On February 4, 2004, a 52-year-old male volunteer Fire Fighter (FF) responded to two false alarms and performed station duties throughout the day, including repacking the speed lay (preconnected crosslay) on a fire engine. After he backed the engine into the fire station at approximately 1525 hours, he complained of not feeling well and having chest pain. The FF declined an offer to be driven to the nearby first aid building. While a crew member went to obtain some water for the FF, the FF suffered a witnessed collapse. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) performed by crew members, a police officer, ambulance service emergency medical technicians (EMTs) and paramedics, and hospital emergency department (ED) personnel, the FF died. The death certificate, completed by the Medical Examiner, listed "arteriosclerotic cardiovascular disease" (CAD) as the cause of death. No autopsy was performed. The NIOSH investigator concluded the physical stress of repacking the hose load and the FF's underlying arteriosclerotic CAD contributed to his sudden cardiac death. The following recommendations are preventive measures recommended by other fire service groups to reduce, among other things, the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters. These recommendations are listed in order of priority. 1. Provide pre-placement and annual medical evaluations to ALL fire fighters to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. 2. Consider conducting exercise stress tests for male fire fighters over the age of 45 years with two or more risk factors for coronary artery disease. 3. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 4. Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582, Standard on Comprehensive Occupational Medicine Program for Fire Departments. 5. Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting. 6. Use a secondary (technological) test to confirm appropriate placement of the endotracheal (ET) tube during emergency intubations. 7. Perform an autopsy on all on-duty fire fighter fatalities.
Region-2; Cardiovascular-system-disease; Heart; Physical-stress; Physical-fitness; Fire-fighters; Emergency-responders; Medical-screening; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system; Cardiovascular-system-disorders; Medical-examinations; Medical-monitoring; Medical-screening