On April 15, 2004, a 57-year-old male career Acting Fire Chief worked his normal 10-hour shift, during which he participated in union negotiations. Throughout the day, he complained of not feeling well, and, after going home, his symptoms worsened. He telephoned his fire station and requested transport to the hospital. Thirty-eight minutes later, as the ambulance arrived at the hospital's emergency department (ED), he suffered cardiac arrest. Despite advanced life support (ALS) performed by ambulance service emergency medical technicians (EMTs) and paramedics and hospital emergency department (ED) personnel, he died. The death certificate listed "cardiac event" as the immediate cause of death. No autopsy was performed. The NIOSH investigator concluded that a heart attack was the most likely cause of death. The first five recommendations are preventive measures recommended by other fire service groups to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters. The last recommendation is made to ensure adequate medical information is available on which to base prevention programs: 1. Provide pre-placement and periodic medical evaluations to ALL fire fighters consistent with NFPA 1582 to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others; 2. Conduct exercise stress tests (EST) for fire fighters with two or more risk factors for coronary artery disease (CAD); 3. Provide fire fighters with medical evaluations and clearance to wear SCBA; 4. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity; 5. Ensure the City-contract physician reviews all "return to work" clearances for both on and off-the-job injuries; and, 6. Perform an autopsy on all on-duty fire fighter fatalities.
Region-10; 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