By FireRescue1 Staff

DALE CITY, Va. — The importance of incorporating medical monitoring of trainees into rehab programs has been stressed in a NIOSH firefighter fatality report.

EMT Cecilia Turnbough suffered sudden cardiac death during firefighter maze training at the Public Safety Training Center in Dale City on November 9 last year.

The report into her death also recommends that training maze props or trailers used in SCBA confidence training have adequate safety features such as emergency egress panels, emergency lighting and ventilation.

After completing the hose maze evolution, the report said Turnbough was tired and sweating heavily. After lunch, she began the maze portion and completed approximately half of the exercise when her SCBA low-air alarm sounded, it added.

She informed the instructor that she wanted to continue, but after entering the next portion of the maze and crawling up a slight incline, she did not turn around and back down the decline as required.

The instructor saw that something was wrong and spoke to the Turnbough but received no response, the report said. At this time, Turnbough's personal alert safety system alarm sounded, but it took instructors about 10 minutes to remove her from the maze.

Paramedics began advanced life support and transported her to a local hospital, but efforts to revive her were unsuccessful.

"In this incident, all participants should have been assigned to rehabilitation after the hose maze drill," the report said. "Perhaps if the Trainee had gone to rehabilitation and her vital signs (including pulse oximetry) were checked, an abnormality might have been detected. This may have led to the Trainee being referred for further medical diagnosis/treatment."

Among the NIOSH recommendations in the report are:

• Conduct all SCBA training in accordance with NFPA 1404, Standard for Fire Service Respiratory Protection Training

• Have adequate safety features for training maze props or trailers used in SCBA confidence training, including emergency egress panels, emergency lighting, ventilation, and a temperature monitoring system to measure the ambient temperature inside the maze

• Provide firefighters with medical clearance to wear a self-contained breathing apparatus as part of the Fire Department's medical evaluation program

• Provide preplacement and annual medical evaluations to firefighters

• Incorporate medical monitoring of trainees into rehabilitation programs

• Educate firefighters to report signs and symptoms consistent with a heart attack to appropriate authorities for prompt medical evaluation

• Perform a preplacement and an annual physical performance (physical ability) evaluation

• Ensure firefighters are cleared for return to duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by firefighters, and the various components of NFPA 1582

• Phase in a comprehensive wellness and fitness program for firefighters