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Captain collapses at a structure/grass fire and dies 9 days later - Oklahoma.

Authors
Baldwin-T; Hales-T
Source
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2011-24, 2012 Feb; :1-15
NIOSHTIC No.
20040345
Abstract
On July 29, 2011, a 53-year-old male career fire department captain ("the Captain") was on call when the fire department (FD) was dispatched to a grass/structure fire. At the scene, the Captain assisted in exterior fire suppression operations of the dwelling and the surrounding grass for about 13 minutes. Shortly after the fire was extinguished, the Captain suddenly collapsed. Crew members notified dispatch to request an ambulance and a medical evacuation helicopter while cardiopulmonary resuscitation (CPR) was begun. Advanced life support was provided by the ambulance service and medical helicopter personnel at the scene and during transport to the local hospital emergency department (ED). Prior to arrival at the ED, the Captain's pulse returned, but he never regained consciousness. An acute heart attack was diagnosed in the ED. The Captain was flown to a regional hospital for emergency cardiac catheterization, but the procedure was not performed because of his poor hemodynamic status. Because of the prolonged period of cardiac arrest and resuscitation efforts, the Captain suffered brain damage from lack of oxygen and had a very poor prognosis. In consultation with the Captain's family, on August 7 the decision was made to remove him from life support; he died 1 hour later. The death certificate listed "anoxic encephalopathy due to myocardial infarction due to smoke inhalation due to fighting a grass fire" as the cause of death. No autopsy was performed. Given the Captain's probable underlying coronary artery disease, NIOSH investigators concluded that the physical stress of fire suppression activities triggered his initial cardiac event. NIOSH investigators offer the following recommendations to address general safety and health issues. If in place before this incident, these recommendations may have prevented the Captain's death. 1. Provide annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Ensure that fire fighters are cleared for return to 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. 3. Provide automated external defibrillators (AEDs) as part of the basic life support equipment on all fire apparatus. The following recommendations would not have prevented the Captain's death, but they address safety and health issues that all fire departments should consider. 1. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 2. Perform an annual physical performance (physical ability) evaluation for all members. 3. Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube. 4. Request that carboxyhemoglobin levels be measured on symptomatic or unresponsive fire fighters exposed to fire smoke. 5. Perform an autopsy on all on-duty fire fighter fatalities.
Keywords
Region-6; Fire-fighters; Emergency-responders; Cardiovascular-disease; Cardiovascular-system-disease; Cardiovascular-system-disorders; Physical-fitness; Medical-screening; Physical-stress; Training; Personal-protective-equipment; Fire-fighting-equipment
Publication Date
20120201
Document Type
Field Studies; Fatality Assessment and Control Evaluation
Fiscal Year
2012
NTIS Accession No.
PB2012-105523
NTIS Price
A03
Identifying No.
FACE-F2011-24; B02292012
NIOSH Division
DSHEFS
Priority Area
Public Safety
SIC Code
NAICS-92
Source Name
National Institute for Occupational Safety and Health
State
OK; OH
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