On March 16, 2005, a 39-year-old male volunteer Sergeant (SGT) was preparing a physical ability course for search and rescue training at an acquired structure. Wearing full turnout gear and self-contained breathing apparatus (SCBA), the SGT and a crew member completed the course and sat down for about 5 minutes. Both fire fighters stood up and the SGT suddenly collapsed. The crew member assessed the SGT and finding him semi-responsive, ran next door to notify the ambulance service. Emergency medical service (EMS) personnel responded, cardiopulmonary resuscitation (CPR) was performed, advanced life support (ALS) treatment was given, and the SGT was transported to the local hospital's emergency department (ED). In the ED, ALS treatment continued for 30 additional minutes. Despite these measures, the SGT died. The death certificate, completed by the attending physician, listed "acute myocardial infarction (MI)" as the cause of death. The autopsy, completed by the Medical Examiner, listed "hypertensive/ischemic cardiovascular disease (CVD)" as the cause of death. The NIOSH investigator concluded that the SGT's sudden cardiac death was due to his underlying hypertensive/ischemic CVD, probably triggered by the physical exertion associated with performing search and rescue training. NIOSH investigators offer the following recommendations to prevent similar incidents, or to address general safety and health issues: 1. Provide pre-placement and 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. Consider conducting exercise stress tests (ESTs) for male 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 CVD and improve cardiovascular capacity. 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. Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of the National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments (FDs).
Region-4; Fire-fighters; Emergency-responders; Cardiovascular-disease; Cardiovascular-system-disease; Cardiovascular-system-disorders; Cardiac-function; Cardiovascular-function; Medical-examinations; Medical-screening; Physical-stress; Physical-fitness; Cardiovascular-system; Medical-monitoring; Fire-fighting-equipment; Self-contained-breathing-apparatus; Respiratory-protective-equipment; Respirators; Personal-protective-equipment; Protective-clothing; Protective-equipment