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

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■ Firefighter Autopsy Protocol ■ 155 ■ I: Background ■ NIOSH REP. # F2000-22 Mar 15, 2000 F2000-21 Jun 02, 1998 DATE OF INCIDENT Title CAUSE OF DEATH AUTOPSY AUTOPSY COMMENTS Wildland fire claims the life of one volunteer firefighter and injures another firefighter— South Dakota On-duty driver/operator dies in sleep—Indiana Sepsis as a result of extensive thermal burns due to a grass fire Probable arrhythmia due to hypertrophic cardiomyopathy, fibrosis of sinoatrial node Not mentioned None Yes • Since the driver/operator was not engaged in fire suppression activities, his blood was not tested for carbon monoxide poisoning (carboxyhemoglobin levels) • Moderate coronary artery disease – Up to 50% stenosis of the proximal circumflex artery – Up to 50% stenosis of the mid left anterior descending coronary artery – Intramyocardial tunneling of coronary artery – Fibrosis of the sinoatrial node • Concentric hypertrophic cardiomyopathy – Diminished left ventricular cavity – Dilated right ventricle – Significant myocyte hypertrophy with nuclear enlargement and fiber disarray involving the septum of both ventricles • Biventricular and ventricular septum hypertrophy • Severely congested lungs bilaterally with edema • Hepatosplenomegaly with passive congestion • Hashimoto’s thyroiditis F2000-20 Feb 10, 1998 Driver/Operator dies at a motor vehicle fire—Wisconsin “Myocardial infarction” as the immediate cause of death, due to “severe atherosclerotic cardiovascular disease.” Yes • Severe arteriosclerotic heart disease – High-grade atheromatous plaques of up to 100% occlusion of the left anterior descending and the right coronary arteries • Large remote myocardial infarct in the lateral wall of the left ventricle • Three graft vessels • Cardiomegaly (enlarged heart) (750 gms) PDF LINK
■ Firefighter Autopsy Protocol ■ 156 ■ I: Background ■ NIOSH REP. # F2000-19 Mar 17, 2000 F2000-18 Jan 17, 2000 F2000-17 Feb 11, 2000 F2000-16 Mar 03, 2000 F2000-15 Oct 15, 1997 F2000-14 Feb 06, 2000 DATE OF INCIDENT Title CAUSE OF DEATH AUTOPSY AUTOPSY COMMENTS Motor-vehicle incident involving amtrak train claims life of career firefighter/engineer— North Carolina Tanker rollover claims life of volunteer fire chief—Missouri A volunteer firefighter/driver was killed and another volunteer firefighter was injured while responding to a motor vehicle incident with injuries—California Arson fire claims the life of one volunteer firefighter and one civilian and severely injures another volunteer firefighter—Michigan Battalion chief suffers a heart attack and eventually dies while participating in a fitness program—California Firefighter dies at a singlefamily dwelling fire—Iowa Multiple blunt-force injury from the fire truck/train collision Massive neck trauma and upper chest trauma Adult respiratory distress syndrome [lung failure]/ischemia and encephalopathy due to motor vehicle crash Not mentioned None Not mentioned None Not mentioned None Asphyxiation Not mentioned None Cardiogenic shock due to enterobacter sepsis due to multiorgan failure due to ischemic cardiomyopathy “Occlusive coronary artery disease” as the immediate cause of death due to “atherosclerotic vascular disease” No Perform autopsies on all onduty firefighter fatalities Yes • Atherosclerotic vascular disease – Severe coronary artery disease – Right coronary artery, 75% stenotic – Left circumflex artery, 80% stenotic – Left anterior descending artery unavailable due to organ harvesting for donation • Focal contraction band necrosis in the right ventricle • Acute pulmonary congestion, agonal • Pulmonary anthracosis without emphysema • Carbon monoxide level of 4% PDF LINK
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Firefighter Autopsy Protocol ■
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■■Acknowledgement This project
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