Firefighter Autopsy Protocol - US Fire Administration - Federal ...

■ Firefighter Autopsy Protocol
■ 126 ■
I: Background ■
NIOSH
REP. #
F2003-26 Feb 20,
2003
F2003-25 May 14,
2003
F2003-24 Jan 21,
2003
DATE OF
INCIDENT Title CAUSE OF DEATH AUTOPSY AUTOPSY COMMENTS
Firefighter suffers sudden
cardiac death at his fire
station—Oregon
Career Federal firefighter
dies from injuries sustained
at prescribed burn—Arizona
Firefighter suffers fatal heart
attack while performing physical
fitness training—Missouri
Per death certificate:
“ischemic heart disease”
as the immediate
cause of death due to
“atherosclerotic coronary
heart disease.”
Per autopsy:
“arteriosclerotic cardiovascular
disease” as
the cause of death
Adult Respiratory
Distress Syndrome
secondary to severe
inhalation injury
with cardiovascular
compromise.
Per death certificate:
“acute myocardial
infarction” due to “atherosclerotic
coronary
artery disease”
Per autopsy:
“coronary atherosclerosis”
followed by
“stenosis, thrombosis,
chronic myocardial
infarct, subacute
myocardial infarcts,
acute myocardial
infarct, and acute
ischemic change” as
the cause(s) of death.
Yes • Moderate calcification and atherosclerotic narrowing of
the coronary arteries
None
mentioned
• Softening and dark discoloration of the left ventricle, more
toward the apex” [a finding suggestive of a recent myocardial
infarct (MI) (otherwise known as a heart attack)]
• No scars suggestive of old/remote heart attacks
• No evidence of a blood clot (embolus) in the pulmonary
arteries
• Microscopic examination of the heart muscle showed no
inflammation, necrosis, or scarring
• Blood carboxyhemoglobin level (a test of carbon monoxide
exposure) was not checked due to no exposure to fire
smoke during his shift, and no drug screen was performed
Note: Thirty-six % of the victim’s body surface area had
second- and third-degree burn injuries and he had a
significant inhalation injury
Yes • A large heart (435 grams with normal less than 400
grams)
• Significant coronary atherosclerosis
• Stent placement in three coronary arteries [left anterior
descending (LAD), left circumflex, right coronary artery]
• Evidence of old heart attacks (myocardial infarcts or MIs)
• Subacute MIs
• Acute (recent) MI in the interventricular septum and left
ventricular free wall
Since the captain was not involved in any fire suppression
duties that day, a carboxyhemoglobin level (a measure of
exposure to carbon monoxide) was not checked
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