On March 22, 2003, a 62-year-old male volunteer Fire Fighter (FF) responded to a structural fire. The FF had conducted fire suppression activities on-scene for about 29 minutes when he began complaining of difficulty breathing and fatigue. He presented himself to the on-scene ambulance, where he suddenly collapsed. Approximately 20 minutes later, despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) administered on-scene, en route, and at the hospital, the FF died. The autopsy report, completed by a pathologist, stated the FF "died of acute, occlusive thrombosis of the left circumflex coronary artery secondary to coronary artery atherosclerosis." The physical stress of fire fighting and the underlying atherosclerotic coronary artery disease (CAD) contributed to this fire fighter's cardiac arrest and sudden death. The first four recommendations below 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 next recommendation addresses a potential safety issue related to this particular event. The final recommendation addresses a potential safety issue unrelated to this particular event. 1. Conduct pre-placement and periodic medical evaluations to determine medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. 2. Conduct Exercise Stress Test (EST) for FFs with two or more risk factors for CAD. 3. Phase in a mandatory wellness/fitness program for FFs to reduce risk factors for cardiovascular disease and improve cardiovascular conditioning. 4. Perform pre-placement and annually, a physical performance (physical ability) evaluation on ALL FFs to ensure they are physically capable of performing the essential job tasks of structural fire fighting. 5. Ensure that FFs are cleared for duty by a physician knowledgeable about the physical demands of fire fighting and the various components of National Fire Protection Association (NFPA) 1582 and that the results of the exam are discussed with the FF. 6. Provide FFs with medical evaluations and clearance to wear self-contained breathing apparatus (SCBA).
Region-5; 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