Fatality Assessment and Control Evaluation (FACE) Report: Volunteer Fire Chief Suffers Cardiac Arrest at Brush Fire in North Carolina.

摘要

On March 3, 2013, a 44-year-old Fire Chief experienced coughing, shortness of breath, and difficulty breathing while functioning as incident commander at a brush fire. The Chief drove himself to an on-scene ambulance and requested assistance. On-scene emergency medical service (EMS) personnel performed an initial assessment, initiated care, and began transport. En route to the emergency department (ED), the Chief suffered cardiac and respiratory arrest. Despite cardiopulmonary resuscitation (CPR) in the ambulance for about 60 minutes, the Chief died. The death certificate and autopsy report, both completed by the County Medical Examiner's office, listed the cause of death as 'atherosclerotic and hypertensive cardiovascular disease.' The autopsy revealed a massively enlarged heart with severe coronary atherosclerosis. Given the presentation of his illness and his underlying heart disease discovered at autopsy, the Chief's respiratory distress was probably due to acute exacerbation of undiagnosed heart failure, precipitated by any of the following: a hypertensive crisis, ischemia, a heart attack, or a primary arrhythmia. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country.