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Two Salina (KS) Fire Department members were hospitalized and numerous other people were treated at the hospital last night after being overcome by carbon monoxide poisoning in a townhouse. A civilian is also reported dead from this run.

The civilian victim was reported to be unconscious and not breathing when SFD firefighters were called to his home around 1900 hours Wednesday.

A woman who had been trying unsuccessfully to reach the man called the SFD when she went to his home and discovered him unconscious. She was sickened by carbon monoxide when she entered the townhouse, but was able to get out and call for help.

However, an SFD paramedic and firefighter who went into the house upon arrival were quickly overcome, and they collapsed. The Captain and FF/driver who were on the apparatus with them had to go in and pull them out.

Additional help was requested, and before the  night was over, a total of seven Salina Fire Department members ended up being treated at the hospital for elevated carbon monoxide levels. A Salina police officer also was treated, he said, as was the woman who called 911.

The hospital reported that one person had died-would not identify but it was likely the initial victim. 

The SFD paramedic and firefighter who were the first to enter the townhouse were admitted to the hospital for treatment. The source of the carbon monoxide was a car that had been left running in an attached garage. The car had run out of gas, and the battery also was run down, but SFD Fire Marshal Williams said the engine was still warm.

 

 

There are sigle gas CO meters that cost about $200 that can be clipped to your EMS bags. Why are we not using these? Or, how many of you are? We have the Industrial Scientific Rattlers, but most of the guys don't use them. Our shift has discussed clipping them to the bag on any "sick" call or unconcious call to see if we accidentally come across a CO situation that may go unreported. We need to protect ourselves better.

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My question is why didn't the first FF on scene recognize the symptoms of CO poisoning? Were there any questions asked of the woman who called 911? Did the captain and driver pack out? Why was PD in the house w/o ppe? So many questions . . . but, 10 poisoned, one a fatality, should have clued someone in before nine had to be treated. JMHO.

TCSS

Shawn
It sounds like there were numerous errors which occurred. A breakdown in communications on the initial call for help, to situational awareness from the responders. Even my "country" department has single gas CO monitors on all our apparatus and ambulances.

Of course the occupant of the house bears responsibility as well. A couple of home CO detectors might have alerted the occupant to the fact he left the car running in the garage.
a total of seven Salina Fire Department members ended up being treated at the hospital for elevated carbon monoxide levels.

The clip on CO meters for EMS bags has been discussed and hopefully we will get some. However, this incident screams lack of recognition of a hazard and lack of PPE to mitigate. When you have 7 people treated, something is wrong. The two who went in AFTER seeing the other two FF's collapse, should have packed up...seems they just ran in and were also exposed. Where was the caller? Outside, seems she was "sick" too, so that makes me think a possible poisoning. Even the two who initially went in, you are doing OK then start feeling "woozy" time to get out.....Candle moth here, candle moth.

Although I agree with Ralph here and thinking the same thing for a cause.
I bet someone will have a new SOP/SOG on CO responses very soon.
I did not post this so that we can Monday morning quarterback or flame or Brothers. I posted this so that we can learn from it and not let it happen again. The fact that a $200 detector is available and most of us do not have them, is the problem here. We are required to have $5000 SCBA and a cadre of other very pricey equipment at all times. Why are we not required to have $200 CO meters on our EMS bags? If we were required to have them, more Chiefs would go to bat to get them.
Yes, this is a lesson to be learned and was also a lesson that HAS been taught before so should have been learned. Reality is that it does come down to a candle moth syndrome here without doing a proper size up, not flaming, bashing, Monday QBing, but learning from mistakes, so they can be prevented in the future.

Now the CO detectors on EMS bags ARE a great idea to have and would definately help prevent similar responses. However, they are also a cost item which can be difficult to acquire in some cases, especially when there are CO monitors already with most departments. Secondly, we also need to rely on training and situational awareness in such cases too. When 2 responders go down, the prudent thing to do is to pack up. There is more to learn in this case than just the idea to look at purchasing a CO detector to clip on a med bag.
Any multiple-patient scenario that does not involve obvious trauma should be considered an inhalation hazmat call until proven otherwise. CO is the most likely culprit, but there are others.

I've run numerous calls with this assumption, and most of the time it's a CO call.

The memorable exception was a three-patient heroin OD that resulted in two live patients and a DOA, but we had an engine company with SCBA and a 4-gas monitor ensured that the atmosphere in the apartment was normal and that natural ventilation was started before the unprotected EMS personnel entered.
It is routine for our guys to pack up on a co call
I agree with Ralph
Isnt that somthing like the old saying "your house is your world lets get you into my truck where it is my domain and I can help you there"
our department policy is full ppe including scba on co calls. once we meter the residence,ventilate if necessary, and deem it safe then ems may enter. this was a fire department response not bashing but they should have done a better size up like talking to the female caller that was on scene, the one who was sickened when entering the house.
Hmmm... let's see, we have more than one patient down and no visible signs as to why?

We need to expand what we know about EMS and couple if with Hazmat using a term I have defined as BHLS or Basic Hazmat Life Support. When you come across this type of situation, you have to change how you look at things. This is not an AEIOU TIPS type of thing because there is the potential for hazardous materials to be involved in both the exposure and insult to the patient / victim.

Please keep in mind the following:

Toxic + Syndrome = Toxidrome

5 fundamental hazmat toxidromes:

Note: Think "CHICA" which means "girl" in spanish.

1. Corrosive
2. Hydrocarbon & halogenated hydrocarbon
3. Irritant gas
4. Cholinergic
5. Asphyxiant

If you take the time to research and learn about these five basic toxidromes, then incidents like the one you outlined will have different outcomes. Take CO poisoning for example. Have you ever seen a fatal victim from Carbon Monoxide exposure?

A fatal case of CO poisoning displaying distinctive pink discoloration.

If you have one person down, we all know what dead people look right... You know... code BLUE... not PINK! There are lots of clues to learn about and I could go on and on here but in this case, we are talking about CO poisoning that should be ruled out when you are dealing with an unknown. You hear that you have more than one person down and you see the victims skin discoloration... Not that you will always have a bunch of dead people lying around. Many cases you get on scene and folks are exposed but still breathing... what do they look like?

Reddish flush in a non-fatal case of CO poisoning.

While I applaud your focus on all engine companies being provided with detection devices, this is not always realistic for no-budget volunteer departments who are basically getting by and doing the best they can with what they have.

CO Meters for example do require maintenance with replacement filters and calibration not being free. The filters have to be replaced annually after re-calibration or after an incident. And, it's not free...

What is free is learning more about situational awareness, something that you don't want to focus on but in my opinion needs to be the key point here. Understanding that people are not unconscious without explanation, and typically it's a reasonable medically explained situation. Involve more than one person, now you have something that's gotten outside of the box unless of course this incident looked something like this...


Memorize the BHLS Toxidromes and you will have a better chance at both protecting your crew as well as saving lives through expedient knowledge about what caused the problem to begin with.

TCSS,
CBz

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