Air consumption, oxygen uptake (VO(2)), carbon dioxide output (VCO(2)) and respiratory exchange ratio (RER=VCO(2)/VO(2)) were measured directly from the self-contained breathing apparatus (SCBA) as 36 professional firefighters (three women) completed scenarios of high-rise stair climbing and fifth floor search and rescue. During stair climbing VO(2) was 75+/-8% VO(2max) (mean+/-SD), RER=1.10+/-0.10, and heart rate=91+/-3% maximum (based on maximum treadmill data). Firefighters stopped climbing on consuming 55% of the air cylinder then descended. In the fifth floor search and rescue VO(2) was slightly lower than stair climbing but RER remained elevated (1.13+/-0.12) reflecting high anaerobic metabolism. The first low air alarm sounded, indicating 25% of the air remaining in a "30-min cylinder", during the stair climb at 8 min with 19 of 36 sounding before 12 min. Aggressive air management strategies are required for safety in high-rise firefighting.