Captain Suffers Sudden Cardiac Death While On-Duty – Tennessee

A 49-year-old male career fire captain (referred to as “Captain”) was assigned to a 24-hour duty on August 20, 2012. At 0700 hours, the Captain reported for duty at the fire station. At 07:27, the captain reported experiencing dyspepsia and pain in his chest. He urged his Lieutenant to summon an ambulance as he went inside the bunkroom to get an antacid. After a short while, the crew noticed what sounded like snoring and discovered the captain unconscious in the corridor. While an ambulance was being called, an automatic external defibrillator (AED) was acquired. After three AED shocks were given without resultant change in his clinical condition, cardiopulmonary resuscitation (CPR) was initiated at 0728 hours. At 07:38, the ambulance came, and advanced life support was initiated. The Commander

The following suggestions have nothing to do with the Captain’s passing. However, NIOSH investigators provide these suggestions to enhance the FD’s all-encompassing safety and health programme.

Event. The Captain began his 24-hour shift on August 20, 2012, at 0700 hours at his fire station. His two-month medical leave due to knee surgery began today, marking his first day back at work. He reported to his Lieutenant that he was experiencing dyspepsia and chest pain about 27 minutes into his shift. He went to the bunkroom to get an antacid and begged the Lieutenant to summon an ambulance. The Lieutenant thought he heard what sounded like snoring just after the Captain had left the room. The captain was discovered unconscious and laying in the corridor by the crew. Upon assessment, there was no pulse or breathing. An AED was retrieved and used, and CPR was started. The three shocks that the AED advised were given.

When the ambulance came at 07:38, the paramedics discovered that the captain was not breathing or had a pulse, and they began CPR. Medication for cardiac resuscitation was given and an intravenous line was inserted. Asystole (no heartbeat) was shown on the cardiac monitor, CPR was done throughout. Following a failed attempt at intubation, 100% oxygen was given and a Combitube® was inserted. After being loaded into the ambulance, the Captain left the scene at 07:48 in order to get to the closest hospital.

At 0758 hours, the ambulance pulled up to the hospital. The heart monitor remained in an asystolic state. An attempt at external cardiac pacing was made, however it failed. The Captain was given advanced life support and CPR until 08:17, at which point the attending physician declared him dead and the resuscitation operations were stopped.

Clinical Results. “Acute coronary insufficiency” was reported as the cause of death on both the death certificate and the autopsy, along with “possible plaque haemorrhage in the middle third of the left anterior descending coronary artery.” The autopsy’s noteworthy discoveries are enumerated in Appendix A.