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By Attorney Gordon Johnson
The National Carbon Monoxide Awareness Association (NCOAA) is advocating for all emergency responders to wear personal protective carbon monoxide (CO) alarms when on duty. Protecting responders from CO exposure is critically important. But the value of these personal devices extends far beyond just safeguarding the wearer—they can provide crucial early warning that helps identify CO exposure in patients or environments, preventing tragic outcomes.
The Silent Danger of Carbon Monoxide Exposure
Personal CO alarms are life-saving tools that alert wearers to the presence of CO, a colorless, odorless gas that can cause severe poisoning. CO alarms can quickly differentiate whether an individual's symptoms are due to CO exposure rather than another medical condition, providing a critical layer of protection for both responders and the public.
Real-Life Case: CO Exposure Misidentified
Consider the following incident: An 11-year-old girl fainted and experienced a seizure in her apartment. First responders evacuated her but did not remove the other occupants. Only after three hours did a call from the hospital lead to the realization that the apartment had high CO levels. The utility company instructed the remaining occupants to open windows and doors, rather than evacuating immediately. While waiting inside, the CO levels measured 80 ppm—significantly lower than the likely 300-400 ppm before ventilation.
If the EMTs had been equipped with personal CO alarms, they would have detected the gas immediately, leading to a faster evacuation. The remaining occupants, including a five-year-old girl, faced serious exposure to CO for hours, which could have led to life-threatening consequences.
Extending Protection Beyond First Responders
While EMTs and firefighters are at the forefront, CO exposure is a risk for others as well. Employees in hotels, apartment complexes, and various maintenance roles should also wear personal CO alarms, including:
Hotel staff (maintenance, housekeeping, front desk)
Hotel brand inspectors
Health department inspectors
Fire department inspectors
Elevator service/repair workers
City/county code officials
Private HVAC and plumbing contractors
Gas utility workers
The Impact of Misdiagnosis: A Second Tragic Story
Another distressing case involved a patient misdiagnosed with a stroke after being evacuated from his home with dangerously high COHb levels. In reality, he suffered a heart attack and substantial brain damage from CO poisoning. Despite a documented COHb level of 30.2% after 74 minutes on oxygen, the ER doctor wrongly attributed the elevated level to the patient’s smoking history. Consequently, he did not receive the appropriate treatment, and his partner wasn’t treated until four days later, following her own "stroke" diagnosis.
This type of misdiagnosis occurs too frequently. Often, EMTs only realize the CO exposure once they observe similar symptoms in additional patients on the scene, as evidenced in this report from an EMT team:
“After 20 minutes of treating the patient, the patient's girlfriend exhibited similar symptoms. The call was then upgraded for an engine response. Upon arrival, the engine crew found CO levels at 535 ppm, indicating a leak in the facility. During transport to the ED, the M25 crew began feeling symptoms of CO exposure and required a secondary firefighter to drive them to the hospital. The M25 crew and both patients were treated for CO exposure.”
The Consequences of Inaction
These incidents highlight a recurring problem: Without personal CO alarms, responders are forced to play a guessing game, delaying crucial care and evacuation. The stealthy nature of CO poisoning—often undetected until it’s too late—leaves both victims and responders vulnerable.
Let an alarm, not symptoms, serve as your warning device.
The use of personal CO alarms can prevent delayed diagnosis, unnecessary morbidity, and fatalities. Don't let CO's silent, ravaging symptoms be the way you discover its presence—let an alarm do it for you.
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