On February 12, 2003, a 46-year-old male career Fire Fighter Recruit was performing the tower climb portion of his fire fighter recruit training. After reaching the sixth (top) floor of the training tower for the third time that morning, he began to have leg and neck pain. The pain was severe enough that crew members carried him down the stairs and onto the sidewalk. Shortly thereafter, he lost consciousness. Crew members assessed him and found him to be unresponsive, not breathing, and pulseless. Approximately 37 minutes later, despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) administered on-scene and at the hospital, the Recruit died. The autopsy revealed "cardiac hypertrophy," "biventricular dilatation" and "cardiomegaly." The death certificate listed "cardiac hypertrophy" as the immediate cause of death. The following recommendations address some general health and safety issues. This list includes some preventive measures that have been recommended by other agencies to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters. These selected recommendations have not been evaluated by NIOSH, but represent published research, or consensus votes of technical committees of the National Fire Protection Association (NFPA) or fire service labor/management groups: 1) Consider incorporating exercise stress tests at part of the Fire Department's medical evaluation program; 2) Equip training instructors with portable radios; 3) Ensure defibrillation equipment is readily available for emergency use during training; 4) Use a secondary (technological) test to confirm appropriate placement of the endotracheal (ET) tube during emergency intubations; 5) Ensure ET tube is firmly secured in place to prevent dislodgement after intubation; 6) Although unrelated to this fatality, the Fire Department should consider these additional recommendations based on health and economic considerations; 7) Conduct mandatory annual medical evaluations consistent with NFPA 1582 on ALL fire fighters to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others; 8) Discontinue the routine use of annual chest x-rays for the Hazmat and Medical Strike Teams unless specifically indicated; 9) Provide fire fighters with clearance to wear self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program; 10) Phase-in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity.
Region-6; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-function-tests; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Fire-fighters; Medical-examinations; Medical-monitoring; Medical-screening; Occupational-health; Occupational-health-programs