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Carbon Monoxide

Carbon Monoxide. The Silent Killer!. Purpose/Intention of this Presentation. This Presentation Was Designed to Give General Information About Carbon Monoxide for: Emergency Responders Fire EMS Police Dispatchers, AND General Public. ** Disclaimer**.

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Carbon Monoxide

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  1. Carbon Monoxide The Silent Killer!

  2. Purpose/Intention of this Presentation • This Presentation Was Designed to Give General Information About Carbon Monoxide for: • Emergency Responders • Fire • EMS • Police • Dispatchers, AND • General Public

  3. **Disclaimer** • This Presentation is Merely a General Informational Guide About: • Carbon Monoxide (CO) • CO Accidental Poisoning, AND • Detection, Symptoms, Tools and Treatments • This Presentation is NOT Intended to be a Comprehensive, All Encompassing Resource about CO • More in Depth Information is Available Online and/or in Books • Please Use the Handy Reference at End of Presentation for More Information

  4. Presentation Overview • CO Basics- the Hidden Danger • At Risk Populations • Accidental Poisoning Prevention • What to do when you encounter CO • Both the Public and Emergency Responders • Symptoms of CO Poisoning • Treatments • Civilian • BLS • ALS

  5. Presentation Overview (Cont.) • Understanding your CO Detector/Monitor • Residential/Commercial and RAE Systems • Exposure Limits • Local Statistics • Charts • Headlines • Technical Data • Physical & Chemical Properties • References

  6. What Is Carbon Monoxide? • CO is a compound of Carbon and Oxygen • One atom carbon to one atom oxygen • Colorless • Odorless • Tasteless • POISONOUS Gas

  7. Where Does It Come From? • CO is Produced by the Incomplete Combustion of Various Fuels (Hydrocarbons) , Including: • Coal • Wood • Charcoal • Oil • Kerosene • Propane • Natural Gas Note production of CO from the fire on right

  8. What is Incomplete Combustion • Reaction That Does Not Convert All of a Fuel's Carbon and Hydrogen Into Carbon Dioxide and Water, Respectively • Example, Incomplete Combustion of Carbon Produces Carbon Monoxide, Carbon Dioxide and Water.

  9. Common Causes ofIncomplete Combustion • Smoldering Fires • Burning Wet Wood • Burning Green Wood • Lack of O2 During Combustion • Malfunctioning Appliances • Malfunctioning Exhaust Systems

  10. Complete Combustion • When a Hydrocarbon Burns Completely • Usually in Environment Abundant in Oxygen • Emitting Carbon Dioxide & Water • Zero Emissions of CO • Makes Indoor Gas Cook Stoves Safe (right) Note the bright blue & uniform flames- indication of Complete Combustion

  11. Common Sources ofCarbon Monoxide Pollution WATER HEATERS & FURNACES FIREPLACES

  12. Sources (Cont.) VEHICLE EXHAUST SMOKING INDOORS

  13. More Sources-Common in Power Outages PORTABLE GENERATORS PORTABLE PROPANE HEATERS

  14. The Hidden Dangers of CO • Carbon Monoxide Poisoning is the Most Common Exposure Poisoning in the United States • Carbon Monoxide is Not Easily Recognized Because the Signs and Symptoms Are Similar to Those of Other Illness • This Odorless, Colorless Gas Can Cause Sudden Illness and Death

  15. At Risk Populations DUE TO THE CHANGES IN PHYSIOLOGY AND EXPOSURE, THE FOLLOWING POPULATIONS ARE AT THE GREATEST RISK: • The Very Young • The Very Old • Pregnant Women & Most Important- their Fetus • Fetal Hemoglobin has an Even Higher Affinity for CO Than Adult • People With Existing Respiratory Compromise • Firefighters

  16. Prevent Accidental CO PoisoningList of DO’s DETECTORS UNITS WITH DIGITAL READOUT BETTER THAN UNITS WITHOUT • DO- Install a Battery-operated CO Detector In Your Home • check or replace the battery when you change the time on your clocks each spring and fall • If the Detector Sounds Leave Your Home Immediately and Call 911.

  17. Prevention DO’s • DO- Have Annual Inspections of Your Solid-Fuel and/or Gas Appliances in Your Home By a Qualified Technician; Including: • Home Heating Systems • Water Heaters • Fireplaces & Chimneys • And Any Other Gas, Oil, or Coal Burning Appliances

  18. Prevention DO’s • DO- Seek Prompt Medical Attention If You Suspect CO Poisoning • You and/or Family Feeling: • Dizzy • Light-headed • Nauseous • Especially if CO Alarm is Sounding

  19. Prevention DO NOT’s • DO NOT- Use The Following Appliances Inside Your Home, Basement, or Garage or Near a Window: • Portable Generators • Charcoal Grills • Camp Stoves • Any Other Gasoline or Charcoal-Burning Devices

  20. Note on Portable Generators • During Power Outages Place Portable Generators at Least 50 Feet From Your Home • If Possible, Place Generator Downwind and Away From Any Openings in Your Home: • Windows • Doors • Vents/Air Intakes

  21. Prevention DO NOT’s • DO NOT- Run a Car or Truck Inside a Garage Attached to Your House • Even if You Leave the Garage Door Open • DO NOT- Burn Anything in a Stove Or Fireplace That Isn't Vented to the Outside • DO NOT- Attempt to Heat Your House With A Gas Oven

  22. What To Do- Civilian? • If You Suspect the Presence of CO in Your Home and/or Office: • Immediately Evacuate the Building of ALL People • Evacuate Pets (if you can do so Safely and Quickly) • Call 911- From Outside • From Cell Phone • Neighbor House/Business • DO NOT Re-Enter the Building Until Safe to Do So- • Typically After Building Deemed Safe by: • Fire Department, and/or • Your Gas Company (such as Excel)

  23. Civilian (Cont.) DO NOT REASONS FOR CO SUSPICION • Please Do Not Open Windows & Doors • This is a Common Reaction • A Closed Building Helps Fire/Gas Company • Learn Full Exposure Levels • Potentially Locate Source(s) • CO Detector Alarming • Sudden and/or Extreme Headache- • Especially Multiple People in Same Building • For More Symptoms See “Symptoms” Slides Later in this Presentation

  24. What To Do-Emergency Responders • Turn On Your Gas Detector (QRAE) • Perform a Fresh Air Calibration in Fresh Air • Review Your Department SOP/SOG/OD Regarding Carbon Monoxide Calls Periodically • At PFA This is The Operational Directive Section 3.3.4: “Carbon Monoxide Alarm Response” • Always Remember Safety First!

  25. Emergency Responders (Cont.) • If the Resident Does Not Have a Functioning CO Detector, Give Him/Her a “Portable Peace of Mind” • Instructions Are on the Back of this Unit • Be Sure the Individual Understands this Detector and its Limitations • Encourage the Resident to Purchase and Install a Battery Operated CO Detector ASAP

  26. Understanding Your Detector-Civilian • Read & Understand Detector Instructions Before Use • Detectors Should Be Battery Operated or Backed Up • Check/Change Batteries Each Time you Change Your Clocks (Daylight Savings) • If your CO Detector Sounds, Call 911 For Assistance While the PFA does not recommend specific brands, we suggest detectors with digital readers give you more accurate information than those without

  27. Understanding Your MonitorEmergency Responder • The User Should Review Monitor’s Instruction Manual Periodically • If You Have Further Questions, Refer to Your Department’s Monitor Technician(s) • At PFA- Station 10 • Monitor Should Be Properly Calibrated • Once Per Month • Anytime It’s Exposed to 200 ppm or Higher

  28. Exposure Limits • A Properly Ventilated Building With Properly Functioning Appliances Should Have Zero CO Present • Generally Speaking, Levels Between 0-5 parts per million (a Measurement of Substance in Air, Indicated by the Letters- ppm) are Commonly Found Indoors and is Considered Safe • For Greater Details, Please See “Exposure Limit Details” Slides in the Technical Data Section Towards the End of This Presentation

  29. Action Levels- Lower Limits • 0 to 9 ppm- Normal • No Action: Typically from multiple potential sources • 10 to 35 ppm- Marginal • This level could become problematic • Actions: Occupants should leave the building and be advised of a potential health hazard to small children, elderly people and persons suffering from respiratory or heart problems • Find source and mitigate/fix problem

  30. Action Levels- Medium Limits • 36 to 99 ppm- Excessive: Medical Alert • Conditions must be mitigated • Actions: Ask occupants to step outside and query about health symptoms • Call 911 • Contact Gas Company and/or Contractor • Advise occupants to seek medical attention • If occupants exhibit any symptoms of CO poisoning, they should be immediately transported to a medical facility • Preferably by ambulance • Professionals Required From this Point On- • Fire/EMS • Gas Company/Contractor

  31. Action Levels- Higher Limits • 100 – 200 ppm- Dangerous: Medical Alert • Emergency conditions exist • Actions: Evacuate the building immediately and check occupants for health symptoms • Call 911 • All occupants Should Be Evaluated by EMS Personnel • If occupants exhibit any symptoms of CO poisoning, they should be immediately transported to a medical facility • Preferably by ambulance • Greater than 200 ppm- Very Dangerous: Medical Alert • Actions: Same as Above

  32. Symptoms of CO Poisoning • ANY OR ALL OF: • Headache • Dizziness • Irritability • Confusion/Memory Loss • Disorientation • Nausea and Vomiting • Abnormal Reflexes • Difficulty in Coordinating • Difficulty in Breathing • Chest Pain • Cerebral Edema • Convulsions/Seizures • Coma • Death

  33. Symptoms (Cont.) BE HIGHLY SUSPICIOUS OF CO POISONING IF: • Any of the Symptoms Found on Previous Slide is Present in More Than One Individual in the Building • Any of these Symptoms are Sudden (Acute) • Any of these Symptoms Accompanied by a Sounding CO Detector • If you Suspect Faulty Appliances

  34. Treatment of CO PoisoningFor Victims of Acute and/or Mild Exposure • Move Victims to Fresh Air Immediately • this will only relieve immediate symptoms of acute poisoning • Activate the Fire/EMS System (if not already) • Administer High-Flow Oxygen • Monitor Vital Signs • Transport via ALS if Symptom(s) persist

  35. Treatment of CO PoisoningFor Victims of Chronic and/or Moderate to Extreme Exposure • Move Victims to Fresh Air Immediately • Call 911 From a Safe Location • Administer High-Flow Oxygen • Monitor Vital Signs • Monitor Level of Consciousness • Monitor for Respiratory Problems • Get a Carboxyhemoglobin (Cohb) Test to Check for Carbon Monoxide Levels in the Blood

  36. Chronic/Extreme Exposure (Cont.) • Consider Early Transport to a Hyperbaric Oxygen Chamber for Severely Poisoned Patients • Any Patient Found Unconscious, Seizing, or With EKG Changes and With an Associated History Should Be Treated as a Severe Carbon Monoxide Poisoning Until Proven Otherwise

  37. Local Statistics2001-2009 The Information in the Following Seven Slides Was Compiled by: Kevin Contreras and Gil Fisher

  38. 63% of PFA Calls Involving CO Come in as "CO" Detector Calls • The Rest are Odor/Leak, Service or EMS Calls • On Average, 53% of Those Calls Revealed CO Levels Greater than 35ppm • The CO Level at Which Our QRAEs alarm


  39. The Busiest Months (in order): 
        1.      January
        2.      December
        3.      February
        4.      November
        5.      March
        6.      April
        7.      October
     8.      June
     9.      September
     10.    July
     11.    August
     12.    May

  40. Most Common Culprits(in order): • HVAC (44% of All CO Calls) • Water Heater • Other Appliances (Stove, Oven, Dryer) • A Running Vehicle Parked in the Garage or Drive Way  (With the Front Door Open) • Wood Stove, Fireplace (Gas or Wood)





  41. Interesting Tidbits • Other Interesting Culprits: • Whole House Fans • Large Fans in Windows • Perhaps Most Interesting- • A Room full of Cigarette Smoke • Carboxyhemoglobin & Smokers • Non-smokers Generally Have Less Than 1.5% CO In Their Blood • Smokers Tend To Have Between 3-15%

  42. More Statistics • Carbon Monoxide Is the #1 Cause for Poisoning Deaths in the U.S. • Effects of Co Poisoning Can Generally Be Experienced With as Little as 10% • According to Information Provided by Mary Makris, People Recover 4-5 Times Faster When Administered High Flow O2

  43. General Symptoms by Exposure-From NFPA • 50 ppm: No Adverse Effects With 8 Hours of Exposure • 200 ppm: Mild Headache After 2-3 Hours of Exposure • 400 ppm: Headache and Nausea After 1-2 Hours of Exposure • 1,600 ppm: Headache, Nausea, and Dizziness After 20 Minutes of Exposure

  44. IDLH • 3,200 ppm: Headache, Nausea, and Dizziness After 5-10 Minutes; Collapse and Unconsciousness After 30 Minutes of Exposure • 6,400 ppm: Headache and Dizziness After 1-2 Minutes; Unconsciousness and Danger of Death After 10-15 Minutes of Exposure • 12,800 ppm: Immediate Physiological Effects, Unconsciousness and Danger of Death After 1-3 Minutes of Exposure

  45. Home Depot Suggested MonitorUse & Placement

  46. Tragedy In Colorado The Lofgren Family Photo; Parker, Caroline, Owen and Sophie

  47. Faulty Heating Connection Leads to Carbon Monoxide Death of Family • A Prominent Denver Family Perished in a $9 Million Dollar Home in Aspen • The Family of Four All Died in Their Sleep • This Tragedy Could Have Been Avoided With the Proper Use and Installation of CO Detectors

  48. A National Problem • The Center for Disease Control and Prevention Has Concluded that Between 1999-2004 an Average of 439 Persons Died Annually From Unintentional, Non--fire-related CO Poisoning • Rates Were Highest Amongst Persons 65 Years Old and Older • The Average Number of Deaths Was Highest During January

  49. Technical Data-Chemical & Physical Properties

  50. Chemical & Physical PropertiesPhysical Data • Molecular Weight: 28.01 • Boiling Point (At 760 Mm Hg): -191.5 Degrees C (-312.7 Degrees F) • Specific Gravity (Water = 1): 1.25 at 0 Degrees C (32 Degrees F) • Vapor Density: 0.97 • Freezing Point: -205 Degrees C (-337 Degrees F) • Vapor Pressure at 20 Degrees C (68 Degrees F): Greater Than 1 Atmosphere (760 Mm Hg) • Solubility: Sparingly Soluble In Water; Soluble in Ethanol, Methanol, and Some Organic Solvents • Evaporation Rate: Not Applicable

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