1) Determine whether the call is for a smoke or CO alarm, location of ph. call, whether anyone has passed out, whether there is vomited or the person(s) is showing other CO poisoning signs, and whether the CO alarm has a reset button. This information should be gathered quickly.
2) Verbal warnings should be given - "If the people have not left the building yet and the alarm has sounded again after reset, they should leave immediately if physically possible.
3) If one or more of the peoiple in the building have headaches or are vomiting or showing any other physical indications of CO poisoning, they should all get fresh air immediately, if possible.
4) If someone has fainted or is unconscious and/or cannot be moved outside the affected area, windows and doors should be opened, especially in the room where the unconscious victim is located. Get everyone else outside.
5) Instruct them not to go around opening windows, doors and turning off appliances if everyone can get outside immediately. Have them go to a neighbor's house if possible. The calling adult should wait for the first response team in front of the building.
6) Gas company personnel should also be notified, if notification is not automatic.
First Response Protocol:
1) Before testing a building's air for CO, it is vital that an instrument be calibrated to manufacturers specifications and be turned on outside the building. Do not "zero" your instrument inside the building.
2) If the calling person is not standing in front of the building, first responders should enter directly. There may be someone inside.
3) If the caller is waiting outside the building, one responder should find out about all other inhabitants' locations and the general health conditions, while another responder enters the building, CO monitor in hand. (some emergency responders are required to wear self-contained breathing apparatus - CO over 35-50 ppm)
4) Inside, responders are measuring air for CO and looking for people and animals. Even though a caller says everyone is out of the building, a search should be done since confusion is a major effect of CO poisoning. Written notes should be made of the CO concentrations.
5) Outside, the team member is still with the caller. The first to be attended to are those most sick. Oxygen should be administered and calls made for back-up support, if needed.
6) If none of the building's inhabitants are demonstrating debilitating CO poisoning symptoms, obtain a Breath Sample from whoever has been in the building the longest time and perhaps the healthiest person in the group. If CO poisoning is verified, the specific procedures for management of poisoning should be followed. Samples should be taken from several people in the building - record all measurements.
7) Once you have determined the health of all the people involved, your next steps are to dependent upon the supporting activities of public service personnel, fuel suppliers, and other responders. If you have source investigation support by qualified technicians, they will test individual appliances inside the building. If not, you will need to do that as well.
8) Breath Analysis may confirm the presence of CO, but measurements inside may indicate no CO. Complete testing of the building must be performed. The temporary housing of the inhabitants must be addressed. The decision then is how and when and by whom the next set of tests will be performed, and who pays for them.
9) Leaving a CO-monitor with data-logging capability in the building for several days may assist in discovery of the specific CO source. Note should be taken to the weather conditions during this period.
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