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Instructor-in-charge suffers sudden cardiac death during live fire training - Pennsylvania.

Smith-DL; Hales-T
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 F2011-28, 2012 Oct; :1-14
On September 25, 2011, a 38-year-old male volunteer lieutenant (LT) was serving as the instructor-in-charge during live fire training. The LT spent about 60 minutes setting up the training drills and then spent about 30 minutes debriefing and orienting the instructors and trainees. He was inside the specially designed burn building attending the fires when his low air alarm sounded and he exited the building. After changing his air cylinder, he began debriefing the fire department (FD) chief when he suddenly lost consciousness. Fellow firefighters immediately began cardiopulmonary resuscitation (CPR) and attached an automated external defibrillator (AED) which delivered a series of shocks that did not revive the LT. An ambulance arrived on scene about 12 minutes after the LT collapsed and provided advanced life support (ALS) while en route to the local hospital's emergency department. Despite these efforts, the LT never regained consciousness and was pronounced dead at the hospital at 1120 hours, approximately 40 minutes after losing consciousness. The death certificate and autopsy listed "cardiac dysrhythmia due to hypertrophic cardiomegaly" as the cause of death. Given the underlying heart abnormalities found at autopsy, the moderate-to-heavy physical exertion during the training most likely triggered a sudden cardiac event. The following recommendations probably would not have prevented this LT's death. Nonetheless, NIOSH investigators offer these recommendations to address general safety and health issues: 1. Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Develop a mandatory comprehensive wellness and fitness program to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 3. Perform an annual physical performance (physical ability) evaluation. 4. Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the FD annual medical evaluation program. 5. Provide on-scene emergency medical services with advanced life support and transport capability during live fire training as required in NFPA 1403, Standard on Live Fire Training Evolutions.
Region-3; Fire-fighters; Fire-fighting; Cardiovascular-disease; Cardiovascular-system-disease; Cardiovascular-system-disorders; Heart; Medical-screening; Physical-stress; Physical-fitness
Publication Date
Document Type
Field Studies; Fatality Assessment and Control Evaluation
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
FACE-F2011-28; B10242012
NIOSH Division
Priority Area
Public Safety
SIC Code
Source Name
National Institute for Occupational Safety and Health