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

Disaster Med Public Health Prep. 2018 Jun;12(3):373-378. doi: 10.1017/dmp.2017.65. Epub 2017 Oct 10.

Abstract

ABSTRACTCarbon 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).

Keywords: carbon monoxide; hyperbaric chamber; intoxication; oxygen treatment; triage.

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Breath Tests / instrumentation
  • Breath Tests / methods
  • Carbon Monoxide / analysis
  • Carbon Monoxide Poisoning / diagnosis*
  • Carbon Monoxide Poisoning / therapy
  • Child
  • Exhalation / physiology
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods
  • Hyperbaric Oxygenation / statistics & numerical data
  • Male
  • Mass Casualty Incidents / statistics & numerical data*
  • Middle Aged
  • Triage / methods*
  • Triage / trends

Substances

  • Carbon Monoxide