Firefighter/Paramedic Dies of Sudden Cardiac Event at Home Following Shift—Illinois
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2016-10 Date Released: August 1, 2016
Executive Summary
On January 10, 2016, a 56-year-old male career firefighter/paramedic (FF/P) worked a 24-hour shift. He responded to several calls including a vehicle fire, medical call, and activated alarm. The following day, he worked with the Fire Prevention bureau for over 6 hours. In the evening, the FF/P shoveled snow at his home and then went to his bedroom. His family found him unresponsive in his bed 10–15 minutes later. They started cardiopulmonary resuscitation (CPR). Emergency medical services (EMS) found the FF/P unresponsive, pulseless, and not breathing. He was in asystole (no heart rhythm). On scene and enroute to the emergency department (ED), EMS provided CPR and advanced cardiac life support measures. ED staff treated the FF/D without success for 35 minutes and pronounced him dead at 2147 hours.
The autopsy report listed hypertensive-arteriosclerotic cardiovascular disease as the immediate cause of death. The report listed diabetes mellitus and obesity as contributing conditions. Autopsy findings included cardiomegaly, biventricular myocardial thickening, and left ventricular dilation. Two main arteries had calcified atherosclerotic plaque. The left anterior descending artery had significant stenosis. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the physical stress of shoveling snow likely triggered the sudden cardiac event. Given his uncontrolled diabetes mellitus and other cardiovascular disease risk factors, a more careful evaluation for fitness for firefighting duty, including a full medical evaluation consistent with National Fire Protection Association (NFPA) 1582 was needed.
Key Recommendations
- Ensure that all firefighters receive an annual medical evaluation consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.
- Incorporate exercise stress tests (ESTs) into the fire department medical evaluation program for firefighters at increased risk for coronary heart disease.
- Phase in a mandatory comprehensive wellness and fitness program for firefighters.
- Perform an annual physical performance (physical ability) evaluation.