NFPA Journal - November/December 2017 - 106

The commanding officer of the
emergency medical services
(EMS) unit decided that the
firefighter needed to be transported due to a cardiac event.
The 52-year-old male was
diagnosed with demand ischemia, a cardiac event where
the heart needs more oxygen
than is available in the body's
supply and occurs in patients
with tachyarrhythmia (abnormally fast heart rates). He was
hospitalized for a few days and
cleared to return to firefighting
duties several weeks after the
incident.
At that same fire event, an
engine company staffed with
a captain and two firefighters
were tasked with advancing
a hoseline into an exposure
building on the right side of
the original fire building. The
wood-frame building was
similar to the original fire
building in terms of construction type and occupancy. All
the fire in the apartment and
walls on the third floor was
extinguished, and the building
was overhauled and thoroughly ventilated. The wind
was blowing into the front of
the building toward the back
with sustained winds at 20-35
mph (35-56 kph) with gusts
recorded at 46 mph (74 kph).
The officer and the firefighters,
along with another engine and
ladder company, were ordered
to advance a hoseline up the
rear stairs to extinguish fire on
the fourth floor. Conditions on
the third floor were clear, with

strong swirling winds blowing
through the apartment. Firefighters used the third floor as
an area of refuge to conserve
their air and removed their
SCBA facepieces while cycling
in and out of the rear stairs and
fourth floor, believing the atmosphere was clear.
The fire captain with 31 years
of firefighting experience fell
down the stairs and twisted
his knee while exiting the
building after a strenuous work
cycle. He was transported to
the emergency room from the
scene by ambulance. During
his treatment at the emergency
room for his knee injury, he
began having difficulty breathing, eventually going into
respiratory arrest. He was intubated and ultimately treated
for cyanide poisoning and hospitalized in critical condition.
The department reached out
to members who experienced
symptoms of cyanide toxicity and directed them to the
emergency room for treatment.
Three firefighters were immediately treated for cyanide
poisoning in addition to the
captain. The following morning,
another six firefighters sought
treatment at the emergency
room. A total of 10 firefighters
received treatment for cyanide
poisoning. Seven of those 10
firefighters treated operated
inside or near the same exposure building.
The captain never returned
to fire duty and continues to
experience respiratory issues.

Firefighters work to
prevent hot spots
from flaring up at
a restaurant fire in
California that injured
three firefighters.

106 | NFPA JOURNAL * N O V E M B E R / D E C E M B E R 2 0 1 7

or pieces of fire service apparatus or equipment
in response to an alarm. "Injury" refers to physical damage suffered by a person that requires
(or should require) treatment by a practitioner
of medicine (physician, nurse, paramedic, EMT)
within one year of the incident, regardless of
whether treatment was actually received, or that
results in at least one day of restricted activity
immediately following the incident.

Injuries by type of duty
As in past reports, type of duty is divided into five
categories, including responding to or returning
from an incident (including fire and non-fire
emergencies); fireground (including structure
fires, vehicle fires, brush fires, etc.), referring to all
activities from the moment of arrival at the scene
to departure time (e.g., setup, extinguishment, and
overhaul); non-fire emergency (including rescue
calls, hazardous calls such as spills, and natural
disaster calls; training; and other on-duty activities (e.g., inspection or maintenance duties).
Firefighters were more likely to be injured at
fireground operations than at other types of duties.
In 2016, 24,325, or 39.2 percent, of all firefighter
injuries occurred at the fireground. This was a
decrease of 8.8 percent from the previous year,
which was the lowest number since 1981. Injuries
at the fireground decreased from a high of 67,500
in 1981 to 24,325 in 2016, a drop of 64 percent. The
number of fires also declined steadily, for an overall
decrease of 53.6 percent, and the rate of injuries
per 1,000 fires over the past 35 years has fluctuated
between a high of 28.3 injuries per 1,000 fires in
1990 and a low of 18.1 injuries per 1,000 fires in
2016. These results suggest that even though the
number of fires and fireground
injuries declined during the period,
the injury rate did not, meaning the
fireground injury rate per fire risk
has not changed much since 1981.
Overall, the number of injuries
at non-fire emergencies increased
33.1 percent between 1981 and 2016,
from 9,600 to 12,780. During the
same period, the number of nonfire emergencies also increased
340 percent, due in large part to
an increase in the number of fire
department responses to medical
emergencies. The injury rate per
1,000 non-fire emergencies declined
between 1981 and 2016, from 1.24
to 0.38, largely because the number
of non-fire emergencies increased
at a higher rate than the number of
injuries at non-fire emergencies.
In addition, 5,200 firefighter
injuries occurred while responding
to or returning from an incident in

ORANGE COUNT Y REGISTER/AP/WIDE WORLD

Selected 2016 U.S. Firefighter
Injury Incidents (continued)

Table of Contents for the Digital Edition of NFPA Journal - November/December 2017