NFPA Journal - July/August 2019 - 80

Selected 2018 U.S.
Firefighter Fatality Incidents
SUDDEN CARDIAC DEATH
FOLLOWING TRAINING
At approximately 7:45 a.m., a
30-year-old career firefighter
arrived at the firehouse for his
24-hour shift. Soon after arriving,
he began washing and cleaning
apparatus and checking equipment. After morning equipment
checks, the firefighter helped
move over 200 pounds (90 kg)
of trauma kits into a vehicle in
the back of the station. A half
hour later, he and his truck mates
repaired a pullout tray located in
an upper storage compartment
on the heavy rescue. During the
repairs, he was on a ladder and
handed down numerous heavy
tools and then repaired the
pullout tray and placed all items
back into the compartment.
For the next three hours, the
firefighter performed more
vehicle maintenance and then
participated in training with
five other firefighters. The
training evolution consisted of
donning structural firefighting
protective ensembles, including
self-contained breathing apparatus (SCBA), and performing
search training while on air.
The members participating
then performed low profile
and maneuvered through
tight spaces under a fire truck
while on air. At the end of the
drill, the victim had used more
than half of his air cylinder and
began complaining of chest
discomfort.
The training ended around
2 p.m., when the firefighters ate lunch and had some
down time in the firehouse. At
approximately 7 p.m., the victim
took 200 mg of ibuprofen and
seemed unsettled for the next
few hours. Fellow firefighters
observed the victim kneeling on
the concrete in obvious discomfort. He stated that he thought
he pulled a pectoral muscle. At
10:30 p.m., the victim informed
his company officer he was
going home before the "pain
struck again." The victim left the
firehouse and went home, which
was located a mile (1.6 km) down
the road.
An hour later, the victim's wife
dialed 911 reporting her husband was unconscious. Fellow
firefighters arrived on scene and
began advanced life support
measures, and he was transported to the hospital, where he
died from an acute myocardial
infarction.
The fire department does not
provide annual physicals for
its members but does have a
voluntary wellness and fitness
initiative.

CARDIAC EVENT WHILE
RESPONDING TO FIRE
A local volunteer fire department received calls reporting
a dwelling on fire. Firefighters
were dispatched at 1:46 p.m. A
firefighter with nine years' experience responded in his personal
vehicle to the firehouse, got out
of his vehicle, donned his turnout
coat and bunker pants, climbed
into the front driver's seat of the
engine company, and responded
at 1:48 p.m. with another firefighter. The engine arrived in two
minutes and the crews encountered a confined cooking fire on
the stove.
The driver suffered a medical
emergency while sitting in the
driver's seat, never leaving the
cab of the truck. Fellow firefighters unfastened his seatbelt and
removed him from the cab. They
brought him to the ground where
they initiated basic life support.
An advanced life support
ambulance was dispatched on
the initial call and arrived on
scene to begin life saving measures. The 64-year-old victim was
initially in ventricular fibrillation,
and CPR was initiated and sustained using a mechanical CPR
device. An intravenous line was
established. The victim was intubated in accordance with local
protocols and was defibrillated
five times. He was transported
and treated at the emergency
room. Resuscitation efforts
ceased just over an hour later.
STRUCTURAL COLLAPSE
DURING OVERHAUL
OPERATIONS
A 38-year-old firefighter died
while performing salvage and
overhaul when a ceiling collapsed, trapping him and two
other firefighters.
The fire department initially
responded with six firefighters to
a fire in a single-family, one-story
residence. Upon arrival, they
encountered a large volume of
fire and dark, dense smoke billowing from the attic area. Crews
successfully rescued three
trapped occupants, removing
them from the burning structure
during the initial stages of the
fire attack. The fire attack quickly
transitioned into a defensive
operation to extinguish the large
amount of fire consuming the
structure.
Three hours into the incident,
four firefighters entered the
structure to perform salvage and
overhaul. As they were working
in the den, they noticed the
ceiling beginning to sag. They
immediately turned to exit the
room. As they were retreating,

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vehicles, one ran out of air during a water rescue,
and one suffered sudden cardiac death.
The remaining 13 firefighters died while
involved in a variety of normal station, administrative, or maintenance activities. Nine of these
fatalities were due to sudden cardiac death and
one to an unintentional drug overdose. One firefighter was working with compressed air cylinders
when one failed, resulting in a fatal head injury.
One firefighter died in a crash while taking a
pump for its annual certification. One firefighter
slipped and fell off a fire truck while repacking
hose after a fire response.

Cause and nature of fatal injury
or illness
To summarize the details presented above, overexertion, stress, and medical issues accounted for
by far the largest share of deaths. Of the 28 deaths
in this category, 25 were classified as sudden cardiac deaths (usually heart attacks) and one was
due to an accidental overdose of prescription pain
medication. Two firefighters collapsed and died at
the fire station, but no cause of death has yet been
reported in either case. In addition, a firefighter
suffered a fatal asthma attack shortly after arriving at the scene of a house fire, and another died
of pneumonia shortly after being released from
serving on a wildland fire.
The next leading cause of death was internal
trauma and crushing, with 23 deaths. Six firefighters died of asphyxia or smoke inhalation, three
died of burns, and there was one each due to
drowning and gunshot.

Sudden cardiac deaths
The 25 sudden cardiac deaths in 2017 with onset
while the victim was on duty is the third consecutive year that the toll has been below 30, but
they still account for the largest share of deaths
while on duty. These are cases in which the onset
of symptoms occurred while the victim was on
duty and death occurred immediately or shortly
thereafter. Cardiac-related events accounted for
44 percent of the on-duty deaths over the past 10
years. Though it usually accounts for the largest
share of deaths in any given year, this compares
to the earliest years of the study when an average
of 60 firefighters a year suffered sudden cardiac
deaths while on duty. In addition, the US Fire
Administration (USFA) is following up on the
deaths of more than a dozen other firefighters
who reportedly died within 24 hours of non-routine strenuous and stressful physical activity,
potentially qualifying them for federal benefits
under the Hometown Heroes Act.

Vehicle-related deaths
In 2018, 12 firefighters died in vehicle crashes,
three were struck by vehicles, and one fell from

NFPA Journal - July/August 2019

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