information provided, right?
Today, although rapid intervention teams are commonplace and despite all our technological advances, national firefighter line-of-duty deaths are not decreasing. Since 1977, the national average of firefighter fatalities has been approximately 100 annually, with 114 occurring in 2008. Of the firefighter fatalities in 2008, 31 (or 27.1 percent) occurred in structural fires.1 Perhaps the time has passed when we should have left 31 vacant lots and gone home to our families instead.
We can and must conduct a realistic survivability profile of trapped victims using proper size-up.2 We must acknowledge that, in some instances, the chances of survival for the occupants are no longer and that rescue has turned into a recovery. We need to recognize and accept this reality when it is presented and before we commit firefighters, thus using survivability profiling.
Risk vs. reward analysis and survivability profiling must go hand-in-hand. The National Fire Academy (NFA) risk vs. reward analysis model is simple: “Risk a lot to save a lot, risk a little to save a little, risk nothing to save nothing.” We should all adopt it.
Deputy Chief Todd LeDuc of Broward Sheriff Fire Rescue in Ft. Lauderdale, Florida, points out, “Don’t mistake risk for chance!”3 He acknowledges that incident commanders (ICs) may take acceptable risks, especially when trapped occupants or firefighters are at stake. “However, to forgo risk assessment [and survivability profiling] and leave the results to chance should raise the big red flag of unacceptable risk and behavior,” he adds.
Perhaps no one knows that better than District Chief Mike McNamee of the Worcester (MA) Fire Department who, on the night of December 3, 1999, courageously made the decision to stop firefighters from entering a cold storage warehouse fire to search a building that had already claimed (at that time) the lives of four firefighters. Although two additional firefighters were ultimately lost during that tragic event, the risk assessment McNamee performed certainly saved the lives of at least a dozen more. He used survivability profiling in the harshest sense. He knew that after losing radio contact and being out of air for more than 15 minutes in a windowless and fully engulfed building, the missing firefighters were beyond rescue. He boldly decided to cut the department’s losses and not risk the lives of the remaining firefighters who so bravely and readily were willing to go back in to search for their brothers.
Understandably, we in the fire and emergency services always give victims and patients the benefit of the doubt. We save hundreds of fire victims every year because of our notion that someone could “possibly” be trapped. It is also well documented that our perception of “probable” life hazard (based on the time of the fire and occupancy type) has led us to feats of superhuman effort to locate and save those who could not assist in their own removal. Conversely, our automatic assumption as to “possible” and even “probable” life hazards has also led to firefighter fatalities in structures where no civilian life hazard existed.
The number of civilian fatalities that occur annually in the same incidents as firefighter fatalities appears to be disproportionate. According to the National Fallen Firefighters Foundation (NFFF), “Firefighters are doing a better job at preventing civilian deaths than they are at protecting their own lives.” For example, during my 19-plus-year career as a member of the Fire Department of New York (FDNY), there have been 32 firefighter fatalities from being caught or trapped in structural fires to date (not including the 343 members killed on September 11, 2001, and seven other members who died in that same timeframe in other circumstances). The immensely sobering fact in each of those tragic fires is that not one civilian fatality occurred! As another example, in 2005 the Boston Globe examined the federal investigative reports of 52 fires that killed 80 firefighters between 1997 and 2004. In only 14 of those 52 fires was there even a suspicion of trapped occupants. In only six of those 52 fires were people in the building at the time of the fire department’s arrival and, once again, not one of the 52 fires resulted in a civilian fatality.
Admittedly, the unfair and often undocumented flip side of the above statistics is that many civilians were safely rescued or evacuated prior to or following the events that led to the firefighter fatalities. Unfortunately, among the United States Fire Administration (USFA), the National Fire Protection Association (NFPA), the Federal Emergency Management Agency (FEMA), the National Fire Incident Reporting System (NFIRS), and the National Institute for Occupational Safety and Health (NIOSH), no such statistical data are recorded or required. In an effort to start gathering such information (saved victims), FDNY has recently begun collecting such data as part of its NFIRS reporting.
The USFA, through the NFA and the NFFF’s Firefighter Life Safety Initiatives, has set goals to reduce firefighter fatalities by 25 percent within five years and by 50 percent within 10 years. To assist in obtaining those worthy goals, the NFFF has published the “16 Firefighter Life Safety Initiatives” as a blueprint for fire service change.4
Looking at firefighter fatality statistics, we see the same reoccurring issues: heart attack, no seat belts, vehicle crashes, disorientation, structural collapse, and burns. Although some items on the list are less preventable than others, the majority of them are preventable, according to the NFFF.
Another consideration in survivability profiling is the aggressive interior attack—sending firefighters into buildings where civilian survivability is very small or nonexistent. It is used a great deal by many progressive departments and, according to FDNY Deputy Chief (Ret.) Vincent Dunn, is successful 95 percent of the time if the fire is extinguished quickly before flashover occurs. This strategy also puts firefighters in vulnerable positions in and around the fire area before a hoseline is in place and before the fire has been darkened down. The result may be cut-off and trapped firefighters.
I have always believed that the words “an aggressive interior attack” should be removed from standard operating procedures (SOPs) and replaced with the phrase “an intelligent and coordinated fire attack,” not always aggressive and not always interior. The SOP of the forward-thinking Fulton County (GA) Fire Department says: “Though the mission of the fire department involves response to emergency incidents, the preservation of life (including those of Fire Department members) is paramount .... No property is worth the life of a member of the Fire Department.” It continues: “Fire Department members shall NOT be committed to interior firefighting operations in any structure that is obviously abandoned, derelict, known or reasonably believed to be unoccupied.” Bravo! As a national service, we should take a close look at the present “aggressive attack strategy” (especially in understaffed departments); it is killing us—literally.
I am in no way saying that “surround and drown” operations should become our bread-and-butter operations—quite the contrary. What I am saying is that we need to slow down. We need to stop, look, and think before we run into burning buildings blindly, assuming that there’s a life to be saved every time.
Ed Fletcher, Executive Fire Officer Program instructor at the NFA, adds: “If it’s predictable, it’s preventable; and if it’s preventable, then it wasn’t an accident.” We owe it to ourselves, our families, and those we serve to stop repeating history and to lower the number of firefighter line-of-duty deaths.
Survivability profiling is the educated art of examining a situation and making an intelligent decision of whether to commit firefighters to life saving and/or interior operations. It differs from basic risk vs. reward in that it goes beyond the tendency to justify risk whenever we respond to an occupied building.
As firefighters, our knowledge of fire behavior, fire spread, smoke conditions, smoke movement, and building construction as well as individual experience level play vital roles in profiling the survivability of known or reported trapped occupants. Therefore, the first step in survivability profiling must be to STOP. Stop and consider your normal size-up points and risk vs. reward idiom in addition to the realistic sustainment of life. If paramedics and EMTs can pronounce death based on given signs and symptoms (or lack thereof), can’t firefighters do the same with survivability profiling?
THE KEOKUK TRAGEDY
In a real-life scenario eerily similar to the one at the beginning of this article, on December 22, 1999, at 0824 hours in Keokuk, Iowa, three firefighters and the three children they were trying to save died in a house fire. When the town’s four available career firefighters arrived at the scene, a woman was out front, covered in soot and yelling, “My babies are inside.” Apparently, the plastic trays from her 22-month-old twins’ high chairs were left on the stove, and a four-year-old sibling turned on a burner. After the three firefighters recovered the lifeless twins (who were never revived) and attempted to exit with the third unconscious child, a flashover occurred instantly, killing the firefighters. “Even in that situation, despite their instinct to save lives, the firefighters should not have gone into that house. The children were probably already dead,” said Keokuk Chief Mark Wessel.5 The official NFPA report on the fire found the contributing factors in the firefighter fatalities to be (1) lack of proper building/incident size-up (risk vs. reward/survivability profiling), (2) lack of a proper incident command system, (3) lack of an accountability system, (4) insufficient resources to mount suppression and rescue activities, (5) lack of a RIT, and (6) lack of SOPs requiring a RIT.
Using survivability profiling, the Keokuk firefighters may have realized what their chief had said: Because of the amount and volume of smoke, the advanced stages of fire progression on arrival, and the limited resources to conduct simultaneous attack and search and rescue, victim survivability was extremely unlikely. Keokuk’s Wessel continued: “Did they do what any red-blooded American firefighter would do? Yes, they did.” The lessons learned that day, according to Wessel, were ‘’ ... what you need to do is slow down your operation. We should have focused more on the hose, less on the mother screaming ....”6
Although a neighbor is standing on the front lawn telling you there are (or may be) people inside a structure, do you ever stop to ask them how they know that there are people inside? And if by chance they say they do indeed know there are people inside, do you ask them where the people were last seen or where they would be expected to be found? Logical follow-up questions (although unreliable at best) might be, How long has the fire been burning? and Where is the fire located?
At a recent basement fire in a private dwelling, the homeowner notified the first-arriving chief officer that everyone was out of the house and accounted for. The first search and hoseline teams entered the front door in a heavy smoke/medium heat condition to search for the stairs to the basement, with no luck. After several minutes, the IC ordered an attack through the rear yard basement door. As that attack commenced, the first team found a narrow circular staircase leading from the first floor to the basement and attempted to descend it. The attack from the exterior door was halted while a dangerous and time-consuming attack down the circular stair was attempted (and subsequently aborted).
My question to the first-arriving chief officer was, Why didn’t you ask the homeowner where the location of the basement stair was before commencing the initial attack? The answer? No answer! Had those first search and hoseline teams become trapped on or at the bottom of the circular stairs, it would have proven difficult for them to self-extricate or to be rescued. Remember, the homeowner told us everyone was out!
In February 2009, NIOSH released the report “Preventing Deaths and Injuries of Fire Fighters When Fighting Fires in Unoccupied Structures.” The report contends that firefighters may not fully consider information related to building occupants or their likelihood of survival before performing offensive (aggressive) interior operations. It cites numerous cases in which fire crews entered and remained in high-risk fire situations when it was known that no occupants could be rescued or even were present. The report concludes with “the top priority at all fire scenes should be saving and preserving lives—both civilian and the firefighters at the scene.” (6)
Using survivability profiling at structure fires, we perform a six-sided size-up (yes, that includes above and below the fire area and its four sides). What is the condition/construction of the structure? What is the fire condition? What color and under what pressure is the visible smoke/flame? In what areas should we concentrate our initial attack and searches? How can we safely access the areas to be searched? Do we have sufficient resources on-scene to start operations and have a rescue team in place?
Survivability profiling asks—if persons are suspected or known to be trapped—is there a reasonable assumption that they may still be alive? If not, we should attack the fire and complete the searches when it is relatively safe for our operating forces to do so.
Survivability profiling is an added tool in our risk vs. reward analysis. Use both in conjunction with proper size-up to help reduce firefighter fatalities.