Fatality Assessment and Control Evaluation (FACE) Report: Fire Fighter Suffers Heart Attack During Structural Fire Fighting Operations and Dies 8 Days Later in Kentucky

摘要

On June 30, 2011, a 49-year-old male volunteer fire fighter (FF) responded to a residential structure fire. The FF, wearing full turnout gear and self-contained breathing apparatus (SCBA) on-air, climbed a 14-foot ladder to the second floor and performed exterior and interior fire suppression activities for about 30 minutes. After the fire was brought under control, he started to perform overhaul (mop-up) operations on the second floor when he suddenly collapsed. Crew members carried the FF down the stairs and outside the dwelling. Cardiopulmonary resuscitation (CPR) was begun as an ambulance was requested. The ambulance arrived, advanced life support was provided, and the FF was transported to the local hospital's emergency department (ED). In the ED, the FF regained a pulse but remained minimally responsive and was flown to a regional hospital where angioplasty was performed. Over the next 8 days, his condition did not improve and, after consulting with the family, the decision was made to remove the FF from life support. The attending physician pronounced him dead at 0434 hours on July 8, 2011. The death certificate listed 'myocardial infarct' due to 'cardiac arrest' as the cause of death. No autopsy was performed. Carboxyhemoglobin levels were not measured to test for carbon monoxide exposure. Given the FF's known underlying coronary artery disease (CAD), NIOSH investigators concluded that the physical exertion of responding to the call and suppressing the fire triggered his heart attack, which caused his death. NIOSH investigators offer the following recommendations to address general safety and health issues. Had some of these recommended programs been in place, it is possible the FF's death may have been prevented. (1) Provide preplacement and annual medical evaluations to all fire fighters. (2) Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of National Fire Protection Association (NFPA) 1582. (3) Phase in a comprehensive wellness and fitness program for fire fighters. (4) Perform a preplacement and an annual physical performance (physical ability) evaluation. (5) Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program. (6) Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube. (7) Perform an autopsy on all on-duty fire fighter fatalities.