The North Carolina nursing home poisoning Tuesday evening sent eight people to the hospital and caused about 45 people to be treated on the scene and then released, according to McDowell News. The carbon monoxide poisoning took place at an assisted living home in McDowell County, North Carolina. The emergency personnel declared the scene a mass casualty incident (MCI), the biggest MCI in the history of McDowell County.
The source of the carbon monoxide poisoning was a malfunctioning boiler. The building was ventilated, and the boiler was shut off. Servicemen came to repair the faulty boiler, and the residents were eventually allowed to re-enter the assisted living home, Lake James Lodge, when the air quality returned to normal.
A North Carolina State Building Code requires that every dwelling unit have a battery-operated or electrical carbon monoxide detector if it has a fossil-burning heater or appliance, fireplace, or an attached garage. The statute does not specifically state that nursing homes or assisted living homes are included in the law. However, they do include hotels and bed and breakfasts in the language.
Older adults can be particularly vulnerable to the effects of carbon monoxide poisoning. Symptoms of carbon monoxide poisoning can often present themselves as flu-like. Symptoms might include chest pains. Carbon monoxide poisoning must be top of mind when the elderly present symptoms that are flu-like, a blockage of blood to the heart, passing out, or mental status changes, particularly during the winter. Those who live alone can be particularly vulnerable.
When several people present with flu-like symptoms in a public place, carbon monoxide poisoning must be a top suspicion. In the North Carolina nursing home poisoning, they were able to identify that it was a carbon monoxide poisoning and not just food poisoning or some other misdiagnosed condition. The incident in North Carolina actually required 60 personnel from all county departments to complete the triage process of the 53 patients in a timely manner, according to the news release.
As we have stated before in previous blogs, the symptoms following the initial carbon monoxide poisoning can worsen in the days and weeks following. The brain damage from carbon monoxide can worsen as time passes. There are two mechanisms that cause brain damage. The first is lack of oxygen. When carbon monoxide enters the bloodstream, it binds to hemoglobin, the protein in red blood cells that carries oxygen, with about 200 times the affinity of oxygen. The parts of the brain located at the end of the oxygen route are most vulnerable. These parts of the brain include the hippocampus, which is in charge of memory, and the corpus callosum, involved with coordination.
The second mechanism that can damage the brain is the toxins that carbon monoxide produces. When one experiences carbon monoxide poisoning, there is an excess of glutamate in the brain. Glutamate is a neurotransmitter that is toxic to neurons, brain cells. The result is dying neurons.
The comments in the McDowell News article expressed gratitude to the emergency personnel in responding in an appropriate manner and helping the people that needed it after being poisoned at the assisted living home.
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