Fatality Assessment and Control Evaluation (FACE) for North Carolina: Fire Fighter Trainee Suffers Heart Attack During Simulated Fire Suppression Exercise

摘要

A 34-year old male volunteer Fire Fighter Trainee attended a 3 month fire fighter certification course at the Regional Fire Academy. On August 14, 2007, the Trainee participated in a simulated fire suppression exercise consisting of rotating fire attack positions and maneuvering a 1-inch charged hoseline for about 30 minutes. After the exercise, participants returned to the classroom. Upon entering the classroom, the Trainee leaned against the wall, complained of chest pain, and collapsed. 9-1-1 was called as vital signs were taken, revealing a blood pressure of 70 millimeters of mercury (mmHg) systolic and a heart rate of 170 beats per minute. Despite supportive measures in the field and en route to the hospital, the Trainee remained in a semi-conscious state, with low blood pressure, and a fast heart rate. Inside the hospitals Emergency Department, an electrocardiogram (EKG) showed the Trainee was suffering from a heart attack and a cardiac arrhythmia (atrial fibrillation with rapid ventricular response). He underwent emergent cardiac catheterization which revealed an acute thrombus completely occluding his left main coronary artery. A stent was placed, but the Trainee went into cardiogenic shock which required prolonged resuscitation measures that resulted in anoxic brain damage. Two days later, the Trainee was declared brain dead by a consulting neurologist. After consultation with the family, the Trainee was taken off life support systems and died. The autopsy report listed the cause of death as 'Acute myocardial infarction with systemic multi-organ effects of severe hypotension.' NIOSH investigators agree with these reports, and that the heart attack was probably triggered by the moderate to severe physical exertion associated with the Trainees simulated fire suppression training.