杰里·纳普（Jerry Knapp）
–Most common:The occupants meet you at the door saying their CO detector went off. They may or may not have mild symptomsthe dog is running around in the house and the kids are excited to see the fire trucks. There may be low levels of CO in the house.
–最危险：The occupants are unconscious orwake up dead. This is an obviousrescue/recoverysituation and an immediately dangerous to life and health (IDLH) environment for firefighters. Mask up and follow your procedures. Don’t forgetCO is flammable at 12.5-74 percent in air. This represents a level of 125,000-740,000 parts per million (ppm), which is really high, probably higher than your meter will read. There are high levels of CO in the house.
–最加重的：乘员说他们的探测器熄灭了。您查看它，它正在闪烁“ B”以用于电池……电池已耗尽。房屋中没有CO的水平。
THE FACTS
Co来自哪里？The burning of most materials produces CO. Especially common sources are incomplete combustion or improperly vented boilers or hot water heaters; an improperly functioning stove; a car running in the garage; a charcoal grill near an open door or window (I’ve seen folks bring these into the kitchen due to bad weather); testing the snow blower in the basement or attached garage; a clothes dryer; space heater; and so forth.
Is CO lighter or heavier than air? It is about the same as air but it will get pushed around by air currents in the residence.美国国家职业安全与健康研究所（NIOSH）化学危险指南states CO is 0.97 percent as dense as air, making it very close to normal air but a slight bit lighter.
How dangerous is CO? It will obviously killat high concentrations. If the occupant has been in the house for some time and just walked out of the house and does not have any symptoms, it is likely the CO concentration is low.
一个人会做什么breathes it into their lungs? It rapidly binds with red blood cells and interferes with the ability of the blood to carry oxygen to all the cells in your body. Red blood cells and CO form carboxyhemoglobin in the blood, which is very stable and continues to inhibit oxygen perfusion in the victim. A reduced oxygen level causes headaches, nausea, vomiting, dizziness, fatigue, and ultimately unconsciousness and death.
在现场
The first step is to check the occupants for symptoms. If symptoms are present, evacuate them to fresh air.Emergency medical services (EMS) should provide oxygen and supportive care and evaluation if symptoms are present. If equipped to do so, determine the level of CO and oxygen in their blood to decide if transport is required.
The other concurrent first step is to question the occupants on details of the CO alarm. Below are some typical questions that will help you determine which mode you are in (most dangerous, most common, most aggravating).
你为什么打电话给消防队?这is a very broad question，但根据它的回答，它通常为您的行为设定舞台。如果乘员说：“我的探测器正在熄灭，我不明白这意味着什么，”该设备检查。您可能处于最严重的模式。如果他说：“探测器已经熄灭了几个小时，我头痛了，”您可能处于最常见的模式。
房子里有人生病吗？如果是这样，他们的症状是什么？这些人在屋子里（并暴露于CO）多久了？如果他们只是在一天的冰上钓鱼之后，五分钟前进入了房子，现在他们很恶心，想到了两个想法：房屋中的CO集中度确实很高（您的仪表应该很快告诉您），或者它们因其他事物而生病无关。您需要通过进一步的询问进行解决。
如果存在症状，请继续询问。他们在屋子里已经多久了？有CO detector gone off before and for how long? Does the detector have a digital readout? What was that reading? If the detector is reading anything above background levels (9 ppm or greater) and they have headaches, it is likely they have a CO concentration in the house. Have you recently had any problems or repairs to your boiler, furnace, hot water heater, clothes dryer, etc.? These questions will help you find the potential source of the CO if it is present.
What were you doing when the alarm went off? This is a great question so be prepared for some really stupid answers. Here is what I have heard:
“我在车库里加热汽车.”
“我只是在检测器上喷洒了房间除臭剂.”
“I have been cooking all day and I think I burned a plastic container in the oven.”
The black smoke coming out of the oven was probably a really good clue, along with the blob of theplastic remains hanging from the oven racks. This question, coupled with your evaluation of their lack of symptoms, usually puts the call to bed.
But always follow up with, “Did you open the windows and doors or turn on the attic fan to vent it out?”
THE NEXT STEP
当然需要空气监控，但是如果您可以提出重要问题和上面列出的其他问题，则坚持下去。如果房屋中有CO，并且乘员打开窗户，您可能找不到任何东西。如果他们告诉您他们在锅炉上遇到麻烦，您可能需要派遣机组人员检查它。通常，它会显示出不良的维护和性能的迹象，例如烟囱堆栈中的烟灰或其他标志。
空气监测
是时候进行空中监视了instrument inside the home. But before you do, consider the following:
- 什么时候仪器最后校准了吗？您在这里处理潜在的致命气体，如果您的乐器处于最佳工作订单，那将是非常好的！Read the manufacturer’s directions that come with it.It will tell you how to properly maintain your particular instrument to ensure accurate readings.
- 您是否对其进行了校准，还是站在钻机的排气管附近？
- 移动缓慢through the house, giving the instrument time to detect the gas and provide you a reading or alarm. If you walk quickly through the area you are monitoring and the alarm sounds, was it sensing a high concentration when you walked in and just alarmed when you reached the second room, or was there something else?
NUMBERS
What do the numbers on the monitor mean? There are no national standards for actions at different levels. According to an article inWNYF Magazine克里斯托弗·弗拉特利（Christopher Flatley）中尉（第三期，2009年），“读数小于9 ppm，除非存在症状，否则不需要疏散。读数超过9 ppm和症状，建议撤离。读数100 ppm或更多或症状存在，强制性撤离。”
一般来说，1-9 ppm的读数被认为是背景级别。职业健康与安全管理局（OSHA）允许工人在工作场所中以35 ppm的速度保持八个小时。但是请记住，这是针对健康的工人的；非常老，非常年轻，生病或虚弱的人可能更容易受到影响。
With readings between 9 and 100 ppm, you need to do your detective work and make decisions based on symptoms and specific conditions at the scene. Although the numbers from experts vary, the following CO levels provide a relative value of risk.
- 35 ppm是工人加权时间的平均时间
- 200 ppm导致头痛如果暴露了两到三个小时
- 400 ppm results in a headache if exposed for一到两个小时
- 1,500 ppm是IDLH环境
- 2,000 ppmcauses death or irreversible damage in one hour
- 3,200 ppm causes headache and dizziness in五到10分钟
Understanding these numbers will be helpful on the scene. But remember, the primary considerations that drive your decision making are the symptoms of the occupants and the safety of your members.
您在现场的成功和安全将取决于您可以从以下内容评估和提取假设的程度：Symptoms (if any), the occupant’s answers to your questions, the occupancy’s meter reading, and your air monitoring results.
我们从经验中知道对CO警报的回应是一部分经验，一部分艺术和一部分科学。在您使用电表冲刺之前，许多出色的侦探工作确实会有所帮助。
您的标准操作准则（SOG）将确定您是否始终致电公用事业公司，以及是否尝试确定源或只是始终撤离每个电话中的所有人。
这article not a complete summary of the hazards of CO, but rather an operational reminder and refresher for you of some important points. Always follow your SOGs and safety procedures for your department.
杰里·纳普（Jerry Knapp）
is the assistant chief for the Rockland County (NY) Hazmat Team and a training officer at the Rockland County Fire Training Center in Pomona, New York. He is a 35-year veteran firefighter/EMT with the West Haverstraw (NY) Fire Department, has a degree in fire protection, and was a nationally registered paramedic. Knapp is the plans officer for the Directorate of Emergency Services at the United States Military Academy in West Point, New York.
