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29-Year-Old Firefighter Suffers Cardiac Arrest After Two 24-hour Shifts—Wisconsin
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2019-06 Date Released: July 1, 2019
Executive Summary
On April 1, 2018, a 29-year-old male career firefighter (FF) suffered a sudden cardiac arrest after having brunch with family members following a 48-hour shift. Friends called 911 and initiated cardiopulmonary resuscitation (CPR). An ambulance was dispatched at 1504 hours and arrived on scene at 1508 hours and initiated advanced cardiac life support, which was continued en route to the hospital emergency department (ED). The ambulance arrived at the hospital ED at 1543. Personnel continued resuscitation efforts unsuccessfully for approximately 25 minutes. The FF was pronounced dead at 1609 hours.
The Medical Examiner’s report listed the cause of death as acute cardiac arrest with hypertensive heart disease as the underlying cause of death and obesity as a contributing factor. The autopsy report noted an enlarged heart (weight of 550 grams). National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the FF suffered a sudden cardiac arrest from an unknown cause. The FF had an enlarged heart which may have made him more susceptible to an arrythmia. The FF was a 29 year old male, a non-smoker, and was very physically fit. The FF had a medical evaluation when he joined the fire department (FD) in 2012, and had an optional medical evaluation in 2013 and he received respiratory clearance every year. None of the available records indicate that the FF had elevated blood pressure or a diagnosis of hypertension. The FF was diagnosed with sleep apnea and used a continuous positive airway pressure (CPAP) machine.
Key Recommendations
NIOSH offers the following recommendations to reduce the likelihood of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country.
- Ensure that all firefighters receive an annual medical evaluation consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.
- Ensure firefighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by firefighters, and the various components of NFPA 1582.
- Phase in a mandatory comprehensive wellness and fitness program for firefighters.