In August 2015, a 38-year old fire fighter/paramedic (FF/P) was working a 24-hour shift. During the shift he responded to five calls. He then exercised for about 1 hour in his fire station’s gym.
After showering, he developed chest tightness. He analyzed his own heart rhythm on a cardiac monitor, entered a restroom, and collapsed. Crew members found the FF/P. They began cardiopulmonary resuscitation (CPR) and advanced life support. They defibrillated the FF/P five times. Then they transported him to the hospital’s emergency department (ED). ED staff continued CPR and advanced life support. The FF/P was taken emergently to the cardiac catheterization lab. Coronary angiography and balloon angioplasty revealed a totally occluded left anterior descending coronary artery. A stent was placed and the artery opened. However, the FF/P’s heart rhythm remained in pulseless electrical activity/asystole and he was pronounced dead.
The death certificate and the autopsy report listed “coronary artery thrombosis due to atherosclerotic heart disease” as the cause of death. They also listed “coronary vessel disease – coronary sclerosis” as a contributing factor. The FF/P’s biventricular hypertrophy and coronary heart disease were undiagnosed before this incident. These underlying conditions and the exertion of physical fitness training contributed to the FF/P’s heart attack. The heart attack resulted in his death.
The following recommendations address general safety and health issues and would not have prevented the FF/P’s death:
- 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 components of National Fire Protection Association (NFPA) 1582
- Perform an annual physical ability evaluation
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters