On May 6, 2007, a 54-year-old male volunteer Fire Fighter (FF) responded to a fire in a large machine shed. While operating an external attack hose line for about 20 minutes, the FF collapsed. Cardiopulmonary resuscitation (CPR) was begun immediately by on scene emergency medical service (EMS) personnel. An automated external defibrillator (AED) was retrieved from the on scene ambulance and attached to the FF within two minutes of his collapse. Two defibrillations were delivered without a change in the FF's condition. Advanced life support was administered en route to the hospital, and in the hospital's emergency department. Despite these efforts, the FF could not be revived. The death certificate and the autopsy listed "Coronary Atherosclerosis" as the immediate cause of death. The NIOSH investigator considered that responding to the fire alarm and the physical effort needed to sustain the exterior fire suppression could have triggered a probable heart attack and the subsequent sudden cardiac death of this FF. It is unclear if any of the following recommendations could have prevented the death of this FF at this time. Nonetheless, NIOSH offers the following recommendations to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters at this, and other, fire departments across the country. 1. Provide mandatory pre-placement and period medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) Standard 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 3. Provide fire fighters with medical clearance to wear self-contained breathing apparatuses (SCBAs) as part of the fire department's medical evaluation program. 4. Develop a comprehensive wellness/fitness program for fire fighters to reduce risk factors for cardiovascular (CVD) and improve cardiovascular capacity.
Region-5; Fire-fighters; Fire-fighting; Emergency-responders; Cardiovascular-disease; Cardiovascular-system-disorders; Cardiovascular-system-disease; Cardiac-function; Heart; Cardiovascular-function; Medical-examinations; Medical-screening; Physical-stress; Physical-fitness; Cardiovascular-system; Medical-monitoring