The Civilian Casualty Form (NFIRS-2)

The casualty form NFIRS-2 is used to report any civilian injuries or deaths associated with incidents

responded to by the fire department. Some of the same entries appear on both the Casualty and the

Incident Forms so that specific incident and casualty information can be linked together and the detailed

information about both can be provided. The elements that identify the incident are described here, in the

same way they were in the Incident Form Section, for convenience.

In addition to Line A, which contains the information identifying the incident, the civilian casualty form

contains three identical sections relating to individual casualties. Each section consists of lines GA through

GF, and is used for one casualty. The signatures on line T at the bottom, of the form serve the whole form,

whether there are 1, 2 or 3 casualties reported.

Again, as on the incident form, a civilian casualty is a person who dies or is physically injured as the result

of an incident. To be recorded, the injury must be severe enough to require treatment by a practitioner of

medicine within one year after the incident, whether or not treatment was received, or the injury must result

in at least one day of restricted activity immediately following the incident. A death is recorded if the victim

dies within one year after an incident as a result of injuries sustained. If a casualty is initially recorded as

an injury, and the victim subsequently dies, a change to the casualty form for that incident must be

submitted. A change to “severity”on the casualty form will automatically adjust the casualty totals entered

on the incident form.

The number of sections on the civilian casualty form completed must be the same as the number of civilian

casualties reported on the incident form.

NOTE: This form is for civilian and non-fire service emergency personnel only. Do not use this form for fire

service casualties.

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The Civilian Casualty Form (NFIRS-2)

With minor exceptions, the guidance and directions for completing line A of the casualty and incident forms

are the same. The name of the fire department is entered on the line at the top of the form. Each individual

Casualty Report must be identified by the following elements from line A of the Incident Report: fire

department identification, incident number and exposure number. The remaining entries on line A of the

casualty form must be identical with the corresponding entries on the incident form. If injuries occur in an

exposure fire, the casualty report should have the same entries as those from line A of the exposure fire

incident report,

Fire Department Identification (FDID)

Entry

Enter the State-assigned fire department identification number. This is the same FDID number found on

the incident form (NFIRS-1).

Incident Number (Incident No.)

Entry

Enter the number assigned to the incident. This will be the same incident number found on the incident

form.

Exposure Number (Exp. No.)

Entry

Enter the exposure number assigned to the property on which the casualty occurred. This will be the same

exposure number used on the corresponding incident form.

Calendar Date: (MO., Day, Year)

Entry

For each incident, enter the same information as found in the corresponding entry on the incident form.

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Day of Week

Entry

Enter the same information as found in the corresponding entry on the incident form.

Alarm Time

Entry

Enter the same information as found in the corresponding entry on the incident form.

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Casualty Number

Definition

This is a unique number assigned to each casualty occurring at a single incident or resulting from the

incident.

Purpose

This unique number permits each casualty to be separately identified on the casualty file. Data and

information concerning the casualty can be accessed using this number.

Entry

Enter the casualty identification number assigned to each casualty. The first casualty for each incident is

always 001, the second casualty is 002, etc.

Example

Delete/Change

Definition

This block is used to signal the change or deletion of information submitted on a previous casualty report.

These changes or deletions should be authorized by the officer who signed the original incident report.

Purpose

The purpose of the delete/change entry is to correct previously reported information.

Entry

1. A new Casualty (ADD).

If the casualty report being completed is a new report, or a casualty not previously reported, leave

this box blank and complete the casualty report as instructed in this manual.

2. Updating a Previously Submitted Casualty (CHANGE).

If new or updated information concerning a casualty becomes available on a previously submitted

casualty, it is possible to update the original casualty report information by submitting a “Change”

casualty report. To submit a change:

A) Enter the same FDID, Incident Number, Exposure Number and Casualty Number of the Casualty

you want to change.

B) Check or “X” the Change box.

C) Enter the new or updated information and the applicable code numbers.

D) Sign and date the report. Normally a Change report should be signed by the officer in charge of

the incident; and

E) Forward the report according to your normally established procedures.

3. Cancelling a Previously Submitted Casualty (DELETE).

If a previously submitted Casualty report was found to be erroneously submitted, of if it contains

errors in the FDID, Incident Number, Exposure Number or Casualty Number fields, it may be

necessary to delete the incorrect Casualty from the computer. To submit a Delete Report:

A) Enter the same FDID, Incident Number, Exposure Number and Casualty Number of the report you

want to delete:

B) Check or “X” the Delete box;

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C) Sign and date the report. Normally a delete report should be signed by the officer in charge of the

incident; and

D) Forward the report according to your normally established procedures. Some states may have

restrictions on who may delete a casualty report. Additional verification may be required before a

delete report will be processed by a state.

Example

To change a previous casualty report, when a a victim dies two months after the incident, the “Change”

box would be marked and the report completed as follows.

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Casualty Last Name, First Name, MI

Definition

The last name, first name, and middle initial identify the casualty.

Purpose

The name of the casualty may be required for legal purposes. It may also be useful for notification to

employers, for insurance purposes, and for filing disability claims.

Entry

Enter the full name of the person. Names should be clearly printed or typed. Use NMI if no middle initial

is available.

Example

Date of Birth (DOB)

Definition

The month and year of birth for the casualty.

Purpose

This data element may be useful for further identifying the individual, and for verifying the age entry.

Entry

Enter the date of birth showing month and year.

Example

A casualty born in February, 1937.

Age

Definition

The age of the casualty in years.

Purpose

This entry permits an analysis of casualties by age with type, severity, and cause of injury to identify trends

and patterns that might be helpful in planning casualty prevention techniques.

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Entry

Enter the age of the casualty. Make an approximation if the age cannot be determined. For those casualties

less than 1 year one, record a 1. For any casualty over age 99, record 99.

Example

Time of Injury

Definition

The time of day, using the 24 hour clock, when the casualty occurred.

Purpose

This information is sometimes needed for legal or insurance purposes. In addition, it may be used to

analyze when injuries occur during the course of a fire and during fire suppression activities.

Entry

Enter as closely as possible the time when the injury occurred using the 24-hour clock, i.e., 0001-2400.

This could be before or after the alarm time shown on the Incident Report. If the date is different from the

date of the incident, show the date of the injury in the remarks section.

Example

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Home Address

Definition

The casualty’s current place of residence. The address includes street address, city,state, and zip code.

Purpose

This data element provides additional identification, a, means of contacting the next of kin, or of later

contacting the casualty, if necessary. It allows determination of casualties which are transients, that is not

residents of the jurisdiction in which they were injured. This is sometimes useful for directing prevention

education.

Entry

Enter the casualty’s home address, including street address, city, state and zip code.

Examples

Telephone

Definition

The casualty’s telephone number.

Purpose

The telephone number may be helpful in notifying the next of kin or contacting the casualty.

Entry

Enter the casualty’s home telephone number including the area code if available. If not available enter “n/

a.”

Example

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Sex, Casualty Type, Severity, Affiliation

These four characteristics assist in categorizing each casualty. One selection should be made under each

column heading.

Sex

Definition

The identification of the casualty as male or female.

Purpose

Knowing the sex and age of the casualties can help target prevention activities such as public education

and is useful for identification purposes.

Entry

Check the appropriate box.

Casualty Type

Definition

The three categories of Casualty Type are used to identify the circumstances under which the casualty

occurred.

Fire Casualty

A person injured or killed as a direct result of a fire regardless of whether it happened before or after the

alarm for the incident. Examples of types of fire casualties include: burns, smoke inhalation, and injuries

from a ceiling collapse.

Action Casualty

A person injured or killed after the alarm for the incident is received, but not due to fire products or fire

damage. Examples of Action Casualties include: a sprained back raising a ladder, cut hand, overexertion,

drowning while attempting a rescue, heart attack, and casualties due to the violence of others.

EMS (Emergency Medical Service) Casualty

A person injured or killed before the alarm for a non-fire incident is received, but for whom the alarm is

sounded. Examples of EMS casualties include: civilian drowning, vehicle crash injury, heart attack,

chemical or electrical burns, and broken bones. A fire fighter injured in a fire station, and for whom a rescue

call is made, would be an EMS casualty.

Purpose

This element identifies the general type of casualty. Analysis of this data assists in identifying the various

casualty categories.

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Entry

Check the appropriate box.

Severity

Definition

The severity of the casualty stated as either injury or death.

Purpose

This data element provides a basic severity indicator. It can be used as a measure for prevention programs

aimed at reducing injuries and deaths.

Entry

Check the appropriate box.

Affiliation

Definition

Indicates whether the casualty involved in the incident was emergency personnel or a civilian.

Affiliation has two categories which are:

A) “Other Emergency Personnel” includes persons working at the scene from other public or private

service organizations such as the police department, utility company, other city agencies, the Red

Cross, the Salvation Army and the like;

B) ‘Civilian” includes non-emergency personnel such as occupants, passers-by or onlookers.

Purpose

This element identifies the groups suffering casualties. This information along with the data on the cause

of the casualty and associated incident can help target programs for reducing casualties, and can be used

to measure their success.

Entry

Check the appropriate box.

Examples

A policeman falls and sprains his ankle while helping an occupant leave an apartment building which was

involved in a fire.

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Familiarity with Structure

Definition

This element identifies how much time the casualty had previously spent within the building or structure

where the injury occurred: For example, a person visiting a neighbor’s home only on Christmas day for

three different years has a familiarity with the structure of three days, and not three years.

Purpose

To determine if familiarity with the structure influences whether a casualty can be avoided.

Entry

Enter the approximate length of time the casualty was acquainted with the inside of the building or

structure.

Examples

Codes © NFPA 1976

FAMILIARITY WITH STRUCTURE

1. Less than 1 day.

2.1 to 7 days.

3.8 to 30 days.

4. 1 to 2 months.

5.3 to 6 months.

6.7 to 12 months.

7. Over 1 year.

8. Not a structure.

0. Familarity with the Structure undetermined or not reported.

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Location at lgnition

Definition

This element identifies the location of the casualty in relationship to the area where the fire started.

Purpose

To provide more information on how the injury occurred. This can be helpful in directing public education

efforts. For example, for those types of casualties which are directly involved in the ignition of fires,

prevention efforts have to be directed at preventing the fires rather than on escape. For casualties not

directly involved in ignition, a wider range of prevention strategies are possible.

Entry

Enter the location of the fire casualty when the fire started. If the fire did not occur in a structure, indicate

the distance of the person to the point of ignition. If the casualty is not a Fire Casualty, enter “Not a Fire

Casualty” and code “8.”

Examples

A fire casualty who was on the same floor as the fire origin.

Codes © NFPA 1976

LOCATION AT IGNITION

1. Fire casualty intimately involved with ignition.

Included are ignition of clothing on a person

and ignition of bedding or furniture on which a

person is sitting or lying.

2. Fire casualty in the room or space of fire

origin.

Included are vehicle compartments, porches,

tents, and playhouses.

3. Fire casualty on same floor as origin of fire.

4. Fire casualty In same building as origin of

fire.

5. Fire casualty outside of building of fire origin

but on property.

6. Fire casualty off property of fire origin at time

of ignition.

8. Not a fire casualty.

9. Location of Casualty at Time of lgnition not

classified above.

0. Location of Casualty at Time of Ignition undetermined or not reported.

Coded Examples

A fire casualty who was on the same floor as the fire origin.

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Condition Before Injury

Definition

The physical or mental state of the person shortly before becoming a casualty.

Purpose

One purpose here is to determine the number of people who require special training in what to do in case

of a fire. The information is also useful in planning rescue services. For example, the frequency of

encountering handicapped persons is important for planning rescue equipment and training. The frequency of smoking and drinking as a cause must be distinguished from smoking alone as a cause in

planning prevention education.

Entry

Indicate the person’s condition prior to being injured.

Examples

A person was reading a book when the fire started.

Codes © NFPA 1976

CONDITION BEFORE INJURY

1. Asleep.

2. Bedridden, other physical handicap.

3. Impaired by drugs, alcohol.

4. Under restraint.

5. Too young to act.

6. Too old to act.

7. Mentally handicapped, senile.

8. Awake, unimpaired.

9. Condition Before Injury not classified above.

0. Condition Before Injury undetermined or not reported.

Coded Examples

A person was reading a book when the fire started.

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Condition Preventing Escape

Definition

The most significant condition preventing the casualties uninjured escape.

Purpose

To provide additional information on how a casualty occurred. This information will be helpful in targeting

fire prevention techniques, and checking the adequacy and enforcement of codes. For example, if many

casualties resulted from illegally-locked doors in public occupancies, that would indicate a need to check

inspection practices.

Entry

Indicate why the person could not escape without injury.

Examples

A person was injured while helping to fight the fire.

Codes © NFPA 1976

CONDITION PREVENTING ESCAPE

1. No time to escape; explosion or fire progressed too rapidly.

2. Fire between casualty and exit.

3. Locked door.

4. Illegal gates, locks.

5. Clothing on casualty burning.

6. Moved too slowly. Included are failures to follow correct (available) escape procedures,

7. Victim Incapacitated prior to ignition.

8. No conditions prevented escape or not a factor.

9. Condition Preventing Escape not classified above.

0. Condition Preventing Escape undetermined or not reported.

Coded Examples

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Activity at Time of Injury

Definition

The action or activity in which the person was engaged at the time of injury.

Purpose

To identify the situations in which people are injured most frequently so that public education can be

improved to reduce fire injuries. Data on those situations in which the person is injured while sleeping may

help in improving fire detection methods and equipment.

Entry

Record what the person was doing at the time of injury.

Codes © NFPA 1976

ACTIVITY AT TIME OF INJURY

1. Escaping.

2. Rescue attempt.

3. Fire control.

4. Response/return.

5. Cleanup, salvage, mop-up.

6. Sleeping.

7. Unable to act.

8. Irrational action.

9. Activity at Time of Injury not classified above.

0. Activity at Time of Injury undetermined or not reported.

Coded Examples

A person was injured while helping to fight a fire.

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Cause of Injury

Definition

The physical event that caused the injury.

Purpose

This is another dimension in describing the cause of an injury. The analysis of this information may permit

an understanding of the conditions causing the injury, and a means of planning suitable preventive

techniques.

Entry

Indicate the immediate cause or condition responsible for the injury.

Examples

A person’s hand is burned by the fire.

Codes © NFPA 1976

CAUSE OF INJURY

1. Caught in, under, between; trapped by.

2. Exposed to fire products. Included are flame, heat, smoke, and gas.

3. Exposed to chemicals, radiation. Excluded are fire products (2).

4. Fell or stepped on, over, into.

5. Overexertion.

6. Rubbed by, contact with.

7. Struck by.

8. Not applicable.

9. Cause of injury not classified above.

0. Cause of Injury undetermined or not reported.

Coded Examples

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Nature of Injury

Definition

The type of injury received by the person. Reference should be made to the most serious injury suffered.

Other injuries, if any, can be covered in the Remarks section.

Purpose

This entry can be used to analyze the number of each type of injury. This entry can be correlated with other

data collected on the incident and casualty reports to provide useful information in reducing injuries.

Entry

Indicate the nature of the injury received by the casualty.

Examples

A person burns his hand while fighting a fire.

Codes © NFPA 1976

NATURE OF INJURY

1. Burns and asphyxla/smoke.

2. Burns only.

3. Asphyxia/smoke only.

4. Wound, cut, bleeding.

5. Dislocation, fracture.

6. Complaint of pain. Included are heart attacks and strokes.

7. Shock.

8. Strain, Sprain.

9. Nature of Injury or Illness not classified above.

0. Nature of Injury or Illness undetermined or not reported.

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Coded Examples

A person burns his hand while fighting a fire.

Part of Body Injured

Definition

The part of the body which sustained the injury.

Purpose

This information, when correlated with other entries on lines GC through GF, will provide data useful in the

planning for the emergency treatment of injuries, and injury prevention.

Entry

Record the exact part of the body injured.

Examples

PART OF BODY INJURED

1. Head, neck.

2. Body, trunk, back.

3. Arm.

4. Leg.

5. Hand.

6. Foot.

7. Internal. Included are respiratory system and heart.

8. Multiple parts.

9. Part of Body Injured not classified above.

0. Part of Body Injured undetermined or not reported.

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Coded Examples

A person burns his hand while fighting a fire.

Definition

A description of what was done for the casualty by providing care or by assisting in obtaining medical care.

Purpose

This information is useful in determining the requirements, both personnel and equipment, for handling

casualties. This entry also provides another indication of severity of injury.

Entry

Indicate what primary disposition was made of the casualty. If several actions are taken, select the most

important. For example, a badly burned casualty is given preliminary first aid and rushed to the burn center

at the hospital. Getting the person to the hospital is the primary disposition.

Codes © NFPA 1976

DISPOSITION

1. Refused help.

2. Treated at scene and released.

3. Taken to hospital by fire department vehicle.

4. Taken to hospital by nonfire department vehicle.

5. Taken to other than hospital.

6. Died.

9. Disposition of Casualty not classified above.

0. Disposition of Casualty undetermined or not reported.

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Coded Examples

A casualty is taken by the fire department to a hospital for treatment.

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Remarks

The remarks box is checked if any remarks have been entered on the’ reverse side of the casualty form

or on a separate continuation sheet.

The Additional Report box is checked if a supplemental report is submitted concerning a particular

casualty.

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Officer in Charge (Name, Position, Assignment), Date

Definition

The officer in charge is the senior fire service person concerned with the incident. Position refers to the

person’s rank or office held. Assignment refers to the person’s job at that particular time. The signature

of the officer in charge should be entered in this block also. The date used is when the officer in charge

signs the casualty form.

Purpose

The signature and the date may make the report a legal document. The name, position, and assignment

indicate who is responsible for the information.

Entry

The signature of the officer in charge, the position and assignment, and the date are required.

Example

Member Making Report (If Different from Above), Date

Definition

This entry will be completed if the officer in charge is a different person from the one making the report,

which is often the case. The member making the report should sign the report and include his position and

the date.

Purpose

In the absence of the signature of the officer in charge, the signature of the member completing the report

and the date may make the casualty form a legal document.

Entry

In the absence of the signature of the officer in charge, the signature of the member completing the report

is required. If the officer in charge completed the report, enter “n/a” in this box.

Example

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