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Firefighter Safety
by Ronald J. Siarnicki

3 steps to prevent after-incident heart attacks

Fatal heart attacks can strike several hours after the fire is out; this kills about 10 firefighters per year, but doesn't have to

By Ronald J. Siarnicki

If you are the incident commander at a fire and you hear that one of your firefighters isn't feeling quite right and requests to go home or back to the firehouse, I urge you to say no.

On the surface, that answer may seem cruel. But by instead insisting that the firefighter be evaluated medically right away, you could be preventing a line of duty death. In fact, making this a clear policy in your department could further reduce the number of firefighters who die each year.

Every year as I read the fatality reports this scenario crops up multiple times. A firefighter begins to feel unwell at some point during an incident. They may or may not notify others on their team that something is wrong and return to the station or even go home to rest.

Unfortunately then, the unthinkable happens: they collapse or are found dead when friends or relatives attempt to wake them the following morning. Annual data shows that this happens up to 10 times each year.

The lesson to be learned from this is that our bodies sometimes provide us with a warning signal and we have to then take appropriate steps to do something about it. All too often, we make excuses. Maybe it's because of our ego, or fear of being pulled from the crew, or we just think we’re invincible. 

But the simple fact is that an untreated coronary issue will lead to death. Several steps have to be taken in order to reverse the trend that is occurring when this situation arises. 

Steps 1 and 2
The first is reporting the signs and symptoms the firefighter is experiencing. We cannot ignore it or convince ourselves that there is nothing wrong with us. We have to have the courage to admit that we need immediate help.

The second step is to take personal responsibility; we must report it then seek out medical attention to address it. That medical attention may be something as simple as placing a cardiac monitor into service and conducting a heart check.

I am convinced that in some of the cases reported each year this intervention would have made a difference in the outcome for the firefighter and his or her family. Those incident reports I read each month are telling us that these firefighters are actually having the onset of a heart attack and need medical treatment. Otherwise they are going to die. 

I am confident that fewer deaths will occur each year if we admit we need assistance and then follow-through with intervention. It's that simple. 

Step 3
The third step is to collect more evidence-based research about cardiac emergencies within the public safety community. Several institutions and medical centers are examining why firefighter deaths can occur up to 24 hours after the strenuous activity that contributed to the onset of the event. 

They are looking at what triggers may cause the abnormal rhythm that puts that heart in danger. They are also exploring what interventions can be developed and placed into departmental policies to reduce the leading cause of firefighter fatalities in our nation.

I truly believe these researchers are doing their part to address this last step. The question I have for you is: Are you dealing with the first two?

As members of the fire service community we have a duty and responsibility to be accountable for ourselves and others. We also have a duty to act when we encounter unsafe actions or situations that may result in injury or death to ourselves and others.

That is why everyone must be empowered to act when the situation warrants itself. The difficulty in doing this is rooted in peer pressure and denial, which are still a part of the culture within the fire service.

However, true leadership and individual courage comes forth when we act without worrying about what others will say or do. That is the true test of having the courage to be safe.
 

About the author

Fire Chief Ronald Jon Siarnicki began his fire service career with the Prince George's County Fire/EMS Department in 1978 and with 24 years of fire, rescue and emergency medical services operational experience, he has progressed through the ranks to chief. In July 2001, Chief Siarnicki retired from the Prince George’s County Fire/EMS Department to take the position of executive director of the National Fallen Firefighters Foundation. He is a graduate of the masters program, school of management and technology at the University of Maryland, University College and has a bachelor's of science degree in fire science management from UMUC. He is a certified Fire Officer IV, Firefighter Level III and State Emergency Medical Technician. Prior to joining the Prince George's County Fire/EMS Department, he served as a volunteer firefighter with the Monessen VFD Hose House 2 and currently serves with the United Communities VFD in Stevensville, Md. Chief Siarnicki can be reached at Ronald.Siarnicki@FireRescue1.com



Comments
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Aaron Ciotti Aaron Ciotti Tuesday, March 19, 2013 10:56:41 AM Probably not a bad idea to take an aspirin when the call goes out either.
Nicholas Cave Nicholas Cave Tue Mar 19 21:42:58 PDT 2013 thats a good idea
Sturgis Volunteer Fire Department Sturgis Volunteer Fire Department Tuesday, March 19, 2013 1:37:58 PM Some excellent advice.
Sharon Purdy Sharon Purdy Tuesday, March 19, 2013 4:08:16 PM Thank you Chief. As the wife of a fallen firefighter who died of a cardiac event your words are well said. I love your last statement "the true test of having the courage to be safe". You are right, it takes courage to make changes and it takes courage to admit that you might be having chest discomfort at a fire scene or seek treatment if the onset happens soon after. Be smart, be safe, and come home to you families at the end of the day. Sharon Purdy wife of Lee A, Purdy Jan. 8 2000
Reid Timothy Reid Timothy Tuesday, March 19, 2013 9:33:57 PM Forwarding to our Chief... We haven't had an issue (yet) but I think identifying the tell-tale signs is essential for any fire department.
Peggy Bourrienne Peggy Bourrienne Thursday, March 21, 2013 6:41:06 PM Thank you Chief, the two young men standing next to me are my twin sons, both proud firemen in Missouri. I plan on telling them this warning so their pride does not get in the way should they feel ill on the job. I am so proud of them, but they meen everything to me.
Jerry Taylor II Jerry Taylor II Friday, March 22, 2013 8:36:03 AM thanks chief..... as the new safety officer I will use this and push for more check-ups... as an hazmat tech. on a team we had to be cleared by ems to return to duty or leave the scene it was just an extra part of rehab I plan on talking with our ems to start doing this at every fire over 45 min. and have put in our sop's it is our lives and if it saves just one I am happy to open the can of worms.... again thank you.
Mark Bulla Mark Bulla Friday, March 22, 2013 4:27:11 PM Thanks Chief - Honestly, I think that some of the resistance that I would have to go to the doctor is that, as soon as there is any hint of a cardiac problem, my career as a volunteer is over. It doesn't matter if it's a minor problem that is controlled by medication, or that I could do less energetic work like driving the ambulance or something, it would be a "thanks for your service, don't let the door hit you on the way out." I'm 2 years away from getting LOSAP (a volunteer pension-like program), and I worry about this every year when I get my treadmill test. To tell you the truth, I'd rather not know if it meant having to stop volunteering. I am doing my part by exercising, taking an aspirin a day, watching what I eat, and getting regular checkups by my personal physician, though. And I am very aware that this is a problem - I've been at the Fallen Firefighters Memorial Service every year since 1990, and have been an escort for several families whose loved ones have died because of this exact cause. I guess I will need to work on my individual courage if I ever have a problem like this.
Badanga Ahmed Lamidi Badanga Ahmed Lamidi Thursday, April 18, 2013 5:20:00 PM Tribute to DALLAS Captain Kenny Harris killed in the West plant explosion. A great man, captain Kenny Harris, although I may not know you in person but your memories will live forever among many, both in America and the rest of the World for your bravery, dedication to duty and above all your effort to always lay down your life to help others. Rest in Peace. Fire all over the world is devastating, it has killed millions of people, destroy unquantifiable properties, no nation is speared from the dreaded nature of Fire, I use to imagine that if big flooding occur there is the possibility for good swimmer to successfully swim across and survive the havoc of water or flooding. but when fire disaster strikes , the victims hardly survive it, because it consume in totality anything in its parts and turn them to ashes, and such ashes can never be brought back to its original shape or state. so I used to wonder that in spite of this devastating nature of FIRE world over United Nations is yet to dedicate a day to be marked as "WORLD FIRE SAFETY DAY" to further promote fire safety worldwide and remember gallant fire captains like Kenny Harris and other Hero killed by fire world over. I therefore pledge to myself and the rest of the world that I will continue to promote this idea of World Fire Safety Day to United Nations as long as I LIVE. Once More RIP the great Kenny Harris from Badanga Ahmed Lamidi, President Fire Disaster Prevention & Safety Nigeria.

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