The NIOSH Firefighter Fatality Investigation and Prevention Program has released the line of duty death report of a Texas fire chief who suffered cardac arrest at a structure fire on April 21, 2014.
Read the Report
Fire Chief Suffers Sudden Cardiac Death at Structure Fire
On April 21, 2014, a 52-year-old male volunteer fire chief (“Chief”) responded to a single family dwelling fire at 2303 hours. Responding in the fire department’s engine, the Chief arrived on scene at 2320hours.
The Chief was acting as incident commander and assisting fire fighters over the course of an hour, when the fire re-ignited. The Chief was pulling 300 feet of 3-inch supply line to the hydrant when he collapsed. A crew member found the Chief unresponsive with a fading pulse. Dispatch was notified as a deputy sheriff (on scene for traffic control) began cardiopulmonary resuscitation (CPR).
An ambulance and a life flight helicopter responded and provided advanced life support (ALS) as the Chief was flown to the hospital’s emergency department (ED). Despite CPR and ALS forover an hour at the scene, during transport, and int he ED, the Chief died.
The death certificate, completed by the county assistant medical examiner listed “atherosclerotic and hypertensive cardiovascular disease” as the cause of death.The autopsy report by the forensic pathology fellow in the county’s Institute of Forensic Services concurred, finding severe coronary heartdisease(CHD), borderline cardiomegaly (enlarged heart),and left ventricular hypertrophy (LVH).
Given the Chief’s underlying CHD, NIOSH investigators concluded that responding to the structure fire, assisting with fire scene activities for over an hour,and the physical exertion of pulling the supply hoseline 300 feet probably triggered a fatal cardiac arrhythmia.
Key Recommendations:
- Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for coronary heart disease)
- Ensure exercise stress tests are performed on fire fighters at increased risk for CHD
- Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the components of NFPA 1582
The following recommendations address general safety and health issues:
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters
- Perform a candidate physical performance (physical ability) evaluation for fire fighter candidates
- Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program
- Conduct annual respirator fit testing
