Fatality Assessment and Control Evaluation (FACE) Report: Wildland Fire Fighter Trainee Suffers Sudden Cardiac Death During Physical Fitness Exercise - California.

摘要

In 2011, a 54-year old State inmate was accepted into the State's 'Conservation Camps' program which trains inmates for wildland fire suppression. On January 4, 2012, the trainee was participating in a physical fitness exercise which involved hiking in moderately steep terrain while wearing wildland personal protective equipment (PPE) and carrying handtools. The PPE and the tools weighed approximately 18 pounds. As the Trainee completed the exercise, the crew leader determined he needed medical attention and called for an ambulance. While awaiting an ambulance, the Trainee's condition deteriorated and he became unresponsive. Cardiopulmonary resuscitation (CPR) was begun and 15 minutes later an automated external defibrillator (AED) from the responding engine arrived and advised no shock. Approximately 3 minutes later, the ambulance with paramedics arrived and provided advanced life support (ALS). Despite CPR and ALS in the ambulance and in the local hospital's emergency department (ED), the Trainee died. The autopsy report listed 'acute myocardial infarction due to atherosclerotic coronary artery disease' as the cause of death. Given the Trainee's underlying cardiovascular disease, NIOSH investigators concluded that the physical stress of physical fitness training probably triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues and to prevent future similar events. (1) Provide preplacement and annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, and NFPA 1051, Standard for Wildland Fire Fighter Professional Qualifications. (2) Make basic life support equipment, including an AED, readily available during strenuous training exercises. (3) Provide fire fighters with medical clearance to wear a respirator as part of the Fire Department's medical evaluation program. (4) Provide annual respirator fit testing for fire fighters who wear respirators.