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At a minimum of once every two weeks, I get one of those dreaded e-mails distributed by the U.S. Fire Administration (USFA). It is the announcement of a firefighter death in the United States. The e-mail contains all the relevant information, including the firefighter's name, age, department and circumstances surrounding the death. I read each one of these. Read these often enough and you can almost predict what you are going to see as you scroll down to read the circumstances surrounding the death after you see the firefighter's age. Usually, the firefighter collapsed while performing some chore or did not feel well after returning from a call. Essentially, the firefighter had some type of coronary event.
A recent study conducted by researchers from the Harvard University School of Public Health looked at firefighter deaths and their link to coronary heart disease. In the study, the researchers looked at firefighter deaths between 1994 and 2004, with the exception of the deaths that occurred in New York City on Sept. 11, 2001.
Of the 1,144 firefighter line-of-duty deaths reported during that period, 449, or 39%, were attributed to coronary heart disease. The researchers' estimates show that firefighters spend just 1% to 5% of their time on fire suppression, yet that responsibility accounts for 32% of deaths from a coronary event. Therefore, the researchers concluded that the risk of a firefighter dying from a coronary event during fire suppression is 10 to 100 times greater than when a firefighter is performing non-emergency duties. The research also showed an increased risk during other emergency duties such responding to and from an alarm.
To those of us engaged in the business, this study comes as no surprise. Firefighting can be extremely physically demanding. It can involve heavy lifting, and maneuvering in awkward areas and positions while wearing heavy personal protective gear in a hot environment. This extreme physical exertion can lead to a heart attack. Numerous studies over the years have shown how extreme exertion can lead to heart attacks. The studies have run the gamut from snow shoveling to recreational exercise.
The results of this study validate what we already knew without looking at it on paper. Of any firefighter deaths you know of or have read about involving a coronary event, how many occurred on a scene and how many occurred with the firefighter sitting in a recliner? If you do not know, I recommend you go to the National Institute for Occupational Safety and Health (NIOSH) website and review the reports found there on firefighter deaths, or get on the USFA e-mail distribution that reports when each firefighter death occurs.
So what has your department done to take care of your own? Does your fire apparatus carry some form of defibrillation capability such as an automatic external defibrillation (AED) or a monitor/defibrillator? Key to surviving a cardiac arrest is rapid defibrillation. Studies have shown that the chances of surviving a cardiac arrest decrease by about 10% for each minute that goes by without defibrillation. The success rates in the casinos in Las Vegas from rapid defibrillation are outstanding since a security guard with an AED usually is at somebody's side shortly after he or she collapses.
Each piece of fire apparatus in the United States should have defibrillation capability. It should be as basic as hoses, ladders and SCBA. The defibrillation capability is not only essential for first responder calls, but also if a firefighter suffers a cardiac arrest while working on the fireground.
Second, does your department dispatch an ambulance to all working fires? If not, you should be. Whether it is your department ambulance or the ambulance service responsible for 911 in your community, it should be dispatched to the scene in the event a firefighter not only has a heart attack, but if is injured.