Madison Incident
An incident in Madison, WI this past weekend provides a very valuable lesson that should be shared with all Fire Departments.
As you know we've been advocating carrying a monitor on the medic bag that goes in with every EMT – and many communities are equipping their first responders. The old way, trying to guess when Carbon Monoxide might be an issue so the people with the proper training and equipment can be sent just isn't working.
Here's what happened. A mother was working as a volunteer in a church. Her two year old son was with her. The two year old became very ill so the mother called the father who is a physician. The father came and immediately left to take his son to an emergency room. Meanwhile someone had called 911. As the father was leaving the paramedics met him outside the church. They all agreed the child was stable enough to be transported by the father and the paramedics left without entering the building. About 30 to 40 minutes later, the paramedics were called again. This time they were accompanied by a Haz Mat team. Both teams went into the building and their CO monitors alarmed upon entry (the paramedics carry our monitors on their medic bags).
Here's the lesson. All those people – the doctor father and the paramedics are trained to recognize CO poisoning and they all missed it. The son didn't receive the proper treatment for at least one additional hour and at least 13 more people were affected. I'm not writing to cast blame on the Doctor who didn't recognized CO poisoning, or the paramedics who were carrying a monitor but didn't go into the building to check for it. The fact is CO poisoning is missed a lot. The CDC says there are over 15,000 cases of CO poisoning a year that are diagnosed after delivery to an emergency room. The AMA feels there are over 100,000 cases of CO poisoning every year that are never diagnosed, just in the US. I'm writing because this situation illustrates how difficult it is to identify CO poisoning. The training and the equipment were there – and it was still missed on the first contact.
Every EMT and other first response team should be carrying a CO monitor with them on every call. It's the most effective way to protect the responders and bring better care to patients who have been poisoned by Carbon Monoxide. It's also almost a certainty every First Response team will sooner or later encounter Carbon Monoxide Poisoning. Teams that are using our monitors are telling us they expected an event every few years but are finding many more than that with equipment that allows them to "see" the problem.
Before our equipment became available there might have been an argument that the cost and complexity of the monitors available outweighed the advantages. The lost cost of purchase and maintenance for our equipment blows that argument right out the door. The fact is the low cost of our monitors makes it almost irresponsible not to equip.
Carbon monoxide forces evacuation
Jsonline WEDNESDAY, July 30, 2008, 9:09 a.m.
By Linda Spice
A Milwaukee Fire Department medical unit responding to a person experiencing dizziness last night found a more serious call when their hand-held carbon monoxide unit started sounding, requiring evacuation of about 30 people at a GE facility.
Fire officials responded about 11:15 p.m. to GE Healthcare, 4856 W. Electric Ave. in West Milwaukee, for the original medical call in which a man complained of dizziness as well as nausea.
Within the last six months, private donations to the Milwaukee Fire Department have allowed for the purchase of carbon monoxide detectors the size of a cell phone. Those stay on while they are taken on every medical call, 24 hours a day, 7 days a week, according to Battalion 3 Fire Chief Richard Wahlgren.
"We have our people carry it in the EMS kit just for this very thing," he said.
He said as emergency personnel were caring for the patient at GE that the detector went off, showing readings of 300 parts per million. Crews are trained to evacuate at readings of 30 parts per million, he noted.
"We realized we were dealing with a larger problem than one ill patient," Wahlgren said. Two fire engines, a ladder truck, a battalion chief and medical unit all responded to the scene.
Employees evacuated the building. There were no other reports of illness or injuries.
The man who originally complained of dizziness and nausea was taken to Aurora St. Luke's Medical Center for treatment.
Meanwhile, firefighters worked an additional 90 minutes to shut down the flow of hydrogen and natural gas in the plant, and to ventilate the building.
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