By Jim Sideras
RN, MSN, CFO, CMO, MIFireE
Carbon Monoxide is an odorless and tasteless gas that attaches to hemoglobin with a greater affinity than oxygen and is called Carboxyhemoglobin. Since symptoms of carbon monoxide poisoning can easily be mistaken for the flu, patients often do not realize they have been exposed to carbon monoxide. In one recent study, it is estimated that as many as 11,000 cases of carbon monoxide poisoning could potentially go undetected each year in the United States. Screening for carbon monoxide is easy, reliable and something every community should consider implementing.
Be sure to consider these important factors when buying CO testing products.
There are two basic methods that can quickly screen for carbon monoxide. Both methods are simple, accurate, and easy to implement.
One technology measures carbon monoxide that is exhaled by the patient. The patient is required to blow through a tube that analyzes the exhaled breath for levels of carbon monoxide. This method requires the patient to be conscious and able to follow instructions.
The other method measures carboxyhemoglobin in the blood using an electronic technology similar to measuring pulse oximetry. A noninvasive probe, similar to a large clothespin, is placed on the patient's finger. The device can measure carboxyhemoglobin in the patient's blood regardless of the patient's level of consciousness. These units can be handheld, or in some cases built into cardiac monitoring units.
The devices that measure exhaled carbon monoxide should be calibrated every six months using a calibration kit. Electronic units generally do self-calibration.
Units measuring exhaled carbon monoxide cost around $1,500. In addition, there is a cost for each test tube, although this cost can be minimal. If doing a large or regular screening, these supplies will need to be maintained and stored.
Electronic units can cost around $3,500 to 4,000. These units generally do not need additional supplies can be used repeatedly, provided they are not contaminated.
Carbon monoxide can happen at any time of the year. It should be considered part of a patient's regular set of vital signs. With the ease of determining a patient's level of carbon monoxide, there is no valid reason to postpone carbon monoxide screening.
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James Sideras is a Division Chief for Sioux Falls Fire Rescue and has received both the Chief Fire Officer (CFO) and Chief Medical Officer (CMO) designations. He is a 25-year veteran of SFFR and a registered nurse with a Master of Science degree in nursing as a Clinical Nurse Specialist.
He received the Harvard University Fire Executive Fellowship, completed a Human Resources program through Cornell University, and the National Fire Academy's Executive Fire Officer program. He has spoken on various topics concerning fire and EMS at national and international conferences, including the World Conference on Disaster Management. He has written more than 20 articles on the fire service and EMS.
Jim is a member of the National Association of EMS Physicians, International Association of Fire Chiefs, the South Dakota Nurses Association, and the South Dakota EMT Association.
He can be contacted at: Sideras@post.harvard.edu