Line of Duty Death

Line of Duty Death

Introduction

On May 6, 2007, a 54-year-old male volunteer Fire Fighter (FF) responded to a fire in a large machine shed. While operating an external attack hose line for about 20 minutes, the FF collapsed. Cardiopulmonary resuscitation (CPR) was begun immediately by on scene emergency medical service (EMS) personnel. An automated external defibrillator (AED) was retrieved from the on scene ambulance and attached to the FF within two minutes of his collapse. Two defibrillations were delivered without a change in the FF's condition. Advanced life support was administered en route to the hospital, and in the hospital's emergency department. Despite these efforts, the FF could not be revived. The death certificate and the autopsy listed “Coronary Atherosclerosis” as the immediate cause of death. The NIOSH investigator considered that responding to the fire alarm and the physical effort needed to sustain the exterior fire suppression could have triggered a probable heart attack and the subsequent sudden cardiac death of this FF. It is unclear if any of the following recommendations could have prevented the death of this FF at this time. Nonetheless, 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.

Provide mandatory pre-placement and period medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) Standard 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.

Issue

The machine shed was fully involved when the FF arrived and several pieces of farm equipment were burning inside the shed. He donned his PPE, including coat and bunker pants, but did not wear an SCBA. The FF worked an exterior attack hose line (1¾”) to help extinguish the fire in the machine shed and to protect a nearby structure for approximately 20 minutes. The FF was on the nozzle the entire time he was working the attack line with assistance from other firefighters. When he was in position to operate the attack line he knelt on one knee and directed the water to the structure. It is estimated that the work involved in pulling the hose into position and moving the charged line represented “moderate” physical activity (about 7-9 metabolic equivalents [METS]) [Glenhill 1991].

Some crew members offered to relieve the FF, but he refused. During the suppression effort, EMS personnel provided bottled water for hydration and they noted the FF interacted in a normal manner. The EMS personnel who provided water to the FF was not in bunker gear and reported that the FF was not close enough to the fire to be subject to much radiant heat from the fire as he was operating the attack line. A short time after receiving a bottle of water, the FF suddenly collapsed. Fire fighters assisting with the hose line, and others nearby, immediately pulled him away from the involved structure. An EMT who was near the FF when he collapsed, found the ...