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LODD Category: Stress and Overexertion
This thread is to spark an open conversation about OUR number 1 killer in the fire service. Everyone knows about it... Firefighters.... Fire Officers..... Fire Chiefs. Well unless you live under a rock, how can you not know about it with the internet? I am an instructor and advocate for the NFFF - Courage to be Safe Program, I was one of the first to be awarded the CTBS - Challenge Coins.
The program... OUR program was developed to reduce line of duty deaths. The program has 16 life safety initiatives. They clearly spell out a roadmap to reduce your chances of suffering a line of duty death.
Now, being a progressive instructor who values the cause, I have a serious issue with our number 1 killer. "Stress and Overexertion" or simply stated in common terms cardiac related incidents. You see after studying the NFPA report on a ten year period the details are saddening. Full report here: www.nfpa.org/assets/files/PDF/OSCardiacDeath.pdf
This report states under "Medical History" of a fellow brother or sister victim, it reads: In some cases, information was widely known to the fire department (such as prior heart attack or heart surgery) and is mentioned on the report. Such medical history information was available for 308 of the 440 victims of sudden cardiac death in this 10 year period. Of these 308 firefighters, 134 (43.5 percent) had prior KNOWN heart-related conditions, such as previous heart attacks or had undergone bypass surgery or angioplasty/stent placement. Another 97 of the victims (31.5 percent) had arteriosclerotic heart disease, defined as arterial occlusion of at least 50 PERCENT. Of these 97 victims, this condition is detectable, but the victims may not have been tested, and may never have been aware of their condition.
Seems to me that to reduce the numbers, to dramatically reduce hearing about another cardiac related or stress induced LODD, we the "INDIVIDUAL", we the "Fire Chief" or we the Fire Service as a whole need to take some responsibility for nearly half of the known underlying cardiac conditions..... "personal responsibility" will go a long way, otherwise the numbers will not be reduced year after year.
I personally would like to see in a statistical report, how many of these "LODD's" happened to a healthy, NFPA 1582 physically fit firefighter?... who suffered so much stress that it caused a LODD? I would bet that number, would be significantly small.
What's your thoughts on this issue?
Replies to This Discussion
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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Having just retired... I have a couple of thoughts that are salient to your post FETC. First off, as a hazmat team member, I had to undergo stress physicals annually and this included blood panels and stress ekg's. As I neared my retirement, I took advantage of my health insurance policy that is associated with the Los Angeles City Fire Department. The benefit that I took advantage of was a full body scan. And was I surprised...
I don't smoke, and drink minimally but yet the body scan revealed serious issues with coronary artery blockage. I have no symptoms but the MRI does not lie. After visiting a cardiologist and getting a complete workup, I was put on medications designed to stabilize the cardiac plaque on the walls of the coronary arteries to prevent stroke or heart attack potential and the medication slowly dissolves the plaque, but only in the heart arteries. Any plaque built up on the walls of the aorta for example are there for good.
I feel lucky finding out that I had invisible issues. I added a couple of years onto my life and I know that I too could have very easily been another LODD statistic.
If you are over 40, are you taking one 81 mg chewable baby aspirin a day? 1200 mg fish oil daily? 30 minutes minimum daily exercise to increase cardiac flow and heart conditioning? Anyone doing this job, especially those working as volunteers need to be heads up that this job is cool, but certainly not worth dying for.
Individuals need to take responsibility for their own actions and health. NFPA 1582 is something that ALL firefighters need to adhere to. Their lives may depend on it.
CBz
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Permalink Reply by Richard Armstrong on
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my dept. also has two bottles sit for one Jim.I think its a smart thing to do cause you may feel fine but 2 min into the third you may let out the next drop of sweat and that's the end of it and you could start to feel the effects and down ya go.Your body will need a rest and adreniline will tell you otherwise.So when your rehab guy tells you to sit I strongly suggest that you listen cause adreniline can hide fatique to a certain extent but after you start to get exhausted it may be too late.dehidration is not a good thing and ask any paramedic and he'll tell ya after you feel very thirsty it may be too late.Just be safe guys and don't be foolish.That's why there are other companies/departments there so guys get a chance for a break!!
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Permalink Reply by Mac Conant on
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We share the 2 bottle rule in my Vol Dept. And should be strickly enforced.
I had a scare last summer..we had a large lumber mill fire (The kiln room, and about 3 storys worth of stacked, dry wood went up) It was in the 80's, to mid 80's, and hot! (Maine is a Humid climate in the summer)
I was on a inch and a half for maybe..20 minutes? The fire was so hot that the water seemed to evaporate before it reached the building, or any fire. They then brough up a 2 1/2. And lucky me..they picked me to help the guy on the nozzle. I was already tired, but thought "Hey..just sit there and hold the guy up...no biggy.
No'sah that heat kept on baking, and i was sweating up a storm. Soon enough (Bout..35 minutes later) They came and said "take a break guys" I promptly sat on the ground a few feet back and sat down. Taking off my gear, and suddenly felt as tho I may throw up, or pass out.
Then they swooped in! Emts throwing away my gear, and pulling my shirt up. They then walked me to the ambulance, bunker pants around my ankles, and threw me into the ambulance and started taking BP and Pulse, and making me drink everything in sight. It was quite the scare. Ive never been that exhausted before...So keep that as a lesson to anyone who hasn't had Heat Exhaustion/heat stroke. Its a killer..and will sneak up on you when you think "Im fine..I can keep going"
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Permalink Reply by Derek R. on
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Great post FETC. This is a great eye opener for those that chose not to get tested. I'm not 40 yet, but will indeed be getting checked out. A lot of people wait for the symptoms before getting it looked at, and as previousely mentioned, a lot of times, by then it's too late. As CBz found out, it's the silent layed back ailments that folks don't think about.
Like I said, Now with eyes opened, I'm going in. You never know. Maybe this will be an eyeopener for others as well.
And just to add, It doesn't matter how many bottles you go through that matter, it's WHEN the problem decides to bite you. You could be donning your gear and next thing you know, you're on the ground sucking air from a paramedic's O2 bottle, (f you're lucky).
Thanks FETC.
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Permalink Reply by FETC on
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This is far far deeper than a two bottle and forced to go to rehab - rule. That is not any sort of pre-qual for if you are fit to be there in the first place...
Many of these cardiac induced LODD were from non-emergency incidents, unrelated to the stress of an actual building fire. I am talking about the stress from an alarm assignment, or the guy's pager going off or the lights and sirens response... That stress compiled with a pre-existing cardiac condition and boom lights out.
So I ask again, why aren't fire department's taking true FD physicals? Not DOT physicals... NFPA 1582 Fire Department Health and Wellness Physicals specific for our occupation.
If you say we can't afford them do you allow their personal physician sign them off. Do you understand that some firefighters are having their personal physicians sign them off as OK to be a firefighter and they are NOT. Does the doctor even know NFPA 1582 exists?
I have even seen firefighters who knew their personal doctor would deny them active firefighter status so they went to a "Doc in the Box" to get an OK...
Many of these cardiac related LODD's are clearly an event waiting to happen in the fire service. I read some of the news reports, read the details and sometimes think to myself, how was this guy allowed to be an active firefighter?
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Permalink Reply by Olivia Jones on
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OK as a ISO and HSO the "when its your time" attitude gets a lot of firefighters dead every year! Im not saying that I can outsmart a divine being, however a 300lbs person that cant walk a mile let alone run, and sucks down a tank of air like its crack should NOT be allowed to activly run calls. END OF STORY! I have had to call a firefighters family and say your son is in the emergency room, he will be ok, but let me tell you I got out emerg- and the mother was in a panic. After the call where one of ours went to the ER, I sat down with all the officers and new standards went in place.
No that not true, we are now going to inforce the standard that had always been there just disregarded. As a service we have to say enough you must be physically fit to do this job. And I challange anyone out there that says "if I had to I could do it" or "NFPA standards are fine for paid but the rest of us...." anyone that thinks its ok to not meet NFPA 1582, go to National Fire Academy in Emmitsburg Md on Oct 2-3 2010 for the National Fallen Firefighters Memorial Weekend and tell those families and departments that it cant happen to you.
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Permalink Reply by NOVAFireman on
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I started a discussion on this a while back; http://www.firefighternation.com/forum/topics/line-of-duty-deaths-c...
There will be someone along in a little while who will tell you it's nothing to worry about, and it's always going to happen, and there is nothing we can really do, or should do about it.
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Permalink Reply by Ben Waller on
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'Then they swooped in! Emts throwing away my gear, and pulling my shirt up. They then walked me to the ambulance, bunker pants around my ankles, and threw me into the ambulance and started taking BP and Pulse, and making me drink everything in sight. It was quite the scare. Ive never been that exhausted before...So keep that as a lesson to anyone who hasn't had Heat Exhaustion/heat stroke. Its a killer..and will sneak up on you when you think 'Im fine..I can keep going'."
That's not exactly the recommended way to treat anyone with heat exhaustion, let alone a firefighter.
There are several things wrong there - all turnoug gear should have been removed, active cooling started, and the firefighter should NEVER be forced to walk to the ambulance, particularly with turnout pants around the ankles.
Put the rehab area in the shade, have the heat exhausted firefighter get completely out of all turnout gear, rehydrate and cool him off in place, and if necessary to transport, take the firefighter to the ambulance on a stretcher so he isn't being forced to exert himself at all until he's adequately rested, cooled off, and most importantly, rehycrated.
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Well I will have to respectfully disagree with anyone who will say "It's always going to happen - so not to worry about it." Thats simply bs.
Yes it will probably continue to happen, but does it have to happen at our current average? I understand yes, even fit firefighters will suffer an incident... but to have active firefighters who are walking around daily with known, (fixed or unfixed) cardiac conditions??? These firefighters are jeapordizing the lives and safety of fellow firefighters who are going to make an attempt to save a friend.
That in my opinion is a type of behavior is not respectful of our fellow brother and sisters.
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Permalink Reply by Ron Ayotte on
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There are many reasons....
One is the cost. FD budgets are already being cut into the bone all over the country and cities and towns don't want to pay for it. Some career locals want to have this type of physical ncluded in their contracts, while others are fighting it for this reason, which you nailed with this...
"I have even seen firefighters who knew their personal doctor would deny them active firefighter status so they went to a "Doc in the Box" to get an OK..." as long as the doc signs off, it's okay.
Volunteer FD's have enough problems getting members, and to make a volunteer firefighter pay out of pocket for a NFPA 1582 physical.
Another reason is the present healthcare system. HMOs and Health Insurance are looking to cut costs any way they can, and to do a full NFPA 1582 physical cuts is too costly for them to pay out, and universal health care will make it unobtainable.
You have some fire chiefs and city administrators who will not let firefighters work out on duty because they are afraid that they will get hurt or that they should do it on their own time and not on the taxpayer's dime (insert rolling eyes smiley icon here)...
You have firefighters who are content to be fat, dumb and happy....
You have volunteer and paid on call firefighters that can no longer do the job due to physical condition and age, but are kept on the rolls for "exterior operations only and fire police"...
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