Fatality Assessment and Control Evaluation (FACE) Report: Fire Apparatus Operator Suffers Sudden Cardiac Death During Physical Fitness Training - Hawaii.

摘要

On January 18, 2012, a 50-year-old male career fire apparatus operator (FAO) was working a 24-hour shift. During the day he responded to one emergency call, a reported structure fire near his home. Later that afternoon, the FAO began working out as part of the FD's wellness/fitness program. Approximately 3 hours later a crew member found the FAO unresponsive in the station's exercise room. CPR was initiated, and an automated external defibrillator (AED) was placed, but no shock was advised. Approximately 2 minutes later, paramedics arrived, assessed the FAO, and concluded that the FAO had been dead for a significant time. They pronounced him dead. The death certificate and autopsy listed 'ischemic heart disease due to hypertensive and kidney disease and an old myocardial infarction' as the cause of death. Given the FAO'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. It is unclear whether these recommendations could have prevented the FAO's death, however his underlying cardiac disease may have been identified sooner, possibly allowing for further evaluation and treatment. (1) Provide annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. (2) Ensure on-duty fire fighters exercise in pairs or within viewing/hearing distance of another crew member. The following recommendations would not have prevented the FAO's death, but they address safety and health issues that all fire departments should consider. (1) Phase in a mandatory comprehensive wellness and fitness program for fire fighters. (2) Perform an annual physical performance (physical ability) evaluation for all members. (3) Discontinue lumbar spine x-rays as a screening test administered during the preplacement medical evaluation.