Posted By Near Miss Team/ Friday, January 4, 2019 / Print
What was the initial size-up?
At approximately 1900, a ladder company was dispatched to an unresponsive patient. While responding, dispatch upgraded the call to a Cardiac Arrest Echo Response.
The ladder company arrived on scene and the crew found four people in the driveway hugging and crying. One of the four people broke away from the family and led the crews inside a single-story residential house. While walking up to the house, they advised the last time they spoke with the victim was two days ago. They had called a couple times yesterday and today and after no answer, they came over and made the discovery.
Upon entering the home, crews immediately found one victim laying prone on the floor of the den. The victim presented with rigor mortis. There was a small pool of blood underneath the victim’s head, and the skin tone had a “pinkish hue” per the paramedic. Crews quickly obtained a 3-lead and confirmed the “no code, no vitals”. As they were packing their gear up, the lieutenant noticed the dog was laying nearby. Crews went to check on the dog and noticed he had expired as well. The victim’s son advised the dog had been extremely sick, vomiting and having diarrhea for several days. The crew and the male exited the structure together at this point. The ladder crew turned the scene over to the local police department and returned to their assigned fire station.
A short while later, the same ladder company was recalled to the scene by the local police department requesting them to monitor for carbon monoxide per dispatch. The heavy rescue and ladder crew responded to the scene. The ladder crew established Command, and the heavy rescue crew prepared to make an entry. Crews donned full PPE and went on air. They also brought in the Multi-Rae and PH papers. The police department advised they weren’t sure if there was foul play or not and wanted the crews to rule it out if possible as they “smelled a weird smell” inside the structure. The victim’s family advised the victim had just had the entire house painted inside and that could be the smell.
The heavy rescue’s crew entered the structure once the ladder company established “2 out”. Immediately upon entering, crews started getting Carbon Monoxide (CO) and Volatile Organic Compounds (VOCs) readings. As crews moved through the house, the readings steadily climbed to around 27ppm for Carbon Monoxide and around 47ppm for Volatile Organic Compounds. Crews began looking for a cause or source and noticed the dog had vomited and expired where he laid. The dog’s food bowl had water and food indicating he had not died of starvation or dehydration.
The crew continued into the garage and readings were still holding. There was a car in the garage, but it was not running. The crew opened the door and immediately readings shot up and the monitor began alerting. Values peaked at 268PPM of CO and 334.5PPM of VOCs, and 1PPM of Hydrogen Cyanide (HCN). The crew notified Command and exited the structure. PD and command were notified and when PD was ready, the house was ventilated, and air monitored several times until clear for them to enter. It was determined the push button car was left running unintentionally, causing the home to fill with CO. This eventually overcame the victim and his dog, before the car shut off.
Describe the lessons learned at this event:
This could have been bad for the crews had they arrived right after the victim had expired. The CO concentrations were likely higher at the time of death and had dissipated in the home as people entered and exited the structure numerous times. If our crews would have worked the code for twenty minutes in place as the protocols call for, this could have been a tragedy for the department. Imagine that they had worked that code for the recommended twenty minutes, expending energy, using up their oxygen in their blood, increasing their heart rates and their respiratory rates, all while breathing in high amounts of Carbon Monoxide (a colorless, odorless gas). Luckily, they were only exposed for a few minutes before exiting the structure. We were extremely lucky in the case that our crews, PD officers, and the family that entered were not exposed long term and had no illness come of this incident.
Consider placement of gas monitor on each defibrillator. Consider bringing a gas monitor (if assigned to apparatus) to unresponsive calls with no additional call notes. Be sure to paint a picture for the on-duty shift supervisor. In this case the assigned BC may have noted a problem if the crew shared additional information via radio or phone call, such as there was a dog deceased in close proximity to the victim. Identify strange odors; In this case a "new paint" scent may have distracted the crew from another source/possible hazard.
What specific recommendations do you have regarding the lessons learned?
The information regarding this incident has been shared with the department and improved situational/scene awareness will be practiced.
Describe the leading practices you noticed at this incident:
Which of the following occurred, if any:
Date the event occurred:
Approximate time the event occurred:
Location of the emergency/ event:
Was a 360-degree size-up performed?
Which strategic mode was initially implemented?
What was the estimated percent fire involvement of the structure?
Was there a life hazard?
How many life hazards were there?
Medical call reference - unresponsive
List any other info that was important for situational awareness. What were key indicators and factors to consider?
Victim was last seen two days ago. We identified death of the dog in addition to the human in close proximity.
Were unsafe act(s) performed?
Resources and Weather
Which of the following resources were on scene when the event took place?
Approximate number of personnel per unit:
Specialty Vehicle: Heavy Rescue
Did the weather/environmental conditions impact operations or the event?
Were there civilian injuries or fatalities?
How many civilians had major injuries?
What was the nature of their injuries?
Succumbed to IDLH environment.
What caused the injuries?
Push-button start vehicle was left on in garage unintentionally.
How many civilian fatalities occurred?
Were there any firefighter injuries?
Was there substantial property/equipment damage or other cost?
Number of views (51)/Comments (0)