Firefighter Rescue Survey (FRS) is a firefighter-built database that tracks real-world civilian rescues from structure fires, with more than 4,000 unique rescues logged across the U.S. by late 2024. The aim is simple: give fire departments actionable information to sharpen search training, fireground tactics and medical readiness.
Roughly 74% of recorded rescues occurred in low- or zero-visibility conditions with heavy smoke. About 93% of victims had smoke inhalation noted at the time of rescue, highlighting how routine and severe toxic smoke exposure is at real incidents. Most rescues took place in residential occupancies, which continues to be the primary setting for fireground rescues.
In some cases, Cyanokit use is noted in the rescue record. While FRS doesn’t publicly break out a specific “Cyanokit survival rate,” the fact that it’s tracked at all reflects how common significant smoke exposure (including potential cyanide toxicity) is and that crews are already deploying antidotes in the field.
What is a Cyanokit and why does it matter to firefighters?
A Cyanokit is a cyanide antidote carried by EMS and fire departments. It contains hydroxocobalamin, a form of vitamin B12 that binds to cyanide and turns it into a harmless compound the body can flush out. When burning modern materials (plastics, foams, synthetics) release cyanide gas — not just smoke and carbon monoxide — hydroxocobalamin binds the cyanide and transforms it into a safe, excretable form.
Because FRS data shows:
- Most rescues involve heavy smoke / inhalation risk
- Smoke inhalation victims are frequent
- Victims are often incapacitated, unconscious and might not show obvious signs until it’s too late
Having Cyanokit ready on fire/EMS rigs gives medics a direct tool to treat toxic smoke exposures on the fireground immediately, rather than waiting for hospital.
Why should fire departments carry Cyanokit?
- Cyanide is everywhere in modern structure fires — foam, carpet, insulation, wiring, plastics.
- Victims in enclosed-space fires often have both carbon monoxide and cyanide poisoning.
- Early treatment dramatically improves survival and prevents neurological damage.
- Hydroxocobalamin is safe to give even if cyanide is only suspected, making it ideal for fireground medicine.
- Older antidotes (nitrites) were dangerous for CO-positive patients; Cyanokits are now the standard.
Having the antidote on your rigs means you don’t wait for ALS arrival or the hospital — you treat immediately.
What firefighters should do to get Cyanokits
- Advocate within your department: Use FRS data to support acquiring Cyanokits.
- Reach out to medical leadership and EMS agencies: Cyanokits are FDA-approved, available from medical suppliers, and typically require only standing orders and training.
- Include Cyanokits in standard fire-ground medical protocols, especially for enclosed-space rescues, heavy smoke, unconscious victims, or any smoke inhalation scenario.
- Report rescues to FRS, This strengthens the dataset, helps refine protocols, and builds the case nationally for routine Cyanokit deployment.
How can fire departments get Cyanokits?
- Purchased through normal medical supply distributors.
- Cost is usually $900–$1,200 per kit.
- Many departments fund them through grant programs (DHS, UASI, state EMS funds).
- Shelf life is typically 3–4 years, so replacement is infrequent.
- Requires medical director approval and a straightforward training protocol.
What data and medicine tell us
FRS confirms what firefighters see every shift: structure fire rescues rarely look like textbook scenarios. Smoke inhalation, toxic exposures, low visibility and incapacitated victims are common. Carrying and using Cyanokit provides a practical, lifesaving extension of traditional fire/EMS rescue, translating “we found you” into “we gave you a fighting chance.
FireRescue1 is using generative AI to create some content that is edited and fact-checked by our editors.
