CO/CN Exposure Flashcards
Patients or Firefighters who become ill or are being evaluated for a possible Carbon Monoxide (CO) exposure will be monitored on a_____________ as close to the time of exposure as possible. The CO level is used to determine transport and treatment
CO Monitor (i.e., Rad 57)
There is no pre-hospital test for CN and treatment is based on a high clinical index of suspicion for CN poisoning. In the setting of a building fire, consider possible Cyanide (CN) exposure, particularly in_____
firefighters who develop an altered level of consciousness and/or hemodynamic instability.
P4
Why are the sign and symptoms of carbon monoxide poisoning
Dyspnea Headache Chest pain Muscle weakness Nausea Vomiting Dizziness Altered mental status Death
Cyanide poisoning may result from
inhalation, ingestion, or dermal exposure.
Prior to administration of Cyanokit, smoke inhalation victims should be assessed for:
P2
a. Exposure to fire or smoke in an enclosed area
b. Presence of soot around the mouth,nose, or oropharynx
c. Altered mental status
In addition to Cyanokit , treatment of cyanide poisoning must include the following
a. Immediate attention to airway patency
b. Adequacyofoxygenation
c. Adequacy of hydration
d. Cardiovascularsupport
e. Managementofanyseizureactivity
During high risk CO/CN situations what will be your best asset for assessment and treatment
High index of suspicion. Especially in fire scene and rehab sectors
P3
In regards to CO/CN exposures the fallowing are to be considered high risk
P3
Building fires, including salvage & overhaul
Areas where generators are used or misused
The report of symptomatic or unconscious patient(s) in a car where the garage door is closed
Areas where paint or varnish is stripped from furniture
Areas where gasoline engines, gas powered heaters or water heaters are run with poor ventilation
In some cases with symptomatic divers from contaminated air in their SCUBA tanks
Indoor grills
Hookah bars
CO/CN High Risk Patients include
P3
Elderly Children Pregnant women Patients with cardiac disease Patients with chronic lung disease Patients with chronically elevated CO levels (e.g., cigarette smokers)
PT who is exposed to a high risk situation and experiences hemodynamic instability and/or a cardiac arrest may also have
cyanide (CN) toxicity.
During management of high risk situations, including cardiac arrest,shock, seizures and coma, consider administration of
Cyanokit
Indications for obtaining a CO level.
- Apply to patients when CO poisoning is suspected.
- Apply to patients being treated for smoke inhalation
- Apply to individuals when CO has to be ruled out as with firefighters in the rehab sector of a major fire
If you are assigned to the rehab sector of a major fire, what should be routinely done when evaluating vitals of firefighters during rehab ?
Rule out CO poisoning with CO monitor (Rad 57)
P4
If you ask one of your FF’s to assess a FF in rehab in a major fire and he tells you that he can’t get a reading on the Rad 57 you should know that?
P4
Poor perfusion states where circulation to the fingers is severely compromised may make readings inaccurate or unattainable. Ex ; if PT is hypotension
What are the procedures for assessing a PT with poss CO poisoning
- Apply finger probe to finger with cap refill of less than 5 seconds
- SpCO less than 3%- no further evaluation for SpCO
- SpCO less than 12% W/ NO symptoms- no further evaluation for SpCO needed
- SpCO less than 12% W/ Symptoms- Transport on 100% O2 to nearest ER
- SpCO 12% or greater, but less than 25%,with symptoms or pregnant–transport on 100% O2 to a hyperbaric oxygen facility
- SPCO 25% or greater - transport on 100% O2 to a hyperbaric oxygen facility
