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pdfNFIRS 5.0 Self-Study Program
Personnel Module:
NFIRS-10
Objectives
After completing the Personnel Module you will be able to:
1. Describe when the Personnel Module is to be used.
2. Demonstrate how to complete the Personnel Module and identify
appropriate other modules, given the scenario of a hypothetical
incident.
10-1
Table of Contents
Pretest #10 – Personnel Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Using the Personnel Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Section A: FDID, State, Incident Date, Station, Incident Number, Exposure. . . . . . . . . . . . . . 10-4
Section B: Apparatus or Resources, Dates and Times, Sent, Apparatus Use,
and Actions Taken. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7
EXAMPLE: Automobile Crash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
EXERCISE SCENARIO 10-1: Structure Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
EXERCISE SCENARIO 10-2: Structure Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-13
Personnel Module Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-19
NFIRS 5.0 Self-Study Program
Pretest #10 – Personnel Module
1. A Basic Module must be completed if the Personnel Module is completed.
(a) True.
(b) False.
2. The Personnel Module is a required NFIRS Module.
(a) True.
(b) False.
3. Either the Personnel Module or Apparatus or Resources Module may be used, but not both.
(a) True.
(b) False.
4. The Personnel Module can be used to help manage and track apparatus and resources used on
incidents.
(a) True.
(b) False.
5. The data element Attend allows fire departments to preprint or preenter personnel in the
Personnel Module.
(a) True.
(b) False.
10-3
NFIRS 5.0 Self-Study Program
Using the Personnel Module
T
he Personnel Module (NFIRS-10) is an optional module that is used to help manage and track
personnel and resources used on incidents. This module can be used in place of the Apparatus
or Resources Module (NFIRS-9) if more detail on personnel is needed.
NOTE: Either the Personnel Module or Apparatus or Resources Module may be used -- not both.
Section A: FDID, State, Incident Date, Station,
Incident Number, Exposure
MM
A
FDID
DD
YYYY
Incident Date
State
Station
Incident Number
Exposure
Delete
NFIRS–10
Change
Personnel
Sent
Number
Apparatus Use
Actions Taken
Apparatus or
Dates and Times
B information
The
in Section A isCheck
drawn
from
A of the Basic
Use the data
in the Basic
if same date
as AlarmSection
date on
of Module.
Resources
Check ONE box for each
List up to 4 actions for
the Basic Module (Block E1)
X
apparatus to indicate its main
each apparatus and
Module to help you supply the
information.
If youPeople
are using
an
automated
system the
Month requested
Day
Year
Hour/Min
use at the incident.
each personnel.
data
need to be entered
automatically
into other modules
Sent
1
Dispatchonly once, then they will be transferred
ID
Suppression
that use the data. Arrival
EMS
Midnight is 0000
Type
Other
Clear
Personnel
ID
A
MM
Action
Taken
Action
Taken
X
YYYY
Action
Taken
Action
Taken
Delete
Incident Date
State
Apparatus or
Resources
DD
Station
Dates and Times
Incident Number
Sent
Midnight is 0000
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
Attend
Section B: Apparatus or Resources, Dates and Times,
NFIRS–10
Sent, Apparatus Use, and Actions Taken
Personnel
FDID
B
Rank or
Grade
Name
Year
X
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Sent
Dispatch
Arrival
Dispatch
Clear
Arrival
ID
Number
of
People
Hour/Min
Change
Exposure
Suppression
EMS
ID
Type
Suppression
Other
EMS
Type
Other
Clear
Action
Rank
or module.
Personnel
Attend Record
Action the apparatus
Action
Action
Name
You can
record multiple pieces
of apparatus in
this
ID
and apparatus
Taken
Grade
ID
Taken
Taken
Taken
X
Rank ortypeAttend
Personnel
type on
the first two lines. Codes
are in the
Complete Action
Reference Guide
(CRG).
Action
Action
Action
Namefor the apparatus
Taken
Grade
ID
Taken
Taken
Taken
X
2
Sent
DATES AND TIMES
MM
A
FDID
B
Apparatus or
Resources
DD
YYYY
Incident Date
State
Station
Dates and Times
Midnight is 0000
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
2
ID
3
ID
Type
Type
Personnel
ID
Personnel
ID
ID
Dispatch
Arrival
Type
Dispatch
Clear
Arrival
Clear
Personnel
ID
Dispatch
Arrival
Name
Name
Rank or
Grade
Rank or
Grade
10-4
Sent
X
Hour/Min
Sent
Clear
Name
Year
Incident Number
Exposure
Number
of
People
Delete
NFIRS–10
Change
Personnel
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Sent
Suppression
Suppression
EMS
EMS
Sent
Other
Suppression
Other
EMS
Action
Rank or
AttendOtherAction
Action
Action
Attend
Action
Action
TakenAction Taken
Grade
Taken
X
Taken
Taken
Taken
Taken
X
Action
Attend
Action
Action
Action
Taken
Taken
Taken
Taken
X
Action
Taken
NFIRS 5.0 Self-Study Program
Record dates and times for Dispatch, Arrival, and Clear in the Dates and Times block. Record all times
in 24-hour time (midnight is 0000). If the alarm date is the same as the dispatch, arrival, or clear
date, check the box that appears to the left of the appropriate field.
MM
A
FDID
Station
Dates and Times
Incident Number
Sent
Midnight is 0000
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
SENT
YYYY
Incident Date
State
Apparatus or
Resources
B
DD
Year
X
Hour/Min
Type
Number
of
People
Delete
NFIRS–10
Change
Personnel
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Sent
Dispatch
Arrival
ID
Exposure
Suppression
EMS
Other
Clear
Personnel
A box
ID
Action
or
Attend
Action
Action If it did,
Name
is available to indicate
whetherRank
or not
the
unit actually
responded
toAction
the incident.
Taken
Grade
Taken
Taken
Taken
X
mark the box. If the unit was held in quarters, leave it blank. (For paper copy only.)
MM
A
FDID
Station
Dates and Times
ID
2
Type
Personnel
Record the
Personnel
ID
ID
provided.
MM
or
Year
DD
Grade
Type Clear
Type
DD
Station
Incident Number
Midnight is 0000
Year
Sent
X
Hour/Min
Midnight is 0000
3
ID
Year
Dispatch
Arrival
Type Clear
el Name
Personnel
ID
Suppression
Suppression
EMS
EMS
Other
Other
X
Taken
Taken
Number
of
People
Taken
Taken
Delete
NFIRS–10
Change
Personnel
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Sent
Suppression
Sent
EMS
Other
Taken
Taken
Taken
Suppression
Suppression
EMS
EMS
Other
Other
Action the Action
clarify
main
useAction
of
each piece
of apparatus at the
Action
Action
Action
Action
Action
Taken
Attend
Taken
X
Action
Taken
Taken Taken
Taken
Taken
Taken
Action
Taken
Taken
Action
Taken
NFIRS–10
ACTIONS
TAKEN
Personnel
Delete
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
List up to 4 actions for
each apparatus and
each personnel.
Exposure
Sent
Dispatch
Dispatch
Arrival
Arrival
Clear
Clear
Station
Times
Personnel
Actions Taken
Taken
X
Grade
YYYY
Date
NFIRS–10
Change
Check ONE box for each
apparatus to indicate its main
use at the incident.
Sent
or
Attend
Action to
Name choices areRank
offered
in
this
Rank section
or
Personnel Three
Attend
Name Grade
Rank or
Personnel
Taken
Name
X Grade
ID
incident.
Mark only one box.
X
Grade
ID
el
Delete
Apparatus Use
APPARATUS USE
Incident Date
Dispatch
3
ID
Arrival
X
Sent
Check if same date as Alarm date on
the Basic Module (Block E1)
ID
Number
of
People
Hour/Min
YYYY
Month Day
Exposure
Action
or
Attend
Action
Action
Action
Name number of Rank
total
people
responding
on the
specificAction
piece ofAction
apparatus
on the line
Rank
or
Attend
Action
Action
Name
Dates and Times
2
Sent
Midnight is 0000
Dispatch
Dispatch
Arrival
Arrival
Clear
Clear
ID
Type
State
Incident Number
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
NUMBER OF PEOPLE
YYYY
Incident Date
State
Apparatus or
Resources
B
DD
Incident Number
Sent
X
Hour/Min
Sent
Dispatch
Arrival
Clear
Rank or
Name
Grade
Exposure
Number
of
People
Change
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
SentSuppression
Sent
EMS
Other
Suppression
EMS
Other
NFIRS–10
Suppression
EMS
Other
Action
Attend
Action
Action
Action
Action
Rank or
AttendTakenAction
Action
Action Action
Rank or
Taken
Taken
Attend
Action
Action
Taken
Name
X
Taken
Grade
Taken
Taken
X Grade
Taken Taken
Taken
Taken
X
10-5
Action
Taken
Revision 01/01/04
NFIRS 5.0 Self-Study Program
A
FDID
State
MM
DD
YYYY
Incident Date
Station
Incident Number
Enter codes (taken from Section F of the Basic Module) here to describe actions taken by firefighters.
Sent
Apparatus
or
Dates
and Times
You can record up to four actions for each
of apparatus.
Local
fire departments Midnight
haveis 0000
the option
B piece
Check if same date as Alarm date on
Resources
the Basic Module (Block E1)
to develop plus one codes.
X
Month Day
1
Year
Hour/Min
PERSONNEL IDArrival
Type
MM
FDID
DD
Attend
Action
Taken
X
YYYY
Incident Date
State
Rank or
Grade
Name
Station
Incident Number
1
Exposure
Personnel
ID
MM
DD
Incident Date
State
Rank or
Grade
Attend
X
Dispatch
Arrival
ID
Type
Rank or
Grade
Name
Name
YYYY 3
use at the incident.
Sent
NAME
Type
FDID
Hour/Min
Dispatch
Arrival Personnel
ID
Clear
ID
A
Year
Clear
Station
Incident Number
Exposure
Clear
Action
Taken
Delete
Sent
NFIRS–10
Change
Personnel
NFIRS–
Person
Actions Take
Su
List up to 4 actions fo
EM
each apparatus and
each personnel. Oth
Action
Taken
1
ID
Type
Dispatch
ArrivalPersonnel
ID
Clear
Personnel
ID
Type
Personnel
ID
use at the incident.
RANK OR
GRADE
Name
Rank or
Grade
Attend
X
Rank or
Grade
Action
Taken
each personnel.
OtherX
Suppression
Attend
Action
EMS
Taken
Other
X
Action
Taken
Action
Taken
Sent
Dispatch
Arrival
ID
Type
ID
Hour/Min
Sent
Name
3
2
Year
Clear
Name
Sent
Rank or
Grade
Name
10-6
Rank or
Grade
Attend
X
Action
Taken
Suppression
Attend
Action
EMS
Taken
X
Other
Action
Taken
Actio
Take
Action
Taken
Ac
Ta
Actio
Take
Action
Taken
Suppression
EMS
Other
Clear
Dispatch
ArrivalPersonnel
ID
Clear
Action
Taken
Ac
Ta
Su
EM
Oth
Sent
Midnight is 0000 onSent
Number
Apparatus
Use are two
Actions
Taken
Dispatch
Apparatus or enter2Dates
and Times
AtBa minimum,
theIDlast
name of each
individual
the lines
provided.
If there
orSuppression
more
Check if same date as Alarm
date on
of Name
Resources
Rank
Personnel
Attend
Action
Check ONE box for each
List or
up to 4 actions
for
Arrival
EMS
the
Basic
Module
(Block
E1)
identical last names, be
sure to include an initialIDor a first XnamePeople
to differentiate
between
them.
apparatus to indicate
its main
each
apparatus and
Grade
Taken
Type
Month Day
Ac
Ta
Change
Suppression
Attend
Action
EMS
Taken
OtherX
Action
Taken
Check ONE
apparatus
use at the i
Delete
SentUse
0000 individual’s
Sent
Number
and
This identification isB setApparatus
by theorlocal Dates
fire2 department.
DoDispatch
not Midnight
use isthe
SocialApparatus
Security
ID Times
Check if same date as Alarm date on
of
Resources
Check ONE box for each
the Basic ModuleArrival
(Block E1)
number, as this puts the individual at risk.Type
X
apparatus to indicate its main
People
Month Day
Appara
Su
EM
Oth
Clear
Personnel
ID
A
Number
of
People
Sent
Dispatch
ID
Exposure
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Actio
Take
s or
es
A
FDID
Apparatus or
Resources
B
Station
Dates and Times
1
Midnight is 0000
Type
Year
DD
Station
Rank or
Grade
Incident Number
Midnight is 0000
Sent
Year
Arrival
Number
Action
Taken
Action
Taken
Exposure
Hour/Min
Delete
NFIRS–10
Change
Personnel
Apparatus Use
Action
Taken
Action
Taken
Actions Taken
use at the incident.
Sent
Clear
Arrival
Personnel
ID
Rank or
Grade
Attend
X
EMS
Other
Suppression
Action
Taken
Other
Attend
X
Action
Taken
Action
Taken
Clear
For each individual,
you canSent
document up toSuppression
four actions.
entered on Lines F of the Basic Module and areEMS
in the CRG.
Personnel
ID
Name
Rank or
Grade
Name
Rank or
Grade
Attend
X
Action
Taken
Other
Attend
X
Action
Taken
Action
Taken
Action
Taken
Sent
Dispatch
Arrival
ID
each personnel.
ACTION
EMS TAKEN
Rank or
Grade
Name
Name
nel
X
of
box for each
List up to 4 actions for
Sent
Mark the box if the individualXresponded
toCheck
theONE
incident
copy only).
apparatus
to indicate its main(for
eachpaper
apparatus
and
Suppression
People
Month Day
Clear
Attend
Check if same date as Alarm date on
the Basic Module
(Block E1)
Dispatch
Type
Dispatch
Type
Dispatch
Arrival
List up to 4 actions for
each apparatus and
each personnel.
Suppression
EMS
Other
YYYY
Dates and Times
3
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
Sent
Name
Incident Date
Clear
Hour/Min
Personnel
Apparatus Use
Clear
MM
ID
Number
ATTEND
Personnel
ID
2
Sent
Change
Exposure
of
NFIRS 5.0 Self-Study
Program
X
People
Dispatch
Arrival
ID
State
Incident Number
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
nel
nel
Incident Date
State
Action
Taken
Action
Taken
Action
Taken
Suppression
EMS
Other
Codes
should
Action
Taken
Action
Taken
SUMMARY
Action
Taken
correspond with those
Action
Taken
Action
Taken
Action
Taken
Use the Personnel Module as a local option to document personnel and apparatus information for
individual incidents. If a Personnel Module is completed for each apparatus sent to the scene, it is not
necessary to complete the Apparatus or Resources Module.
NFIRS–10
Sent
Dispatch
Arrival
Suppression
EMS
Other
Clear
Name
Rank or
Grade
Attend
X
Action
Taken
Action
Taken
10-7
Action
Taken
NFIRS–10
Action
Taken
Revision 01/01/04
Revision 01/01/04
NFIRS 5.0 Self-Study Program
EXAMPLE: Automobile Crash
Directions: Read the call information in the example below. Then look at the completed Personnel Module form. Look at each
section and follow along with the proper use of the information as applicable to the Personnel Module.
On July 6, 1998, (FDID #TR100) Engine 1 and Ambulance 3, along with Rescue Squad 6, were
dispatched at 1705 hours to an automobile crash involving personal injuries at Main Street and
Laurel Blvd., Eau Claire, WI. Engine 1 and Ambulance 3 arrived on the scene at 1710, and the
squad arrived at 1713. The crew on Engine 1 consisted of Captain Jones (ID #JP0275), Driver
Boswell (ID #BK3451), and Wilson (ID #WS6753) was in the Bucket. Incident #9222108 was
assigned.
The crew on Ambulance 3 consisted of Paramedic Smith (ID #SB9078) and Driver/EMT Conrad
(ID #NC2165). Rescue Squad personnel included Lt. Holmes (ID #JH2580), Driver Torre (ID
#TJ3425), and FF Kerns (ID #KF4791).
The officer in charge reported a vehicle crash with one person trapped. Engine 1 personnel pulled
a hoseline and provided vehicle stabilization. Ambulance 3 personnel provided traction on the
patient’s neck until Rescue Squad 6 extricated the victim.
The victim in the second car received minor injuries but signed a release stating that he refused
treatment or transport to the hospital. After patient 1 was extricated he was placed on a long back
board and transported to the hospital. Engine 1 and Rescue Squad 6 cleared the scene at 1812. The
ambulance cleared the hospital at 1840.
10-8
NFIRS 5.0 Self-Study Program
A TR100
FDID
B
MM
WI
06
E1
ID
Type
11
Dates and Times
Dispatch
Arrival
Clear
Type
AMB3
76
Jones
Boswell
Wilson
Dispatch
Arrival
Clear
X
X
X
Personnel
ID
Name
S B 9 0 7 8
N C 2 1 6 5
3
ID
Type
RS6
71
Smith
Conrad
Dispatch
Arrival
Clear
Personnel
ID
J H 2 5 8 0
J T 3 4 2 5
K F 4 7 9 1
Year
Rank or
Grade
Name
Holmes
Torre
Kerns
Incident Number
Sent
X
X
Attend
X
X
X
X
1705
1710
1840
Sent
Rank or
Grade
PM
EMT
000
Exposure
Number
of
People
X
Attend
X
X
X
003
Personnel
Actions Taken
List up to 4 actions for
each apparatus and
each personnel.
X
Suppression
EMS
Other
Action
Taken
73
73
73
58
X
73
Action
Taken
Suppression
EMS
Other
Action
Taken
Action
Taken
31
Action
Taken
003
X
Suppression
EMS
Other
Rank or
Grade
Attend
X
Action
Taken
Action
Taken
Lt.
Tech
FF
X
X
X
23
23
23
58
34
Action
Taken
23
Action
Taken
NFIRS–10
10-9
Action
Taken
32
58
Sent
X
NFIRS–10
Change
Check ONE box for each
apparatus to indicate its main
use at the incident.
Action
Taken
002
Delete
Apparatus Use
Sent
Capt.
Tech
FF
1705
1713
1812
X
X
X
9 2 2 2 1 0 8
Hour/Min
1705
1710
1812
X
X
X
Name
J P 0 2 7 5
B K 3 4 5 1
W M 6 7 5 3
ID
Midnight is 0000
Check if same date as Alarm date on
the Basic Module (Block E1)
Personnel
ID
2
001
Station
Month Day
1
YYYY
1998
Incident Date
State
Apparatus or
Resources
DD
07
Action
Taken
Revision 01/01/04
NFIRS 5.0 Self-Study Program
EXERCISE SCENARIO 10-1: Structure Fire
Directions: Read the call information in the exercise below. Use the information provided to complete the Personnel Module
form. Compare your work to the answers provided on the completed Personnel Module form. If your answers are different from
the ones provided, read over the Personnel Module again.
On 11/22/2000, in Eau Claire, WI, FDID #TR100, Station 42, responded (Incident #3402341)
to a structure fire.
Engine 422 (driven and operated by FF Richardson) was dispatched at 1345 and arrived at the
8503 Spring Drive structure fire at 1347 hours. Captain Cooke, FF Groshong, and Probationary FF
McIntire advanced one 1-3/4-inch line to the first floor.
Medic 1 (driven and operated by FF/First Responder Worley) was dispatched at 1347 and arrived
on scene at 1350 hours. Paramedic Burnette found the homeowner in the front yard suffering
from smoke inhalation and administered oxygen. FF Worley treated a child for a cut received
while escaping the structure.
Truck 1 (driven and operated by FF Mitchell) was dispatched at 1345 and arrived at 1351 hours.
Captain Fritz and FF McAllister conducted a search of the second floor while FF Dupeire performed ventilation. After the fire was knocked down, the whole crew performed salvage and
overhaul.
Engine 422 cleared the scene at 1431 and was available for duty at 1445. Truck 1 was clear at 1450
and available at 1510. Medic 1 was clear of the scene at 1510 and available at 1540.
Personnel ID Numbers are as follows:
Capt. Cooke
976202020
FF Groshong
534879310
PFF McIntire
721201241
FF Richardson
711349089
Capt. Fritz
314895310
FF Mitchell
734902143
FF McAllister
675906301
FF Dupeire
368319752
FF Worley
752372291
Medic Burnette 901190111
10-10
NFIRS 5.0 Self-Study Program
MM
A
FDID
B
Apparatus or
Resources
DD
Incident Date
State
Station
Dates and Times
ID
Type
ID
Type
ID
Type
Personnel
ID
Year
Sent
X
Hour/Min
Exposure
Number
of
People
Sent
Name
Rank or
Grade
Attend
X
Action
Taken
Sent
Dispatch
Arrival
Rank or
Grade
Attend
X
Action
Taken
Sent
Dispatch
Arrival
Rank or
Grade
Attend
X
Personnel
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
NFIRS–10
10-11
Action
Taken
Action
Taken
Suppression
EMS
Other
Clear
Name
NFIRS–10
Change
Suppression
EMS
Other
Clear
Name
Delete
Suppression
EMS
Other
Clear
Personnel
ID
3
Midnight is 0000
Dispatch
Arrival
Personnel
ID
2
Incident Number
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
YYYY
Action
Taken
Revision 01/01/04
NFIRS 5.0 Self-Study Program
A TR100
FDID
B
MM
WI
22
Dates and Times
Type
Dispatch
Arrival
7
3
2
1
2
6
4
1
1
11
2
8
2
3
0
7
0
4
Clear
2
9
1
9
Type
Name
0
3
2
0
2
1
4
8
T1
ID
0
0
1
9
Cooke
Groshong
McIntire
Richardson
Dispatch
Arrival
3
1
3
7
6
4
4
5
8
12
8
9
9
3
9
0
0
1
Clear
5
2
6
9
1
4
0
5
M1
ID
Type
Name
3
1
3
7
76
Midnight is 0000
0
3
1
2
Fritz
Mitchell
McAllister
Dupeire
Dispatch
Arrival
Clear
Personnel
ID
7 5 2 3 7 2 2 9 1
9 0 1 1 9 0 1 1 1
Year
Name
Worley
Burnette
X
X
Attend
Capt
FF
PFF
FF
X
X
X
X
X
Number
of
People
004
Rank or
Grade
Attend
Capt
FF
FF
FF
X
X
X
X
X
NFIRS–10
Change
Personnel
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
X
Suppression
EMS
Other
Action
Taken
11
Action
Taken
004
X
Suppression
EMS
Other
Action
Taken
Action
Taken
20
58
20
51
12
Action
Taken
002
20
12
51
Action
Taken
Action
Taken
12
12
X
Suppression
EMS
Other
Rank or
Grade
Attend
X
Action
Taken
Action
Taken
FF
Medic
X
X
32
32
31
31
32
Action
Taken
NFIRS–10
10-12
74
11
11
11
58
Sent
X
Delete
Apparatus Use
Action
Taken
Sent
X
000
Exposure
Sent
Rank or
Grade
1347
1350
1510
X
X
X
Sent
Hour/Min
1345
1351
1450
X
X
X
Personnel
ID
3
7
6
3
Incident Number
1345
1347
1431
X
X
X
Personnel
ID
9
5
7
7
3 4 0 2 3 4 1
Check if same date as Alarm date on
the Basic Module (Block E1)
E422
ID
042
Station
Month Day
1
YYYY
2000
Incident Date
State
Apparatus or
Resources
DD
11
31
Action
Taken
Revision 01/01/04
NFIRS 5.0 Self-Study Program
EXERCISE SCENARIO 10-2: Structure Fire
Directions: Read the call information in the exercise below. Use the information provided to complete the entire Personnel
Module form and other forms needed to complete the scenario. Compare your work to the answers provided in Appendix A. If
your answers are different from the ones provided, read over the Personnel Module again.
The Alberta Fire Department (FDID #92188) received a call for a reported house fire at 5 East
Cary Street, Brunswick, Virginia 23351, on May 1, 2005. The dispatcher assigned the incident
(#5433) to Engine 1, Engine 2, and Truck 1 from Shift A. The units received the alarm at 12:53
p.m. Engine 1 and Truck 1 arrived at the scene at 12:58. Engine 2 arrive at the scene at 1:00
p.m. Each unit was staffed with four firefighters. The owner of the single-family dwelling,
Mrs. Christy Gordon (66 years old), said that she was warming her lunch on the stove when the
grease from the pan began to burn. The gas stove was a Whirlpool, Model RF330PXVN, Serial
Number F925888840, Year 2000. The fire spread from the pan to the curtains. She had fallen
asleep upstairs and was alerted when the hardwired smoke detector activated. The flame damage
was confined to the kitchen. The 2,000 square feet, two-story home was filled with smoke in
the other rooms. She called 911. Crews from Engine 1 and 2 worked to extinguish the fire while
the crew from Truck 1 performed ventilation, salvage, and overhaul. The fire was brought under
control at 1:25 p.m. There was $24,000 fire loss to property and $9,600 content loss. The value
of the property was $161,000 and the content value was $80,400. All units cleared the scene at
2:40 p.m. FF1 Adam C. Wallner, Badge No. 224, completed the report after returning to Station
No. 2. Captain Tonya S. Gordon, Badge No. 105, was the officer in charge. The incident was in
Census Tract 501.10, District A12.
Engine 1 Personnel
• Andrew C. Wallner, FF1, Badge No. 224, Duties: Extinguish fire and ventilation
• Karen M. Winer, FF2, Badge No. 111, Duties: Extinguish fire and ventilation
• Andrew B. Starwood, FF3, Badge No. 130, Duties: Operate apparatus
• Tonya S. Gordon, Capt., Badge No. 105, Duties: Command
Engine 2 Personnel
• Paul P. Kritz, FF2, Badge No. 222, Duties: Extinguish fire
• Andy C. Long, FF3, Badge No. 219, Duties: Extinguish fire
• Stan Baron, Capt., Badge No. 007, Duties: Command
• John Mack, FF3, Badge No. 234, Duties: Operate apparatus
Truck
• Juan M. Mills, FO2, Badge No. 317, Duties: Ventilation
• Ronald T. Harris, FF2, Badge No. 299, Duties: Operate apparatus
• Marion Fritz, Capt., Badge No. 847, Duties: Command
• Cal Heilig, FF3, Badge No. 356, Duties: Salvage and Overhaul
10-13
NFIRS 5.0 Self-Study Program
MM
A
C
Delete
Incident Date
State
Location Type
Station
Incident Number
Exposure
NFIRS–1
Number/Milepost
Prefix
Basic
No Activity
Check this box to indicate that the address for this incident is provided on the Wildland Fire
Module in Section B, “Alternative Location Specification." Use only for wildland fires.
Street address
Intersection
In front of
Rear of
Adjacent to
Directions
US National Grid
Census Tract
-
Street or Highway
Street Type
Suffix
Apt./Suite/Room
City
State
ZIP Code
Cross Street, Directions or National Grid, as applicable
Incident Type
E1
Incident Type
D
YYYY
Change
FDID
B
DD
Aid Given or Received
None
Dates and Times
Midnight is 0000
Month
Check boxes if
dates are the
same as Alarm
Date.
Day
Year
Hour
E2
Min
Shifts and Alarms
Local Option
ALARM always required
Shift or
Platoon
Alarm
Alarms
District
ARRIVAL required, unless canceled or did not arrive
1
2
3
4
5
Mutual aid received
Auto. aid received
Mutual aid given
Auto. aid given
Other aid given
Their FDID
Last Unit
Cleared
G1
Resources
Primary Action Taken (1)
G2
Apparatus
Personnel
Suppression
Additional Action Taken (2)
Civilian Fire Cas.–4
Fire Service Cas.–5
EMS–6
HazMat–7
Wildland Fire–8
Apparatus–9
Personnel–10
Arson–11
Check box if resource counts include aid
received resources.
H1
Casualties
None
Deaths Injuries
Fire
Service
Civilian
H2
1
2
U
Detector
Required for confined fires.
Detector alerted occupants
Detector did not alert them
Unknown
H3
1
2
3
4
5
6
7
8
0
Special
Study Value
Estimated Dollar Losses and Values
LOSSES:
Required for all fires if known.
Optional for non-fires.
Property
$
,
,
Contents
$
,
,
None
PRE-INCIDENT VALUE: Optional
EMS
Other
Additional Action Taken (3)
Special
Study ID#
LAST UNIT CLEARED, required except for wildland fires
Check this box and skip this block if an
Apparatus or Personnel Module is used.
Fire–2
Structure Fire–3
Local Option
Controlled
Actions Taken
Completed Modules
Special Studies
CONTROLLED optional, except for wildland fires
Their
State
Their Incident Number
F
E3
Arrival
Property
$
,
,
Contents
$
,
,
Hazardous Materials Release
None
Natural gas: slow leak, no evacuation or HazMat actions
Propane gas: <21-lb tank (as in home BBQ grill)
Gasoline: vehicle fuel tank or portable container
Kerosene: fuel burning equipment or portable storage
Diesel fuel/fuel oil: vehicle fuel tank or portable storage
Household solvents: home/office spill, cleanup only
Motor oil: from engine or portable container
Paint: from paint cans totaling <55 gallons
Other: special HazMat actions required or spill > 55 gal
(Please complete the HazMat form.)
I
Mixed Use
Property
10
20
33
40
51
53
58
59
60
63
65
00
Not mixed
Assembly use
Education use
Medical use
Residential use
Row of stores
Enclosed mall
Business & residential
Office use
Industrial use
Military use
Farm use
Other mixed use
Property Use
None
Structures
Church, place of worship
131
Restaurant or cafeteria
161
Bar/tavern or nightclub
162
Elementary school, kindergarten
213
High school, junior high
215
College, adult education
241
Nursing home
311
Hospital
331
341
342
361
419
429
439
449
459
464
519
Clinic, clinic-type infirmary
Doctor/dentist office
Prison or jail, not juvenile
1- or 2-family dwelling
Multifamily dwelling
Rooming/boarding house
Commercial hotel or motel
Residential, board and care
Dormitory/barracks
Food and beverage sales
539
571
579
599
615
629
700
819
882
891
Household goods, sales, repairs
Gas or service station
Motor vehicle/boat sales/repairs
Business office
Electric-generating plant
Laboratory/science laboratory
Manufacturing plant
Livestock/poultry storage (barn)
Non-residential parking garage
Warehouse
Outside
Playground or park
124
Crops or orchard
655
Forest (timberland)
669
Outdoor storage area
807
Dump or sanitary landfill
919
Open land or field
931
936
938
946
951
960
961
962
Vacant lot
Graded/cared for plot of land
Lake, river, stream
Railroad right-of-way
Other street
Highway/divided highway
Residential street/driveway
981
984
Construction site
Industrial plant yard
J
10-14
Look up and enter a
Property Use code and
description only if you
have NOT checked a
Property Use box.
Property Use
Code
Property Use Description
NFIRS–1 Revision 01/01/05
NFIRS 5.0 Self-Study Program
Person/Entity Involved
K1
Local Option
Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.
Business Name (if applicable)
Mr., Ms., Mrs.
First Name
Number
Prefix
Post Office Box
State
Area Code
MI
Phone Number
Last Name
Suffix
Street or Highway
Street Type
Apt./Suite/Room
Suffix
City
ZIP Code
More people involved? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.
Owner
K2
Local Option
Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.
Same as person involved?
Then check this box and skip
the rest of this block.
Mr., Ms., Mrs.
Business Name (if applicable)
First Name
Number
MI
Prefix
Phone Number
Last Name
Suffix
Street or Highway
Street Type
Apt./Suite/Room
Post Office Box
State
Area Code
Suffix
City
ZIP Code
Remarks:
L
Local Option
Fire Module Required?
Check the box that applies and then complete the Fire Module
based on Incident Type, as follows:
Complete Fire & Structure Modules
Complete Fire Module &
Section I, Structure Module
Basic Module Only
Confined 113–118
Complete Fire Module
Mobile property 120–123
Complete Fire Module
Vehicle 130–138
Complete Fire or Wildland Module
Vegetation 140–143
Outside rubbish fire 150–155 Basic Module Only
Complete Fire or Wildland Module
Special outside fire 160
Special outside fire 161–163 Complete Fire Module
Complete Fire or Wildland Module
Crop fire 170–173
Buildings 111
Special structure 112
ITEMS WITH A
MUST ALWAYS BE COMPLETED!
More remarks? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.
M
Authorization
Check box if
same as
Officer in
charge.
Officer in charge ID
Signature
Position or rank
Assignment
Month
Day
Year
Member making report ID
Signature
Position or rank
Assignment
Month
Day
Year
10-15
NFIRS 5.0 Self-Study Program
A
MM
FDID
B
DD
YYYY
Incident Date
State
Station
Property Details
B1
C
Not Residential
Incident Number
On-Site Materials
or Products
Change
Exposure
None
Enter up to three codes. Check one box for each code
entered.
On-Site Materials
Storage Use
On-site material (1)
1
2
3
4
U
Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined
On-site material (2)
1
2
3
4
U
Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined
1
2
3
4
U
Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined
Buildings not involved
Number of buildings involved
B3
None
,
Less than one acre
Acres burned (outside fires)
On-site material (3)
D
D1
D2
Ignition
E1
Area of fire origin
Heat source
D3
Item first ignited
1
Check box if fire spread was
confined to object of origin.
Cause of Ignition
Skip to
Section G
Check box if this is an exposure report.
E3
Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation
E2
Factors Contributing to Ignition
3
4
5
None
6
Estimated age of
person involved
Required only if item first
ignited code is 00 or <70
Equipment Involved in Ignition
None
Age was a factor
7
1
Factor contributing to ignition (2)
F1
F2
None
Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved
1
2
Factor contributing to ignition (1)
Type of material first ignited
Human Factors
Contributing to Ignition
Check all applicable boxes
1
2
3
4
5
U
D4
Fire
Complete if there were any significant amounts of
commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved
Estimated number of residential living units in
building of origin whether or not all units
became involved
B2
NFIRS–2
Delete
Equipment Power Source
G
2
Male
Fire Suppression Factors
Female
None
Enter up to three codes.
If equipment was not involved, skip to
Section G
Equipment Power Source
Equipment Involved
F3
Brand
Model
Serial #
Equipment Portability
1
Portable
2
Stationary
Portable equipment normally can be moved by
one or two persons, is designed to be used in
multiple locations, and requires no tools to install.
Year
H1
Mobile Property Involved
1
Not involved in ignition, but burned
2
Involved in ignition, but did not burn
3
Involved in ignition and burned
None
H2
Fire suppression factor (1)
Fire suppression factor (2)
Fire suppression factor (3)
Mobile Property Type and Make
Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:
Mobile property type
Mobile property make
Mobile property model
License Plate Number
Year
State
Arson report attached
Police report attached
Coroner report attached
Other reports attached
VIN
Structure fire? Please be sure to complete the Structure Fire form (NFIRS–3).
NFIRS–2 Revision 01/01/05
10-16
NFIRS 5.0 Self-Study Program
Structure Type
I1
If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.
1
2
3
4
5
6
7
8
0
Enclosed building
Portable/mobile structure
Open structure
Air-supported structure
Tent
Open platform (e.g., piers)
Underground structure (work areas)
Connective structure (e.g., fences)
Other type of structure
Fire Origin
J1
I2
Building Status
1
2
3
4
5
6
7
0
U
Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined
J3
Number of stories w/significant damage
(25 to 49% flame damage)
N
None Present
1
Present
U
Undetermined
Detector Type
1
2
3
4
5
0
U
Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined
M1
Number of stories w/extreme damage
(75 to 100% flame damage)
Detector Power Supply
1
2
3
4
5
6
7
0
U
0
U
L4
Detector Operation
1
Fire too small to activate
2
Operated
Complete
Block L5
3
Failed to operate
Complete
Block L6
U
Undetermined
Type of Automatic Extinguishing System
Required if fire was within designed range of AES
Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined
Width in feet
Type of Material Contributing Most
to Flame Spread
Check if no flame spread OR if
same as Material First Ignited (Block D4,
Fire Module) OR if unable to determine.
K1
Skip to
Section L
Item contributing most to flame spread
M3
K2
Type of material contributing
most to flame spread
L5
Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined
1
2
3
4
5
6
7
Presence of Automatic Extinguishing System
None Present
N
Present
1
Complete rest of
Section M
2
Partial System Present
U
Undetermined
M2
K
,
BY
Length in feet
Number of stories w/heavy damage
(50 to 74% flame damage)
L3
Skip to
Section M
,
,
Total square feet
,
Total number of stories
below grade
Fire Spread
(In area of the fire)
NFIRS–3
Structure
Fire
OR
Number of stories w/minor damage
(1 to 24% flame damage)
Presence of Detectors
L2
Total number of stories at or
above grade
Story of
fire origin
Confined to room of origin
Confined to floor of origin
Confined to building of origin
Beyond building of origin
L1
Main Floor Size
I4
Count the roof as part of the
highest story.
Count the roof as part of the highest story.
If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).
2
3
4
5
Building
Height
Number of Stories Damaged by Flame
Below grade
J2
I3
1
2
3
4
U
L6
Detector Effectiveness
Required if detector operated.
Alerted occupants, occupants responded
Alerted occupants, occupants failed
to respond
There were no occupants
Failed to alert occupants
Undetermined
Detector Failure Reason
Required if detector failed to operate
1
2
3
4
5
6
0
U
Power failure, shutoff, or disconnect
Improper installation or placement
Defective
Lack of maintenance, includes
not cleaning
Battery missing or disconnected
Battery discharged or dead
Other
Undetermined
Operation of Automatic
Extinguishing System
M5
Required if fire was within designed range
Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined
1
2
3
4
0
U
M4
Number of Sprinkler
Heads Operating
Required if system operated
Required only if item
contributing code is 00 or <70.
Reason for Automatic
Extinguishing System Failure
Required if system failed or not effective
1
2
3
4
5
6
7
8
0
U
System shut off
Not enough agent discharged
Agent discharged but did not
reach fire
Wrong type of system
Fire not in area protected
System components damaged
Lack of maintenance
Manual intervention
Other
Undetermined
Number of sprinkler heads operating
NFIRS–3
10-17
Revision 01/01/06
NFIRS 5.0 Self-Study Program
MM
A
FDID
B
Apparatus or
Resources
DD
Incident Date
State
Station
Dates and Times
ID
Type
ID
Type
ID
Type
Personnel
ID
Year
Sent
X
Hour/Min
Exposure
Number
of
People
Sent
Name
Rank or
Grade
Attend
X
Action
Taken
Sent
Dispatch
Arrival
Rank or
Grade
Attend
X
Action
Taken
Sent
Dispatch
Arrival
Rank or
Grade
Attend
X
Personnel
Apparatus Use
Actions Taken
Check ONE box for each
apparatus to indicate its main
use at the incident.
List up to 4 actions for
each apparatus and
each personnel.
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
Action
Taken
NFIRS–10
10-18
Action
Taken
Action
Taken
Suppression
EMS
Other
Clear
Name
NFIRS–10
Change
Suppression
EMS
Other
Clear
Name
Delete
Suppression
EMS
Other
Clear
Personnel
ID
3
Midnight is 0000
Dispatch
Arrival
Personnel
ID
2
Incident Number
Check if same date as Alarm date on
the Basic Module (Block E1)
Month Day
1
YYYY
Action
Taken
Revision 01/01/04
NFIRS 5.0 Self-Study Program
Personnel Module Test
1. The Personnel Module
(a) is required when a firefighter is injured.
(b) cannot be used in place of the Apparatus or Resources Module.
(c) can be used in place of the Apparatus or Resources Module.
(d) can be used for non-fire service personnel.
2. The Personnel Module uses the following to record the duties performed at the incident by the
individual responder:
(a) Personnel Action Taken.
(b) Apparatus Action Taken.
(c) Use.
(d) Apparatus or Resources Type.
3. The Personnel Module uses the following to record the duties performed by specific apparatus
or resources at the incident:
(a) Personnel Action Taken.
(b) Apparatus Action Taken.
(c) Use.
(d) Apparatus or Resources Type.
4. The Personnel Module uses the following to identify personnel on specific pieces of apparatus:
(a) Personnel Action Taken.
(b) Personnel Identification.
(c) Name.
(d) Attend.
5. Provide basic life support and provide air supply are examples of which data element?
(a) Apparatus Use.
(b) Apparatus Action Taken.
(c) Personnel Action Taken.
(d) Apparatus Type.
10-19
| File Type | application/pdf |
| File Modified | 2008-02-12 |
| File Created | 2008-02-12 |