Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigationF2016-04 Date Released: August 17, 2016
Executive SummaryOn January 2, 2016, a 47-year old trainee was participating in his fire department’s search and rescue training. After 3 hours in the classroom, practical training began. It involved doing primary searches while wearing full turnout gear and self-contained breathing apparatus (SCBA). After about 1½ hours of practical training, the students took a break. The Trainee sat down, removed his turnout coat, and drank Gatorade®. He became dizzy and lightheaded and laid down onto the floor. He denied having chest pains, sat up, and drank more Gatorade®. He then vomited and became unresponsive.
Dispatch was notified and an ambulance was requested. Ambulance paramedics hooked up a cardiac monitor. It revealed a heart attack. Aspirin was given, the hospital’s emergency department (ED) was notified, and the emergency cardiac catheterization team was mobilized. Upon arrival in the ED, an EKG confirmed a heart attack. The Trainee was taken for emergent cardiac catheterization.
Severe three-vessel coronary artery disease was identified. The Trainee’s distal right coronary artery was occluded. He had several episodes of ventricular fibrillation followed by cardiac arrest. Resuscitation efforts were unsuccessful. The Trainee was pronounced dead by the attending physician.
The death certificate listed “coronary artery disease” as the cause of death. No autopsy was performed. The Trainee’s coronary heart disease (CHD) was undiagnosed prior to this incident. The underlying CHD and the physical stress of the training probably triggered the Trainee’s fatal heart attack.
- Provide preplacement and annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for coronary heart disease (CHD)
- Ensure exercise stress tests (ESTs) are performed on fire fighters at increased risk for CHD
- 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 components of NFPA 1582
- Perform an annual physical ability evaluation
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters