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

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.

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