I took a class called Courage to Be Safe. It was a very interesting class. This class was about speaking up and keeping yourself and your fellow firefighters safe. We discussed the fact that firefighters are dying and was it preventable. As it turns out most were.

What we saw were firefighters that died because of vehicle crashes, these crashes were in fire apparatus and personal vehicles. Why? Well they didn’t drive like they would on a normal day that wasn’t having them respond to an emergency. They were responding to a call and were not obeying traffic laws. They didn’t stop at stop signs or stop lights. They were speeding some of them and why? You don’t get there any faster and you put your life, the lives of your crew and the public at risk for what? I don’t get it and I have tried to figure it out and haven’t come up with an answer. The other result from the crashes were that some of the firefighters who died were not wearing their seat belts. What is wrong with these firefighters? I don’t get it. We enforce and reinforce with our children to buckle up and we also preach to the public to buckle up and yet we don’t. What is wrong with this picture? It needs to stop and we need to take responsibility for each other. If we see a member in the apparatus and they aren’t wearing their seat belt, speak up and tell them to buckle up. If the apparatus driver is driving to fast and is going over the speed limit, tell them to slow down. We need to drive with due regard.

We discussed the fact that firefighters are being killed in fires because of being trapped or collapse. This is unacceptable. We are going into burning buildings and getting right up on the fire. Why are we doing this? We have hose lines and nozzles and we can spray water great distances and yet we go in and get right on top of the hazard that we are trying to put out. We don’t need to be right on top of the fire. We need to decide, what are we saving, is there a life to be saved and is this, a rescue or is it a recovery. I know we tend to not want to think of the later but, we need to sometimes. The new materials that are being used in buildings is not necessarily better for us the firefighter.

One of the last things that we discussed on why firefighters are dying is health issues. There are firefighters dying from heart attacks and this is a concern but it is also confusing. Some of the firefighters are young and there was no history of a heart condition. We asked ourselves and discussed what may have caused this. We never really could come up with an answer. We did say that we as firefighters are not necessarily in good health. Some of us are over weight and out of shape. We need to get ourselves in better shape. We are in a very strenuous job and it is a strain on us physically and emotionally. I know I could be in much better shape than I am and I know that I need to make this happen. Truly it is not an easy task.

As I said in the beginning, this was an interesting class and in the end an excellent class to take. It reinforces the fact that we need to speak up when we see something. If it raises a question in your mind then ask. Don’t wait or question whether you should ask it or not. Don’t be afraid to ask questions and that the only stupid question is a question not asked.
This class is a class that all firefighters and all officers whether they are fire or EMS. There is plenty of information to be learned.

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FETC,

You are correct, but there are firefighting heart attack fatalities in young, healthy firefighters that do not have "all that plaque from Mickie' D's or KFC". The mechanism that you describe doesn't apply to them.

It's easy to blame age, poor diet, inadequate excercise, or whatever for these LODDS, and those are undoubtedly contributing factors to some. The problem is that this issue has been framed exclusively in the manner that you present it, and that is demonstrably not the case.

The NFPA lumps at least four distinctly different cardiac problems into the "heart attack" category.

1) Out of shape/overweight/coronarty artery plaque rupture myocardial infarctions as you describe.
2) Genetic disorders that cause myocardial infarction.
3) Heat stress/dehydration-induced myocardial infarctions.
4) Cardiac arrythias, that may occur in the absence of a coronary artery plaque rupture or a myocardial infarction.

Improving firefighter physical fitness and diet will probably contribute to fewer LODDs, but it will not eliminate the problem. There is no single solution for these four seperate problems. The NFPA doesn't have the mandatory reporting mechanism to isolate those four seperate LODD causes, so they lump them together. That makes it look as if a single solution will eliminate that LODD category. A single-variable fix almost never corrects - or even accurately defines - a multivariate problem. Firefighter "heart attack" LODDs are clearly not the single category that they appear to be.

Diet and excercise are long-term solutions for one of the four categories - firefighters with McD-induced coronary artery plaques. Good rehab and on-scene medical care will likely have a more immediate and more global impact on LODDs than will an overall diet and excercise program. And regardless, we'll still see young, in-shape firefighters with good diets dropping from heart attacks in places that still have the "Rehab is for sissies" mentality.
Ben,

I always enjoy your opinion and totally agree with your point about heat stress and dehydration. Everyone must provide better identification towards firefighter overheating and being exposed to overexertion. Rehab is NOT for sissies and I think many do a very poor job of providing quality rehab and firefighter monitoring.

I didn't even get into those catergories because I was trying to explain the fight / flight response and poor dieting habits and how it causes a LODD when we respond to a false alarm (never exposed to heat stressors)

Thanks my friend!
Nick,

I never said the answer to reduce our chances of suffering a serious event in our stressful occupation was easy. Unfortunately, we are product of the modern society. We live fast, eat fast, use stimulants because we are tired all the time and then the stimulants cause us to get very un-restful sleep. All of which are terrrible for free radicals and chronic stress effects.

If you were coming to me for suggestions towards better wellness as a trainer, I would suggest looking at your dietary habits, preparing a good luch to take to work from the previous nights dinner (like make extra lean chicken and chop it up into a nice low fat salad) and I know it is extremely hard to do, but stop smoking. If you have seen poor results with any traditional medicine to stop, may I suggest an alternative because I have seen great results with hypnosis. (it is usually guaranteed or your money back) Then, if you succeed with the first two suggestions, I would then incorporate some cardio exercise first thing in the morning... 2 or 3 times a week, go for a run with the dog, etc.

Can I make one point without being a know it all... as I think you are looking for an honest response to how we can be healthier firefighters? You said, you keep yourself hydrated in one sentence but then state you drink a pot of coffee each day. For every CUP of coffee you need to drink 2 glasses of water to maintain hydration. Coffee is a dieuretic which unfortunately causes dehydration. Causes us to pee more and when we do it also flushes other water that we already had inside us. So before the pager sounds, many think they are hydrated (full belly / bloated) but are actually DEhydrated. This is also a major factor with firefighters suffering a heat stress emergency post interior fire exposure as Ben has identified. Coffee, Soda, or ZERO Water Intake.... same poision. Cardiac heat stress loves dehydration, as it aggreviates many non-life threatening conditions into more serious concerns. I understand coffee is the crutch that America needs to survive. Remember we are product of our society. Double D (dunkin donuts) wrote a motto from it. Be very careful with that much intake, a ton of empty calories and allot of caffeine. Just try to replace some of that with water over time.You will feel like crap at first without the stimulant but over time you will feel better and sleep much better!

I will be honest... it is far more difficult to address many of these issues in the volunteer fire service. You have work or multiple jobs, spouse, kids, games, sports, bills, training, emergency responses, and then a little time to rest.

In a paid department, if the organization is proactive, time for a better diet preparation and exercise can be more controlled. Many consider health and wellness is very important and provide time during the shift thus being paid to exercise and prepare meals in between vehicle maintenance, training, inspections, pre-plans and emergency responses, etc.

If you are thinking about it, then you obviously have a good attitude toward the issues.
That sounds like a great class and it's true, sometimes it does take courage to be safe. I for one, have a child at home who doesn't need a chief picking her up while I'm on shift because some preventable happened to me. I dont' know why some firefighters cannot stop at stops and reds and why some of them have to drive at ridiculous speeds knowing the time it takes to stop a vehicle like that, especially in a high traffic residential area. sometimes it definitely has to do with their own control issues, sometimes it is the ego.

As for dying due to heart attacks and disease. Sometimes this is not preventable, some people are pre-disposed to these diseases and every ounce of prevention will not protect them. Although, there are many who still insist on walking into smoke with their mask off,taking it off too early, allowing toxins to invade their bodies needlessly. And physical fitness... why someone would not take the time and effort to ensure they are in shape is beyond me. If I know I'm going to be strapped for time the next day, I go to bed early and get up extra early to train. Being fit is the #1 thing that is going to make this career easier and keep us alive. I do not want to end my career suddenly due to disease (or death), and i do not want to be the reason another firefighter has to put their life at risk to rescue me if I go down in a fire. I always tell people, if you aren't going to get in shape for yourself... do it for me and the rest of your crew so we don't die trying to rescue you.

We can be our own worst enemies, but we can also be the reason we have long and healthy careers.

The job is changing, the onus is on us to protect ourselves. Everyone loves a hero, but who wants to die to be considered one. I'd rather be considered a working schlep all my life. Time to stop the neanderthink and move forward. 150 years of tradition, unimpeded by progress...make a change.
I read an article a little while ago about the seriously negative effects of caffiene on firefighters. I can't for the life of me now remember what the main issues were (elevated heart rate and blood pressure no doubt), if i can find it I'll post it.

Well, that was easy, a quick search on msn.com and here it is... it has more to do with core temperature, judgement and oxygen intake... (it's not the original article I had read that was on canada.com, but an abreviated version)

http://www.canada.com/vancouversun/news/story.html?id=da236cfd-9611...
I often wonder....why the ## of LODD's donot decline.....if you look at the past 10 years there have been consistently the same ## of LODD's(Except of course 9-11...extra 343 there)...Maybe its because it sometimes takes more courage to do the "right" thing then it does to run into a burning building....So why not show some real corage and wear your seatbelts....hell, go way out on a limb...tell your people in the rigg to wear them....it really sucks to be in a MVA in the rigg and to get thrown out and rolled over or to be stopped by that tree or rock....Get into shape (no, I don't mean round....yes, that IS a shape)...I mean Cardiovascular wise...you don't have to be able to lift a small elephant...but Cardio exercise will go a long way to preventing a heart attack...and now for the biggie...WEAR YOUR PPE...all of it....its there to save your butt.....Stay safe all and remember to keep the faith.....Paul
Excellent info, Thanks for letting us all know about this class. I agree with alot of those things, we need to be more agressive with OUR safety responding to a call, at a fire scene and our health and fitness.
sounds like a class everyone company should offer
Paul, Thanks and this is why I wrote this discussion because I truly believe that we need to be aware and take this class...
Nor did I... Ben, I also thank you for bringing to our attention the fact about concentrated blood due to dehydration. This, along with the discovery of high CO concentrations is really starting to put the puzzle pieces together.
I took the same class and liked it very well also. Its a great class if you have the oppurtinity take it.
WOW! this is a really on Par Discussion, and it sounds like a class i would like to take.. where can i take this class at???

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