On December 25, 2003, a 51-year-old male career Assistant Chief (AC) responded to a supervisory (trouble) fire alarm in a five-story building. After walking up four flights of stairs to the fifth floor, he checked the smoke detector that was showing "trouble" on the alarm panel. Since no fire was present, he walked down the same stairs and exited the building. At the same time he complained of feeling "ill." After returning to the fire station, he complained of severe back and chest pains and he was transported to a local hospital's emergency department (ED) for evaluation. Testing revealed a possible aortic aneurysm dissection and he was flown to a regional hospital for surgery. Despite corrective surgery, 6 days post-operatively he suffered another heart attack (myocardial infarction). Despite being successfully resuscitated, he suffered anoxic brain damage. Life support machines were disconnected on December 31, 2003, and he was pronounced dead shortly thereafter. The death certificate, completed by the attending physician, listed "multi-organ system dysfunction" due to "cardiac arrest" as the immediate cause of death with "aortic dissection" as a significant condition. No autopsy was performed. The first three 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 fourth recommendation is made in accordance with fire service medical guidelines. The fifth recommendation addresses a potential safety issue related to this particular event. The final recommendation addresses the need to obtain vital medical information regarding this particular event. 1. Perform mandatory annual medical evaluations consistent with NFPA 1582 to determine fire fighters' medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. 2. Incorporate exercise stress tests into the FD's periodic medical evaluation program. 3. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 4. Discontinue routine annual electrocardiograms (EKG) unless medically indicated. 5. Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting. 6. Perform an autopsy on all on-duty fire fighter fatalities.
Region-1; 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