On August 6, 2000, a 27-year-old male Fire Fighter (FF) was performing physical fitness training alone in the exercise room of his fire station after the end of his 24-hour shift. After the FF had been in the exercise room approximately 43 minutes, crewmembers found him on the floor experiencing a grand mal seizure. Seizure activity was witnessed for about 20 seconds followed by 30 seconds of post-seizure (post-ictal) activity, during which the victim was making purposeful movements but not responding to commands. Shortly thereafter, he slumped backwards. Vital signs revealed no pulse or respirations. Cardiopulmonary resuscitation (CPR) and advanced life support (ALS) resuscitation efforts were begun immediately. Despite CPR and ALS administered by crewmembers, the ambulance paramedics, and by hospital personnel in the emergency department (ED), the FF died. Both the autopsy and death certificate were completed by a pathologist with the County Medical Examiner's Office. They both listed arteriosclerotic heart disease as the cause of death while the autopsy also noted hypertensive heart disease. Given the cause of death, it is unlikely the Fire Department (FD) could have done anything to prevent the tragic and untimely death of this FF. Therefore, the following recommendations address general health and safety issues identified during the National Institute for Occupational Safety and Health (NIOSH) evaluation. This list includes some preventive measures that have been recommended by other agencies to reduce the risk of sudden cardiac arrest and or death among fire fighters. These recommendations have not been evaluated by NIOSH, but represent research presented in the literature or of consensus votes of Technical Committees of the National Fire Protection Association (NFPA) or labor/management groups within the fire service. Issues relevant to this Fire Department (FD) include: 1. The FD should negotiate with the local union to convert their voluntary wellness/ fitness program for fire fighters to a mandatory program to reduce risk factors for cardiovascular disease and improve cardiovascular capacity; and, 2. During annual medical evaluations, discontinue the routine use of biannual chest x-rays.
Region-7; 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; Medical-screening