HONOLULU (KHON2) — What started out as a routine call left one man dead, and a paramedic fighting for his life. Now an investigation is underway to figure out what caused the fire and possible explosion on board an ambulance.

According to the Honolulu Emergency Medical Services, its crew was transporting a 91-year-old man to Adventist Castle Medical Center around eight o’clock Wednesday night.

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As the ambulance was pulling into the hospital, a fire broke out in the back and the patient died. The paramedic who was treating him was critically hurt.

The EMT who was driving the ambulance managed to get out safely. Their identities are not being released out of respect for their family’s privacy.

The 91-year-old man, a patient in the ambulance, was later pronounced dead at the scene. The paramedic, who was treating the patient in the back of the ambulance, suffered critical injuries. He was medically treated at Adventist Health Castle first before being transported by EMS to a secondary emergency room.

The paramedic critically injured is at the Straub Medical Center Burn Unit. As far as the possible cause of the explosion, EMS said all options are being investigated and they’re asking some national agencies to help.

EMS said the paramedic who was injured by the fire had been with Honolulu EMS for eight years.

“My deepest condolences and prayers to the family and friends of the patient who lost his life in Wednesday night’s fire. Please keep our Paramedic in your thoughts. We are praying he makes a full recovery and know he’s in the best care with the talented team at the Straub Burn Unit. A heartfelt mahalo to the staff at Adventist Heath Castle, our entire EMS ‘ohana, the Honolulu Fire Department for their quick response, and all the hands that responded in this tragedy.

HONOLULU EMERGENCY SERVICES DEPARTMENT DIRECTOR DR. JIM

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EMS officials said they had never seen anything like it. Once the ambulance went up in flames the EMT who was driving jumped out to help the patient and the paramedic.

“The paramedic was able to escape from the ambulance although he was critically injured, and the patient was unable to be saved at that time. The fire was just too intense,” said Dr. Jim Ireland, Honolulu Emergency Medical Services Director.

The Honolulu Fire Department is in charge of the investigation but EMS said the city has reached out to the National Highway Traffic Safety Administration and the Bureau of Alcohol Tobacco Firearms and Explosives.

“We’re making all records available to these agencies because I want answers.  We want answers because we want to know what happened and we want to make sure this never happens again,” said Ireland.

Ireland said they’re looking at all the options as to what may have caused the explosion. Among them are oxygen tanks that are regularly used for many situations.

“So all of our ambulances carry that. I don’t have information on exactly what was transpiring in the back of the ambulance and I don’t want to speculate. But I think that will all be part of the investigation,” Ireland said.

As far as changes in policy Ireland said it’s too early to do that.

“Is there anything we need to change operationally immediately based on what we know right now? And the answer to that is no. So we are not changing anything operationally. But obviously, if anything does come of the investigation that will give us info on best practices and something we should do differently. Of course, we’ll do that,” Ireland said.

Ireland said in addition to finding out what happened the priority is helping the injured paramedic and the entire EMS community.

“This is their job, they go to emergencies, they take care of people in life-threatening situations. But when we, as a team or one of the members or our department is the patient, it’s just that much harder,” said Ireland.

The paramedic being treated is a 10-year veteran. Ireland said mental health services are being provided for those who responded to the incident and others who may need them.

The EMS crew and ambulance worked out of Kaneohe. EMS said the Honolulu firefighters arrived at the scene and had the fire under control within 11 minutes of their arrival.

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The cause of the fire has not yet been determined. Honolulu police and firefighters are investigating.