On December 12, 1998, a 44-year-old male volunteer Assistant Chief responded to a request from the local police department for assistance in conducting a search of a wooded area for a person thought to be suicidal. After approximately 5 minutes of searching for the suspect, the victim suffered a witnessed cardiorespiratory arrest. Resuscitation efforts, begun immediately by EMTs at the scene and continued by paramedics and hospital personnel, were not successful. The death certificate listed an enlarged heart (cardiomegaly) as the cause of death. The autopsy revealed no coronary artery disease, an enlarged heart, and small areas of heart muscle scarring (myocardial fibrosis). The following recommendations address preventive measures that have been recommended by other agencies to reduce, among other things, the risk of on-duty cardiac arrests among fire fighters. It cannot be determined, however, whether these recommendations could have prevented the sudden cardiac arrest and subsequent death of this fire fighter. These recommendations have not been evaluated by the National Institute for Occupational Safety and Health (NIOSH), but represent research presented in the literature, consensus votes of technical committees of the National Fire Protection Association (NFPA), and products of labor/management technical committees within the fire service. This preventive strategy consists of (1) minimizing physical stress on fire fighters; (2) screening to identify and subsequently rehabilitate high-risk individuals; and (3) encouraging increased individual physical capacity (fitness). Steps that could be taken to accomplish these ends include: Emergency response personnel should have annual medical evaluations to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. These evaluations should include an exercise stress test as recommended by NFPA 1582: Reduce risk factors for cardiovascular disease and improve cardiovascular capacity by offering a wellness/fitness program for emergency response personnel.