Preventing Sudden Cardiac Death Part 1: The Physiological Effects of Firefighting


Dangers of Firefighting

Firefighting is a dangerous and physically demanding occupation.  The United States Fire Administration reports that approximately 100 firefighters die in the line of duty each year (USFA, 2009). The number of structure fires per year is decreasing, safety standards are higher and technology is better.  Why haven’t we seen a dramatic reduction in firefighter fatalities?

Let’s take a look at  some of the life-threatening situations that firefighters may face:

  • Flashover
  • Backdraft
  • Explosion
  • Entrapment
  • Building Collapse

Statistics show that these events do not cause the majority of firefighter deaths.  The majority of firefighters dying in the line of duty are succumbing to a sudden cardiac event. The USFA reports that in 2009 heart attacks and strokes account for nearly 60% of all firefighter deaths (USFA, 2009).

Smith, Liebig, Steward, and Fehling (2010) found that the acute physiological effects of firefighting such as adrenaline surge, increased core temperature and dehydration coupled with underlying cardiovascular disease may contribute to a sudden cardiac event (Smith, Liebig, Steward, & Fehling, 2010).


Physiological Effects of Firefighting

Picture yourself sound asleep at your fire station on a Tuesday night.  The tones go off for a residential structure fire with victims trapped.  What is your heart rate as you leap out of bed and run to the rig?  Your sympathetic nervous system has just been activated.  Siddle (1995) states, “The activation of this system increases heart rate, which in turn, has a crucial effect on motor performance, visual processing and cognitive reaction time” (Siddle, 1995, p.7).  You pull up on scene and it is time to get to work.  The initial adrenaline surge has already impacted your cognitive and motor function.  Now consider the physical, mental and emotional stress of the fire scene.  You are in full gear doing strenuous work in a super heated environment.  The physiological strain of this incident is enormous.

Smith et al. (2010) detail research findings on the effect firefighting has on the major systems of the body:

Cardiovascular:  Heart rate and blood pressure are increased.  Firefighters may be working near maximum heart rate for the duration of their air bottle depending on the circumstances.

Thermoregulatory: The superheated environment coupled with the layers of protective clothing causes a significant increase in core body temperature.  The physical work and heat conditions can quickly lead to dehydration.

Respiratory and Metabolic: The mental, emotional and physical stress causes increased respiratory rate, oxygen consumption and lactate fatigue.

Nervous: The sympathetic nervous system is activated and large amounts of adrenaline are being released to help manage the perceived threat.

Muscular: The physical nature of the work leads to increased oxygen consumption, heat production and fatigue.

These stressors may help explain how firefighting may serve as a trigger for a sudden cardiac event in individuals with underlying cardiovascular disease. This “trigger effect” may be the root cause of many fire fighter deaths each year (Smith et al., 2010 pp. 3-10).

If we know what the physiological effects of fire fighting are, can’t we prepare our bodies and minds to better handle these stressors?


Survival Stress Management for Fire Fighters

Siddle (1995) states the three important perceptions that influence the level of survival stress:

1.  Level of threat perceived such as nature of the incident, potential victims, etc.

2.  Individual confidence in knowledge, skills and ability to control the threat.

3.  Past experience in dealing with the threat.


This provides the foundation for training goals and objectives:


Skill Confidence: Hands on training for the wide variety of skills required for firefighters such as hose and ladder evolutions, ventilation, etc.

Situational Confidence: Participation in regular scenario based training to prepare for the incidents that may be encountered such as residential structure fires, high rise drills, firefighter survival drills, etc.

Visualization: Use fire scene photos to generate conversation about strategy and tactics.  Discuss fire scenarios for buildings in the response area.

Breath Control:  Practicing slow controlled breathing when stress levels are increased can help control anxiety and re-focus on the task at hand (Siddle, 1995, pp. 91-107).

Physical Training: Firefighters are tactical athletes.  Sonnon (2010) states, “tactical athletes require a comprehensive physical training program which will foster the physical skills, attributes and energy reserves necessary for tactical response (Sonnon, 2010).  This training approach not only improves performance on the fire ground, but it will also help prepare your body for the physiological strain of firefighting.

Understanding the physiological effects of fire fighting and training frequently to minimize these effects is a vital first step to preventing a sudden cardiac event.


Next week we will take a closer look at the risk factors for cardiovascular disease.




Smith, D., Liebig, J., Steward, N., & Fehling, P.  (2010).  Sudden Cardiac Events in the Fire Service: Understanding the Cause and Mitigating the Risk.  Skidmore College.


Siddle, B. K.  (1995). Sharpening the Warrior’s Edge: The Psychology and Science of Training. Millstadt, IL: PPCT Research Publications.


Sonnon, S.  (2010). TACFIT: First In – Last Standing.  Atlanta, GA:  RMAX International.


United States Fire Administration (USFA). (2009).  Firefighter fatalities in the United States in 2009. Emitsburg, MD.



Have you ever walked away from a class or seminar feeling like the knowledge that you gained will have a huge impact on the quality of your life?  I had the privilege of joining fitness professionals from around the world at the recent CST and TACFIT Certification Seminar in Bellingham, Washington.  The experience changed the way I will approach my fitness training forever.  We engaged in five full days of physical training, testing, coaching and learning.  By the end of the seminar I was physically, mentally and emotionally exhausted.  I want tell you a little bit about me and my approach to fitness training because I think it will sound very familiar to a lot of people.  I hope that the lessons that I learned will be helpful to you.

I discovered CST and TACFIT six years ago when Coach Scott Sonnon walked in off the street and proposed a tactical fitness competition between local police and fire fighters.  I embraced the TACFIT program because it was specific to my job and it was the most fun, challenging and comprehensive workout program I had ever done.  I have been dedicated to the TACFIT 4 Day Wave over the past couple of years and the results have been amazing for me.  I think it is safe to say that I am in the best shape of my life as I approach 40 years old.

Things slowly started to change for me over the past year.  I accepted the position of Training Captain in our fire department.  I have been actively involved in developing and implementing training programs for all of our fire fighters as well as our new recruits.  Being on the drill ground all day and training with new recruits is physically demanding work.  There have been many other stressors in my life wearing on me as well.  I started to notice little aches and pains that weren’t there before and my workout performance was not as strong as it had been.  I kept going full speed ahead.  No matter how tired I was from work (or life in general) I didn’t want to deviate from my own workout schedule.  If it was high intensity day, that is what I did.  It didn’t matter how physical my work day was or how I was feeling.  Somewhere along the way I lost sight of where I was going.  I didn’t put the extra time into joint mobility and compensatory movements that I should have.  I was focused on “staying on track”. Deep down I feared that if I took a break from the way I was training I might lose what I had gained.  I didn’t listen to my body telling me it was time to slow down.

The harsh reality of my current state hit me square in the face during the CST Certification.  I realized that my decreased mobility and over-training were actually inhibiting my performance.  More than one CST Faculty member expressed concern about my well-being.  At first, I was very disappointed and a little embarrassed about my physical performance.  I had to take a look in the mirror and remind myself of where I actually wanted to be.  I understand now that this was the perfect place to experience this type of “crash”.  I was surrounded by coaches and peers willing and able to help me.  Here are a few of the lessons I learned (and re-learned) over the weekend:

1. Address Mobility Issues: Coach Sonnon is fond of saying, “mobility is king, strength and conditioning are queen”.   This concept is difficult for some people to buy into.  A lot of us grew up following the “go big or go home” style of weight lifting.  If you weren’t working hard, you weren’t working.  The fact is, without mobility you will never be able to express your strength to the fullest.  Not only do you leak power but your body will compensate for this lack of mobility.  If you do not have proper form in technique, you will create potentially dangerous adaptations.  These compensations will ultimately lead to decreased performance and injury.  Think about where your limitations in mobility might be and work to free up that range of motion.  Intu-flow, Ageless Mobility and the Prasara Yoga programs are all great resources.  Coach Jones is an excellent example of an athlete who maximizes expressible strength through mobility and efficiency of movement.  He makes the 45lb clubbell (a.k.a. The Bruiser) look like a swizzle stick when he swings it!

2. Utilize Coaching: If you train alone all of the time, you never get feedback about your technique.  You may not know that you are compensating or leaking power during a particular movement or exercise.  A qualified coach can help you discover these issues and help you resolve whatever the underlying problem may be.  A good coach will help you periodize your training over time to maximize your results.  It also helps to keep you motivated when you know you are accountable to someone else.

3. Cycle Your Training: The 4 day wave is amazing. It provides a tremendous balance of work and recovery.  It is also important to cycle your training throughout the year.  Determine when you want to “peak” and make sure your training schedule builds towards that goal.  Once you have reached that goal, take a break, recover and then start working towards the next peak.  If you don’t map out your peaks and valleys over a long period of time, you may easily fall into over-training.

4.  Intuitive Training: Listen to your body.  If you notice a “hitch” in your movement, stop and deal with it.  Don’t try to “power through” the discomfort.  Taking the extra time to deal with a small issue may keep it from becoming a big issue.  The time it takes to address the issue before the injury occurs will be much less than the time it takes to rehabilitate after the injury.

5. Factor in Physical Demands of Life: Life can get crazy for all of us. There will be times when you are experiencing higher than normal physical, mental, or emotional stress.  Make adjustments to your workout schedule as needed.  Don’t think that you have to “stay on track” or “power through” these stressful times.  Listen to your body.  If you need to slow down to maintain your health, please do.  On the other hand, if you need to slam the medicine ball to the floor as hard as you can to blow of steam, have at it.

6. Leave Your Ego at the Door: We are all competitive, hard working people to a fault at times.  Sometimes we let ego and vanity affect how we train.  If I achieve my goal for body composition, I don’t want to go backwards.  If I achieve a high level of sophistication for a particular exercise, I do not want to drop down no matter what.  These concerns are unfounded and short sighted.  If you look at the big picture, making adjustments when necessary will actually help you perform at your highest level.

7. Turn Weaknesses Into Strengths: Coach Hurst said this at the end of the seminar.  “Turn your weaknesses into your strengths”.  I think it is human nature to focus on what we are good at.  It is rewarding to feel like we perform well in a certain activity, or posses a certain attribute.  If we are not good at something the process of improvement can be a frustrating and painful one.  If we take the time and make the effort to turn our weaknesses into strengths, eventually there will be more strengths than weaknesses.  You don’t need to look much further than the CST faculty and Head Coaching Staff to realize that these guys are doing something right.

8. Health First Means Health First: At the end of the day, it all boils down to being healthy.   Defining “health” is something that we each have to do for ourselves.  I think that we can agree that finding balance in our training and in our lives provides a pretty solid foundation for good health.  Coach Wilson talked with me about the importance of occupational/tactical athletes finding balance in their physical training.  Law enforcement, fire fighters, military personnel, etc. must be response ready at all times.  He has learned how to periodize his high intensity training and recovery periods throughout the year depending on the physical demands of his job. Take a look at your current fitness program.  Do you have a healthy balance between mobility, strength, conditioning, and recovery?  If not, what adjustments can you make in your training schedule and in your life?

I hope that these lessons will help you to avoid the “crash” that I experienced.  I want to thank each of the CST Faculty members and Head Coaches for your help during the seminar.  I learned something valuable from each and every one of you.  I also want to thank the other CST Head Coach, Coach, and Instructor candidates.  I learned a lot from you as well.  The energy, camaraderie and work ethic of the team is inspiring.









Ryan Provencher

TACFIT Division Chief

CST Instructor

Thank You


Dear RMAX Family,


A couple of days have passed since our last CST and TACFIT Seminars and I have been spending time reflecting, not only on this past week but of my entire TACFIT journey.


Flash back six years ago, when I met Coach Scott Sonnon and he introduced me to my first TACFIT experience!  At the time, I didn’t know if I should run for cover or stick around and risk it all for this bald man, standing in the corner, arms crossed, and a slight crazed look in the eyes.  Well, fortunately for me, I possess enough character flaws that I dove right in and I haven’t looked back since.


At that moment I was welcomed, with open arms, into a very special group of people, the RMAX Team.  During this time I have come to know Scott, not only as a coach, but also a mentor and a friend.  He has taken me to the edge and back in my training more times than I can remember.  Scott has a considerable amount of experience to share and he has always taken the time to listen and provide insight into training, business, and life.  He has literally saved me years of wandering and mistakes by sharing his lessons learned and accelerating my growth.  I would like to express my sincere gratitude for Scott’s selfless guidance as I continue my journey.


Experiencing a CST and TACFIT Seminar is a sight to behold.  The energy is palpable, the combined talent of faculty, head coaches, coaches and instructors produce a synergy, unparalleled.  The experience, intelligence, professionalism, and passion of all involved create an incredible sharing and learning experience.  I always leave with a great deal of emotion.  Reacquainting with old friends, meeting new ones, delving deeper into my practice with expert guidance, and just having a great time makes it difficult to say goodbye.


When a man treks into the unknown he cannot go it alone.  As he faces fear and adversity he must look to his right, and to his left, and know he can depend on his team for the support and courage to continue.    His success lies in the balance of the team.  I am honored to be a member of the greatest team, one that leads from the front, one that insures the success of all it’s members through trust and support of one another.


This past week I was appointed Division Chief of TACFIT Fire Fighter.  I am deeply, deeply humbled and proud to serve.  This team has given me so much, I can’t help but get excited for the opportunity to give in return.


I now stand on the shoulders of all of you and I want you to know that it is because of you, your support, encouragement, and faith that I am here.  I want to thank every member of the RMAX Team with a promise to serve with the same professionalism and enthusiasm that is standard of all RMAX members.


My first order of business as Division Chief is to put the World on notice.  “World, you better watch the hell out!  TACFIT is coming to a neighborhood near you.”



Very Respectfully,





Christian Carson

TACFIT Division Chief










The spring CST Certification is coming up next weekend in Bellingham, WA. Coaches and athletes from around the world will gather to develop their knowledge and skills in Circular Strength Training.

I was unable to attend last year, so I am really looking forward to participating this year. I wanted to push myself to achieve a personal best in the “Trial by Fire”. I finished in just under 20 minutes at my initial certification. Men compete with 15 lb. Clubbells, and women compete with 10 lb. Clubbells. The Trial by Fire is comprised of three Clubbell exercises:

Double Swipes – 100 reps

Mills – 100 reps right handed and 100 reps left handed

Hammer Swings – 50 reps in one grip, then 50 reps with the opposite grip in the other direction

My goal was to complete the Trial by Fire and have enough time left to complete 100 quad sprawls before hitting the 20 minute mark. Here is my training journal:

Cycle 1: TBF 19:15 + 21 quad sprawls
Cycle 2: TBF 19:31 + 14 quad sprawls
Cycle 3: TBF 17:00 + 60 quad sprawls
Cycle 4: TBF 15:56 + 81 quad sprawls
Cycle 5: TBF 14:45 + 96 quad sprawls
Cycle 6: TBF 14:56 (no sprawls)
Cycle 7: Check out the video below…………………..

Trial By Fire

Ryan Provencher
CST Instructor
TACFIT Team Leader

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