Lieutenant suffers sudden cardiac death at motor vehicle crash - Ohio.
Authors
Baldwin T; Hales T
Source
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 F2013-23, 2014 Feb; :1-12
On July 1, 2012, a 24-year-old male volunteer lieutenant (LT) was dispatched to a motor vehicle crash at 0208 hours. The LT responded to the fire station where he rode in the fire department's (FD) rescue vehicle to the crash scene. The crashed vehicle had struck a utility pole and slid down an embankment. As crew members were extracting the driver, the LT climbed a 10-foot embankment to retrieve a backboard from the ambulance when he collapsed. He was treated by the on-scene ambulance paramedic and transported to the hospital's emergency department (ED). En route to the ED, the LT suffered cardiac arrest; cardiopulmonary resuscitation (CPR) was begun. Despite CPR and advanced life support (ALS) by ED personnel, the LT died. The death certificate, completed by the deputy county coroner, and the autopsy, completed by the forensic pathologist, listed "cardiopulmonary arrest due to dilated cardiomyopathy" as the cause of death. Prior to this incident the LT was asymptomatic and not known to have any cardiac problems. Given the LT's underlying dilated cardiomyopathy, the physical stress of responding to the call and climbing the embankment may have triggered a fatal heart arrhythmia. The following recommendations would not have prevented the LT's death. Nonetheless, NIOSH investigators offer these recommendations to address general safety and health issues. 1. Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 3. Perform a candidate and an annual physical performance (physical ability) evaluation for all members. 4. Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program. 5. Ensure paramedics are trained and follow proper ALS protocols regarding patient assessment and cardiac monitoring. 6. Ensure that transport vehicles are in proper working order.
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