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Line of Duty Deaths, Cardiac Related. WHAT THE HELL ARE WE DOING?
Brothers and sisters, 2010 is not off to a good start for the fire service. Yesterday I read about our sixth LODD that occurred in Arkansas, and which happened to be cardiac related. Did you know this was the fifth LODD this year that was cardiac related? That's 5 out of 6 people!
Looking back at 2009, we had 93 LODD notifications from the U.S. Fire Administration. Out of those 93 deaths, 45 were cardiac related. I know it's early, but if our trend for 2010 continues, we may pass last year's number.
I ask these questions to the Chiefs on here. What are you doing to prevent cardiac related deaths in your department?
· Do you require NFPA 1582 physicals for new employees and/or volunteers? If so, do you also require annual NFPA 1582 physicals? If not, you better review OSHA 1910.156(b)(2).
· Do you require firefighters to maintain the same physical entrance standards for the duration of employment/membership?
· Do you have a Physical Fitness SOP/SOG requirement for on duty personnel?
For the line officers and supervisors, paid and volunteer. Do you,
· promote physical fitness to your firefighters?
· lead by example and join in during PT?
· promote healthy eating while on shift?
· speak with crews about the risks of obesity, heart disease, and smoking, and unhealthy eating?
· have a reading of the latest LODD notifications during shift briefing, or post them in the station for all to see highlighting the cause of death?
For the firefighters. Do you, or have you
· made yourself aware that heart disease is a leading killer of firefighters, both paid and volunteer. Even more so than tanker and POV collisions?
· made an effort to make and keep yourself physically fit for duty by eating healthy meals and working out both on and off duty?
· talked with fellow firefighters, and supervisors on the importance of living a healthy lifestyle, and been leading by example?
I don't expect everyone to be a marathon runner, UFC fighter, or Olympic Weightlifter. There are no excuses though for not losing weight, eating right, and working out!
What I'm about to say is harsh, but the truth. If you are a firefighter, or emergency service worker with cardiac problems, obese, and/or not able to physically perform duties, then you are a ticking time bomb, and liability.
I don't care if you give the excuse of, "well I'm a driver only, or fire police, EMS only or just don't go inside". You are dead wrong, and still a liability. There have been plenty of drivers, fire police, etc who have collapsed on scene and became a cardiac related LODD. Just go back and look at LODD listings for previous years.
Let's all do something to prevent this stuff from happening again.
Replies to This Discussion
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Permalink Reply by Oldman on
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If one looks at the total number of firefighters in the US vs the number of cardiac related deaths, the percentage is actually very low. Compare this to the population of the US vs the 1000s of cardiac related deaths every year. Marathon runners, UFC fighters, or Olympic Weightlifters, and people who work out still die of cardiac related events.
I have personally witnessed 5 teenage athletes die of a cardiac related event, and 2 others who were 10 years old. The athletes all passed physicals, with 3 also having EKGs prior to participating in sports. The 2 younger ones most likely had some genetic anomaly which caused their event, although nothing showed up on the PM.
Can we do more? Certainly proper diet and exercise, weight control, and healthy living will have an effect on decreasing the chance of a cardiac related event, as will regular physicals. But we cannot forget the fact that while these are risk factors we can change, there are many such as genetics that we cannot change.
I am all for decreasing the probability of occurrence, but much like airbags and seatbelts decrease the chance of death in a crash. Death from cardiac related issues cannot not be "prevented from happening again".
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Permalink Reply by Loyd Dittfurth on
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Im not going to speak scripture here but I believe that alot of it has to do with the age
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Permalink Reply by FETC on
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I am all for fitness, physical testing and making sure everyone is healthy enough to do this job. Many times, we read about firefighters who were not, but allowed to work in the service anyway. Cardiac arrest in your 20's or 30's is not unheard of lately and most likely not screened by the FD to begin with. Then again, some members may know about the pre-existing condition and choose to not tell if they KNOW THEY are not screened either. Some have even asked on FFN what department's are using what standard...
BUT If you were to implement the NFPA 1582 physical to all departments in the US, many who have never had any baseline standards at all, many would have a hard to remain in existance due to most on the department failing. Most of the Chief's would fail the process, you wouldn't see 60-70-80 year old members either and therefore if the standard was mandatory many would not be allowed to be a member of the active fire service all together. So there is your glitch, why would some chief's or upper management envoke a new standard knowing they would be affected by the outcome?
Second, the NFPA 1582 standard physical costs on the low end about $1000.00 per person, now times the number of firefighters you have on your department and then times that ANNUALLY per the standard..... Most can't survive the times now...
So to state WHAT THE HELL ARE WE DOING? well the standard you have stated as the minimum requirement may be too strict and clearly unrealistic to phase in to most departments.
Just look at the newest BMI test for commercial CDL licenses, many good truck drivers I know are now struggling to keep their card because of the weight issue.
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Permalink Reply by Art "ChiefReason" Goodrich on
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I don't know why we're acting so surprised.
Heart related sudden death fatalities have led all other LODD categories every year since they started keeping LODD statistics.
What are we doing? First let's not jump the gun. Fix the cause of death that we can fix without intervention into personal lives. That is: slow your people down and have them obey rules of the road when responding, fasten seatbelts always and teach them about lightweight construction and fire behavior. This will take care of the other major causes of death of firefighters.
Now; you want to tackle the heart attacks? OK; with the average age among volunteer firefighters as 40 something, do you grandfather them and require physicals from this day forward for everyone or do you go with the ones in high risk, on the tech teams or anyone over a certain age? I have read NFPA 1582, but remember; it isn't the law. There is no law except Murphy's Law.
Right now; if you dropped the hammer and required everyone to be in good shape with no known medical issues, you would lose more than HALF of the volunteer firefighters in this country. I am not saying that I disagree. I am saying that you'd better have people who have passed their physicals in place and ready to go when you drop the hammer.
Better still, put a drop dead date out there and give everyone the goal to hit it. If they don't, then retire them. If they do, then the fire service is on their way to reducing the Number One killer of firefighters.
IMHO.
Art
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Permalink Reply by Jack/dt on
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At the least a basic annual physical and EKG, some kind of height to weight ratio and ABSOLUTELY NO SMOKING or tobacco use of any kind. I would suggest a modified annual CPAT.
Mandatory EVOC for any vehicle operator, documented training course and completion with annual mandatory refresher. BRT's do NOT roll over by themselves, it is a result of too fast a speed and/or inexperience and along with POV LODD/injuries, are almost 100% avoidable.
If you're eating something other than a veggie or fruit right now while you're reading this, you probably need to go on a diet.
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Permalink Reply by Jeff Cole on
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FETC makes some valid points. This is a subject that I am very passionate about. Many won't agree with me, and that's fine. The fact is we continue to hide our head in the sand. Most likely, with mandatory fitness standards and annual medical evaluations and screening we would certainly NOT have 60-7-80 year-old "firefighters" on the line. There's a good start.
Of course we will never be able to prevent every single cardiac-related death in our business. But with identification of risk profiles, we could have a much better chance. Back in the mid 90's my department sent me to a week-long course in Montgomery County, Maryland, in Rockville, for certification as 'firefighter fitness program coordinator'. It was developed and presented by Dr. Paul Davis, who is one of the developers of the Firefighter Combat Challenge. I had always been involved in some degree of personal fitness development way before that oppurtunity, but the course really opened my eyes. The goal was to bring it back to my department, begin implementation of a department-wide fitness program.
Once I brought it back though, it was a major dissapointment. I was actually resented before I could even begin to explain the intent, the goals, and the improvement it would bring to the ability of the fire department. Misconceptions and rumors flew everywhere. Many thought that they would be fired if they couldn't do ten push-ups, or that the ability to even do one chin-up had no impact on their ability to engage in firefighting duties. And while failure to meet those particular marks ARE pretty sad for someone in this business, it was the furthest thing from the truth.
It was, and is, all about recognizing personal risks and vulnerablities through lifestyle, and heridity. It was about trying to reduce the risks of cardiac disease and sudden cardiac event through behavior and lifestyle modifiactions. It was about INDIVIDUAL goals in improvement and fitness levels. While there was an eventual target standard, it was designed to be job-specific, and validated as directly related to firefighting tasks.
We all know, or should know, that for many of us, we have to do this job with far fewer firefighters on the initial response than we actually need. Politicians don't look at the number of us riding the rigs, they seem to look towards the eventuality of dozens of us on scene well after mutual-aid has been called, and we transitioned from an offensive interior attack, to a defensive exterior attack, when we finally have enough help, and the newspaper photos show ample numbers of firefighters hanging around deluge guns. They just don't grasp, or they don't care that our ability to secure a water supply, stretch the APPROPRIATE size hoseline, force entry, and advance to the seat of the fire requires enough of us to facilitate the proper ventilation, through ladders to provide for EGRESS as well as entry, perform a rapid primary search, and cover command positions, apparatus operations, and RIC simultaneously.
How many of us are trying to cover these positions with a handful of initial responders? The ONLY responders you can actually count on are the one's that are there now. Ever since NASCAR has become so popular, creative union officials and officers have likened the actions of the pit crews to the ability of the firefighters to be successful. The jobs HAVE to be performed simultaneously.
And so enters the whole fitness topic. As they explained in the fitness coordinators course, it's important for us to have the ability, the reserves to be able to make that stretch, maybe even force the door, make entry, and if we find someone, do our absolute best to make the grab and get 'em out...and just maybe have to go back and grab one of our own! Sound like overkill? IT IS! But don't say it isn't a possibility. Ever since I have been around the fire service (since I opned my eyes at birth in 1958) and especially since I entered this business for real, well over 30 years ago, it was always impressed upon me not to worry, that my Brother or Sister firefighter who's beside me will watch me and "pull me out" if anything ever happened to me. And that's the whole creed of the firefighter. "You go...we go!"
Ever try it? How many of us have gone through the firefighter survivor courses, the RIC/RIT training? Better yet, how many of us have actually had to pull someone out or real? How about over a ladder? All things considered, these are some of the most streneous, physically demanding activities we will ever do. Put it together during July or August in 90+ degree heat and the same levels of humidity, ...and who is required to wear the equivelent of a full 'Carhardt' winter insulated suit in such weather?
If that doesn't equate to demanding we maintain the highest degree of physical fitness PERSONALLY possible, then the non-beleivers have either never had to do these things (those who like to wear the costume, and be lawfully allowed behind the caution tape, and hide) or dismiss their obligations to protect themselves, our firefighters and the public. But if you THINK that the one time you may be called upon to completely extend yourself you'll pull it off just becouse you wear the magical turnout coat, you are completely clueless. It's nothing but a fantasy. Either that, or I have been dreaming these last three+ decades and it's actually as easy as some people think it is.
Being "combat ready" is a matter of both physical, and mental preperation. And if you rarely respond to actual working firs, you have that much more reason to be prepared physically. It isn't so much about being body-beautiful, having washboard abs, or bench pressing 300+ pounds. nd it isn't about spending every day in the gym, for two hours a day. Actually that is more counter-productive than anything! And who really has the time for all that? And the absolute worst thing we can do is to set some abstract, totaly unattainable goal for ourselves that will just set us up for failure, and then quiting all together.
It IS about being the bst YOU that you can be. REASONABLE effort to maintain a reasonable degree of fitness. That's not to say the guy with the over-40 gravity-induced "beer belly" is not, and will not be fit for firefighting duty. But the sedentary coach spud who is 20 some pounds overweight, and hasn't even walked a mile in years IS far more of a hinderence, and a liability than he/she is an asset. There is this notion that many larger, and overweight men have that they are somehow more capable of producing 'power' and strength, and can knock down doors with ease, and therefore don't need to worry about any sissy fitness programs. SOME of these guys DO exist, but mostly, in MY experience, they are good for maybe one or two good swings with the flathead, and if the door doesn't give by then, they are done...gased.
MODERATION! Endurance and the ability to pull and push YOUR own weight CAN save your life! Your wearing ALOT of weight with your firefighter suit on, right? So, should you find yourself in the position that you need to pull yourself up and over an obstacle to get the heck out of trouble...is the ability to do a dozen or so push-ups NOW irrelevent to the job?
Firefighting, REAL firefighting IS a young persons job. Those of us who are in a career position know we have to do put in 25 years or so, and we may be well into our 50's before we can go. And not all of us make it into "the car" either! In fact, not all of us even make the right front seat during our careers! Courtesy and department protocol MAY put the old timers in the engineers seat, but that doesn't come without certain requirements either!
Perhaps some volunteer groups may be able to get away without certain absolute requirements, but in the end, if you signed on for protecting your community, you have an obligation to be the best YOU that you can be. Maybe not beter than the guy or girl next to you, but better than you were before you finally realized that being firefighter requires you to be in the best POSSIBLE physical condition.
If you haven't yet started, you have have already been cheating yourself. Ease into it. Get phyical, then find someone who cn develop a PERSONAL program to fit YOUR ability. If your fire department has the facilities, you are lucky, that shows they care. Sadly more emphasis has been placed on the construction and maintainence of bars in some fire stations and the idea of a fitness room is avoided becouse then they would have to use it! Educate your members, and then go and grab some publicity for it locally. That will yield you far more positive reviews than havin your members seen hanging out wahing their pick-up trucks or sitting in the station bar.
Long winded? Sorry. Obviously I am all for mandated fitnes requirements for line firefighters and officers, volunteer, and career, it doesn't matter. We all say the fire doesn't know the difference, right?
Spelling errors here will have to stand, I don't even have the time to proof read this now...gotta go!
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Permalink Reply by Paul Montpetit on
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old news brother...old news....sorry isn't it...the numbers killed either "stress" related or in training.....I see no excuse or rationalization in it......
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It is old news for the most part. Too often we seem to use those 'fit as a fiddle' individuals that died at a young age despite their dedication to fitness. My opinion is that is a cheap cop-out. It is pretty much up to the individual if they have the motivation, or dedication to be serious enough to TRY to do something, as in change those habits we say we know we shouldn't be doing.
No the sky isn't falling either. But if it started to fall, they'd probably call us first to try to stop it. Anyone who doesn't understand the concept of how we are at a greater risk due to the very nature of our work will most likely never get it.
I know so many guys who are still hangin' on to their high school glory days. Tip-top shape, the school jock. But a couple decades later, years without so much as an hour a week on even the most basic of fitness attempts, and they blame it all on age. Wonder how it all happened? LIFESTYLE can be changed!
Smoke? Individual choice. You don't have to. It's an addicition, as we all know, and not so easy to break. Oh, it's legal, so we tend to seperate ourselves from other forms of addicition. Keep on teeling ourselves it's different. Maybe we even believe it. Overweight? Fat? It get's harder and harder every year to try to get ahead of that one. But not trying means you have lost that one too.
It seems to be simple lack of effort. I have spent time in the gym with people much older than me, and with real, limiting handicaps. Yet they find no excuses to just sit around and chalk it all up to the oh well file.
MY genetics suck terribly. History oof cardiac disease and cancer on both sides. Yet I choose this occupation to support my family. Maybe becouse of these genetics I SHOULD work harder to try to stay reasonably fit? No excuses. I have heard of plenty of fit, healthy people who have died early. I have been on those jobs myself. But that's no excuse for me to not make the effort.
I have also worked with far too many overweight...and seriously overweight, soft, weak, blown-up gasping for air so-called firefighters to tolerate complacency for myself. If that's thier style, that's their choice, but I don't want them anywhere's near me.
Yes the chance of it happening to anyone is there. But this about the bigger picture. It's also about having strength, endurance, and physical ability to do this JOB. Personally I have found that those who make these arguments against the need for an above-average level of fitness for firefighters to be the individuals that are the least fit, that make every excuse and defend their lack of motivation.
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Permalink Reply by Ben Waller on
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Just curious - how many of the heart attack-related LODDs occur in firefighters who are obese or who have not had a medical evaluation compared to those who are not obese and who do have the evaluations?
We still hear about recruits who are young, fit athletes dying while doing PT during recruit school, we still hear about relatively young firefighters in good shape having cardiac events, and we hear about some of these LODDs occuring while the firefighters were working out or engaging in other PT while on duty.
We also hear about other LODD heart attacks that hit firefighters hours when at rest after a call, or when involved in relatively sedentary activities around the station.
What does that tell us? It tells us that being in good physical shape helps with being able to do the job, but it doesn't tell us that there is a higher percentage of unfit firefighters having heart attack LODDs compared to the more fit firefighters.
Further, a lot of the heart attack LODDs occur in 60 to 70 year-old firefighters who are at higher risk for cardiac events if they've been retired for 20 years.
In other words, blaming heart attacks on just physical attributes hasn't been shown to have any scientific validity, and we need to make sure we're not engaging in "ready, FIRE, ummm, uhhh, aim???" when we advocate the "solution".
50 or so cardiac-related deaths per year out of a population of undreds of thousands of firefighters may be cause for concern, but it shouldn't be unexpected, given the relative odds of heart attack in the general population that doesn't fight fire.
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Permalink Reply by Norm Tindell on
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I hope we as volunteers want to take good care of ourselves. the hard truth is we are a bunch of old guys at our department with just a few young, strong guys. If we change our standards there won't be anyone left to respond on Tuesday at 10am when Shirley's house catches fire. We worry more and more about recruitment and retention. Perhaps we could implement smarter standards in phases to keep this from being such a shock.
I know --- LODD's are the biggest shock!
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We can debate this for a long time. And we are mainly only looking at LODD's related to Cardiac Events. How about the heart attacks that don't result in death, but end a career? And I think the biggest problem lies in between those in the absolute best possible phyiscal condtion, and the obese. Should we call 'em average?
As far as fitnes and health for firefighters, we should also be looking at 'brain attacks' (stroke) and cancers, and lung disease. These are the issues that we face that are supposedly more realted to our line of work as opposed to other occupations. These are related to heredity AND lifestyle, with the latter the part of the issues we MAY be able to reduce as far as risk goes.
"Normt" pretty much sums up the problem faced by so many fire departments. Especially in many smaller communities, where the younger population goes through the cycle of school, college, and moving on to other areas where maybe more oppurtunity exists for careers...resulting in an ever-aging local fire department.
However...if we DO know that we are involved in a business that can require extreme pressure, strenous physical activity and mental and emotional stress at a moments notice, all things that can tear down our health over time, and sometimes all at once, shouldn't this be enough of a warning to wake up those who can't even pull their own weight off the ground, or climb a flight of stairs without getting winded?
Sometimes it seems that even when your response IS an engine or two with seats filled with over 40 and 50-something firefighters, the common thought process is that someone else will be able to haul the hose up those stairs...even though they are ALL in the same condition!
It's called DENIAL!
Go ahead and debate the statistics. Believe that it doesn't apply to you, or affect you. Excuses abound.
Firefighting efforts, and not just resigning yourself to permenant driver, but REAL firefighting activity requires a fair amount of physical conditioning to perform. If you signed on for it...volunteered for it, or are getting paid for it, you MUST know there are REALLY no valid excuses for NOT making the effort to increase your personal levels of fitness. Those who don't most likely have "the other guy" mindset.
Wear the costume, ride the trucks, but when it comes to the real rough stuff, maybe that very rare situation...the other guy(s) will be there. All that fitness stuff is for somebody else, and everybody else.
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Permalink Reply by Spanner 122 on
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The cause of LODD's being heart attacks or heart related incidents has been hovering at or around 50% for years/decades. It is not something new and it's incredible sad to see that it has not changed. I think it's what we're not doing as opposed to what we are doing.
First of all, many firehalls are still serving giant meals. We're starving by the time lunch or supper rolls around and we fill our plates beyond what is normal. Of course we wouldn't dare have smaller meals and allow for snacks before or after, that "would just be weird."
Second, we are not training nearly enough. And by training, I do not mean fire ground operations, I mean in the gym working out like our lives depended on it. Oh, that's right, they do!
Thirdly we're still taking in too much smoke. We're (and by we, I mean officers) are still ordering firefighters into operations such as ventilation and overhaul without proper PPE, without SCBA. It's very discouraging. Not only that, when one sees another not putting on the SCBA, they feel obligated to be the "brave guy/girl" and also not wear theirs. Be the solution, stop being the problem. Smoke is deadly. Particulates from three blocks away, if exposed to them on a regular basis, will cause cancer.
Fourth we do not take any of this seriously. We believe we are infallible, or that dying of cancer means we were "true smoke eaters" or going down in a "blaze of glory (also known as stupidity) will mean we live on as heroes forever.
We are not heroes if we do not protect ourselves. We are not heroes if we are dead. We are not heroes if we cannot make the save because we need to be saved. We are heroes by leading by example, teaching the new firefighters to be the new class of firefighters.
Disclaimer - this is not meant to say that a firefighter who dies in the line of duty is not a hero for doing his duties. I have known heroes who are no longer with us, this is for the cowboys who think being rogue is cool.
Disclaimer #2 - no offense to actual cowboys; they're cool!
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