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Lieutenant suffers sudden cardiac death at scene of a brush fire - Missouri.

Smith DL; Hales T
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2010-01, 2010 Mar; :1-14
On March 14, 2009, a 49-year-old career Lieutenant (LT) responded to a brush fire as a "paid on-call" fire fighter. Once on-scene, he worked with hand tools for approximately 50 minutes to bring the fire under control. Approximately 10 minutes after the fire was reported under control the LT collapsed. Fellow firefighters began cardiopulmonary resuscitation (CPR) and moved the LT to the roadway where an automated external defibrillation (AED) was available. One shock was delivered without a change in the LT's clinical condition. An ambulance crew arrived on-scene approximately 15 minutes after the collapse, followed 5 minutes later by an air flight ambulance. The LT was intubated prior to transport and advanced life support (ALS) measures continued during the flight to the hospital's emergency department (ED). The LT arrived in the ED at 1534 hours, and ALS continued without change in the LT's condition. Approximately one hour after his collapse, the LT was pronounced dead and resuscitation efforts were discontinued. The death certificate listed "myocardial infarction [heart attack]" as the cause of death with "atherosclerotic coronary vascular disease" as a contributing condition. NIOSH investigators agree with this assessment and conclude that the heavy physical exertion associated with fighting the brush fire triggered the LT's sudden cardiac death. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this, and other FDs, across the country. 1. Provide mandatory pre-placement and periodic medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) 1582. 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. Develop a comprehensive wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease (CVD) and improve cardiovascular capacity. 4. Ensure that an automated external defibrillator (AED) is available at all emergency responses and planned training. 5. Perform a preplacement and an annual physical performance (physical ability) evaluation. 6. Provide fire fighters with medical clearance to wear SCBA as part of the Fire Department's medical evaluation program.
Region-7; Fire-fighters; Emergency-responders; Accident-analysis; Accident-prevention; Accidents; Cardiovascular-disease; Cardiovascular-system-disease; Cardiovascular-system-disorders; Physical-fitness; Medical-screening
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Field Studies; Fatality Assessment and Control Evaluation
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Services: Public Safety
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National Institute for Occupational Safety and Health
Page last reviewed: September 22, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division