Ossining VAC CO Incident discussion Nov 12, 2010

[huzzie59 75]

Anymore news on this call?

How are the six OVAC members doing?

Can anyone from OVAC give details regarding this call?

Edited November 19, 2010 by huzzie59

[jack10562 414]

I missed seeing the original I A on this call but did see a small article in the JN:

http://www.lohud.com/apps/pbcs.dll/article?AID=2010311130029 ,Stating two people were hospitalized, not a peep about eight people being evaluated for CO exposure!

[CM36 4]

OK, so first it was not a CO call. It was originally an EMS call. A female called up stating she was having a stroke. When EMS arrived they found the female's husband unresponsive on the floor, so they were providing care to two pt's. EMS was on scene by themselves for approx 20 min before they notified FD due to an odor that they noticed in the residence. FYI all the OVAC members were treated (including hyperbaric chamber) and released for CO related symptoms. It is my personal feeling that all EMS should carry CO detectors or multi gas meters to prevent incidences like this from happening in the future. Thankfully, no EMS members were seriously injured or killed.

[FDVA356 23]

Glad the crew is ok!!! Note: while serving my term as Lieutenant at Croton EMS (after split from CFD) one of our first purchases and additions were CO meters for the 1st in bags that go in with the crew every call (or supposed to). In addition we also purchased the RAD 57 pulse oximeters/CO detection device. This day in age, we should have these neccessary items. No excuse!!! As a proactive agency I'm sure OVAC already is working on this as well as other ways to improve their already excellent operations.

[huzzie59 75]

I could have labelled this differently, I knew it didn't come in as a CO call.

That, of course, is the scarey thing. CO being odorless and colorless. You never know what you're walking into.

Glad everyone is okay. I assume there are no long term affects.

[Guest jcnyc]

It would be great if you could have a CO meter that didnt need to be calibrated so frequently. If the one in my house doesn't need to be calibrated why do the ones we carry? Give guys idiot proof ones that just alarm when the presence of CO is there. Then bring in the units that are more accurate to give a count of the PPM.

[jack10562 414]

As far as the EMS responders not having personal CO /gas/monitor/detectors, I bet that is going to change.

At least I certainly hope it does. In fact, it had better change, otherwise somebody is going to get hurt!

There is no excuse not to have these devices.

They were very lucky this time, next time, they may not be so lucky. Same goes for the residents. Had the concentration of CO had been higher the outcome would have been much different.

An acute exposure to high levels of CO does not present the typical symptoms like a chronic exposure to lower level doses, such as dizziness, headaches, nausea, flu-like symptoms. If the readings are high enough the exposure can quickly cause convulsions, unconsciousness and death. Quickly, as in, within minutes.

Additionally, studies have shown that CO exposure can cause heart muscle damage and increase chances of mortality due to cardiovascular problems years later, related to exposure!

([Jan 2006] Journal of the American Medical Association )

I'm curious as to why there were no working CO detectors in the house?

Did the homeowners not hear about "Amanda's law" the New York State law that went into effect Feb, 22, 2010,

§ 2. Subdivision 5-a of section 378 of the executive law, as amended by chapter 202 of the laws of 2006.

The law prescribes, In a nutshell, ALL dwellings (that meet the requirements, and the list is comprehensive)

shall have installed an operable carbon monoxide detector ...

I know I'm preaching to the choir, here, but having working smoke and CO detectors is a no-brainer.

[antiquefirelt 994]

It would be great if you could have a CO meter that didnt need to be calibrated so frequently. If the one in my house doesn't need to be calibrated why do the ones we carry? Give guys idiot proof ones that just alarm when the presence of CO is there. Then bring in the units that are more accurate to give a count of the PPM.

We're on our third generation of two year disposables and the last ones are as maintenance free as they can be. They get checked as part of the daily check and monthly get a fresh air bump that the unit tells you it needs. Once in a while they ask for the span gas test, but very infrequently. These units low alarm at 35 ppm period an go to high alarm at 200 ppm. At any sign of CO (35 ppm w/ these) the crew exits with any civilians and calls for an engine co. if they're not on scene for a multi-gas meter check. Interestingly, we call anything over 9 ppm abnormal if we detect it, but on EMS runs, no one would be the wiser until it reached 35. Basically we do anything we can to ensure the level is under 9 ppm before we leave, though 0-3 is really preferred.

As I recall these last ones were under $200 each. We have one on each primary EMS jump kit, the ALS out of town bag (mutual aid EMS calls) and one in each first due fire apparatus.

[MKEMT 0]

We now carry both personal CO meters and Dosimeters in FDNY EMS. The personal CO meters have proved themselves on many occasions citywide. Glad to hear the OVAC crew is ok

[Guest 29-Indigo]

You mean to tell me that EMS personnel walked in, found one unconscious subject and another with "stroke-like" symptoms and some kind of bell in their heads didn't go off?! I've been to calls for unknown medicals where we have found a patient, or in some cases multiple patients, ill and realized something is wrong. Why didn't they get out of there sooner? Why not call the FD sooner?

Seems to me that there is a severe lack of training (and/or common sense) on the part of arriving EMS.

I concur with the other gents who said every EMS unit should have an idiot-proof CO detector that goes into every building, that requires no activation and alarms personnel when there is a CO issue.

On an aside, I am told by colleagues who work at OVAC that the FD showed up, walked in without any kind of PPE or SCBA and checked the house for gas. WHAT IS WRONG WITH PEOPLE? You have to treat CO incidents and any odors of gas as a real threat.

WAKE UP PEOPLE!

[Faded Soul 6]

I seem to recall... scene safety? The most basic and very favorite phrase in Ems training.

[gatello 1]

You shouldn't be so quick to judge a crew's response to a situation if you do not know all of the details. While scene safety is always of the utmost importance, perhaps the scene did not initially present itself as a danger. Hearsay never conveys a true account of an incident. Hindsight is always 20-20.

Instead of being so quick to judge, be thankful the crew and patients are doing well, and many positive lessons were learned.

[Guest 29-Indigo]

Instead of being so quick to judge, be thankful the crew and patients are doing well, and many positive lessons were learned.

I am thankful, but to me, they should have realized their was an issue sooner. Perhaps some training on the effects of CO and purchasing some CO detectors can prevent this in the future.

[jack10562 414]

... they should have realized their was an issue sooner. ...

With all due respect, the arriving responders were facing two patients in distress, one unconscious, the scene presented several critical challenges. Any unusual odors may have gone unnoticed initially. That's the thing, with CO there is no odor.

There can be other faint, telltale smells associated with a CO condition, but not always. The presence of unburned hydrocarbons such as aldehydes which have a sweet taste, are usually good indicators something is very wrong. These are what they probably noticed after a while and they reported that. How the FD responded to this "odor of gas" report is another topic ripe for discussion.

[huzzie59 75]

I started this topic to hopefully find out what the crew thought at the time.

I would rather "monday morning quarterback" when everything turns out okay. So yes things, maybe, could have been handled differently.

The call came in as a man down, or something to that affect. Once the crew discovered there were two patients, did they think there was something in the house that affected both patients? And that they should be removed from the scene prior to continuing treatment?

Did they think the 2nd patient was reacting to the situation of the first patient?

The suggestion that crews carry CO detectors is a constructive suggestion.

Any others?

[PFDRes47cue 653]

Having a CO detector or even better a multi gas detector on all in bags is a must. This one detector will protect all personnel that are in the house or where ever the call is. Personal detectors for each member is a little excessive...these will be lost and broken way to frequently. Most of the time, the in bag stays with the crew in the house. And if the EMS in bag is not often brought in, the police or a medic usually have a bag. If all bags had detectors...problem solved.

Also, as a rule of thumb, whenever I have two or more patients found in the same environment (not MVA's, domestic violence calls) I always right away become suspicious of the surroundings, and air quality. It is rare to have an entire house full of people have difficulty breathing. or headaches, dizzyness without an underlying cause...probably the environment they are in. Unless its an amazing coincidence!

[antiquefirelt 994]

Having a CO detector or even better a multi gas detector on all in bags is a must.

The issue with multi-gas detectors is that they generally must be "fresh air bumped" before any use and cannot sit with he power on 100% of the time. The single gas disposable CO detectors have a sealed 24 month battery and require little maintenance and limited user interaction (infrequent fresh air bumps every 30 days or so. The actual CO detection within the units is either far more simple than most other gases or due to the proliferation (millions of in home units) the technology was made simpler as there is a large market for it. We run a handful of multi-gas meters as well on fire apparatus and all the other sensors seem to require far more intervention by way of sensor replacement and/or span gas calibration. Most of these units run CO/O2/LEL/H2S. Also, the aniticpation of most other gases being present without signs/symptoms is far lower than CO.

CO (carbon monoxide): odorless, colorless, virtually undetectable without metering/detection equipment

LEL (lower explosive limits): The common expectation is natural gas or LPG leaks, both of which are treated with an odorant to ensure leaks are detectable by the human nose.

O2 (oxygen concentration): very little expectation of a low O2 issue in most settings. Calls where this mighjt occur are generally known to the responders and anticipated (or should be).

H2S (hydrogen sulfide): stinks like rotten eggs/ sulfur. Also more predicable if you understand the common causes and places to anticipate it.

Other Gases: Most other gases are metered for when they're anticipated. Most of us don't carry Chlorine sensors routinely, but guys in treatment plants might (being phased out?) The same with many other gases that are far less common outside specific settings.

Also, as a rule of thumb, whenever I have two or more patients found in the same environment (not MVA's, domestic violence calls) I always right away become suspicious of the surroundings, and air quality. It is rare to have an entire house full of people have difficulty breathing. or headaches, dizzyness without an underlying cause...probably the environment they are in. Unless its an amazing coincidence!

This is how many of us think. It's good to be highly suspicious in this business. Flu season can bring about whole households of sick people displaying CO poisoning symptoms, but being suspicious could uncover that it is not in fact the flu. Without the detectors or as part of your investigative "toolkit" understanding other signs of CO potential such as tight dwelling units with condensation on the inside of the windows, soot near floor registers, fuel oil odors, etc. all can help. Edited November 18, 2010 by antiquefirelt

[fireguy30 13]

OK, so first it was not a CO call. It was originally an EMS call. A female called up stating she was having a stroke. When EMS arrived they found the female's husband unresponsive on the floor, so they were providing care to two pt's. EMS was on scene by themselves for approx 20 min before they notified FD due to an odor that they noticed in the residence. FYI all the OVAC members were treated (including hyperbaric chamber) and released for CO related symptoms. It is my personal feeling that all EMS should carry CO detectors or multi gas meters to prevent incidences like this from happening in the future. Thankfully, no EMS members were seriously injured or killed.

I know a F.D in dutchess that bought co/gas detectors for all the radio straps that the guys were when they walk into the homes for ems calls so they knowit was costly but there is no price on life safty

[INIT915 1,119]

You shouldn't be so quick to judge a crew's response to a situation if you do not know all of the details. While scene safety is always of the utmost importance, perhaps the scene did not initially present itself as a danger. Hearsay never conveys a true account of an incident. Hindsight is always 20-20.

Instead of being so quick to judge, be thankful the crew and patients are doing well, and many positive lessons were learned.

I think the while the poster may have come off as a little 'judgemental', I think the premise is on.

Faced with a similar situation, (if the details offered above are correct), I'm not sure where else my mind would ever go other then CO or some other type of hazardous condition. Everyone can learn from this incident and if it serves as a reminder to some of a rarely encountered situation, then everyone here can benefit.

[Guest ovaclt]

All OVAC members have returned to duty and are OK. We have purchased C02 meters that will be brought into every call. I monitored the situation via radio, and these members acted in a professional manner. Second guessing and negative posting is NOT appreciated by me. It happened quick, and as soon as they realized what they had, they were out. Trust me,all of us would have been in the same boat. Thank you to all who expressed concern. I cannot comment on the status of the victims.

[ny10570 745]

No one has doubted their ability as providers, but spending 20 mins in an environment that created 2 serious medical conditions is a mistake in judgement. That and I hope you bought CO rather then CO2 meters.

[jack10562 414]

Thanks for the update, John.

I'm glad to hear all your members are alright, AND, that your OVAC crews now have the necessary safety equipment to alert them to a potential hidden danger they might encounter!

I hope the homeowners make a full recovery.

[SRS131EMTFF 471]

2 Rye Officers sickened in a similar incident today.

http://www.lohud.com/article/20101119/NEWS02/11190382/Carbon-monoxide-sickens-2-Rye-cops--1-civilian--saving-woman-s-life

[huzzie59 75]

We now carry both personal CO meters and Dosimeters in FDNY EMS. The personal CO meters have proved themselves on many occasions citywide. Glad to hear the OVAC crew is ok

Do you know what brands/models the equipment is?

[huzzie59 75]

All OVAC members have returned to duty and are OK. We have purchased C02 meters that will be brought into every call. I monitored the situation via radio, and these members acted in a professional manner. Second guessing and negative posting is NOT appreciated by me. It happened quick, and as soon as they realized what they had, they were out. Trust me,all of us would have been in the same boat. Thank you to all who expressed concern. I cannot comment on the status of the victims.

Second guessing and asking questions is okay. That's how I'm gonna learn.

Negative posting - There is no place for it on this site.

I am also happy everybody is okay.

[Guest garyc]

Anymore news on this call?

How are the six OVAC members doing?

Can anyone from OVAC give details regarding this call?

All members are OK the call wasn't for co the call was for a lady not feeling well when OVAC was at seen found husband upstairs in hall on floor after awhile they started feeling ill and figured out what was happening everyone is fine thanks to OVAc and rest of responders.

[Remember585 815]

All OVAC members have returned to duty and are OK. We have purchased C02 meters that will be brought into every call. I monitored the situation via radio, and these members acted in a professional manner. Second guessing and negative posting is NOT appreciated by me. It happened quick, and as soon as they realized what they had, they were out. Trust me,all of us would have been in the same boat. Thank you to all who expressed concern. I cannot comment on the status of the victims.

I think you mean CO meters... unless you're monitoring for Carbon Dioxide. Glad everyone from OVAC is OK.

[jack10562 414]

That was a test to see who was paying attention.

[TR54 239]

Dräger X-am 5000 the ideal companion for personal protection.

Used by FD's here in the county attached to portable radio straps...on all calls.

As far as calling it CO2 instead of CO that could be a training issue. PD's quite often dispatch calls as CO2 activations.

Glad the OVAC crew is recovering. This could happen to anyone of us !

http://www.draeger.com/US/en_US/

[Skooter92 7]

Stamford EMS has been carrying one CO device per unit for about six months. We have a RAD unit from Massimo on the tour supervisor's truck, and we're switching to LP-15s with CO monitoring capability. That being said, OVAC has always been among the first to field new diagnostic tools including glucometers and pulse oximetry. Many agencies are still in the process of adopting CO monitors-but remember, change occurs at different rates in different organizations. Criticizing an agency without knowing the internal structure(s) that govern change is a pointless exercise.