Just a friendly reminder...

Buzz

Buzz

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to all of you that sit in your trucks waiting for calls all day/night. Keep an eye on where your exhaust is blowing on these cold winter days. My partner and I both got headaches and began feeling nauseas. We noticed that the wind had shifted and had been blowing exhaust right up under the truck for the amount of time we'd be sitting at post... which is right about the time something clicked. Once we got into the light, we noticed we were both a little red and we checked our SpO2s... 100% each.

D'OH!

So yeah. Just a friendly reminder: Keep an eye on your vehicles exhaust.
 
Not to diminish the seriousness of carbon monoxide poisoning, I have a few questions.


What does 100% O2 saturation prove in this "diagnosis"?

What do red faces on a cold and windy day prove?

How does one get exposure to the exhaust without being in a semi enclosed or enclosed space?

I mean if the wind is strong enough to blow it back under the unit, what makes it stay under the unit and not continue to the other side and disperse?

Headache and nausea...mass hysteria or same food?

Just curious as it all seemed incredible to me. Now if you have a leak in your exhaust in the engine compartment or under the unit and it is coming in through that route totally understandable, but some of the questions above still apply.
 
akflightmedic said:
Not to diminish the seriousness of carbon monoxide poisoning, I have a few questions.


What does 100% O2 saturation prove in this "diagnosis"?

What do red faces on a cold and windy day prove?

How does one get exposure to the exhaust without being in a semi enclosed or enclosed space?

I mean if the wind is strong enough to blow it back under the unit, what makes it stay under the unit and not continue to the other side and disperse?

Headache and nausea...mass hysteria or same food?

Just curious as it all seemed incredible to me. Now if you have a leak in your exhaust in the engine compartment or under the unit and it is coming in through that route totally understandable, but some of the questions above still apply.
Click to expand...

The O2 sat was just another piece of the puzzle. It's just odd to see someone on room air with a 100% sat.

These red faces were noticed when we turned on the cab light. We hadn't been outside for hours and it was quite comfortable temperature wise.

The headache and nausea couldn't be attributed to food because neither of us had eaten the same thing or at the same place any time recently. From looking out the windows, it appeared that the exhaust was coming up from under our truck. It's difficult to explain exactly how it was moving.

There may be a leak, or it could have just been the amount of time the truck was sitting in the area... It could be CO, or it could just be our minds playing tricks on us. Either way, I'm a little more aware of a CO poisoning possibility on the job.
 
No worries, just trying to wrap my pea brain around it all.
 
"The O2 sat was just another piece of the puzzle. It's just odd to see someone on room air with a 100% sat."


I smoke and can have a SPO2 reading of 100% on RA!


It may have been what you thought. But, if the wind was strong enough to blow it back under the truck, what kept it there? Were you parked up against a building? You see it more on days when the wind is calm.

It is something to always keep in mind though. Maintenance on ambulances are poor at best. Diesels have a lot of gaskets in the exhaust systems and they are never checked for leaks.
 
reaper said:
"The O2 sat was just another piece of the puzzle. It's just odd to see someone on room air with a 100% sat."


I smoke and can have a SPO2 reading of 100% on RA!


It may have been what you thought. But, if the wind was strong enough to blow it back under the truck, what kept it there? Were you parked up against a building? You see it more on days when the wind is calm.

It is something to always keep in mind though. Maintenance on ambulances are poor at best. Diesels have a lot of gaskets in the exhaust systems and they are never checked for leaks.
Click to expand...

I'm normally around 95% on RA, and a non-smoker... Maybe I was just breathing funny?

Actually, we were parked up along side the building. Generally the engine is off when we do this because the noise annoys us, but we'd just seemed to have forgotten about the whole exhaust thing and left it on because it was so darn cold last night. It wasn't an overly windy night or anything either. Trees weren't swaying in the wind, but there had to have been some sort of breeze or air pressure to cause the vehicle exhaust to move in the direction it did.
 
Ah, hate to double post, but just finally got a chance.

Apparently the crew that comes in opposite our shift were smelling a lot of exhaust in the cab while driving and wrote up the truck for an exhaust leak.
 
Carbon monoxide will bind to hemoglobin. 100 % SpO2 will not be diagnostic.

Carbon monoxide has a significant affinity to the iron sites in hemoglobin, the principal oxygen-carrying compound in blood. The affinity between carbon monoxide and hemoglobin is about 230 times stronger than the affinity between hemoglobin and oxygen.[18] CO binds to hemoglobin, producing carboxyhemoglobin (COHb); the traditional belief is that carbon monoxide toxicity arises from the formation of carboxyhemoglobin, which decreases the oxygen-carrying capacity of the blood. This inhibits the transport, delivery, and utilization of oxygen.
Click to expand...
wikipedia
 
Actually you get false high O2 readings in cases of carbon monoxide poisoning.
 
medic417 said:
Actually you get false high O2 readings in cases of carbon monoxide poisoning.
Click to expand...

Exactly. Hence being non-diagnostic of potential hypoxemia.
 
Another point about Buzz's experience is that air temperature effects air density. The cold air can be attributed to an increases in air density and therefore gases such as CO will remain in a more confined space while dispersing. It is not entirely unthinkable that Buzz and his crew member were in fact experiencing some degree of CO poisoning.
 
Yes, rosy red carboyhaemoglobin looks better than the good oxyhaemoglobin .

So the PulseOx will 100% because it reads how red your blood is.
You don't need to build it up in your cab, just have a steady slow exposure and it builds on your red cells. CO is very tenacious, nowhere to go like oxygen has. Not to mention you are also getting the garden variety CO2 and combustion byproducts which are not healthy.

The old 1970's Chevy van ambulances the military used leaked undercarriage air into their wall side cabinets. Funny, how did this fine black soot get into the linens and bandages?....
 
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