On April 20, 2005, a 38-year-old male career Driver/Operator (D/O) responded to an alarm. Finding a falsely activated pull station, his engine company went back into service. Just as another call came in, the engine began to veer off the road. As the D/O collapsed over the steering wheel, the engine's Lieutenant (LT) climbed over the console and stopped the engine. Crew members extricated the D/O and notified Dispatch, who dispatched an ambulance and additional fire department (FD) units. Cardiopulmonary resuscitation (CPR) was performed, advanced life support (ALS) treatment was given, and the D/O was transported to the local hospital's emergency department (ED) for further treatment. Despite these measures, the D/O died. The death certificate and autopsy, completed by the Medical Examiner, listed "acute subarachnoid hemorrhage" due to "rupture of sacular cerebral aneurysm" as the cause of death with "focal coronary artery atherosclerosis" as a significant condition. The NIOSH investigator concluded that the D/O's death was due to a ruptured cerebral aneurysm possibly triggered by some physical exertion earlier in the day and/or responding to the fire alarms. The following recommendations are unlikely to have prevented this D/O's death. However, if implemented, the FD could reduce the risk of future cardiovascular events among its members. 1. Provide annual medical evaluations to 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. 2. Negotiate with the local union to phase in a MANDATORY wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 3. 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. 4. Provide automated external defibrillators (AEDs) as part of the basic life support equipment for fire apparatus. 6. Discontinue lumbar spine x-rays as a screening test administered during the pre-placement medical evaluation.
Region-4; Fire-fighters; Emergency-responders; Cardiovascular-disease; Cardiovascular-system-disease; Cardiovascular-system-disorders; Cerebrovascular-system; Cerebrovascular-system-disorders; Cardiac-function; Cardiovascular-function; Medical-examinations; Medical-screening; Physical-stress; Physical-fitness; Cardiovascular-system; Medical-monitoring