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Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 12
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Book Description
On January 26, 2010, a 52-year-old male volunteer lieutenant (LT) responded to a residential fire. At the scene, the LT, wearing street clothes, assisted in stretching two 1 3/4inch hose lines, carried a positive pressure ventilation (PPV) fan to the porch, and started the fan. After replenishing the fan's fuel supply, the LT collapsed. Cardiopulmonary resuscitation (CPR) was begun. The ambulance, already en route to the structure fire, arrived 6 minutes later, and advanced life support was begun. Despite CPR and advanced life support on scene, during transport, and in the hospital's emergency department (ED), the LT died. The death certificate and the autopsy listed "arteriosclerotic cardiovascular disease" as the cause of death. Given the LT's severe underlying heart disease, NIOSH investigators concluded that the physical exertion involved in responding to the call, stretching the fire hoses, and carrying and starting the PPV fan triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. These recommended programs would have restricted the LT from participating in physically demanding emergency response activities. 1) Provide preplacement and annual medical evaluations to all fire fighters. 2) Ensure fire fighters are cleared for emergency response activities 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) Conduct annual respirator fit testing.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 12
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Book Description
On January 26, 2010, a 52-year-old male volunteer lieutenant (LT) responded to a residential fire. At the scene, the LT, wearing street clothes, assisted in stretching two 1 3/4inch hose lines, carried a positive pressure ventilation (PPV) fan to the porch, and started the fan. After replenishing the fan's fuel supply, the LT collapsed. Cardiopulmonary resuscitation (CPR) was begun. The ambulance, already en route to the structure fire, arrived 6 minutes later, and advanced life support was begun. Despite CPR and advanced life support on scene, during transport, and in the hospital's emergency department (ED), the LT died. The death certificate and the autopsy listed "arteriosclerotic cardiovascular disease" as the cause of death. Given the LT's severe underlying heart disease, NIOSH investigators concluded that the physical exertion involved in responding to the call, stretching the fire hoses, and carrying and starting the PPV fan triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. These recommended programs would have restricted the LT from participating in physically demanding emergency response activities. 1) Provide preplacement and annual medical evaluations to all fire fighters. 2) Ensure fire fighters are cleared for emergency response activities 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) Conduct annual respirator fit testing.
Author: J. Scott Jackson
Publisher:
ISBN:
Category :
Languages : en
Pages : 9
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Book Description
Designate an employee to administer the pre-placement and annual medical evaluations and their outcomes; perform an annual physical performance (physical abiltiy) evaluation; perform an autopsy on all on-duty fire fighter fatalities. Although unrelated to this fatality, the Fire Department should consider these additional recommendations: provide fire fighters with medical evaluations and clearance to wear SCBA; provide adequate fire fighter staffing to ensure safe operating conditions.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 16
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Book Description
On the morning of January 28, 2014, a 53-year-old male career fire chief ("Chief") began his 9-hour shift. During the morning he spent over an hour fighting a grass fire using an attack line to knock down the flames and then wildland fire suppression tools to extinguish hot spots. During the ride back to the fire station, the Chief reported experiencing heartburn. At 1214 hours, the Chief used his command vehicle to respond to another grass fire. When the Chief arrived, the fire had spread to the land owner's residence. While waiting for the fire department's engine to arrive, the Chief began exterior fire attack. Once the engine arrived, the Chief and a lieutenant donned their self-contained breathing apparatus (SCBA) and began interior fire attack. During the attack, the Chief appeared sluggish and somewhat disoriented and did not communicate well. After about 15 minutes, the Chief's and the lieutenant's SCBA low air alarms sounded, and both exited the structure. Once outside, the Chief reported feeling sick and called the emergency medical services (EMS) director who recommended he come to their headquarters for an electrocardiogram (EKG). The Chief drove the command vehicle to headquarters with a mutual aid fire fighter as a passenger. He underwent an EKG, which revealed changes consistent with an acute heart attack. He was loaded into an ambulance for transport to the emergency department (ED) (1423 hours). Approximately 5 minutes into the transport, the Chief suffered cardiac arrest. Cardiopulmonary resuscitation (CPR) and advanced life support were begun, which included multiple defibrillation attempts, intubation, intravenous line placement, and cardiac resuscitation medications. The Chief was still in cardiac arrest when the ambulance arrived at the ED (1441 hours). After approximately 10 minutes of treatment in the ED, the Chief regained a heart rhythm and pulse. He was taken (1522 hours) to the cardiac catheterization lab where he was found to have 100% blockage of his proximal left anterior descending (LAD) coronary artery. Percutaneous transluminal coronary angioplasty successfully opened the blockage; a stent was placed to keep the LAD artery open. Approximately 1 hour after being transferred to the intensive care unit, the Chief suffered another cardiac arrest (1735 hours). Subsequent resuscitation efforts were unsuccessful, and the Chief was pronounced dead at 1800 hours. The death certificate and autopsy report, both completed by the associate state medical examiner, listed "hypertensive atherosclerotic cardiovascular disease" as the cause of death. Given the Chief's underlying heart disease, NIOSH investigators concluded that the physical stress of performing interior fire suppression in turnout gear with SCBA probably triggered his heart attack.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 8
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Book Description
(4) Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. (5) Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting; and (6) Perform an autopsy on all on-duty fire fighter fatalities.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 12
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Book Description
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.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 15
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Book Description
On March 31, 2010, a 53-year-old male career Lieutenant (LT) reported for duty as the officer on Squad 91. During his shift he participated in the Fire Department's (FD) annual self-contained breathing apparatus (SCBA) endurance evaluation. After completing the first evolution in about 15-20 minutes, the LT complained of shoulder pain and sat down to rest. Shortly thereafter, both on-duty crews were dispatched to separate emergency calls. The LT did not respond with Squad 91, and crew members assumed the LT was either taking a shower or had responded with the other crew. Upon returning to the fire station about 1 hour later, crew members found the LT unresponsive in his bunkroom. Cardiopulmonary resuscitation (CPR) and advanced life support were begun, and the LT was transported to the local hospital's emergency department (ED). Advanced life support continued in the ED for an additional 10 minutes when he was pronounced dead by the ED physician. The autopsy, completed by the County Coroner, listed the cause of death as "acute thrombus of left anterior descending artery" due to "hypertensive atherosclerotic cardiovascular disease." Given the LT's underlying coronary artery disease (CAD), NIOSH investigators concluded that the physical exertion involved in performing the SCBA endurance training triggered his acute heart attack and subsequent cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is possible that if some of the recommended programs had been in place, the LT's death may have been prevented. 1) Incorporate exercise stress tests following standard medical guidelines into a Fire Department medical evaluation program. 2) Provide annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 3) Ensure that 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 NFPA 1582. The following recommendations are made for safety and health reasons and would not have prevented the LT's death. 1) Provide preplacement medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582. 2) Perform an annual physical performance (physical ability) evaluation for all members. 3) Phase in a comprehensive wellness and fitness program for fire fighters. 4) Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube.
Author: Denise L. Smith
Publisher:
ISBN:
Category :
Languages : en
Pages : 14
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Book Description
and (6) provide fire fighters with medical clearance to wear SCBA as part of the Fire Department's medical evaluation program.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 15
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Book Description
(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 NFPA 1582. (3) Phase in a comprehensive wellness and fitness program for fire fighters. (4) Perform an annual physical performance (physical ability) evaluation. (5) Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program. (6) Conduct annual respirator fit testing. (7) Discontinue lumbar spine x-rays as a screening test administered during the preplacement medical evaluation.
Author: Denise L. Smith
Publisher:
ISBN:
Category :
Languages : en
Pages : 12
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Book Description
1) Consider providing symptom limiting and diagnostic imaging exercise stress tests for fire fighters at increased risk for coronary artery disease and sudden cardiac death. 2) Work with the local union to phase-in an annual physical ability test.
Author: Tommy N. Baldwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 20
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Book Description
On January 26, 2011, a 38-year-old male career fire fighter recruit ("Trainee") participated in an entry-level fire fighter certification class. The training included maneuvering through a tunnel maze while wearing full turnout gear and self-contained breathing apparatus (SCBA). After he completed most of the maze evolution, the Trainee's SCBA became stuck inside the tunnel. He tried to free himself for several minutes; meanwhile, his SCBA became low on air. Instructors removed the Trainee from the maze and noted that he was breathing hard and complaining of nausea. After rehabilitation, his symptoms resolved, and his vital signs returned to normal. The Trainee went on to complete the basement search portion of the smokehouse training without difficulty. After lunch, the Trainee repeated the maze evolution and became stuck in the same location. After assuring instructors he was okay, the Trainee suddenly became unresponsive. Instructors removed the Trainee from the maze and found him unresponsive, not breathing, and without a pulse. An ambulance was requested, cardiopulmonary resuscitation (CPR) was begun, and an automated external defibrillator was utilized; no shock was advised. Paramedics assigned to a nearby flight ambulance responded and began advanced life support including the administration of intravenous cardiac resuscitation medications. A cardiac monitor was placed, revealing asystole (no heart beat) and pulseless electrical activity. The ambulance arrived about 11 minutes later and transported the Trainee to the hospital's emergency department (ED), where CPR and advanced life support treatment continued. Approximately 47 minutes after his collapse, despite CPR and advanced life support, the Trainee died. The death certificate and the autopsy, completed by the medical examiner, listed "dilated cardiomyopathy" due to "hypertensive cardiovascular disease" as the cause of death. NIOSH investigators concluded that the Trainee's underlying cardiomyopathy coupled with the physical exertion involved in performing the fire fighter training triggered his sudden cardiac death.
