Fire EMS, Firefighting, Fireground Safety

National Fire Fighter Near-Miss Reporting System: Carbon Monoxide Exposure

This week’s featured firefighter near-miss report stresses the importance of maintaining a high level of situational awareness on all incidents. It is imperative to avoid complacency on the incidents that we perceive as “routine” calls. Although many of the EMS calls we respond to for “falls” are high frequency and low risk, we must still be careful to not let our guard down:

“The engine and a paramedic unit were dispatched to a report of a subject fallen. Further information was that the patient was now unconscious. Upon arrival, the crews entered the house and found a male patient unconscious in the kitchen. There was no immediate obvious cause for the patient’s presenting symptoms. In the process of questioning the patient’s son (who was awakened when he heard his father fall) offered that his father spent most of his time in an enclosed work room where a furnace was located. The officer assigned to the engine sent the apparatus operator to retrieve the carbon monoxide detector. As the operator entered the front door with the detector, it went into alarm mode…”

Situational awareness is an important factor on every call we respond to as emergency responders. This awareness begins as we receive an alarm from the dispatch center. The information we initially receive is often very limited. As we approach the scene and enter the residence we should be using all of our senses and those of our entire crew to assess the situation. The safety of our crew should be our first priority. Has it been cold recently? Is there a chance residents have been using space heaters, stoves, fireplaces, or other forms of gas or wood-fueled appliances to heat the home? Does it appear that appliances have been properly maintained, properly installed, and serviced; or are they missing pieces, improperly vented, or covered with dust? Is there an attached garage where a vehicle or generator may be in use? Is the patient complaining of flu symptoms, light headedness, or headache? Are other family members experiencing similar symptoms? These are all signs that may point to carbon monoxide (CO) exposure.

Review this week’s report ( and consider the following:

  1. What steps should be taken if carbon monoxide exposure is confirmed? For our crew? For the patient(s)? For the scene?
  2. What are the signs and symptoms of CO exposure?
  3. What is your department’s policy in dealing with calls to investigate residential carbon monoxide alarms?
  4. Does your agency carry gas monitors on the apparatus? Are they properly maintained and are personnel proficient in their use?
  5. Does your local jurisdiction require or promote the installation of carbon monoxide detectors in residences? Does your department educate the public in the importance of their use?  

Carbon monoxide is a colorless, odorless gas that is a product of incomplete combustion. It is not always obvious when someone has been exposed. A keen sense of situational awareness is critical to avoid walking into an incident that could be hazardous to you and your crew. A Carbon Monoxide Training Package was produced by the National Hazardous Materials Fusion Center and is a great training resource for responders.

Have you experienced a near miss from carbon monoxide exposure? Submit your report to today so everyone goes home tomorrow. For more on the value of firefighter near-miss reporting, CLICK HERE.

Note: The questions posed by the reviewers are designed to generate discussion and thought in the name of promoting firefighter safety. They are not intended to pass judgment on the actions and performance of individuals in the reports.