Lieutenant Suffers an Acute Aortic Dissection After Physical Fitness Training —North Carolina

Death in the Line of Duty…A report from the NIOSH Fire Fighter Fatality Investigation and Prevention Program

F2016-17 Date Released: December 13, 2016

Executive Summary

On August 17, 2015, a 40-year-old male career Lieutenant (LT) arrived for duty at his fire station at 0600 hours. He exercised by lifting weights in the fire station gym and running outside. A crewmember arriving at the station at 0735 hours for an emergency medical call found the LT sitting on the dayroom couch unresponsive. Despite cardiopulmonary resuscitation (CPR) and advanced life support, the LT was pronounced dead at the scene.

The death certificate and the autopsy report were completed by the Associate Chief Medical Examiner. The cause of death was listed as “hemopericardium” due to “aortic dissection.”

It is unlikely the following recommendations could have prevented the LT’s death. Nonetheless, the NIOSH investigators offer these recommendations to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters.

Key Recommendations

• Provide annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for coronary heart disease (CHD)
• Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the components of NFPA 1582
• Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program
• Perform an annual physical ability evaluation
• Phase in a mandatory comprehensive wellness and fitness program for fire fighters

Read the full report