Fatality Assessment and Control Evaluation (FACE) Report: Lieutenant Suffers Sudden Cardiac Death After Structure Fire in Florida

摘要

On March 26, 2009, a 60-year-old male career Lieutenant (LT) responded to nine emergency calls. The last call was at 2012 hours for a structure fire. At the fire scene the LT forced entry into the structure and extinguished the fire with a portable fire extinguisher. He then performed overhaul with his crew. After returning to the station, the LT went to his bunkroom. Approximately 30 minutes later, he was found unresponsive in his bunkroom's chair. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) at the fire station, in the ambulance, and in the hospital's emergency department (ED), the LT died. The death certificate and the autopsy listed 'coronary atherosclerosis with remote myocardial infarct' as the cause of death with 'generalized atherosclerosis and pulmonary emphysema' as significant conditions. Given the LT's severe underlying coronary artery disease (CAD), NIOSH investigators concluded that the physical exertion involved in responding to nine calls and performing fire suppression and overhaul triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear if these recommended programs would have prevented the LT's death. (1) Modify the FD's policy for conducting member exercise stress tests. (2) Phase in a comprehensive wellness and fitness program for fire fighters. (3) Ensure fire fighters are cleared for return to duty by a healthcare provider 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. (4) Perform an annual physical performance (physical ability) evaluation for all members. (5) Discontinue lumbar spine x-rays as a screening test administered during the preplacement medical evaluation.