Over the past two decades, carbon monoxide (CO) has gained attention as a hazard to the public. Most firefighters associate CO with routine runs, as carbon monoxide detector activations are frequent responses. Carbon monoxide is commonly associated as a hazard to citizens due to heating...
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The effects of decreased oxygenation within the body are profound. Carbon monoxide toxicity results in a range of symptoms, depending on the actual concentration of CO in the blood. Low levels of CO in the blood result in generalized symptoms that are non-specific and may be misinterpreted as common cold or flu-like symptoms. This includes nausea, vomiting, headache, malaise (the sensation of feeling ill), dizziness, muscle aches, and mild confusion.
Higher levels of CO in the blood will lead to more profound neurologic symptoms as a result of decreased oxygenation to the central nervous system. This includes more pronounced confusion, decreased level of consciousness, coma, seizures and death. Again, since CO levels in the blood will rise more rapidly in physically active individuals, firefighters working at a structure fire may experience the symptoms in the chart on page XX within a shorter period.
Firefighters exposed to the byproducts of combustion and exhibit signs or symptoms of CO toxicity they should be transferred to an emergency department immediately for assessment. Personnel assigned to the rehab sector at incidents should be aware of the signs and symptoms of CO poisoning to be able to identify these symptomatic firefighters.
To prevent CO toxicity, firefighters must first be knowledgeable about the condition and consider it whenever a smoke condition or combustion exists in a structure. Fire departments should also have standard operating procedures (SOPs) or standard operating guidelines (SOGs) concerning removal of SCBA during interior operations at structure fires. All structures with smoke conditions should be monitored for CO to ensure toxic levels of CO do not exist. This includes smoke conditions due to fireplace issues, heating appliance malfunctions, burning wires, food on the stove, chimney fires and similar hazardous conditions.
This procedure should identify the CO level that is deemed safe to remove SCBA. The permissible occupational exposure level (PEL) for CO according to the Occupational Safety and Health Administration (OSHA) is 25 PPM. The PEL is maximum exposure to a chemical a worker can have over an eight-hour period without ill effects. The PEL established by OSHA is a reasonable limit to adopt as the safe level to remove SCBA during interior operations.
The guideline should also clearly identify who is responsible to give the “all clear” to remove SCBA. Some departments designate this responsibility to the incident safety officer, other departments make this the responsibility of the interior operations officer. As with all responsibilities on the fireground, if this responsibility is not formally delegated through standard guidelines, the incident commander assumes the responsibility of giving the “all clear” to remove SCBA. Having a formal policy concerning SCBA removal structure fire allows the incident commander to focus attention on other, more variable operational issues. The policy will also help prevent unnecessary firefighter exposure to CO operating at the scene if SCBA is not allowed to be removed unless the “all clear” is given.
Carbon monoxide is an odorless, colorless gas that is present during all structure fires and is present when combustion is occurring. Structures should be monitored for CO whenever a smoke condition is present in a structure as high levels of CO may exist even with light smoke conditions.
Departments should adopt guidelines regarding CO monitoring at structure fires. During operations at structure fires, personnel should remain on SCBA until the “all clear” to remove SCBA is given based on CO monitoring. Rehab personal should be aware of the signs and symptoms of CO poisoning to be able to identify firefighters that might have suffered CO poisoning. Firefighters with signs or symptoms of CO poisoning should be transferred to emergency departments for further evaluation.
Prevention of CO poisoning requires awareness that CO could be present when any smoke condition or fire condition is present. To accomplish this, carbon monoxide must always be suspected when smoke or fire is present in a structure.