On January 7, 2005, a 41-year-old male career Fire Equipment Operator (FEO) responded to a medical call for an unconscious person. Arriving on the scene, he entered the dwelling and found a person who had been deceased for quite some time. Shortly after exiting the dwelling, he lost consciousness. He regained consciousness when the ambulance arrived and was transported to the hospital's emergency department (ED). In the ED, he was noted to have an acute heart attack and emergent cardiac catheterization and angioplasty were performed. Despite these procedures and other advanced life support (ALS) measures, the FEO died 13 days later. The death certificate, completed by the attending physician, listed "myocardial infarction" due to "renal failure" due to "stroke" as the cause of death. No autopsy was performed. The NIOSH investigator concluded that the physical stress of responding to the alarm and his underlying atherosclerotic coronary artery disease (CAD) probably contributed to this FEO's heart attack and death. NIOSH investigators offer the following recommendations to prevent similar incidents or to address general safety and health issues: 1. Consider conducting maximal (symptom-limiting) exercise stress tests (EST) for fire fighters with two or more risk factors for CAD. 2. Phase in a MANDATORY wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 3. 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. 4. Perform an autopsy on all on-duty fire fighter fatalities. 5. Staff fire stations with a minimum of two fire fighters.
Region-4; 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; Cerebrovascular-system-disorders; Kidney-disorders