Form
Form - Event Triage Record
Document FSSMS-FRM-47Stage 1Revision 3Version 0.3.3
Topic pages open on your jurisdiction, and requirements tables show its line. You can change this on any page.
Completed by the Triage Group for every reported event above a clear Tier 1, within 24 hours or by the next business day of the report. Clear Tier 1 events (a routine working fire, a drill, a good catch with an obvious fix) are confirmed on the shared daily log instead. The record shows which trigger set the tier, who decided, whether anyone asked for a higher tier, and whether the three closing checks were done (Incident Investigation and Learning Program element 5.3; The Human Factor, 2026a); the full method is in Manual 02 - The Three Tiers and Event Triage. The triage step is the department’s classification of incidents, including near misses, that the incident investigation standard requires a program to plan (CSA Z1005:21, cl. 4.4).
| # | Field | Entry |
|---|---|---|
| 1 | Event reference (from the report) and one-line description | |
| 2 | Report received (date, time, route) | |
| 3 | Triage conferred (date, time, method: call / message / meeting) | |
| 4 | Triage Group present (roles): senior officer on duty ____ ; health and safety officer ____ ; JOHSC worker co-chair or designate ____ ; backups used (roles) ____ | |
| 5 | Tier 1 triggers met (tick): ☐ significant call ☐ working fire ☐ multi-unit or multi-agency ☐ exercise or live fire ☐ good catch ☐ someone asked | |
| 6 | Tier 2 triggers met (tick): ☐ near miss with potential for death or critical injury (mayday, collapse close call, lost member, fall arrested, out of air) ☐ lost-time injury ☐ statutory-list event ☐ emergency vehicle collision with injury or significant damage ☐ significant operational failure (accountability lost, water supply failed, command not established, RIT not in place) ☐ patient harm ☐ workplace violence injury ☐ refusal or stop-work not resolved on scene ☐ repeated Tier 1 issue | |
| 7 | Tier 3 triggers met (tick): ☐ death or critical injury ☐ senior leaders’ decisions in scope ☐ low trust or either side requests independence ☐ multiple agencies with shared responsibility ☐ major external scrutiny expected ☐ recurrence after earlier recommendations ☐ no independent Tier 2 capacity | |
| 8 | Tier set (highest trigger met): ☐ 1 ☐ 2 ☐ 3 | |
| 9 | Higher tier requested by anyone? (yes / no; by whom, by role; outcome and reason) | |
| 10 | De-escalation below the indicated tier? (yes / no; reasons; unanimous: yes / no). If not unanimous, the higher tier stands | |
| 11 | Closing check 1: statutory reporting done or not required, against the clocks your jurisdiction sets (J08 Incident Reporting and Investigation) (regulator date-time; WCB date; JOHSC notified date) | |
| 12 | Closing check 2: support offered to the people involved (date; by whom, by role; peer support / psychological first aid / EFAP) | |
| 13 | Closing check 3: scene, equipment and records preserved where needed (what; where; by whom) | |
| 14 | Tier 2: sponsor named (role, date); lead facilitator named (role, date); terms of reference due (date, within 72 hours of triage) | |
| 15 | Tier 3: fire chief informed (date, time); independent reviewer engaged (date, within five working days); oversight group (roles, including bargaining agents and volunteer association) | |
| 16 | Tier 1: officer responsible for the AAR (role); AAR due (date, within 72 hours) | |
| 17 | Interim controls needed now? (what; owner by role; register reference) | |
| 18 | Related program(s) and station(s) | |
| 19 | Next review of this record (date) | |
| 20 | Recorded by (role), date |
| Field | Type | Required | Who completes |
|---|---|---|---|
| Event reference; description | Lookup; free text | Yes | HSO |
| Report received | Date-time; choice | Yes | HSO |
| Triage conferred | Date-time; choice | Yes | HSO |
| Group present; backups | Roles (lookup) | Yes | HSO |
| Tier 1 triggers | Multiple choice | Yes | Triage Group |
| Tier 2 triggers | Multiple choice | Yes | Triage Group |
| Tier 3 triggers | Multiple choice | Yes | Triage Group |
| Tier set | Single choice | Yes | Triage Group |
| Higher tier requested | Yes/no; role; free text | Yes | Triage Group |
| De-escalation | Yes/no; free text; yes/no unanimous | Yes | Triage Group |
| Closing check 1: statutory | Date-times; references | Yes | HSO |
| Closing check 2: support | Date; role; choice | Yes | Senior officer on duty |
| Closing check 3: preservation | Free text | Yes | Senior officer on duty |
| Tier 2 sponsor, facilitator, ToR due | Roles; dates | Yes if Tier 2 | Senior officer responsible for H&S |
| Tier 3 chief informed, reviewer engaged, oversight | Date-times; roles | Yes if Tier 3 | Fire chief |
| Tier 1 officer, AAR due | Role; date | Yes if Tier 1 | HSO |
| Interim controls | Free text; role; reference | No | Triage Group |
| Related program, station | Lookup | Yes | HSO |
| Next review | Date | Yes | HSO |
| Recorded by, date | Role; date | Yes | HSO |
| Date | Event reference | One line | Tier 1 confirmed by (roles) | AAR officer | AAR due |
|---|---|---|---|---|---|
Kept with the event file in {{Records system}}; summarized to the JOHSC at each meeting; counted for the triage-within-24-hours indicator.
This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.
| Topic | What to check in your jurisdiction | Page |
|---|---|---|
| Incident Reporting and Investigation | Which deaths, injuries and no-injury events must be reported to the regulator and how fast, who else must be told (such as the committee), the employer’s deadline to report to the compensation board, and the duty to preserve the scene | J08 Incident Reporting and Investigation |
CSA Group. (2021). CSA Z1005:21 (R2026), Workplace incident investigation. https://www.csagroup.org/store/product/CSA%20Z1005:21/
The Human Factor. (2026a). After the Call, Manual 02: The three tiers and event triage [Unpublished manuscript].