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Book Fire Apparatus Operator Suffers Fatal Heart Attack During Annual Fire Department Medical Evaluatin   Missouri

Download or read book Fire Apparatus Operator Suffers Fatal Heart Attack During Annual Fire Department Medical Evaluatin Missouri written by Tommy N. Baldwin and published by . This book was released on 2011 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: On January 7, 2011, a 54-year-old male career Fire Apparatus Operator (FAO) participated in the Fire Department (FD) mandatory annual medical evaluation program scheduled while the FAO and his crew were on-duty. After completing several portions of the evaluation, the FAO began the exercise stress test component. After exercising for 3 minutes, 10 seconds, the FAO developed a life threatening arrhythmia (ventricular tachycardia), and the test was stopped. While being assisted to the examination table and while an ambulance was summoned, the FAO lost consciousness. Cardiopulmonary resuscitation (CPR) and advanced life support (ALS) were administered at the medical clinic, in the ambulance, and in the hospital's emergency department (ED). In the ED, the FAO regained a heart rhythm, and an electrocardiogram (EKG) showed signs consistent with a heart attack (myocardial infarction). The FAO was taken to the catheterization lab with a very low blood pressure (cardiogenic shock). A 95% blockage of one of his main coronary arteries was opened via angioplasty and a stent. While still in the catheterization lab, the FAO suffered another cardiac arrest from which he could not be revived. The death certificate and the autopsy listed "atherosclerotic cardiovascular disease" as the cause of death. Given the FAO's severe underlying heart disease, NIOSH investigators concluded that the physical exertion involved in the exercise stress test probably triggered a heart attack resulting in the FAO's death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear, however, if these recommendations would have prevented the FAO's death. Ensure fire fighters are cleared for return to duty by a healthcare provider knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of National Fire Protection Association (NFPA) 1582. Ensure that all members participate in the Fire Department's mandatory wellness/fitness program. Perform an annual physical performance (physical ability) evaluation. Notify the U.S. Food and Drug Administration (FDA) that the clinic defibrillator was not working properly.

Book Fire Fighter Suffers On duty Sudden Cardiac Death   Missouri

Download or read book Fire Fighter Suffers On duty Sudden Cardiac Death Missouri written by Tommy N. Baldwin and published by . This book was released on 2011 with total page 13 pages. Available in PDF, EPUB and Kindle. Book excerpt: On October 23, 2010, a 37-year-old male career fire fighter (FF) was working a 24-hour shift as the driver/operator of the tanker. During the shift he responded to two emergency calls. At the first call, a dwelling fire, the FF participated in interior structural fire fighting. At the second fire, a mutual aid call, the FF provided water supply. During the remainder of the shift, the FF performed about 2 hours of physical fitness training. That evening, he was having trouble falling asleep and remained in the day room where he sent a text message to a friend at midnight. The next morning crew members found the FF deceased and notified the coroner. The death certificate listed "sudden cardiac death probably exasperated (sic) or induced by overexertion fighting two structure fires while on duty" as the cause of death. The autopsy listed "cardiac arrhythmia secondary to dilated hypertrophic cardiomyopathy and severe arteriosclerotic cardiovascular disease" as the cause of death. Given the FF's underlying dilated hypertrophic cardiomyopathy, NIOSH investigators concluded that the physical stress of fire suppression activities and physical fitness training triggered a fatal heart arrhythmia. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear, however, whether these recommendations could have prevented the FF's death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unlikely, however, that any of these recommendations would have prevented the Trainee's death. Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. Perform a candidate and an annual physical performance (physical ability) evaluation for all members. Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program.

Book Fire Chief Suffers Fatal Heart Attack   New Hampshire

Download or read book Fire Chief Suffers Fatal Heart Attack New Hampshire written by Denise L. Smith and published by . This book was released on 2013 with total page 11 pages. Available in PDF, EPUB and Kindle. Book excerpt: On September 2, 2012, a 52-year-old Fire Chief experienced chest pains while working at the station. Fire department (FD) personnel transported the Chief to the hospital where he suffered a cardiac arrest and died. The death certificate and autopsy report listed the cause of death as "acute myocardial infarction" due to "arteriosclerotic cardiovascular disease." Activities at the fire station on the morning of September 2 and his duties as the Fire Chief during the State Fair were temporally related to his angina, heart attack, and sudden cardiac death. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country. Ensure that all fire fighters receive an annual medical evaluation consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. Phase in a mandatory comprehensive wellness and fitness program for fire fighters.

Book Fire Chief Suffers Fatal Heart Attack While Responding to a Structure Fire   Pennsylvania

Download or read book Fire Chief Suffers Fatal Heart Attack While Responding to a Structure Fire Pennsylvania written by Tommy N. Baldwin and published by . This book was released on 2009 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: (3) Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. (4) Phase in a comprehensive wellness and fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. (5) Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural firefighting. (6) Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program.

Book Lieutenant Suffers Fatal Heart Attack During Training   Ohio

Download or read book Lieutenant Suffers Fatal Heart Attack During Training Ohio written by Tommy N. Baldwin and published by . This book was released on 2010 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: On March 31, 2010, a 53-year-old male career Lieutenant (LT) reported for duty as the officer on Squad 91. During his shift he participated in the Fire Department's (FD) annual self-contained breathing apparatus (SCBA) endurance evaluation. After completing the first evolution in about 15-20 minutes, the LT complained of shoulder pain and sat down to rest. Shortly thereafter, both on-duty crews were dispatched to separate emergency calls. The LT did not respond with Squad 91, and crew members assumed the LT was either taking a shower or had responded with the other crew. Upon returning to the fire station about 1 hour later, crew members found the LT unresponsive in his bunkroom. Cardiopulmonary resuscitation (CPR) and advanced life support were begun, and the LT was transported to the local hospital's emergency department (ED). Advanced life support continued in the ED for an additional 10 minutes when he was pronounced dead by the ED physician. The autopsy, completed by the County Coroner, listed the cause of death as "acute thrombus of left anterior descending artery" due to "hypertensive atherosclerotic cardiovascular disease." Given the LT's underlying coronary artery disease (CAD), NIOSH investigators concluded that the physical exertion involved in performing the SCBA endurance training triggered his acute heart attack and subsequent cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is possible that if some of the recommended programs had been in place, the LT's death may have been prevented. 1) Incorporate exercise stress tests following standard medical guidelines into a Fire Department medical evaluation program. 2) Provide annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 3) Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. The following recommendations are made for safety and health reasons and would not have prevented the LT's death. 1) Provide preplacement medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582. 2) Perform an annual physical performance (physical ability) evaluation for all members. 3) Phase in a comprehensive wellness and fitness program for fire fighters. 4) Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube.

Book Fire Fighter Suffers Fatal Heart Attack While Fighting Residential Fire   New Jersey

Download or read book Fire Fighter Suffers Fatal Heart Attack While Fighting Residential Fire New Jersey written by Tommy N. Baldwin and published by . This book was released on 2009 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: (4) Phase in a comprehensive wellness and fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. (5) Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting. (6) Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program. (7) Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube.

Book Fire Fighter driver Operator Suffers Sudden Cardiac Death After Responding to a Residential Burning Odor Call   Illinois

Download or read book Fire Fighter driver Operator Suffers Sudden Cardiac Death After Responding to a Residential Burning Odor Call Illinois written by Tommy N. Baldwin and published by . This book was released on 2013 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: On November 11, 2012, a 61-year-old male career driver/operator ("D/O") and his truck company (Truck 40) were dispatched at 2205 hours to a three-story apartment building for a report of a burning odor. At the scene, the D/O set up the ladder and carried a ventilation saw to the roof. Fire fighters inside the building determined the smoke was caused by cooking and notified the D/O that ventilation was not necessary. When the D/O descended the ladder and reached the ground he was breathing rapidly. His shortness of breath persisted during the return trip to the fire station. While cleaning Truck 40 at the station, the D/O's shortness of breath worsened, and he reported some chest pain to crew members. They gave him oxygen and summoned an ambulance. The ambulance paramedics began treatment for pulmonary edema with oxygen, diuretics, and nitroglycerin and transported the D/O to the hospital's emergency department (ED). Shortly after arriving in the ED, the D/O had a cardiac arrest. Cardiopulmonary resuscitation was started followed by advanced life support including intubation with 100% oxygen. After 40 minutes in the ED, the D/O was pronounced dead at 2321 hours, and resuscitation efforts were stopped. The death certificate and autopsy report listed "hypertensive cardiovascular disease" as the cause of death with "coronary atherosclerosis" as a contributing factor. Additional autopsy findings included coronary artery disease, cardiomegaly (enlarged heart), and left ventricular hypertrophy (LVH). Given the D/O's underlying heart disease, NIOSH investigators concluded that the physical stress of responding to the call and ascending/descending the aerial ladder to the roof of a three-story building probably triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address safety and health issues and prevent similar incidents in the future. Provide annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. Conduct exercise stress tests into the fire department medical evaluation program for fire fighters at increased risk for coronary heart disease (CHD). Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department's medical evaluation program. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. Perform an annual physical performance (physical ability) evaluation for all members.

Book Fire Fighter Suffers Fatal Heart Attack While Performing Physical Fitness Training   Missouri

Download or read book Fire Fighter Suffers Fatal Heart Attack While Performing Physical Fitness Training Missouri written by Tommy N. Baldwin and published by . This book was released on 2003 with total page 11 pages. Available in PDF, EPUB and Kindle. Book excerpt: On January 21, 2003, at approximately 2045 hours, a 50-year-old male career Captain was lifting weights and walking on a treadmill in his fire station's exercise room when he experienced chest pains. After alerting his crew members, medical treatment for angina was begun. When his chest pain persisted and he became increasingly ill, he was loaded into an ambulance and transported to the hospital by in-house ambulance personnel. Despite being given advance life support (ALS) in the ambulance, he went into cardiac arrest and cardiopulmonary resuscitation (CPR) was begun. ALS measures were continued inside the emergency department (ED) for 18 minutes until he was pronounced dead and resuscitation measures were stopped. The death certificate listed "acute myocardial infarction" due to atherosclerotic coronary artery disease" as the immediate cause of death.

Book Lieutenant Suffers Sudden Cardiac Death at Scene of a Brush Fire   Missouri

Download or read book Lieutenant Suffers Sudden Cardiac Death at Scene of a Brush Fire Missouri written by Denise L. Smith and published by . This book was released on 2010 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt: and (6) provide fire fighters with medical clearance to wear SCBA as part of the Fire Department's medical evaluation program.

Book Driver operator fire Fighter Suffers a Heart Attack and Dies While Supporting Fire Suppression Activities   New York

Download or read book Driver operator fire Fighter Suffers a Heart Attack and Dies While Supporting Fire Suppression Activities New York written by Thomas R. Hales and published by . This book was released on 2000 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt: On April 29, 1998, a 49-year-old male driver/operator/fire fighter complained of chest pain while supporting fire suppression activities at a high-rise apartment building. Despite treatment by on-scene fire fighters (trained and certified as first responders) and ambulance paramedics, and CPR and ACLS administered by the hospital emergency department, the victim died. NIOSH was notified of this fatality on May 4, 1998, by the United States Fire Administration. On June 3, 2000, NIOSH contacted the affected fire department (FD) to initiate the investigation. On June 26, 2000, an occupational physician from the NIOSH Fire Fighter Fatality Investigation Team Traveled to New York to conduct an onsite investigation of the incident.

Book Volunteer Fire Fighter Suffers a Fatal Cardiac Event After Fire Suppression Training   Pennsylvania

Download or read book Volunteer Fire Fighter Suffers a Fatal Cardiac Event After Fire Suppression Training Pennsylvania written by Denise L. Smith and published by . This book was released on 2010 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt: On May 1, 2010, a 51-year-old volunteer Fire Fighter (FF) died after participating in fire suppression activities associated with a basic firefighting course (part of a 166 hour course). The incident occurred on the final day of training involving interior structural fire suppression and exterior fire drills. The FF, wearing full turnout gear and a self-contained breathing apparatus (SCBA), participated in one evolution of fire extinguishment lasting approximately 5 minutes and then experienced symptoms consistent with exhaustion and/or dehydration. Following rehydration and monitoring in rehabilitation (Rehab) for 1 hour and 45 minutes, he returned to training and completed a liquid propane drill lasting about 2 minutes. Approximately 5-10 minutes after this drill, the FF was found unresponsive and cyanotic. On scene emergency medical service (EMS) personnel summoned an ambulance, began cardiopulmonary resuscitation (CPR), and attached an automated external defibrillator (AED) to the FF from which two shocks were administered without a change in the FF's clinical condition. Advanced cardiac life support (ACLS) was provided by the ambulance crew and the Emergency Department (ED). Despite these efforts the FF could not be resuscitated. The death certificate listed "stress induced cardiac arrhythmia" as the immediate cause of death and severe coronary disease as the underlying cause of death. The pathologist conducting the autopsy listed "severe occlusive coronary artery" disease (CAD) as the cause of death. Based on the autopsy findings and the clinical scenario, the NIOSH investigators conclude that the FF probably died from a cardiac arrhythmia triggered by the physical exertion associated with firefighting training or a cardiac arrhythmia caused by a heart attack, which was triggered by firefighting training. NIOSH offers the following recommendations to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters at this, and other, fire departments (FD) across the country. 1) Provide mandatory pre-placement and periodic medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) Standard 1582, Standard on Comprehensive Occupational Medical Program for FDs. 2) Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 3) Develop a comprehensive wellness/fitness program for fire fighters to reduce risk factors for cardiovascular (CVD) and improve cardiovascular capacity. 4) Perform an annual physical performance (physical ability) evaluation. 5) Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the FD's annual medical evaluation program. 6) Provide on-scene emergency medical services with advanced life support and transport capability during live fire training. 7) Ensure emergency medical services staff in rehabilitation have the authority, as delegated from the Incident Command System, to use their professional judgment to keep members in rehabilitation or to transport them for further medical evaluation or treatment. 8) Training Academy participants must be medically cleared for live fire training.

Book Fire Fighter Suffers Fatal Heart Attack at Fire Scene   Wisconsin

Download or read book Fire Fighter Suffers Fatal Heart Attack at Fire Scene Wisconsin written by Mitchell Singal and published by . This book was released on 2003 with total page 10 pages. Available in PDF, EPUB and Kindle. Book excerpt: This list includes some preventive measures that have been recommended by other agencies to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters. These selected recommendations have not been evaluated by NIOSH, but they represent published research or consensus votes of technical committees of the National Fire Protection Association (NFPA) or fire service labor/management groups. -Institute preplacement and periodic medical evaluations. These should incorporate exercise stress testing, depending on the fire fighter's age and coronary artery disease risk factors.

Book Fire Fighter Suffers Heart Attack During Structural Fire Fighting Operations and Dies 8 Days Later   Kentucky

Download or read book Fire Fighter Suffers Heart Attack During Structural Fire Fighting Operations and Dies 8 Days Later Kentucky written by Tommy N. Baldwin and published by . This book was released on 2011 with total page 13 pages. Available in PDF, EPUB and Kindle. Book excerpt: On June 30, 2011, a 49-year-old male volunteer fire fighter (FF) responded to a residential structure fire. The FF, wearing full turnout gear and self-contained breathing apparatus (SCBA) on-air, climbed a 14-foot ladder to the second floor and performed exterior and interior fire suppression activities for about 30 minutes. After the fire was brought under control, he started to perform overhaul (mop-up) operations on the second floor when he suddenly collapsed. Crew members carried the FF down the stairs and outside the dwelling. Cardiopulmonary resuscitation (CPR) was begun as an ambulance was requested. The ambulance arrived, advanced life support was provided, and the FF was transported to the local hospital's emergency department (ED). In the ED, the FF regained a pulse but remained minimally responsive and was flown to a regional hospital where angioplasty was performed. Over the next 8 days, his condition did not improve and, after consulting with the family, the decision was made to remove the FF from life support. The attending physician pronounced him dead at 0434 hours on July 8, 2011. The death certificate listed "myocardial infarct" due to "cardiac arrest" as the cause of death. No autopsy was performed. Carboxyhemoglobin levels were not measured to test for carbon monoxide exposure. Given the FF's known underlying coronary artery disease (CAD), NIOSH investigators concluded that the physical exertion of responding to the call and suppressing the fire triggered his heart attack, which caused his death. NIOSH investigators offer the following recommendations to address general safety and health issues. Had some of these recommended programs been in place, it is possible the FF's death may have been prevented. Provide preplacement and annual medical evaluations to all fire fighters. Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of National Fire Protection Association (NFPA) 1582. Phase in a comprehensive wellness and fitness program for fire fighters. Perform a preplacement and an annual physical performance (physical ability) evaluation. Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program. Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube. Perform an autopsy on all on-duty fire fighter fatalities.

Book Fire Captain Suffers Fatal Heart Attack After Conducting Live Fire Training   Pennsylvania

Download or read book Fire Captain Suffers Fatal Heart Attack After Conducting Live Fire Training Pennsylvania written by Tommy N. Baldwin and published by . This book was released on 2009 with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt: (3) Phase in a comprehensive wellness and fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. (4) Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program. (5) Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube. (6) Recheck vital signs of fire fighters prior to leaving rehab.

Book Fire Fighter Suffers Fatal Heart Arrhythmia at Structure Fire   Illinois

Download or read book Fire Fighter Suffers Fatal Heart Arrhythmia at Structure Fire Illinois written by Tommy N. Baldwin and published by . This book was released on 2003 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: - Provide mandatory annual medical evaluations to ALL fire fighters consistent with NFPA 1582 to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. - Incorporate exercise stress tests into the fire department's medical evaluation program. - Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity.

Book Fire Chief Suffers Cardiac Arrest at Brush Fire   North Carolina

Download or read book Fire Chief Suffers Cardiac Arrest at Brush Fire North Carolina written by Denise L. Smith and published by . This book was released on 2013 with total page 13 pages. Available in PDF, EPUB and Kindle. Book excerpt: On March 3, 2013, a 44-year-old Fire Chief experienced coughing, shortness of breath, and difficulty breathing while functioning as incident commander at a brush fire. The Chief drove himself to an on-scene ambulance and requested assistance. On-scene emergency medical service (EMS) personnel performed an initial assessment, initiated care, and began transport. En route to the emergency department (ED), the Chief suffered cardiac and respiratory arrest. Despite cardiopulmonary resuscitation (CPR) in the ambulance for about 60 minutes, the Chief died. The death certificate and autopsy report, both completed by the County Medical Examiner's office, listed the cause of death as "atherosclerotic and hypertensive cardiovascular disease." The autopsy revealed a massively enlarged heart with severe coronary atherosclerosis. Given the presentation of his illness and his underlying heart disease discovered at autopsy, the Chief's respiratory distress was probably due to acute exacerbation of undiagnosed heart failure, precipitated by any of the following: a hypertensive crisis, ischemia, a heart attack, or a primary arrhythmia. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country. Ensure that all fire fighters receive an annual medical evaluation consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. Phase in a mandatory comprehensive wellness and fitness program for fire fighters.

Book Fire Fighter operator Suffers Sudden Cardiac Death While Operating a Fire Engine at a Structure Fire   Louisiana

Download or read book Fire Fighter operator Suffers Sudden Cardiac Death While Operating a Fire Engine at a Structure Fire Louisiana written by Tommy N. Baldwin and published by . This book was released on 2010 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: (2) Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. (3) Phase in a comprehensive wellness and fitness program for fire fighters. (4) Perform an annual physical performance (physical ability) evaluation. (5) Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program. (6) Conduct annual respirator fit testing. (7) Discontinue lumbar spine x-rays as a screening test administered during the preplacement medical evaluation.