Scrap Solo

Scrap Solo Episode 7 - Nick Ledin: Data over Dogma

• Corley Moore

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đź‘Š Guest: Nick Ledin
‼️ Topic: Data over Dogma

SCRAP SOLO
A brand-new podcast by Corley, produced by Firehouse Vigilance.
SCRAP SOLO creates a focused space for meaningful conversations:
➡️ One guest
➡️ One topic
➡️ One deep, intentional discussion

This platform allows Corley to sit down one-on-one with trusted professionals across all industries... Leaders, Thinkers, and Experts.
You’ll still hear from some of the most respected voices in the fire service.
You’ll also hear perspectives that challenge thinking, sharpen perspective, and drive growth no matter your profession or organization.

If you’ve grown with The Weekly Scrap…
If you want even more access to the best minds available…
If you’re looking for in-depth, valuable, and intentional conversations…
This podcast is for you.

Welcome to SCRAP SOLO

SPEAKER_00

Let's do it. Let's do this. Nick Ladine on episode number seven of the scrap solo. Welcome, my brother. I'm excited for this conversation.

SPEAKER_01

Yeah, me too. Appreciate the uh the opportunity to come talk with you.

SPEAKER_00

It is the solo, which means we're gonna pick one topic. We're gonna dig into that one topic. We're gonna try and put those bumper rails up and talk about only one thing and not go down rabbit holes to the best of our ability. So, Nick Ladine, what is the topic we are gonna solo today?

SPEAKER_01

What's the topic gonna be? We got data over dogma. So I had to pick something that was broad enough so that even when we go off the bumper rails just a little bit, we're still we're still within the bumper rails.

SPEAKER_00

Trying to outsmart the bumper rails. Right? Right on, right on. So what do you mean when you say when you say data over dogma, what exactly does that mean to you?

SPEAKER_01

All right, so I want to take a step back and I want to talk about like a 30,000-foot view. That's gonna be the entirety of the fire service. Then we're gonna focus in and we're gonna go to the 300-foot level, that's gonna be the incident commander. Then we're gonna go to the 30-foot level, that's gonna be the group or division supervisor, and then lastly, we're gonna have the three-foot or the three-inch level, and that's gonna be the firefighter level, the task level. That's the company officer, that's the firefighter, with the halligan in their hand, with the victim in their hand.

SPEAKER_00

So we're gonna start like the entire fire service, and then we're gonna go and zoom all the way down to the firefighter with the halligan in his hand. That's the hope right now. That's ambitious, brother. That's ambitious. I love it. I love it.

SPEAKER_01

Let's take a step back. I want to start with the entirety of the fire service, and I want to talk about kind of the history of the fire service just very, very briefly to kind of lay some groundwork right now. So the way that I look at this is I kind of have this, it's kind of distinction without a difference, but we kind of have firefighting 1.0, firefighting 2.0, and firefighting 3.0. So firefighting 1.0, that's from like Franklin to fire trucks. So this is everything more or less kind of pre-1900. So we have horse-drawn equipment, a lot of exterior operations, still some interior operations, but it's bucket brigades, it is it is horse-drawn equipment, it is trying to not lose a city, is kind of the ultimate goal of a lot of these fire departments.

SPEAKER_00

Stop it on the block, save the city, wooden plugs.

SPEAKER_01

Exactly. Okay. Then we kind of progress through technology, through training, through all the things to firefighting 2.0, and this is more or less from motorized pumps to mobile phones. So, roughly speaking, this is from 1900 to 2000, give or take. This is the introduction of SCBAs, more interior operations, more career firefighters, especially here in the US. And then we progress to what I like to think of as firefighting 3.0, and that's where we're at right now. That's from ideas to evidence. So this is the 2000s, and this is we're lucky enough to be living in kind of this renaissance of the fire service. So we now have NIST and UL or FSRI, Firefighter Rescue Survey, Fireground Civilian Rescue Research Projects, Firefighter Mayday Survey, Project Mayday preceding that. We got all of Bill Carey's work uh looking at line of duty deaths. We got brass tacks hard facts, we got the infinite internet, we got podcasts everywhere and conferences everywhere. We got NERS, who uh before too long will be giving us really usable, tactical, actionable data for the fire ground. And we are incredibly lucky. So not only is this kind of a renaissance, but it's kind of what I've been referring to as like a rescue. We are really focused on rescue right now, and we have these data streams that we can then get laser focused on what is working, what's not working, what are the things that affect victim survivability, and what are the things that aren't as important that we were taught for the longest time. So, with the ultimate goal of how do we increase the number of rescues that we're making? Right on. The ultimate rescue is the objective. Exactly. So the two kind of main data streams that we're gonna talk about are gonna be FSRI or Fire Safety Research Institute, and then FRS, which is Firefighter Rescue Survey. So taking one more step back, I know we're going backwards right now. I promise we'd go forward, but to go forwards, we got to go backwards. Uh, I want to talk about the best tool that we have for finding the truth. And I think throughout all of humanity, the best tool that we've ever invented and potentially ever will invent is gonna be the scientific method. So taking us back to sixth grade uh science class, we have the scientific method. We have we're gonna ask a question, we're gonna do some background research, we're gonna form a hypothesis, we're gonna test with some experiment or experiments, we're gonna analyze the data, we're gonna draw conclusions based off the data that we have, and then we're gonna communicate those results to everybody. So we are lucky enough to be living in the time of FSRI, and this is more or less exactly what they're doing. They're trying to dissect the fire ground and kind of break it apart into each individual part initially. So they initially started with ventilation. Right. Before we even started talking about water, let's just talk about opening and closing doors. Let's talk about cutting holes and roofs, and let's talk about throwing a fan in there. So we kind of have this ventilation trilogy. Then we transitioned to water. So first it was air, then it was water, exterior streams kind of to start. Then we did some coordination between the two. Now we're starting to add in search, and we have the first version of the search and size up study that's been released, and now they're working on version two, which would be kind of multi-family, multi-uh-floors of our structures as well, because everything was done on single family, single story uh to this point. And so now we have a decent amount of data right there. And now, if we kind of overlay that data with what we have at Firefighter Rescue Survey, we being the entirety of the fire service. Now we have over 5,000 recorded rescues. So we're going to overlay those two data sets on top of each other to try to figure out what do we know is harming civilians? What are the causative factors of victims dying in fires? And I think we have enough data right now to really have a pretty good nuanced discussion. And that downstream will lead to better training, better operations, but all the things downstream really start upstream when it comes to the data. So we're going to overlay the data on top of each other to figure out what do we know for sure, what do we think we know right now, and how strong are we in our beliefs? Um, our our beliefs and our actions have to be proportionate to the data that we have. Um, and we're lucky enough to be living in 2026 where we have a bunch of data at this point in time.

SPEAKER_00

So I want to dig in on 1.0, 2.0, 3.0. I love the breakdown. I love the breakdown. And I want to focus in on 3.0 and ask the question where do you feel like we are in 3.0? Are we in the are we in the the the crescendo of it? Are we on the tapering end? Are we still on the cresting cresting side of the wave?

SPEAKER_01

Yeah, without being able to predict the future, I'm guessing that we're still kind of in this infancy, maybe Tyler phase with this. We've had a ton, we got about 15 years of of really good data coming from FSRI. I'm hoping that's just the beginning. We have about a decade worth of data from FRS right now. I'm hoping that's just the beginning. Now we can start overlaying some of Brush's work with the civilian fire ground rescue research projects. And then we're gonna have NERS to overlay on top of that. So now we can hopefully find out more and more information downstream and hopefully start fine-tuning some of this stuff. If our goal is to collect as many rocks as possible, we've picked up a bunch of big boulders already. Now we're down to picking up some small hand-sized stones and throwing them in our backpack. Um, and then downstream, there'll be even smaller stones and then pebbles, but we've got plenty of room to add more volume to that backpack, more weight to that backpack.

SPEAKER_00

Right on. I love the analogy. Okay, so we've taken some steps backwards. We're predicting the future that we're just on the beginning edge of this 3.0. And uh I hope you're right in that regard, because uh it they these are some very 1.0, 2.0 seem to be very wide swaths of time. And so and 3.0 we're in the 20 years. So if they're if it's holding, but it's also accelerating. So that's the interesting part, and it's a great time to be alive with everything that you referenced. So we got the data, we got the scientific method, we're overlaying it, and it's actually now trying, it's actually that that's the best part of this whole deal to me. The part that blows my mind is the actual data is actually impacting, you know, when you are talking at that three-foot level or at that departmental level in the training grounds and the and training officers, they can actually say, no, this is why we're doing it. But that's just me getting excited. So go ahead and take us to the next point.

SPEAKER_01

The first thing that we're gonna need to have is three things. So we need an open mind, critical thinking, and then on the back end to make sure that we can take kind of this conceptual into the practical, we need open pores. What I mean by that is we need to put in the legwork to figure out what works, what doesn't work on our actual fire ground. So that's really kind of where the rubber meets the road. But when it comes to interpreting the data, we need an open mind and critical thinking. We need to make sure that we are having our conclusions follow the data. So the data comes first, that steers our conclusions. I think too often, as humans, we come up with a conclusion first and then try to cherry-pick data to fit those conclusions.

SPEAKER_00

What we wanted to prove to begin with.

SPEAKER_01

Right? We put the cart before the horse. My favorite analogy is from stealing this from Dr. Jonathan Height. He talks about how all humans have an elephant and a rider inside them. And the elephant is our emotions. The rider is our kind of rational thought. And too many of us, subconsciously, as soon as we hear something, our emotions start steering us a certain way. And then kind of this post hoc logic, this post hoc rationalization comes in, and we start justifying what our emotional pull was. Instead of having somebody get rid of that subjectivity and trying to remain objective and having this higher level rational thought, this kind of prefrontal cortex, steer the actual elephant. So we want the rider to steer the elephant and not the elephant to steer the rider. And we do the same thing when it comes to data. We have our conclusions skew the data or steer the data for us when the data really should be steering our conclusions.

SPEAKER_00

I know the quote from Ramagus. I'm not sure where the quote came from. I just attribute it to him because it's where I learned it from. Uh, emotions are the enemy of facts. And beautiful line right there. Yes, I love that line. And I again I always give credit to Kyle. I don't know if he if he's quoting someone else. So all of them go back to Churchill, I think, is the is the thing. The Churchill syndrome. But no, okay, so open mind, critical thinking. So it's all mental. And then open pores putting in the work. I love one, two, three. Open mind, critical thinking, and putting in the work. So dig into critical thinking is what I want to ask about. Is it just our mindset towards the data? Is that is that really what it needs to be the first part to change?

SPEAKER_01

I I think so. I think that's step one, right? We need to try to be as rational as possible with this stuff. We all have our biases. We're humans. Every human ever has been filled with biases. We need to make sure that we're looking for information, not affirmation. So throw that out. Try to be as objective as possible. And the goal is to have kind of data sets, steer mindsets, which steer skill sets. So not only is this linear in that direction, but it's kind of bi-directional on this positive feedback loop, whereas these skill sets, once we get better, we can start looking at this data potentially with a different perspective as well. So you don't look at the data once and be done with it. All these things kind of build upon each other. And once you realize that I can flow and move with a two and a half with a partner or two and a quarter with a with a partner, that changes how I look at the data potentially. Once I realize that with one or two people we can take a 300-pound victim out a window, that now changes how I look at the data and what is possible for us as well. So this is a bi-directional positive feedback loop between data sets, mindsets, skill sets. All these things play upon each other and affect everything else.

SPEAKER_00

And we have to be super rational in the fact that we start with data sets and not starting with our mindsets.

SPEAKER_01

Yeah. Data sets are going to steer mindsets, but my mindset and my data sets and my skill sets are different at 20 years on than they were at 20 days on. So now that I have a better grasp of the fire ground kind of holistically, hopefully that changes how I look at it and maybe how I approach it and how we instruct and how we even operate on the fire ground. So this isn't something that's static and and and built in granite. This is something that is fluid and dynamic throughout our careers. Um if now all of a sudden your department got really, really, really, really young over the last two or three years, hopefully we're we're training our members better, but maybe that changes how we operate on the fire ground as well, how we teach um and what this data is saying to us. I love it. I absolutely love, love, love the approach. So now we're going to the actual fire ground. So we're going to overlay some of the FRS data and the FSRI data. And here are the things that we know we know are causative factors on the fire ground. These are the toxic and thermal threats. So we have duration. The longer that you're in this space, the worse off you are. Location, everything else being equal, and we'll dig into what that actually means in just a second. I know sometimes people push back when they hear that on the fire ground. Everything else being equal, the closer I am to the fire, the worse off I am. Elevation. Everything else being equal, the higher I am in this space, the worse off I am. That means on top of a bunk bed is worse than on the floor. That typically means above the fire is going to be worse off than below the fire. Lastly, we have isolation. So being behind a closed door is better than not being behind a closed door. Being isolated from the fire or having the fire confined is better off for a victim than not being behind a closed door.

SPEAKER_00

All of the duration, uh, location, elevation, isolation, all four of these is from the vic the unprotected victim's mindset. Is that what we're passing out through?

SPEAKER_01

Yep, absolutely. Yep, that's that's a very good point of clarification right now. We want to know what affects survivability for the unprotected civilian. Okay. And those are four simple things: duration, location, elevation, and isolation.

SPEAKER_00

I want to ask real quick is are these given in an order of importance here, or is this are you going to get into that later as far as which one is it's hard to divorce these.

SPEAKER_01

So all these things matter, but the fire ground is super dynamic. It's complex. There's a bunch of confounding variables on the fire ground. So I don't order these with the order of importance. I go by what we can control on the fire ground as well. There's one more, there's kind of a fifth, maybe a sixth and seventh as well, but a fifth one right now, which is a strong signal. The other four, I would say we have enough evidence to say that these are causative factors of survival. This fifth one right now seems to be a pretty strong signal, and that's going to be medication. That's cyanoquits at this point in time.

SPEAKER_00

Post-removal treatment, cyano kit medication. Exactly. Okay.

SPEAKER_01

Yep, exactly. So this is something that not everybody carries. We have a relatively small sample size. We really haven't dug into trying to compare not only just apples to apples, but Macintosh apples to Macintosh apples when it comes to some of this. But it's a strong enough signal right now that I'm going to make sure that we're at least talking about it. And then we're going to be analyzing some of this data from like a statistical perspective later on this summer through the work of Firefighter Rescues Ontario, which is an amazing group. They kind of hooked us up with a guy named Dr. Michael Robinson, hooked all of us up, their group and firefighter rescue survey up with Dr. Michael Robinson. And we're just kind of starting to dig into some of this data right now. So we'll know more in the future. But to me, right now, it's strong enough of a it's a strong enough of a signal to make sure we at least start talking about this conversation. It's too strong not to at least include this in the conversation right now. The other two, which are a little bit messier and not quite as black and white, much more gray, are ventilation and suppression. Ventilation, roughly speaking, after the fire is knocked down, ventilation is really good. But it depends on flow paths, wind, and a couple other things. We want victims to be in the intakes, not the outlets. So it gets a little bit messy right there. And then roughly speaking, suppression is almost always a good thing if your technique is good. But that's a pretty big caveat. So the epistemology is water is good. The technique right there is really important because there's some nuance to that as well. So poor technique, I can use water and make a situation work worse in a localized and kind of transient manner. Duration, location, elevation, isolation, and we're gonna we're gonna shoehorn in medication here today as well. So duration. This is something we've talked about forever. We've intuitively understood this forever. That fires are getting faster, are we? It's why we have lights and sirens, that's why we have opticons, that's why we stage the gear, the way that we stage the gear. That's why we train as much as we train. That's why we train how we train. We've known this forever. My 10-year-old son understands that time matters on the fire ground. Now we actually have some data through FRS and FSRI that steers us and not only shows us this, but is pretty black and white about how much this actually affects survival on the fire ground. So if you look at data from time from dispatch until fire department arrival on scene, from search time, which is time from fire department arrival on scene until victim located, and rescue time or removal time from victim located until they're outside the IDLH, all of those factors look really similar through FRS that the longer it takes to rescue somebody, the worse off it is for a victim, generally speaking.

SPEAKER_00

Yeah, we all we all get it. We all feel that we all know that it's true in our in our guts.

SPEAKER_01

Yep. Now we actually have some data to back this up. And this is something where common sense oftentimes can lead to common mistakes. But in this case, we've known this forever. This is commonsensical, and we've been accurate in our common sense with this one. Yeah, a common example of common sense gone wrong is for thousands of years, humanity believed that the sun revolved around the earth. We walk outside every day, this is exactly what it looked like to us. Sun rose in the east, set in the west, made sense to all of us forever. Galileo comes along a couple hundred years ago, tells us actually we're spinning every day. And not only that, we're revolving around the sun. That's what makes a year. But the spin, that's a day right there. And people said, heresy, throw this guy in jail. This is not accurate at all. And he's like, I got the data. Show me the data for this because a lot of people can make a claim. Go on social media at any point in time, and all these health influencers, firefighters, whatever you're into, will make these very strong claims. But then when you ask to actually see the data, there's nothing there. It's smoke and mirrors.

SPEAKER_00

I read a study one time that said Right?

SPEAKER_01

On social media, everybody has figured this out that if we speak to the elephant, if we make someone angry, if we make someone excited, if we make someone fearful, that that's going to create more and more engagement, more comments, more likes, more shares. For good or for bad, it drives engagement right there. So that's what everybody's speaking to right now. But we need to be speaking to the actual rider. That's how we make better decisions moving forward. But talking to the writer is not near as sexy or not nearly as sexy that that the rate emotions go up. Yeah, right. We're speaking to the prefrontal cortex, not the limbic system right there. It's not nearly as exciting. Um, it's not gonna get as many likes and clicks, it's not gonna have as many people getting really into the weeds and into the nuance for any of these stuff, but it's where truth is found. Right on.

SPEAKER_00

Right on. And speed are closely tied to each other. I mean, uh, because I I love Ben Schultz, time is the enemy, speed is our weapon. I love quoting it. And and we know that in our guts. Like I said, that heuristic is there for us to say, no, if we're faster, it's better for the victim. So I think we've all known that one. So that one feels like, yeah, yeah, Nick, we get that one.

SPEAKER_01

And you brought up uh Ben Schultz, who is not only involved in the firefighter rescue survey, but teaches one of the best classes out there every second. Counts. If you've never been to it, go to it. And he gets very granular when it comes to the data. So what he does is he breaks this down time on the fire ground into four different buckets. He's got turnout time, that's from tones dropping to wheels moving. He's got travel time, that's from wheels moving to wheels stop moving. He's got tailboard time, that's from when wheels stop moving to when you start your task. So your task is searched until you start searching, and then you have task time. That's from when I start my search to when I end my search or I locate a victim at that point in time. And then he starts looking into how do I make each one of these buckets a little bit faster? How can I make our travel time a little bit less? And that's the hardest one. But how can I make maybe turnout time a little bit faster? Cool. We'll hustle to the rig. We're gonna get geared up, we're gonna get 80% geared up, then we're hopping in and wheels are rolling as I'm getting buckled up in this rig as well. As we're walking out there, we're gonna hit the garage door opener. So I don't have to wait that extra seven seconds until that garage door opens up for us. So just shaving seconds whenever and wherever we can. So we've known that this is accurate, that that duration matters, that speed affects survivability forever. I mean, civilians know this, right? That's why they pull over to the right when they hear us coming lights and sirens. Now we have data to back this up. This one's pretty not only intuitive, but we have insight for this as well now. Next up is we have location. So this is your proximity to the fire. For the longest time, especially in the search world, we've talked about searching from the fire back. Back. That's very close to what I would want done for my family, but it's not quite 100% accurate.

SPEAKER_00

According to what we're saying.

SPEAKER_01

Exactly. According to the data and what we know we know at this point in time. So we have a bunch of unknowns a handful of years ago and things that we thought we knew. Now some of those things we thought we knew, we were 100% right on, and we can say we know this at this point in time. Some of the things we were close, not quite accurate on. And this is one of those things. So location, one of the things that I always think about right here is I want to search more or less from dirtiest to cleanest. That's how I look at this. So if someone's behind a closed door, even if they're closer to the fire, they're not nearly as threatened. So I do want to still search from most exposed to least exposed, but that isn't necessarily from the fire back.

SPEAKER_00

It's not strictly determined by location. Exactly. As opposed to the condition of the location. Exactly. Okay, okay.

SPEAKER_01

Make it your own track. And that's where kind of like a closed door comes into play. That's where maybe being above the fire might be worse off than being in the room right next door to the fire. Especially if we have some flow paths inside this structure, that can absolutely change stuff. Some wind brought in there. Um it could absolutely change some of this stuff. So I want to search from dirty to clean, is what I'm looking at. That's my simplified way to look at this. Same thing when I put hands on a victim, I want to move them from a dirty spot to a cleaner spot. Very, very rarely would I ever bring them, would I continue in a dirty spot or bring them to a dirtier spot? But roughly speaking, I want to move and search from dirty to clean, not necessarily from where the fire is back. Those things are oftentimes related, but they don't always align 100%.

SPEAKER_00

Right. There is a difference, and that's the uh the state there is a distinction.

SPEAKER_01

Yes, there's a distinction with a difference at these at uh on this discussion right now. Taking a step back where it comes to where are we finding people, we know that in single families so far, based on FRS numbers, we're finding over half our victims in single family dwellings, about 35% of our victims in multifamily dwellings, mobile homes, another handful of percentage points, and then this other and commercial buckets, about a handful combined between those two. The reality is we still are finding people in all these structures. When we start looking at single families or multifamilies and where we're finding these victims, most of the time, almost half the time, we're finding these victims in bedrooms. 16% of the time, we're finding them in family rooms or living rooms, hallways, 8%. But everywhere throughout this structure, we are finding victims.

SPEAKER_00

I want to pull this thread real quick and just say, but you said between single family and multifamily dwellings, that's 85% of the victims. If I'm doing quick math in my head.

SPEAKER_01

Yes? Yeah. Yep. Okay. Yep, over that. So almost 90% of victims, 80, 88% of victims are found in single family, multifamily. You throw in, I think it's 94% when we throw in mobile homes as mobile homes. Okay. Yep. So no doubt the vast majority of our victims are found in single family, multifamily, and mobile homes. No question.

SPEAKER_00

And so with that being said, I mean, especially with 50%, just understanding the building construction of uh layouts of the majority of your single family of your era construction in your neighborhood, man, just seems like like a no-brainer when you start thinking about it in that time, you know, that that mindset.

SPEAKER_01

Yeah. And when it comes to location, so part of that is gonna be understanding the layout, having this mental mapping that's gonna make me have a better task time when I get there. One of the things that's beautiful about 2026 and this rescue Assange that that I mentioned earlier is before we even get to the fire ground, nine times out of 10, I can actually see what this structure looks like before I get there. So if somebody tells me we got a buy level with a tuck under on the Delta side, that's super helpful. But I might have already seen this structure knowing that we're gonna be second in and we're gonna be search where I'm at, knowing that they have reports of fire in the living room. Before we even cross the threshold, I've had a conversation with my backspowing, hey, we're gonna walk in on a half landing, we're gonna go seven stairs up, and they're gonna be fighting fire on the left-hand side. We're gonna go two steps farther or two scoots farther, we're gonna hit that hallway, and we're gonna go hit those two bedrooms and a bathroom in that hallway right now. So now we are that tailboard time is getting minimized and minimized and minimized because we've had this discussion on this front end in that travel time. We're making up for some of this due to technology. It's so nice that for a lot of respects, we have mobile phones, we have apps. We had a fire yesterday, and it was an app on some guy's thermostat that told him that there was a fire in his house. So there's an app on his thermostat that said that, hey, this the temperature rose above 80 degrees, and it had a camera on there, and he could see that it was smoky and he could hear smoke alarms going off. So he called in the fire before he was like nobody else called it off. Our guys arrived, and from the alpha side, they said nothing's showing. When he got to the Charlie side, they saw some smoke coming out the Charlie side. It was the kitchen fire, it wasn't the biggest fire in the world, but it was a big enough fire where if somebody was in there, they would have been in a really bad way.

SPEAKER_00

The technology's making it where we can fight in less and less fire. If it without the thermostat, we might have had a rock and roller, which I know is good for the civilian. It's good for the population that we serve. That is a good thing.

SPEAKER_01

And it's kind of maybe just offsetting some of this stuff, right? You don't have to go find a pull box to go two blocks away to do to pull a pull box. You don't have to go to your house now to make a phone call. If you're walking your dog and you see a house on fire, you hear a smoke alarm, you can call this in. So, but we know fires are getting faster at the same time. So maybe when all is said and done, this is a net zero. Maybe it's a net positive, net negative. I mean, there's sometimes it'll be both of those things, but fires are getting faster. How are we getting faster? Technology is helping us get faster uh in some of these ways. Oh God, how should I say this? These small steps forward can lead to these big changes in outcomes for us, hopefully.

SPEAKER_00

Right. And and keep pace with the accelerating pressures and toxic releases that are modern fuels are unleashing. The the pressures are so much higher than they were in the past. And so, which is leading to well, anyway, I not I'm starting to rabbit hole. I'm trying to stay focused. I want to go back to that 50%, 35%, basically 95% when you factor in mobile homes. But one thing I did as a battalion chief is I I spent a lot of time with our company walkthroughs or our shift walkthroughs. We would meet at target hazards, which usually we would do a commercial structure, which you know makes sense to me because that's what hey, this is something that's gonna be rare. We want to be prepared for it, we want to understand the layout, and that's a good thing. But when you start looking at the data and driving, man, most of our rescues are gonna be made. Understanding the layout of the neighborhoods, the houses, the typical constructions, I really want to stress that point, is that should be just as important as those target commercial hazards, or if not more so.

SPEAKER_01

Yeah, and there's value in both these, right? And and for us, when we talk about size up, we talk about life, fire, and layout. So understanding these layouts and how they change our operation, if 90% of our fires are going to be fought in single family homes and multifamily homes, let's have a really good understanding of what these layouts are and then let's make plays for these. Hey, we have a buy-level fire on the upper level, upper level versus lower level for these. Sometimes it's confusing with what's division one, what's division two, or division one and basement, upper level, lower level. Let's get our terminology and our communication and our operations aligned before we even cross the threshold on these things. And it's really easy to do on more houses than not. If we can put 90% of our houses into like six different layouts, roughly speaking, we're making this a lot easier on all of our firefighters. If we can unify and codify some of this language, that makes communication a whole lot easier as well. The solution to complexity is simplicity. So the goal is to try to simplify this as much as possible.

SPEAKER_00

All right. I try not to derail you. So get back. We got duration, location.

SPEAKER_01

Yep. So speaking on location, we talked about big, you know, 30,000-foot level. We got what types of buildings? And then we can go down one more level to what types of room are we finding these victims in. The reality is we're finding 45% of our victims, almost half, in bedrooms. But that doesn't necessarily mean that I should be targeting bedrooms because that's where we're finding the almost the majority of our victims. When we get to a bedroom, we still need to search from high to low. We need to search from most exposed to least exposed. And that's what we want to, the biggest takeaways are if I open a bedroom door and it's clean, I am not searching in there at this point in time. I'm going to search the next bedroom where that door was open. I'm going to search that one first, even if it was farther away from the fire. So I want to search from dirty to clean, is the rough way that I'm looking at this. That's the simplified version of what I'm doing. That typically means I want to search from the top down. That typically means that I want to search from the fire back, but there's a little bit of nuance to some of this as well. It gets a little bit gray, and that gray area, that's what takes the gray matter. So that's where that nuance comes into play. So, yes, bedrooms, we should be targeting bedrooms, but not in the way that a lot of people teach this. We should still, the highest priority is from dirty to clean. That's how we want to search this building. As simple as possible, the dirtiest bedroom first. The simplified version for this, the slipness test, is if this are my family that were potentially inside this structure, where would I want my guys and gals to search? The dirtiest spot first. They are the most exposed right there. They have the least amount of time, they're in the worst spot. Search that area first. So now the nuance and the the the importance as an instructor is to hopefully clarify some of this. So between duration, location, elevation, and isolation, we can hopefully make sure that we are being very thoughtful with where we're searching from first to last, from beginning to end. The other part that we have when it comes to location is the conditions. So my favorite and most surprising kind of three graphs that we have from Firefighter Rescue Survey are what I call the conditions trilogy. This is exterior conditions upon arrival versus survival percentage. So this is this spectrum from nothing showing on one end all the way up to over 75% on the other. So this is from least exposed to most exposed. And just as you would expect, people that are least exposed or nothing showing have a much higher survival percentage than people over here that are most exposed when we have over 75% involvement. But when it's over 75%, yeah, right? This is pretty intuitive stuff. We just now have data to back this intuition up. We have insight along with intuition. And that's oftentimes where the truth is found. So over 75% involvement, we still have a 37% survival percentage right now. Sample size is only 146, but that is not, it's not, it's it's well above zero. So it's not a huge sample size, but it's important enough to make sure that we are understanding that just because you see a lot of fire when you pull up does not mean that nobody can survive in there. If there's searchable space, we search it. If there's not, we make it so it's searchable and then we search it. Very simple heuristic at that point in time. Can we search it? Nope. Then let's make it so we can, then we'll search it. Can we search it? Yep. That's our answer right there. Then we search it. So the second part of this conditions trilogy is gonna be conditions upon entry, and that's incipient stage fire, a room and contents, multiple rooms or rooms and contents, and then structural involvement. And again, as the fire gets bigger, survival percentage decreases, but we're still batting over 500 when we have structural involvement. And then last and maybe most importantly, we have conditions at the victim's location. So this one only has three bars, but we have no smoker fire. We have smoke at the victim's location, and then we have fire at the victim's location. So just like all the other ones, this through line's the true line, as conditions worsen and we get fire at the victim's location, survival percentage decreases. But 46% survival percentage with a sample size of over a thousand when there's fire at the victim's location. So if they're in a bedroom and there's fire in that bedroom, that is fire at the victim's location. Still almost a coin flip so far.

SPEAKER_00

Fire at the victim's location, 46% of the time survival rate.

SPEAKER_01

Yeah. And that's not a thousand. Yeah, it's almost so it's 28% of total recorded rescues. There was fire at the victim's location.

SPEAKER_00

Okay. And that is the conditions, the conditions trilogy. What'd you what do you have a different name for it? The conditions trilogy, exterior conditions on arrival, the interior conditions that you face, and then the the conditions at the victim's location.

SPEAKER_01

Absolutely. I'm gonna talk out of both sides of my mouth right now. I not only love when I'm not surprised by the data that's coming out through anywhere, FSRI, FRS, NERIS moving forward, wherever. I'm I I I love that. That typically means we've been thinking about this correctly for my entire career. But I also love when I'm surprised because that's when I learn something. That's when I can change my operations, hopefully, for the betterment of the victims. That's the goal. So I love being surprised. I also love not being surprised.

SPEAKER_00

Because it is, it's a beautiful thing. If you if you want, but if you want the truth, then that's where you have to be. You have to be able to uh enjoy both of those.

SPEAKER_01

That's that's also why I love science and scientists, because very rarely are they dogmatic and think that their way is correct when there's better evidence that says, no, you're actually incorrect. Almost every scientist that I'm aware of, and any reputable scientist, as soon as the data shows them something different, they will absolutely follow the data. The only dogma that they have in science really is that the conclusion must follow the data. And so that dogma is the road to truth. It's the only dogma that I'm down with.

SPEAKER_00

Right on. You covered duration, location, then conditions in there, the three, the trilogy of conditions. And so are we moving to elevation?

SPEAKER_01

Yep, we got elevation next.

SPEAKER_00

So various elevation within the space, not elevation in the structure. Both of those.

SPEAKER_01

So we're gonna talk about elevation in a box, so in one room. So worse off to be up high than it is down low. We're also gonna talk about the bigger box, meaning it's that house or apartment building or whatever it is. So we're gonna talk about this from a couple different levels. But elevation, a very simple heuristic for the fire ground, is that we want to attack from the bottom up, meaning that if the fire's on division one, we want to go in on division one. I don't want to go in on division two and then go down the stairs to fight that fire. If I if it's a basement fire and I can walk in through a walkout, that's how I want to fight this fire. I don't want to have to go in, cut a hole in the floor, spray water through some lookout or peek out windows. I don't want to have to go down the stairs if at all possible. But our hand is forced oftentimes, right? Right. So we want to attack from the bottom up. We also want to search from the top down. Now, the nuance with this is if this is a 100-story building and fires on division one, I don't necessarily need to go to division 100 to start my search. But on a two-story house, if it's an open stairwell and fires on one, I want to try to get above the fire as soon as possible because that's where the smoke is going. The analogy that I like, the example that I like was shared with me uh from Chief Becky White. She always thought about where the smoke goes and where the heat goes as somebody filling up a bathtub with water, but it's upside down.

SPEAKER_00

Upside down.

SPEAKER_01

So now it's a house and the water is going up, the smoke is going up, the heat is going up, the toxic, the thermal threat is going up, up, roughly speaking. It's gonna go up, then it's gonna go out, and then fill up everything from the top down for the most part. Sometimes that's within the small box, meaning the room. Sometimes that's within the bigger box, meaning the house or the apartment building. Lastly, if you have a one-story house, you want to divide and conquer. So attack goes left, search goes right. I want to cover as much square footage as possible. Again, this is just a simplified heuristic to make a couple big, quick decisions on the front end of our fires. These are rules, not laws, when we're thinking about this. So victim location relative to the fire so far through FRS, 83% of our victims are found on the fire floor. 13% of our victims are found on the floor above. So 96% of our victims are found on the fire floor or the floor above, throwing another 1% of victims for multiple floors above the fire, and then 4% of victims are found below the fire. So typically they're gonna be at a lower threat, uh, a lower hazard, just because they're below the fire. So unless wind is driving things or you have some reverse stack effect or something funky that's happening, they should be in a relatively safe location. And again, this is something that has been in our textbooks for as far back as I can see. We talk about with fire floor, floor above, and then top floor down is typically how we're speaking. Along with this, something that I think is important, and I love how Chief Brian Brush phrases this, or Chief Crush uh phrases this. He says, if you can't see, they can't breathe. And when we're talking with Dr. Michael Robinson, he started looking at our data through his statistical analysis model that he developed. And one of the things that he found is that one of the strongest predictors of survival is visibility. Again, not too surprising for anyone who's done this for any length of time. But when we start looking at where our victims are found and rescued, 63% of our victims happen in low viz and no viz at this point in time. So, are we truly practicing search in low viz and no viz? And then what does that look like? I know Justin McWilliams in Scrap 6 talked about this. He hates blacking out masks.

SPEAKER_00

Right. I was gonna I was gonna actually bring that up to you and say uh what your thoughts were on blacking out masks and training for the 67% that are in low to no viz. So go ahead. You're heading right in the direction I was gonna ask. Perfect.

SPEAKER_01

Roughly speaking, I'm 100% on board with him. I think one of the things that we need to understand is for any of the moves that we make in training, there's gonna be trade-offs. If I want to have the most realistic house possible, I'm probably gonna get less sets and reps that are through this. If we want to make this training as complex as possible, meaning we have attack, we have search, we have ventilation, we have our med group as well, we have IC, we have radio comms. When we have all those things in there, there's a whole lot of instructors that are necessary to do this well. It's also a whole lot of work on the front end and on the back end. Hopefully, we're having some really good discussions and some after actions on these, but I'm gonna get less reps in there as well. More realistic, more complex, less reps when we're doing some of this stuff. So if you're gonna be well said, uh if you're gonna be using live smoke, live burns in like a burn building or an acquired structure, or if you're gonna have burn barrels in there, you probably need more instructors when you're gonna be doing some of these things. You might not be able to do everything that you want to do with all your trainings. But roughly speaking, I'm not a fan of throwing a hood over a mask or using something to take away all visibility completely for exactly the same reasons that Justin said. If that's your only option for a department, make sure that you are acknowledging some of these scars that can develop and the limitations and the trade-offs, and make sure you're teaching around some of those things and being open and honest with your students as well, and coaching them, going, hey, we're the only way that we can simulate low visibility here is when it's dark out, or we close all the windows, or we put garbage bags over the windows, and we that's the only way that we can do this. We don't have theater smoke, we can't do burn barrels, or we can't do anything else. So coach them to keep their eyes open, coach them to every once in a while, when they cross different thresholds, to do a life fire layout, call out, get their ear to the street and look. Coach them through these things. So there's always going to be these trade-offs, I think, as long as we acknowledge that we can be honest and enhance the training moving forward. But it's it's definitely my least favorite. It's not plan A, not plan B, not plan C. It's plan Q for me.

SPEAKER_00

Way down there, way down there. Yeah. Something to ask about because I know that like putting your hood over or completely blacking out the mask, it just makes you close your eyes, which is a terrible habit, just like Justin brought up. What about like the opaque, like almost uh they make some shields that are opaque? There's also like some cling wraps you can use that that will they still allow light, but they block vision. So you your eyes are what do you think of those? Is it a good compromise or it's you know.

SPEAKER_01

It's a little bit better. That's not plan Q. That's going to be plan, you know, F for me.

SPEAKER_00

F or G. Okay. Okay. Yep.

SPEAKER_01

Yep. It's something that we've had to do before. So it depends on what your options are. It's nice because you can get a bunch of sets and reps when you're just throwing some some cling wrap or some wax paper and someone's mask or somehow going oh some type of opacity to make them slightly opaque. Not perfect. Like everything, there is some type of opportunity cost and opportunity gain, but there's there's some cost there. Coach around those costs. I think that's the biggest thing. You got to coach around the cost. And sometimes your hands are tied as a firefighter, as an instructor, based on the department that you're working with, based on the training facility that you're working in, based on all these things that you might have zero control over. So make the most of it, but understand the limitations there and coach around some of these things.

SPEAKER_00

Sure. And obviously, if you can do, if you can do plan A, do plan A. Obviously. If you can afford it, uh the time, the time, the planning, the resources, every all those obstacles in the way. But it, but it's massively worth it. But of course, try to get as close as you can. Don't go all the way to Q if you can't do A. If you can help it.

SPEAKER_01

Yeah, well so as high as you can. And the goal is for us to the goal should be to as we progress throughout our skill sets and our mindsets and our data sets to try to get as realistic as possible. So you're not going to get the number of sets and reps as you progress, but hopefully it's more and more realistic and it's more and more replicating the actual fire grounds that we're on. Because there's a lot of value in that.

SPEAKER_00

I'm seeing a nice correlation between every everything you're talking about here following Justice. And it wasn't planned that way, but just coming off his training for search and everything you're putting in here on this data over it really is is is uh unforeseen uh very nice.

SPEAKER_01

It's likely because he has influenced me, you know, as much, if not more, than probably any other firefighter out there. Uh uh I I'm I'm well entrenched in the search world. Justin's almost the first guy that I go to with every question that I have. Uh, and I make sure I try to not go on social media except for a couple pages, one of them being search culture, because there's great discussion on there, there's good logic, there's good rationale. So I appreciate everything that Justin's been doing for the last decade plus. And I'm fortunate enough to be able to call him a friend and bug him on the phone every once in a while as well. That's fair. Just finish up real quick here with elevation. And again, this is visibility within a space. So Justin touched on it. When you go to a bedroom, don't necessarily you want to go from high to low within that space in any given space. So if I have a thermal imaging camera and I recognize a loft bed or a bunk bed, that's what we're searching first. And searching a loft bed and a bunk bed is one of those things that sounds very, very simple. I promise you it's not. Now try to get somebody who weighs 80 pounds down from a loft bed or a bunk bed without causing more harm to that person. So this is where those skill sets kind of start coming into play as well. Um, all these things make sense when we were when we're working with these dummies that weigh three pounds. I'm really good at searching in these burn buildings with dummies that weigh three pounds. But throw an actual human in there that weighs 80 pounds on a loft bed when I have a pack on and all my gear on and visibility is low, that's where you really find out who's a really good firefighter or somebody who's really good at rescue. And the goal here, we're gonna talk a lot about search, obviously. Uh, but to be really good at at rescue, you need to be good at a couple different things. That's locating a victim or search, removing a victim, that's rescue. And then if you treat or transport victims, you need to be good at that as well. So we need to make sure that we have kind of this triangle of survival where we got search, rescue, and treatment. Um, just to kind of close this door here when it comes to visibility and survival percentage, that's very closely tied to elevation. If there's gonna be any visibility within a space, almost always, and flow path comes into play here, but almost always it's gonna be on the very low portion of the structure, meaning that six inch, one foot, three foot, four foot level, wherever that thermal or that neutral plane is at. So below that, you're gonna be able to see. Above that, visibility is gonna be much worse. But a thermal imaging camera, I know some people swear by them, some people hate them. The truth, as in almost everything, lies somewhere in the middle of the far ends of the spectrums, but it's a good tool and know how to use this thing.

SPEAKER_00

And one of the biggest things I want to stress that you said was from Crush. If you can't see, they can't breathe. How powerful is that line right there? Yeah, just yeah, that that yeah.

SPEAKER_01

It's it's intuitive and it's backed up by data at this point in time as well. Now, closing on the four causative factors, and then we'll make sure that we touch on medication as well. But we have isolation. Very, very simple, and this is something that in every experiment that UL has done to date in a single family or multifamily residence, they have always had a closed door. And in every single one of those experiments, it's been better to be behind that closed door than on the open side of that door, so in that hallway. Just those inch and three-quarter space with a hollow core door, every single time it's been better to be behind that closed door. Again, intuitive. We've known this for years. That's why when we go to public assembly buildings and multifamily structures, we're required by code now to have self-closing doors, to have fire doors. They're called fire doors for a reason. We've known this forever. Now, how does that affect how we are attacking this fire, how we are searching this building? That's where some of this nuance comes into play as well. So if I'm an attack, uh, if I'm part of the attack group and we're going down a hallway and I see an open door on my right, but we still got to travel another 15 feet and to the left to get to that bedroom, I'm just gonna holler out door right. My firefighter behind me is gonna close that door when he gets there. Soon as he gets there and he has a second, just shut that door really quickly. It's a simple thing that I can do to make conditions slightly better in that 100 or 120 square feet right there. Right on. And now when we're searching, I'm gonna close that door if the fire is not under control. And then I'm gonna ventilate. So I'm gonna isolate and ventilate before that fire is under control. Now, if that place was dirty, I will then ventilate and open that door when I leave to make sure that we can recycle as much air in this structure as fast as possible.

SPEAKER_00

You're gonna open that door when you leave. You're talking about water on the fire, or are you talking about thank you.

SPEAKER_01

Once water's on the fire and the fire is knocked down, I want to recycle as much dirty air in this space as possible. The one time I wouldn't do that is if this place was pristine already, the door had been shut the whole time, and it's much cleaner in that room than it is in the hallway. I'm gonna leave that door shut. I'm gonna shut that door, open up that window, and even if I miss somebody in there for some reason, even though it's pristine, even if I miss somebody, I'm making it better for them. We do know that we miss people on our primary search. It's an ugly truth that we need to realize and recognize. We will miss people in our primary search. So if the fire is not under control, we isolate and ventilate. Even if I miss them in that room, I'm making conditions better when I'm not in that space. And then the goal is to recycle as much air as fast as possible to give the best possible outcome for the victims. I can do that if the fire's under control just by ventilating, opening up that window and keeping that door open as I leave.

SPEAKER_00

No, I love uh Lagier. Legier's quote, I use it all the time, but it's uh once we have water on the fire, we should make the building as porous as possible. That's a good one. Dennis is the only person I know who can use the word porous when talking about ventilation, post-knockdown ventilation.

SPEAKER_01

That's a good one right there. Brian Lynch from Colorado Springs and Irons and Ladders had this very beautiful way of simplifying some of this as well. When he was talking about coordination between attack and ventilation or water and air. So when it comes to water and air, once you add one, add the other one. And I thought that was a really simple way of looking at this. If you start taking windows, add water as soon as possible. If you start adding water, open up windows as fast as possible, or cut holes or fan, whatever works for your department.

SPEAKER_00

That's beautiful. Uh, because I've always said one of my one of my things in my class, and I don't know, I I will give I wish I could give credit to who told, but it may be crush. If you give a fire air without giving it water, then then it's highly predictable what's gonna happen next. It's gonna the conditions are gonna rapidly deteriorate. But I love what you just said from Lynch, which is it's it's a two-way street. That really is. So I love that. I heard that put that way.

SPEAKER_01

I think it's a really, really good way to look at coordination between those two. So going back to what we've known for a long time and what's been relatively intuitive for us because of fire doors, and because of unfortunately some really tragic things that have happened throughout the fire service. This is now code. We also have been preaching for a while the importance of the close before you dose message. And when you look at FRS data, 84% survival percentage when someone's behind a closed door, 60% when they're not. So a 24% change in survival percentage just with the closed door. Um, again, not necessarily apples to apples, but just comparing those two big buckets, you're better off to be behind a closed door. Um while we're talking about some public safety stuff, working smoke alarms, also very advantageous for people. Working smoke alarms and are behind a closed door, 95% survival percentage. And that's for the people that couldn't get out. They were likely warned earlier and were in a cleaner spot, so might have been able to get out as well. So we don't we're not capturing how many people exited before we got there right now. That number is likely increased in in those two buckets as well. But for the people that couldn't get out and are still trapped, 95% survival percentage. Closed door and smoke detector, 95%. Yeah. Yep, pretty powerful. That's yeah. The other thing that we have is I talked about we want to search from dirty to clean. When we put hands on a victim, and I kind of alluded to this earlier as well, I have two decisions that I want to make. I want to go and bring this victim cleaner and I want it to be fast. So cleaner and faster. If it's dirtier, but it'll take me three seconds versus cleaner and it'll take me seven minutes. That calculus changes a little bit. But my first thought almost always is like, all right, where's the cleanest router removal for this victim? Maybe we move them from the hallway into this bedroom door that was closed, isolate, ventilate, take them out the window. It'll take an extra two minutes for me to get this person outside or whatever that time is. But it's been cleaner for the entire time when I'm doing this.

SPEAKER_00

But it's exponentially cleaner.

SPEAKER_01

Yes.

SPEAKER_00

And so and vice versa. If it's exponentially faster, but it's a little dirtier. Again, I see what you're saying. It's these two levers, you gotta try and uh that's exactly right.

SPEAKER_01

That's how I look at this is we have these two levers that we can pull, right? Um, it's perfect when cleaner and faster are the same direction. Well, easy peasy at that point. Yep. Uh that's exactly what we want to do. And we also know that when we put hands on victims from talking to victims, uh, we're fortunate enough in the Grabs podcast that we've interviewed almost 200 people that have made rescues at this point in time. Yeah, it's it's amazing. It's such a good idea for a show. And and all credit goes to Chief Swalby with that. Um, that's amazing. Yeah, he is. I'm fortunate enough that I get to help out as well. And almost universally, as soon as somebody puts their hand on a victim, even though their job is to search for victims, and sometimes they know that there's a victim inside this building, almost universally the first thought is, oh shit, I got someone. And now our heart rate jumps up another 30 from all that psychological stress. We already have an elevated heart rate right there. So we kind of turn into the Hulk, is the analogy that I use. Hulk big, hulk strong, hulk lift car, hulk not know how tie knot, hulk not know how read good or make good decision. So now we call over our partner, and hopefully our partner can take a step back. We'll literally be a step back, literally we take a deep breath in and just think which way's the cleanest way, which way's the fastest way, and then have to make that split second decision about which way we're going. But to simplify this, the heuristic is cleaner, faster. Two words relatively hopefully easy for people to remember in the heat of the battle.

SPEAKER_00

Well, also, when it ties into my brain, and I want to point this out, it's it's you just talked about duration location, and one of the keys on the location was how dirty is it, dirty versus clean, and the duration, of course. So it's it's a it's it it ties right back in almost in a reversal of of it analyzing those two those two parts of the the equation. So I love that. I love how it all ties together.

SPEAKER_01

And we talked about visibility when it comes to elevation as well. So they're they're all kind of related, right?

SPEAKER_00

They're all tied, yeah.

SPEAKER_01

No, yeah, that's a great point. Great point. It's hard to divorce these, and and sometimes, and I know I've got pushback before when I'm like everything else being equal, and they're like, well, it's never equal. Every fire is going to be slightly different, victim location is gonna be slightly no, no question. But if we just want to be as as simplified as possible, if I put a victim close to the fire versus 40 feet or four feet away from the fire versus 40 feet away from the fire, everything else being equal, they're on the same level, same floor, this same fire, you're worse off to be closer to the fire. Now, could I take that person and they're 14 feet away behind a closed door versus 40 feet away, not behind a closed door? That's not everything else being equal. Now we have some isolation that's at play right there. So if we just try to divorce these and look at each one of these individually, we want to be in there as quick as as little time as possible, as low as possible, behind a closed door, and as low as possible. The reality is it doesn't work out that way. And really a better way to look at this is I want to search from dirty to clean. That's most exposed to least exposed. Not from the fire back, not from the top down, from dirty to clean. That's the easiest, cleanest way to look at this thing.

SPEAKER_00

The most simplified way you can analyze the priority of where to search is dirtiest to cleanest.

SPEAKER_01

Yep. If you're in a hallway and you're trying to figure out what's the most exposed spot right now, where can't I see very well? That's where I need to go. Where can I see the least at this point in time? The last one that we have that we're gonna talk about is gonna be medication. And this one, I'm I'm not comfortable enough to say that this is causative. It seems to be correlated right now and correlated strongly enough where this signal is worth mentioning. So I'm just gonna bring up a couple different factors that we have right now or data points that we have. We know that when somebody suffers smoke inhalation, they're still breathing and they have pulses. When they're unconscious, again, they're they're breathing and have pulses. When they have severe burns, breathing and have pulses, or they're pulseless and apnea, meaning they're in cardiac arrest. In all four of those buckets, if I give somebody cyanokit versus I didn't give somebody cyano kit so far, they have a higher survival percentage when we gave them a cyanokit. So smoke inhalation, unconscious, severe burns, cardiac arrest, all of those buckets. Same thing for no burns, mild burns, and severe burns. Every one of those buckets, if I gave them cyano kits, they're better off than when I didn't give them cyano kits. Now, I do want to make sure that we throw some caveats in here. Relatively small sample size, we're talking about less than a thousand overall. And what we really need to do is get as granular as this as possible. So that's 562 rescues so far where a cyano kit was given. What we really need to do is look at fire at the victim's location, same amount of duration, cyano kit versus not cyanokit.

SPEAKER_00

A B testing, but we need human lives to get the data from.

SPEAKER_01

100% exactly what we need to do. And that's what our hope is to do this summer as much as we can with our limited data set. We need a bigger sample set, we need more information. The reality is we can't test this in like following the scientific method. Right. Nobody, no IRB will check off going, yeah, give these people cyano kits, burn, put all these victims in the field.

SPEAKER_00

Let's expose them to some hydrogen cyanide and a lot of carbon monoxide.

SPEAKER_01

Give this group cyano kits, don't give this group cyanokits, put this group in the fire room at the same elevation for the same amount of time. Like that's just not gonna happen. It's not gonna be happening. Give those ones placebo. Correct. This is the best data set that we have right now, right? Um, but we need more information on this. But it's it's a strong enough signal to me right now to say, like, there's no real contraindication to giving this medication. Now, double check this with your uh physician advisor, talk with your local EDs, talk with your burn centers, because I do know that some burn center physicians don't love cyanokids because it does mess up some labs downstream. But there doesn't seem to be any strong enough contraindications besides being allergic to this where you wouldn't give this to somebody. And this really just is trying to change something into a B vitamin. I'm not a doctor, don't quote me on any of this stuff, but that's my current understanding right now, is it it seems to be a net positive right now with no real significant downside. So besides the cost and the relatively short shelf life for this medication, that's where where some departments might not be able to afford it at this point in time. But besides money and budgets, doesn't seem to be any other potential downsides for giving this thing or for even holding these on your on your uh rigs.

SPEAKER_00

And like you said, you're not comfortable enough to say this is the at what the data says. You're not comfortable enough to say it, and I respect that, but if you were the chief making decisions, you would absolutely say we're doing this.

SPEAKER_01

Yeah, I pushed it at my department. I pushed this up to our chief of VMS, and now we're fortunate enough that all four of our ambulances have this on them.

SPEAKER_00

Um we haven't given everybody's clear on that. Like even though yeah.

SPEAKER_01

And also, I don't work for CERB pharmaceuticals, I don't make any money for this. And to to kind of start landing this plane, we we talked about this already, but information is more important than affirmation. I think that's a Katie Currick quote, but this is what we need to understand. We want to attempt to quiet the elephant, we want to remove subjectivity and add objectivity. Like I said, the goal is to have our conclusions follow from the data and not have the data follow from our conclusions. It's the cognitive equivalent of having the elephant steering the rider.

SPEAKER_00

Right on. Takeaways. I want to say, I mean, I was just right, that was a beautiful bow, but I'll edit and see what I do with it. But I like for the audience who who who have, I mean, there's so many already, so many. But I want you to say, Nick Ladine, what's the first takeaway you want people to take away from this solo about data over dogma?

SPEAKER_01

Takeaway number. Fighters are getting faster. But are we getting faster? Are we spending too much time on vector solutions and not enough time on the training ground? Is our training as good as it should be and could be? As instructors, are we slowly ramping up the ability and the training and the anti-fragility of our members, or are we not doing that? Because that really is our goal as instructors.

SPEAKER_00

Beautiful. What is the second takeaway, Nicola Dean, you would like people to have from this conversation about data over dogma?

SPEAKER_01

Takeaway number two. The solution to complexity is simplicity. The fire ground is just inherently complex. It's time compressed, we have limited visibility, we have high heat, we have a bunch of unknowns, we have a ton of different operations that are happening simultaneously, we have communication difficulties, and all these things are on the backs of the limitations of the human factors as well. Just inherently complex. The solution to complexity is simplicity.

SPEAKER_00

Beautiful. Simplify, simplify, simplify, man. Doesn't get, I hate to say it, doesn't get any simpler than that. Right. What is the final takeaway? The takeaway number three that you want people to have from data over dogma.

SPEAKER_01

And I am gonna kind of steal a phrase from retired chief McGrail, but are you the firefighter you want showing up to rescue your family? So what I mean by this is we need to make sure that we have the ability and the anti-fragility to make sure that we are operating as good as we can on the fire ground. And really quickly, anti-fragility, it's a concept that I absolutely love. We know that some things are fragile. That means that if I drop them, they will break. Like a wine glass is fragile. If I if I put stress upon the system, it can break. Oftentimes, most of us know what resilience is as well. Uh resilience or robustness is the ability to withstand something. So, like a plastic cup. I drop a plastic cup, it bounces, it does not break. So when I add stress to this, there's no change in the system. And then lastly, there's anti-fragility. Anti-fragility is something that when I stress the system, it becomes stronger. So our muscles, our bones, our brains, our fire departments, all these things require stress. So if I lift weights and I have all these microscopic tears in my muscle, they will rebuild it and my muscle will come back stronger. If just the inverse of that, if I lay in bed for the next month and I don't do a thing, my muscles will atrophy, I will get weaker. So these systems require stressors. A fire department requires these stressors. We should take that understanding, fold that into our training. So the way that I look at our training is we have the why making up the base of the pyramid. That's the mission. Very, very simple. My family's caught inside of a structure fire or a car accident or a water rescue or tech rescue or EMS emergency, whatever the case may be. This was my family. What am I gonna do? Next up, we have our technique. So forcing a door, we'll use as an example, or searching of structure. Do I have the technique? Once I have that technique down, we're gonna just start doing the how faster. So now I'm gonna get a little bit faster, start adding in tempo to this whole thing. And then the last two parts of this pyramid are the what. That's the decision making. What am I gonna do in this instance? I'm doing window-initiated search. I get in the room and three feet inside the room, I find a 200-pound victim. Do I grab the victim, try to get him out the window? Do I continue to the hallway? Do I shut the door? Do I do a life fire layout, call out in the hallway? What about adding friction in there? So high heat, low visibility, poor communication. I have a bunch of clutter inside this structure, a hoarder house. All these things I want to amp up. Not only that, I have all these other groups on the fire ground operating of the training ground operating. Let's make this as complex as possible at times. We want to start ramping up our training as much as we can to make our firefighters anti-fragile. We want when they are stressed out on the fire ground to make the best decisions. To do that ability and anti-fragility.

SPEAKER_00

Beautiful breakdown, brother. I love it. I absolutely love it. The why is the base, the how, and then the what. And really encompass all that in the when, which is as fast as possible. No, that's beautiful, brother. I love it. All right, it's a parting shot because at every solo, we dig into a solo topic, and then I give my guests the chance to give the parting shot. So, Nick Ladine, what have you got?

SPEAKER_01

Looking at data from firefighting 3.0, so since 2000, it doesn't appear that we're risking a lot to save a lot. Well-trained firefighters, that's firefighters with ability and anti-fragility, are risking a little to save a lot. Now, I got that turn of phrase as I was working on a previous article from Chief Eric Sailors, who's been on the scrap a couple of times and one of my mentors. As he was looking at the data and reading through the article, he said, it doesn't look like we are risking a lot to save a lot. It looks like we're risking a little to save a lot. And I thought that is a powerful turn of phrase right there. And backed by data.

SPEAKER_00

Thanks for listening. New episode of the Solos Drop of the first of every month. And what topics do you want to use solo?

SPEAKER_01

And make sure it's see you at the next solo.