Exposure to Carbon Monoxide for Patients and Providers in an Urban Emergency Medical Service

Abstract

Background. Carbon monoxide (CO) poisoning poses danger to both patients and emergency medical services (EMS) personnel, as its symptoms are nonspecific and EMS is currently not equipped to detect CO in ambient air. Objective. We aimed to assess the degree of non–fire-related CO exposure at the high-volume EMS system of a city with 2 million inhabitants. Methods. The EMS system was equipped with handheld CO detectors (Dräger Pac 3500), which were added to EMS standard backpacks and had to be carried to the patient at all times. During a period of one year, all alarms by those devices were recorded, sources of CO were confirmed by the fire department, and hospital follow-up was conducted for both patients and exposed EMS staff. Results. During the study period, there were 40 alarms, including two false alarms. Alarms occurred during the whole year, with a peak during the winter months. The median ambient CO concentration was 167 parts per million; gas heating systems were the main source of CO. One hundred ten patients and 108 EMS personnel were exposed. One hundred fifteen persons, including 22 EMS staff, had to be hospitalized, which represents one out of 1,000 total EMS patients. Conclusions. Carbon monoxide poisoning was found to be a significant matter for a high-volume EMS system. Handheld CO detectors helped in identifying those cases.