Fatality Assessment and Control Evaluation (FACE) Report: After Conducting Fire Suppression Duties at a Structure Fire, Captain Collapses in Incident Scene Rehabilitation in Kansas

摘要

On August 13, 2007, a 44-year-old Captain reported for duty at 0700 hours. At 1819 hours his crew was dispatched to a multiunit apartment fire. At this time the air temperature was 97 degrees Fahrenheit with a relative humidity (RH) of 35%. Initial size-up reported heavy smoke from the two-story wood frame apartment building. The Captain, wearing turnout gear and his self contained breathing apparatus (SCBA), secured water supply to the first-in Engine with a 5-inch diameter hose. He was then assigned to assist with a primary search on the second floor of the apartment building. After being on-scene for about 10 minutes, the Captain was assigned to incident scene rehabilitation (Rehab). While in Rehab, he collapsed. Emergency medical service (EMS) personnel staffing the Rehab area immediately loaded the Captain into the ambulance and began advanced life support including cardiopulmonary resuscitation (CPR). Despite resuscitation efforts in the ambulance and in the Emergency Department, the Captain never regained consciousness. The death certificate and autopsy listed 'Coronary Atherosclerosis' as the immediate cause of death and high heat conditions as a contributory cause. NIOSH investigators concluded that engaging in firefighting activities on a hot day probably triggered a heart attack and the Captains subsequent sudden cardiac death. NIOSH offers the following recommendations to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country. (1) Provide mandatory pre-placement and periodic medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. (2) Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. (3) Provide fire fighters with medical clearance to wear self-contained breathing apparatuses (SCBAs) as part of the Fire Department's medical evaluation program. (4) Ensure that appropriate systems are in place to identify fire fighters who do not participate in medical evaluations. (5) Develop a comprehensive wellness/fitness program for fire fighters to reduce risk factors for cardiovascular (CVD) and improve cardiovascular capacity.