Airway & Respiratory, Mass Casualty Incidents, Operations, Patient Care

CO Causes Mass Casualty Incident at Eastern Pa. Hotel Editor’s Note:„A.J. Heightman was a former operations director at Cetronia Ambulance.

At 6:45 on Friday morning, Cetronia Ambulance in„Lehigh„County (Pa.)„was dispatched to„the Best Western Allentown Inn & Suites for the report of an unconscious man.„The crew treated the unconscious patient in his room, unaware that while assessing and treating the patient, their lives were also in danger because they were surrounded by deadly carbon monoxide (CO) fumes. The fumes were being recirculated into that area of the hotel though a disruption in the hotel’s heating and ventilation system caused by plastic sheeting erected by a construction crew.

One hour after transporting the patient to the hospital, Cetronia crews were dispatched back to the hotel after„two more unconscious people were found. They were then told a deceased man was in one of the guest rooms.„Four hotel guests, as well as two police officers and three paramedics who responded to the scene,„were also overcome by CO fumes„and were taken to area hospitals.„Hospital officials say all„patients arrived„with respiratory problems, nausea and„burning eyes. One patient was critical.„The remaining hotel guests were evacuated and kept warm in a„transit bus dispatched to the scene as a part of Cetronia Ambulance’s MCI operations plan.

Emergency„officials say the level of carbon monoxide was so high on their„gas detection meters when they first„entered the building„that they immediately„retreated and began ventilation operations to clear the building of the deadly fumes before„re-entering the structure.

Authorities report the carbon monoxide came from propane hot water heaters in the basement of the hotel.„Although„ the„gas was vented„to the outside, it was trapped and„allowed back into the building through a plastic, tent-like canopy erected for construction being done on the outside of the hotel, near the room where the deceased guest was staying.

According to the Allentown Morning Call newspaper, the 63-year-old male killed in the incident may have inhaled a higher volume of CO than his wife as a result of using a portable CPAP unit„– which forces higher concentrations of air into its user — to treat sleep apnea.

On Saturday, William Pistone, MD, who directs the sleep disorder center at St. Luke’s Hospital-Allentown, told the Allentown Morning Call that the man_s CPAP machine may have inadvertently harmed him. “Theoretically, if there’s more of any particular substance in the air, then you may, with a CPAP machine, be more susceptible to that substance. If the machine was in an area where there was a greater concentration, he would be getting a higher concentration.”

Also on Saturday, Best Western hotel employees rushed to install carbon monoxide alarms in each of the facility_s 77 rooms. The hotel isn’t legally required to have CO detectors in each room, but manager Larry Kolasensky said it decided to take action. ”We reacted — it’s as simple as that,” he said. Kolasensky said he hopes the Best Western can serve ”as an advocate for change” and inspire more hotels to install the alarms.

This case not only illustrates the need for„CO detection equipment for unconscious victims, but also radiation CO alarms attached to first responders in kits as illustrated in the above photo of a Bonita (Calif.) Fire Department kit.„A small,„handheld CO detector/alarm — such as the one illustrated above from DOD Technologies ( 815/788-5200) — costs just„$200 and operates for two years while attached to your kitsÚ a small price to pay to avoid having your personnel overcome by invisible, odorless hazards.

In addition, this morning RAE Systems announced the new “ToxiRAE 3” toxic gas monitors for CO and hydrogen sulfide (H2S) and the companion “AutoRAE Lite” sensor calibration station. The personal monitors offer programmable alarm limits, fast response and multiple alarms. The calibration station is designed to minimize the calibration gas used and be as fast a possible, At 3.4″ x 2.2″ x 0.8″ and only 12.3 oz, it’s small enough to be vehicle mounted. They cost $179 each. For more information on RAE System’s compact„ToxiRAE 3 monitors, go to„