National Fire Fighter Near-Miss Reporting System: Cardiac Wellness

Living a long and healthy life is a goal all of us seek to achieve. Cardiac related events are often preventable, but don’t always materialize in the heat of battle. However, they often have as much to do with who is a part of our family tree than what we do to ourselves. As this week’s report on firefighter health conveys, knowing your risk factors and working with your physician can be life-saving knowledge. Even when we take care of ourselves, the risk factors that we have little control over can be just as threatening as undiscovered fire in the walls.

Brackets [] denote reviewer de-identification.

“For approximately 5 years, I had been working with my personal physician to reduce my “heart disease” risk factors… Little did I know or understand the significance of heredity. The day before Mother’s Day [year deleted], I drove the rescue squad to a medical emergency only to find upon arrival my mother in full arrest… I didn’t realize at the time that my family medical history was building and its future impact on me. On [date and year deleted], I met with the firefighter in charge of our recruiting drive while he was setting up the trailer. On my way home, I began to feel extremely weak and had chest discomfort. I went home, told my wife that I thought I was having a reaction to the new cholesterol medication that my doctor had just prescribed the day before. I went immediately to the local hospital emergency room…EKG was normal. The blood test results indicated that my “heart enzymes” were slightly elevatedThe doctor said that based on my family history, I needed a cardiac catheter immediately. I was taken to the Heart Hospitalwhere my cardiologist performed the catheter procedure and found my [life threatening blockage]. He implanted stents and advised, subsequent to additional testing, that I would recover fully. In our exit consultation, he emphasized that many people in the population do NOT get the classic signs of a heart attack: chest pain, radiating pain, sweating, shortness of breath, etc. He further stated that if I had not gone to the ER, the discomfort and weakness I experienced would have passed and that the next event would probably have been fatal.

His message to me, which he asked that I share with my fellow firefighters, was the importance of monitoring your risk factors (a process that minimized my event).”

Time and again we hear of someone suffering a “silent” heart attack. Or they go for days with numbness and pain chalked up to indigestion, a pulled muscle, or just being out of shape; then are dropped by a massive MI. Knowing your family history for cardiac events should be a factor in your assessment of unexplained weakness, chest discomfort, or other unexplained ill feeling. Given the high incidence of firefighters suffering cardiac related events, these symptoms should not be ignored. Today’s medical technology includes interventions that save lives every day if action is taken quickly. The reporter’s quick action and his physician’s recognition of heredity turned this potentially fatal event into a near miss that had a positive outcome.

Consider the following:

1. Do you know your full family history relative to all medical issues?
2. Did your last physical include a cardiac stress test?
3. Is your physician aware of the requirements of NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments?
4. How many members of your fire department have experienced a cardiac event? Did the event occur on or off duty?
5. What is your state’s “presumption” law for firefighters?
 

Have you experienced a cardiac event that qualifies as a near miss? Commit a death defying act by telling your story on www.firefighternearmiss.com ; so somebody else will go home because of you.

Note: The questions posed by the reviewers are designed to generate discussion and thought in the name of promoting firefighter safety. They are not intended to pass judgment on the actions and performance of individuals in the reports.

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