Bernalillo County Fire & Rescue Standard Operating Guidelines PDF

Brian Rose, Deputy Chief Greg Perez, Fire Chief Purpose: This procedure identifies operational tactics for responding to and mitigating Carbon Monoxide incidents. Scope: The scope of this guideline will be to describe best practice, tactics, and situational awareness issues for consideration whe...

Brian Rose, Deputy Chief Greg Perez, Fire Chief Purpose: This procedure identifies operational tactics for responding to and mitigating Carbon Monoxide incidents. Scope: The scope of this guideline will be to describe best practice, tactics, and situational awareness issues for consideration when responding to Carbon Monoxide emergencies. It includes response, personal protective equipment (PPE), monitoring/metering, control and Decontamination. General Information: Unintentional, non-fire-related CO poisoning is responsible for approximately 15,000 emergency department visits and nearly 500 deaths annually in the United States. CO poisoning is the number one (\#1) non-intentional poisoning death in the US. The majority of deaths due to non-intentional CO poisoning occur between the months November and February (over 50%) with a majority of the incidents occurring in the Midwest and the Northeast parts of the country. The two (2) most common locations where the incidents occurred are in a residence (77.6%) or the workplace (12.0%). **Product info **   Carbon Monoxide (CO) is produced by the process of incomplete combustion. This typically occurs in automobile exhaust, cooking appliances, heating equipment (i.e.; anything that burns fuel can produce unhealthy levels of CO).    **Carbon Monoxide (CO) -- NFPA 704**    - Health -- 3  - Flammability -- 4  - Instability -- 0 - Special - none  **Carbon Monoxide Physical Properties **   - Colorless, tasteless, odorless gas  - Molecular weight 28.01 (air is 28.97) CO is slightly lighter but will mix throughout the space and not collect only at the ceiling  - Ionization Potential (IP) 14.01 and CAN NOT be seen by most Photo Ionization Detector (PID)  - Upper Explosive Limit (UEL) 74%, Lower Explosive Limit (LEL) 12.5%  **Carbon Monoxide physical and health effect on humans **   Carbon Monoxide is an asphyxiate in humans with no warning properties. CO has 210 times greater affinity to attach to hemoglobin than oxygen. Inhalation of CO causes tissue hypoxia by preventing the blood from carrying sufficient oxygen. CO combines reversibly with hemoglobin to form carboxyhemoglobin. Carbon monoxide can be transported across the placental barrier, and exposure in utero constitutes a special risk to the fetus. Infants and young children are generally believed to be more susceptible to carbon monoxide than adults. The elderly is also believed to be more susceptible to carbon monoxide poisoning. It is not quickly removed from the body so the affects can be cumulative.    - - - - - -   Acute exposure: The signs and symptoms of acute exposure to carbon monoxide may include headache, flushing, nausea, vertigo, weakness irritability, unconsciousness, and in persons with preexisting heart disease and atherosclerosis, chest pain and leg pain. Chronic exposure: repeated exposures to carbon monoxide poisoning may cause persistent signs and symptoms, such as anorexia, headache, lassitude, dizziness and ataxia.  **Most frequent causes of CO exposures **   - - - - - - - Specific procedures: **PPE and allied equipment required **   - All members working in the warm and Hot Zone of the incident will wear full structural FF PPE, SCBA on, with the members face piece available to rapidly don  - 4 gas meter with the following sensors -- O2, LEL, H2S, CO. The meter must be "zeroed out" in fresh air before using in the Hazard Zone.  - FD personnel in the Warm Zone will be limited to the absolute minimum required to size up the incident  - Fan    **Responding to CO Incidents **   All members working in the warm and Hot Zone of the incident will wear full structural FF PPE, SCBA on, with the members face piece available to rapidly don  4 gas meter with the following sensors -- O2, LEL, H2S, CO. The meter must be "zeroed out" in fresh air before using in the Hazard Zone.  **CO Size-Up **   Responding size-up considerations:    - - - - 1. Car in Garage  2. Appliances  3. Fireplace  4. Furnace / water heater  5. Cooking appliances/grills    **Specific 2020 ERG page numbers **   - - - **Rescue **   - - - From this point on, the IC will facilitate:  - - **Metering techniques **   Prepare the gas meter prior to entry, including fresh air calibration. Once calibrated, begin using the meter to monitor the atmosphere outside of structure, working your way to the interior of the structure.    Check with occupants prior to entry for information related to incident:    - - - -   **Control method **   A majority of Carbon Monoxide responses result in a false alarm. The most common types of Carbon Monoxide alarm malfunctions are:  - Old and non-functioning alarms  - Maintenance issue (dirty or exposed to other household products that have cause the malfunction)  - Batteries need to be replaced    False alarms will be verified by thorough metering of the occupancy with insignificant CO readings.    Once entry has been made, begin an organized, systematic metering of the structure to determine the cause, making sure to check all fuel burning appliances and document readings. Any meter readings above 15ppm CO are unusual. With meter readings over 15 ppm:    - - - - - -   Members will need to go on air with any reading over 35 ppm. Anytime an SCBA is used, the IC must ensure two in two out is in place.    Any appliance that has been turned off, unplugged, disabled, or had the fuel shut off to it, must be red tagged by the utility company, put out of service, and be attended to by a qualified technician before placing back into service.    ANY natural gas appliance or meter that has had the gas shut off, the utility company must be notified and dispatched to the incident. AT NO TIME will any FD member turn on a gas meter or any gas appliance that has its gas supply in the off position. Transfer all CO incidents that involve any natural gas-powered equipment over to the appropriate utility company    Once the source has been identified and controlled, ventilation should be started to reduce high CO concentrations. Once started, over ventilation is recommended    Ventilation to move the CO will potentially move the cloud to areas such as exit stairways long way away from the original, contaminated area. Because it is odorless and colorless, other FD members located in stairwells, hallways, or near the ventilation exit points may not realize they are in an area high in CO concentration until they are overcome.    All areas of the structure must be re-monitored after ventilation is completed to confirm all product has been removed from the structure.  **Organization used for CO incidents** **Most CO incidents are handled by the first responding unit and the local utility company and these incidents don't require large command organizations. ** ** ** **Unless the hazards are wide-spread or are affecting multiple people, these types of incidents will not require large HAZMAT organizations. If levels of CO are encountered over 35ppm, the standard OSHA groups will be required to conduct Hot Zone operations. Most notably: ** ** ** - **Research/Recon ** - **Entry ** - **Back-up ** - **No Decon is needed for inert Carbon Monoxide issues ** **Decon ** ** ** **Decon is not required for CO only issues** References: B Shifter Blue Card Hazardous Materials Carbon Monoxide SOG.