Routine carbon monoxide screening by emergency medical technicians.

Abstract

Residential carbon monoxide (CO) poisoning represents a significant cause of unintentional morbidity and mortality in the United States. Screening by fire departments and utility companies is usually limited to instances in which there are symptoms of CO poisoning or there is activation of a home CO detector. To determine whether emergency medical services (EMS) personnel can perform routine CO screening during 911 calls. A prospective observational study was conducted in an urban EMS system using emergency medical technicians (EMTs) to screen for elevated CO levels during emergency responses. The EMTs carried hand-held CO meters that detect as little as one part per million of CO. Readings were taken at the patient's side during indoor patient contacts. If time allowed, a brief questionnaire was then administered to patients or by-standers concerning knowledge about CO poisoning, type of household heating system, and presence of home CO detectors. In a three-month convenience sample of emergency responses, there were 264 residential CO readings obtained. There were nine (3.4%) positive residential readings, all with chief complaints believed to be unrelated to CO toxicity. Two hundred twelve surveys were completed during these emergency responses, with 145 of 212 (68%) participants familiar with the term "carbon monoxide poisoning." Only 54 of 145 (37%) participants could name any signs or symptoms of CO poisoning. Of those surveyed, 133 of 212 (63%) participants reported an oil- or gas-powered heating system in their residence. Carbon monoxide detectors were absent in 185 of 212 (87%) residences, including all domiciles in which a positive CO reading was obtained. Emergency medical services personnel can perform routine CO screening and detect occult elevations in CO levels during 911 responses. Public knowledge of CO poisoning is limited and the use of home CO detectors is rare in this study population.