On August 8, 2003, a 37-year-old male recruit fire fighter (hereafter known as the Recruit) died and four others suffered skin burns and heat exhaustion while participating in their first live-fire training exercise. The training took place in a simulated marine vessel. After completing most of the evolution, the Recruit became separated from his squad as they were returning to the entrance/exit door. All recruits and instructors had exited the structure when the training staff realized a recruit was missing. The structure was "opened up" and the Recruit was found unconscious in cardiopulmonary arrest. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) at the scene, in the ambulance, and in the emergency department of the local hospital, the Recruit died. An autopsy conducted by the County Office of the Medical Examiner concluded the cause of death to be "cardiac arrhythmia" due to "exposure to heat" with "AV node artery stenosis and mild myocarditis" as contributory causes. Findings of the NIOSH investigation support this conclusion. The extreme heat stress could have been avoided if strict compliance with National Fire Protection Association (NFPA) 1403, Standard on Live Fire Training Evolutions, had been followed.1 To reduce the risk of similar occurrences, the fire department (FD) should take the following actions: 1. Ensure the Fire Department's Occupational Safety and Health Bureau (OSHB) provides oversight on all Recruit Training Bureau (RTB) safety issues, including live-fire training. 2. Provide the Training Division, and specifically the RTB, with adequate resources, personnel, and equipment to accomplish their training mission safely. 3. Create a training atmosphere that is free from intimidation and conducive for learning. 4. Conduct live-fire training exercises according to the procedures of the most recent edition of NFPA 1403, Standard on Live Fire Training Evolutions. 5. Ensure that Standard Operating Procedures (SOPs) specific to live-fire training are developed, followed, and enforced. 6. Ensure that team continuity is maintained during training operations. 7. Ensure that fire command always maintains close accountability for all personnel operating on the fireground. 8. Ensure coordinated communication between the Incident Commander and fire fighters. 9. Equip all live-fire participants, including recruits, with radios and flashlights. 10. Establish an on-scene rehabilitation unit consistent with NFPA 1584. 11. Report and record all work-related injuries and illnesses.
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; Occupational-hazards; Training; Heat-stress; Heat-exposure; Surveillance