Mass carbon monoxide poisoning at an ice-hockey game

Mortelmans, Luc; Populaire, Jacques; Desruelles, Didier; Sabbé, Marc

doi:10.1097/mej.0b013e32835d1dcc

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…Collective exposure to toxic materials may lead to a chaotic situation, derived from a lack of communication between varied stakeholders and response teams, scarcity of human and material resources, or deficient infrastructure for provision of patient care [3,19,20]. The severe potential consequences of exposure to toxic materials necessitate the establishment of strategies for life-saving procedures, the implementation of an immediate response, a rapid decontamination process, triage of patients, and on-site and hospital medical treatment procedures [21][22][23].…”

Section: Components Of Hospitals' Preparednessmentioning

confidence: 99%

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

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Section: Components Of Hospitals' Preparednessmentioning

confidence: 99%

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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“…Measurement of on-scene HbCO levels with breath or transcutaneous analyzers is noninvasive and allows quicker results compared with blood samples, either on-site or at the hospital. 2 These triage tools have some significant limitations. A major drawback is the elapsed time between the exposure and the HbCO measurement.…”

Section: Triage Using Transcutaneous Co Oximetry and Exhaled Breath Amentioning

confidence: 99%

“…1 There have been many reports of indoor combustion leading to multiple patients with CO poisoning. [1][2][3][4][5][6][7][8][9] The mainstay of CO poisoning treatment is removing the patient from exposure and administering high oxygen concentrations to reduce the half-life of carboxyhemoglobin (HbCO). Hyperbaric oxygen therapy (HBOT) may also be used to treat severely affected patients because it can reduce the HbCO level more quickly, although its indication is still debated.…”

mentioning

confidence: 99%

“…1,3 Before hospital care, dispatch and on-site triage have the potential to avoid unnecessary transport to hospitals, thereby sparing emergency departments (EDs) that are often already filled to capacity. 2 Conventional triage algorithms are dedicated to trauma patients; however, mass casualty triage of patients with CO intoxication may require a different approach. Medical triage priorities are notably different from trauma because of the potential for respiratory or neurological compromise.…”

mentioning

confidence: 99%

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Mass Casualty Triage in the Case of Carbon Monoxide Poisoning: Lessons Learned

Pasquier

Dami

Carron

et al. 2017

Disaster med. public health prep.

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Carbon monoxide (CO) can cause mass intoxication, but no standard triage algorithm specifically addresses CO poisoning. The roles of some recent diagnostic tools in triage as well as treatment with hyperbaric oxygen are controversial. We describe a mass casualty case of CO poisoning involving 77 patients, with a focus on the triage and treatment options decided on-site. The reasons for choosing these options are reviewed, and the pitfalls that occurred and the lessons learned from this major incident are described. We discuss the potential to improve the management of such an event and strategies to accomplish this, including simplifying triage and administering oxygen to all exposed persons for 6 h. (Disaster Med Public Health Preparedness. 2018; 12: 373-378).

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“…In the recent scientific literature, repeated, partially severe cases of carbon monoxide and nitrogen oxide poisoning in indoor go-kart facilities, [5][6][7][8][9][10] indoor ice skating rinks [11][12][13][14] (eg, ice hockey games), and indoor sports halls 15,16 (eg, monster truck, car demolition, and motocross shows) have been described. The causes of increased pollutant concentrations were the exhaust gases from the propane gas-powered ice surface regeneration machines, the radiators to heat the stalls, engine exhaust gases of go-karts, cars, and monster trucks themselves combined with insufficient or bad ventilation.…”

mentioning

confidence: 99%

Air quality in indoor go-kart facilities in Germany

Wolf¹,

Berlin²,

Fembacher³

et al. 2018

Indoor Air

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Indoor go-kart driving and viewing is enjoyed by people of all ages. However, it may pose health hazards, especially for children, pregnant women, cardiovascular patients, and elderly individuals. Depending on the race length, for example, high concentrations of various contaminants may result in severe health problems. Therefore, this project investigated the Indoor Air Quality of eight indoor go-kart facilities. In general, karts that used regular fuel produced the highest concentrations of CO, benzene, TVOC, and BaP, with maximum levels up to 150 mg/m , 170 μg/m , 2690 μg/m , and 8.7 ng/m , respectively. As expected, the maximum CO concentrations at go-kart facilities that used liquid gas and electric karts (20 and <6 mg/m , respectively) were significantly lower than those at other facilities. The highest 95th percentile values for NO (2680 μg/m ) and NO (280 μg/m ) were measured for karts with liquid gas. The alkane, alkene, and cycloalkane groups, as well as benzene and the alkyl benzenes, were the predominant components of the measured TVOCs. Overall, owners of indoor go-kart tracks should ensure that the ventilation with regard to combustion products is optimally adapted in any case to reduce the levels of critical air pollutants.

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Mass carbon monoxide poisoning at an ice-hockey game

Cited by 8 publications

References 16 publications

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Mass Casualty Triage in the Case of Carbon Monoxide Poisoning: Lessons Learned

Air quality in indoor go-kart facilities in Germany

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