On Jan. 17, 2017, the Grand Island (Neb.) Fire Department was dispatched to a possible overdose with a not conscious, not breathing patient. Response included a med unit, with two personnel, an engine company with three personnel and the shift commander; police also responded.
Upon arrival, the crews were directed to the patient’s location by his wife, who came home and found him unresponsive. The patient was located in the basement and found to be in cardiac arrest. The crew started patient care (code blue protocol).
While they were working on the first patient, the wife lost consciousness. While this was going on, our carbon monoxide alarm started to go off. We carry this alarm on our sealed airway box, since this box is carried in on all medical calls. Our monitor is good for two years and is always on once you activate it.
When the shift commander realized the alarm was sounding due to high CO levels, they removed both patients to the exterior of the residence. The monitor showed over limit on the read out, which would indicate a reading of over 200 ppm CO. Our personnel probably spent approximately 5 minutes in the residence.
It was fortunate that the shift commander had a longer response time as the crew was already disorientated due to the high levels of CO and did not realize the monitor was in alarm mode. This allowed the shift commander to realize what was happening and order an immediate evacuation of the house. It is believed that the fact that the monitor was not initially exposed to the atmosphere allowed the crew to become hypoxic. This was due to the monitor being in an air tight box and not exposed to the atmosphere immediately.
Later readings indicated over 2,000 ppm of CO, as that is the limit on our four gas monitor, and LEL of over 10%. The LEL is attributed to propane leaking from the unlit space heaters, as the oxygen level was too low to sustain combustion.
As a result of the call, six staff members and one police officer received medical treatment at the local hospital. Our people had CO levels ranging from 9 to 23 in their bloodstream; 25 is the trigger level for treatment in a hyperbaric chamber for our hospital. Our people spent approximately 4 hours on high-flow oxygen to get their levels back to normal. They were later released and sent home.
As far as the civilian patients, one deceased male and the female was transported to Omaha for specialized care. The high level of CO was due to the patients using gas powered space heaters in the residence.
Lessons Learned: The use of this monitor saved the lives of the six fire department personnel, one police officer and the wife of the deceased. However, because of this call we have changed our protocol on the location of the monitor. The monitors will now be secured to the outside of the airway box to insure that they are continuously exposed to the atmosphere.
My advice, if you don’t carry a CO monitor that is always on, get one! Our monitor possibly saved all six of our guys as well as the police officer and the female patient.