27-Year-Old Firefighter Has Seizure Then Dies of Cardiac Arrest While Responding to Residential Fire – Kansas

Details

• Personal Author:
  Eisenberg, Judith S. ; Saunders, Robert ; Schaeffer, Tammy
• Description:
  On August 1, 2024, a 27-year-old male career firefighter (FF1) with no known medical conditions participated in a mutual aid response to a residential structure fire. FF1 was inside the building with an active fire for approximately 4 minutes before exiting the front door. Shortly after exiting, the firefighter appeared to have a seizure and collapse to the ground. Nearby firefighters who witnessed the seizure and collapse rushed to assist FF1. FF1's gear and self-contained breathing apparatus (SCBA) were quickly removed, and an initial medical assessment found FF1 to be pulseless and apneic. Cardiopulmonary resuscitation (CPR) was initiated. The initial firefighters tending to FF1 were all basic emergency medical technicians (EMT-B). The first due engine, which was the initial interior fire attack crew, was advanced life support (ALS) equipped and had a firefighter paramedic (FFP) assigned to the crew but no ambulance for patient transport was immediately available. The FFP initiated and continued advanced cardiac care of FF1 until arrival of the ALS ambulance. While en-route, the cyanide antidote hydroxocobalamin was administered. FF1 regained a pulse enroute to the hospital but lost it as he was being taken into the emergency department (ED). The ED staff worked FF1's resuscitation for approximately 15 minutes before he was pronounced dead. The Medical Examiners report listed FF1's cause of death as "unspecified cardiac arrest sustained while fighting a fire". Of note, FF1 had a syncopal event approximately 2 months prior but the cause was not identified, and no further medical evaluation was done. At the approximate time of arrival at the residential fire, the outdoor temperature was 96 degrees F with 44% humidity resulting in a heat index of 103.4 degrees F. However, it is unknown if either the syncopal event or heat stroke was a factor in this death. Key Recommendations NIOSH offers the following recommendations to reduce the risk of sudden cardiac arrest among firefighters at this and other fire departments across the country. Key Recommendation #1: Fire departments should consider implementing annual medical examinations as per National Fire Protection Association (NFPA) 1582 recommendations. Key Recommendation #2: Fire departments should encourage members to reduce and if possible, eliminate intake of/exposure to known risk factors for adverse cardiovascular events and rhabdomyolysis. Key Recommendation #3: Fire departments should increase awareness of conditions that increase risk of heat-related illness (HRI) and implement heat stress management policies to reduce those risks. Key Recommendation #4: Ensure emergency medical service (EMS) with transport capability is on-scene at any fire or special operation location in the event emergency medical care and transport is needed. Key Recommendation #5: Fire officers should ensure crew integrity when entering, operating in, and exiting from an environment immediately dangerous to life or health (IDLH). Key Recommendation #6: Fire departments should provide physicians tasked with pre-employment and return to work medical evaluations, descriptions of the essential tasks and duties and not rely on the cadet/incumbent to relay this information. Key Recommendation #7: Fire departments should ensure that a physician signs off on pre-employment and return to work evaluations. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Emergency Responders Firefighters Fires Heat Stress Disorders Hot Temperature Mortality Occupational Health Safety
• Keywords:
  Cardiovascular Disease Emergency Responders Fatalities Fire Fighters Fire Fighting Heat Stress Medical Fitness Evaluation Recommendations Region 7 Return To Work
• FACE - Firefighter:
  Cause of Death: Medical ; Non-Cardiac ; Non-Cardiac: Miscellaneous Medical COD
• Series:
  Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)
• DOI:
  https://doi.org/10.26616/NIOSHFFFACEF202404
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Genre:
  Field Study ; Case Report
• Place as Subject:
  Chicago Region [OSHA] ; Kansas ; Kansas City Region [OSHA] ; Ohio ; Philadelphia Region [OSHA] ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; DSR - Division of Safety Research
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-20
• NIOSHTIC Number:
  nn:20070764
• Citation:
  Morgantown, WV: 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 F2024-04, 2025 Feb; :1-20
• Federal Fiscal Year:
  2025
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  92 - Public Administration - (NAICS)
• Start Date:
  20240801
• Source Full Name:
  National Institute for Occupational Safety and Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4449bbaa572a2635efb87ca4aa6774c24b57e82dfe3244ef6fd41da398088469670118bc2d817ebb3f20059c0fc1db6bc6fb07be2a9750291f207cd9263bbee1
• Download URL:
  https://stacks.cdc.gov/view/cdc/228552/cdc_228552_DS1.pdf
• File Type:
  [PDF - 403.65 KB ]