Identifying Carbon Monoxide in Ambient Air

Detectors Only way of Identifying Carbon Monoxide

There is no reliable way of identifying carbon monoxide in indoor air other than to have fully functioning carbon monoxide alarms, as carbon monoxide symptoms are too easily confused with far serious health concerns.

By Rebecca Martin

In our previous blog, we talked about procedural deficiencies in the response by those on the scene or those responding to a scene of a possible carbon monoxide poisoning.  Carbon monoxide poisoning is possible in any residence, building, structure, or area where fuel-burning devices are in use. Because it is invisible and odorless, it is impossible to detect in the absence of devices designed to detect its presence. Carbon monoxide detectors are the single most important ingredient for preventing carbon monoxide poisonings.

Identifying carbon monoxide in indoor air can only be done through the use of carbon monoxide alarms. It is imperative that EMT’s carry personal CO alarms to alert them before they too get poisoned.

In the absence of carbon monoxide detectors and the ensuing alarms, EMS can arrive on the scene in response to an unknown medical emergency without the clear indication that carbon monoxide is the cause.

The person or persons may have been moved outside the source of the poisoning and during that period may exhibit an improvement in symptoms. They may be summarily treated at the scene and either sent back into a dangerous environment or released with no medical follow up to determine the cause.

Victims may be misdiagnosed at the scene as suffering from the flu, or food poisoning and again not be medically triaged at an ER. Carbon monoxide shares various symptoms with other afflictions; headaches, nausea, dizziness, chest pains, disorientation, and without the confirmation of a carbon monoxide detection device, misdiagnosis can occur.  Misdiagnosis can result in the victim returning to the same toxic environment.

Fire Department Can Help to Determine Cause and Origin

Usually, if carbon monoxide is considered a possibility by EMS, the fire department is called in to test for the presence of carbon monoxide. However, if doors and windows have been opened, the levels may have artificially been returned to normal by the time testing occurs. And, as we have seen previously, if entrance to a residence or area is not authorized by someone on the scene such as the resident, the police may have to be called in to determine the means of legal entry.

Many of these scenarios would be improved if all emergency workers were equipped with personal carbon monoxide detection. But all of them would be improved with the presence of functioning, maintained carbon monoxide detectors appropriate to the location.

One premise that needs endless repetition is that the danger of carbon monoxide poisoning IS a possibility anywhere there are fuel-burning devices in operation. Another consideration is the weather. Cold weather is a time when most serious carbon monoxide poisonings occur. Coincidentally it is also the period when flu is more likely to be a factor, and diagnosis on the scene becomes more difficult. Severe weather which affects the power supply are also an issue, power outages are a prime time for carbon monoxide exposure.

More Needs to Be Done to Identify CO

Most emergency rooms are aware that classic symptom profiles are important indicators as to when to test for carbon monoxide in the blood. Even so, transport and waiting times can affect the levels in the blood, especially in so-called “milder” exposures. But carbon monoxide can cause long-lasting health problems that may not be discernible at the time of an ER visit as there may not be an accurate record of what the levels were at the time of exposure or how long those levels persisted before presenting to the emergency room. And that does not address those who are examined at the scene and sent on their way. I

t is very important that anytime one is exposed to a suspected carbon monoxide poisoning to go to an emergency room as soon as possible for a blood test to determine if there is exposure to carbon monoxide. Long term symptoms may not appear until days, weeks or months after exposure and a blood test can detect that there was initial exposure to explain later complications.

Identifying Carbon Monoxide Should be a Rule Out for 911

One of the consequences of lack of adequate carbon monoxide detectors is that first responders arriving at the scene are also at risk. For instance, if they receive a call that a person has been discovered unconscious in their home, particularly someone who has a history of health problems, or perhaps someone elderly, the first reaction is to stabilize the patient and get them set for transport.  Dangerous levels may exist in the residence and the EMS workers may suffer substantial exposure. In a case like this, it is only the diagnosis of the victim that may backtrack to also check on the exposure the EMS workers might have suffered.

Even though EMS professionals are aware to look for obvious signs that carbon monoxide may be present; smoke, gas-powered devices left on, a car running in a garage, these visual cues are not effective in ruling out carbon monoxide. Even EMS professionals are vulnerable to carbon monoxide poisoning. “Back in 2010, carbon monoxide poisoning led to the death of an EMS student in Texas. The student fell asleep in an EMS station not realizing that someone had left the portable generator running.” https://pksafety.com/blog/the-best-ems-carbon-monoxide-detectors-for-emts-and-first-responders/

If those in emergency services are not always able to correctly identify carbon monoxide poisoning, none of us should consider ourselves capable of determining if carbon monoxide is present in the absence of a carbon monoxide detector. Many people describe instances where initial symptoms resembled feeling tired and deciding to go to bed or just falling asleep. When you are asleep you are most at risk for death due to carbon monoxide. The greater the exposure the more likely confusion and disorientation can occur and if they do, you are likely to be incapable of calling for help.

People tend to associate the possibility of gas leaks with carbon monoxide. But gas has additives which allow us to identify gas leaks by smell. Carbon monoxide has no odor and is produced by the incomplete combustion of fuels. A gas leak can result in the production of carbon monoxide but is not necessary.

What to Do if You Suspect CO

There is one action you can take if carbon monoxide is suspected, immediately go outside to get fresh air, and call 911. For more on identifying carbon monoxide poisoning symptoms, click here. This is absolutely the most important response to either a carbon monoxide detector sounding an alarm or in the absence of one, suspecting that you might be experiencing symptoms of carbon monoxide. When calling 911, inform the dispatcher that carbon monoxide is suspected so that the fire department is dispatched to test for carbon monoxide before EMS workers enter the scene.

According to the Centers for Disease Control and Prevention; headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion are some of the most common symptoms associated with the presence of carbon monoxide.  https://www.cdc.gov/co/faqs.htm#:~:text=What%20are%20the%20symptoms%20of,pass%20out%20or%20kill%20you.

You can be an advocate for yourself in the event of a CO poisoning incident. Visiting an emergency room for a blood test and doing appropriate follow up care is an important step.  There is no dispute that long-lasting neurological problems can be caused by carbon monoxide poisoning. Making sure that the source of the carbon monoxide is identified and replaced or repaired prior to returning to the scene is another form of self-advocacy.  And most importantly, making sure that carbon monoxide detectors are in place, functioning and maintained going forward.

There are additional signs that may or may not exist that might indicate a potential carbon monoxide danger: Stuffy or stale air, a pilot light that keeps going out, more condensation on windows than normal, soot build up around a fireplace, chimney or other fuel-burning equipment, or fuel-burning equipment has a back-draft (flame flares up when  window or door opens and adds air). https://www.hydro.mb.ca/safety/carbon_monoxide/ But observation is no replacement for detectors.

Check with local fire departments for information on free detectors (based on income) and/or fire inspection (where available).