Line of Duty Death Report F2022-06: 31-Year-Old Firefighter Cadet Collapses During Academy Training Exercise and Dies - Alabama

Details

• Personal Author:
  Eisenberg, Judith S. ; Wilkinson, Andrea ; Barger, Alexandra
• Description:
  On July 25, 2022, at 0718 a 31-year-old, male Cadet was participating in Academy training which included an (air) Consumption Course. While attempting the course for the first time, the Cadet was unable to complete it complaining of dizziness, shortness of breath, and cramping; He was reported to have "nearly passed out". An on-site Paramedic assessed the Cadet's condition immediately and determined he needed further observation and evaluation. The Cadet's PPE was doffed, and he was hooked up to a cardiac monitor to assess his vitals. At approximately 0750, the Cadet was moved indoors to an air-conditioned classroom and advised to drink 1 liter of water. At 0803 the Cadet vomited the water he had consumed, and the Paramedic determined the Cadet's vitals were abnormal and the Captain on scene (Captain 1) called for EMS transport to the Emergency Department. After several hours of observation in the Emergency Department, the Cadet was admitted to the hospital, and then released the following evening. This incident was preceded by another event on July 11, 2022 where the Cadet experienced similar, but less serious symptoms and did not result in hospital referral. The Cadet received clearance from his physician to return to Academy activities on July 28, 2022. The same day (July 28, 2022), at 0930, the Cadet attempts the Consumption Course again, this time accompanied by Captain 2. During the course, Captain 2 notes that the Cadet's breathing was not good, but the Cadet states he is fine and finishes the course. The Cadet promptly collapses just outside of the building where the onsite Paramedic assesses him and documents he is awake, alert and oriented. The Cadet initially denies any medical complaints other than experiencing dyspnea (shortness of breath), but moments later, complains of hamstring and back pain. The Cadet was doffed out of structure fire PPE and moved into an air-conditioned classroom where he began to experience severe respiratory distress. The Cadet was hooked up to cardiac and oxygen monitors which revealed sinus tachycardia and hyperventilation. At approximately 0955, EMS transport was arranged via phone. At 1001, the Cadet was moved from a chair to the floor. Approximately 10 seconds after being moved to the floor, pulseless electrical activity (PEA) was shown on the cardiac monitor with a rate of 23 BPM, and no carotid pulse could be found so cardiopulmonary resuscitation (CPR) was initiated. Following 30-60 seconds of CPR, the carotid pulse was palpable, and he was breathing independently but remained unresponsive. Multiple intravenous lines (IVs) were attempted but line placement was unsuccessful. Upon arrival of EMS, a care report was given to the arriving Paramedic who attempted to place an IV but was also unsuccessful. The original on-site Paramedic simultaneously attempted to perform an endotracheal tube (ETT) placement but was unsuccessful. The Cadet was transferred from the ED to the Intensive Care Unit (ICU) where lifesaving efforts continued. Unfortunately, his clinical condition continued to decline rapidly, and he died later that day. Key Recommendations - NIOSH offers the following recommendations to reduce the risk of heat-related injury and death among firefighters at this and other fire departments across the country. Key Recommendation #1: Review policy on return-to-work medical evaluations as the candidate had 2 prior incidents within the previous 17 days that required medical attention. Key Recommendation #2: Ensure that medical evaluations for Members and Cadets be performed by a provider familiar with the physical and psychological demands of firefighting and the components of NFPA 1582: Standard on Comprehensive Occupational Medical Program for Fire Departments. Key Recommendation #3: Consider feasible options for exertional heat illness monitoring during training including temperature assessment and rapid cooling utilizing NFPA 1584: Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises, and the National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses. Key Recommendation #4: Have onsite staff (e.g., paramedics) assess Cadet's risk for heat-related illness prior to strenuous training, to include any training in full turnout gear; consider use of a checklist or other screening tool.
• Subjects:
  Accidents, Occupational Firefighters Fires Mortality Occupational Health Safety
• Keywords:
  Region 4; Fire fighters; Fire fighting; Fatalities; Emergency responders; Recommendations; Medical fitness evaluation; Return to work; Heat stroke
• FACE - Firefighter:
  Cause of Death Medical (0000) ; Cardiovascular (0001) ; Miscellaneous Medical COD (0047)
• Series:
  Fatality Assessment and Control Evaluation Reports (FACE)
• Subseries:
  Firefighter Fatality Investigation
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Genre:
  Field Study ; Report
• Place as Subject:
  Alabama ; Ohio ; Birmingham Region [OSHA] ; Chicago Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  16 pdf pages
• NIOSHTIC Number:
  nn:20071031
• 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 F2022-06, 2025 Jun; :1-14
• Federal Fiscal Year:
  2025
• NORA Priority Area:
  Public Safety
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  92 - Public Administration - (NAICS)
• Start Date:
  20220725
• Source Full Name:
  National Institute for Occupational Safety and Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7c15893c235bfc48160b3e9290037a4cd395d4529a4d63658940f8f9b88df26a157376b592a25eba63e27726f904a693f88165e79647dfc32e33218ef073d098
• Download URL:
  https://stacks.cdc.gov/view/cdc/257807/cdc_257807_DS1.pdf
• File Type:
  [PDF - 1.41 MB ]