The National Institute for Occupational Safety and Health (NIOSH) recently reviewed the 2012 of a California firefighter during physical fitness training.
On April 3, 2012, a 50-year-old male career fire captain (the Captain) was working an 8-hour overtime shift at a remote fire camp. Soon after arriving at the camp, the Captain participated in a morning physical training hike with his crew. The Captain was assigned the “sweeper” position during the hike. At the 1.4-mile point, one crewmember was lagging behind and the Captain advised him to walk faster to finish the hike on time. Approximately 35 minutes later, the crew became aware that the Captain had not yet returned to camp and a search party was assembled. Approximately 23 minutes later, the crew found the Captain unconscious along the trail. Dispatch was notified and a helicopter, an engine, and an advanced life support squad were sent to the scene. Despite cardiopulmonary resuscitation and advanced life support on the scene, in transport, and at the hospital’s emergency department (ED), the Captain died at 1220 hours. The autopsy revealed “coronary atherosclerosis,” but “no acute intraluminal coronary thrombus” suggesting an acute heart attack did not occur and normal vitreous chemistries suggesting the Captain was not dehydrated. The coroner’s office attributed the cause of death to “atherosclerotic heart disease.” Given the Captain’s underlying coronary heart disease (CHD) disease, NIOSH investigators concluded that the physical stress of the physical fitness training probably triggered a primary cardiac arrhythmia causing his sudden cardiac death.
NIOSH investigators offer the following recommendations, although it unclear if this recommendation would have prevented the Captain’s death.
- Review County policies regarding work restrictions for firefighters with coronary heart disease identified by various screening tests and risk assessment models/databases.
The following recommendations would not have prevented the Captain’s death, but are offered to strengthen the already impressive FD safety and health program.
- Provide annual medical evaluations to ALL firefighters consistent with NFPA 1582 or the IAFF/IAFC Wellness Fitness Initiative.
- Perform an annual physical performance (physical ability) evaluation for all members.
- Discontinue exercise stress tests on asymptomatic firefighters who are at low risk for coronary heart disease (CHD).
- Discontinue routine screening chest x-rays for members, unless clinically indicated.
Read the full report at http://www.cdc.gov/niosh/fire/reports/face201214.html
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