Fire Fighters Suffers Fatal Pulmonary Embolism after Knee Surgery for a Work-related Injury – North Carolina

Details

• Personal Author:
  Hales, Thomas R.
• Corporate Authors:
  National Institute for Occupational Safety and Health. Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)
• Description:
  Death in the Line of Duty…a Summary of a NIOSH Fire Fighter Fatality Investigation
  
  On April 18, 2003 a fire fighter/engineer (FF/E) suffered a knee injury while battling a two alarm apartment building fire. After five months of unsuccessful conservative therapy, the FF/E underwent arthroscopic surgery. On November 30, 2003, six weeks after surgery, the FF/E awoke from sleep at with acute chest pain and shortness of breath. Despite advance life support (ALS) provided by ambulance paramedics and physicians in the hospital's emergency department (ED), and cardiopulmonary resuscitation (CPR) in the hospital's ED, the FF/E died. An autopsy conducted by a pathologist from the Office of the County Medical Examiner determined the cause of death to be a massive pulmonary embolism (PE) due to a deep vein thrombus (DVT) due to knee injury that was treated surgically. Given the cause of death, it is unlikely the Fire Department (FD) could have done anything to prevent the tragic and untimely death of this FF/E. Therefore, the following recommendations address general health and safety issues identified during the National Institute for Occupational Safety and Health (NIOSH) evaluation. This list includes some preventive measures that have been recommended by other agencies to reduce the risk of sudden cardiac arrest and or death among fire fighters. These recommendations have not been evaluated by NIOSH, but represent research presented in the literature or of consensus votes of Technical Committees of the National Fire Protection Association (NFPA) or labor/management groups within the fire service. This strategy consists of: 1) minimizing physical stress on fire fighters
  
  2) screening to identify and subsequently rehabilitate high risk individuals
  
  and 3) encouraging increased individual physical capacity. Issues relevant to this FD include: 1. Provide annual medical evaluations to fire fighters to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. The Department and Union should negotiate the content and frequency to be consistent with NFPA 1582
  
  2. Following an injury/illness, the final determination of a fire fighter's return-to-work status should be made by the FD physician who is knowledgeable about the physical demands of fire fighting, the medical requirements of fire fighters, and the various components of NFPA 1582. Only after requesting, receiving, and reviewing all relevant medical information should the fire department physician clear fire fighters for full duty
  
  3. Fire fighters should be medically cleared prior to participating in the FD's Physical Fitness Qualification (PFQ) test
  
  4. Provide fire fighters with medical evaluations and clearance to wear self-contained breathing apparatus ( SCBA) as required by the Occupational Safety and Health Administration (OSHA)
  
  and, 5. Complement the impressive mandatory fitness program with a mandatory, rather than voluntary, wellness program. Specific programs that can reduce modifiable coronary artery disease (CAD) risk factors include smoking cessation, weight control, and low fact/ low cholesterol diets.
  
  
• Subjects:
  Blood Cardiovascular Diseases Cardiovascular System Emergency Responders Firefighters Health Care Facilities Workforce And Services Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Blood-vessels Cardiopulmonary-system-disorders Cardiovascular-disease Cardiovascular-function Cardiovascular-system Cardiovascular-system-disease Cardiovascular-system-disorders Emergency-responders Fire-fighters Heart Medical-examinations Medical-monitoring Medical-screening Occupational-hazards Occupational-safety-programs OSHA Region 4 Physical-fitness Physical-stress Veins

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• FACE - Firefighter:
  Cause of Death: Medical ; Cardiovascular: Heart Attack (Myocardial Infarction, Coronary Artery Disease and Coronary Vascular Disease) ; Non-Cardiac: Pulmonary Embolus
• Series:
  Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)
• Subseries:
  Death in the Line of Duty Report
• DOI:
  https://doi.org/10.26616/NIOSHFFFACEF200413
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Genre:
  Field Study ; Report
• Place as Subject:
  North Carolina ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-11
• NIOSHTIC Number:
  nn:20025429
• NTIS Accession Number:
  PB2004-107304
• Citation:
  Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2004-13, 2004 Jul ; :1-11
• Federal Fiscal Year:
  2004
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  92 - Public Administration - (NAICS)
• Start Date:
  2003/04/18
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3dfcc62f2a2ad6ba0ec27490620f5aa6a4bafa37dfc2b421e99ce0aee035816b842576110a5e635366f25b43ea3c0b205037c6723472b99dab7b3c97fdab98d6
• Download URL:
  https://stacks.cdc.gov/view/cdc/163761/cdc_163761_DS1.pdf
• File Type:
  [PDF - 232.04 KB ]