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

Published online by Cambridge University Press:  10 October 2017

Mathieu Pasquier ,
Fabrice Dami ,
Pierre-Nicolas Carron ,
Bertrand Yersin ,
Rodrigue Pignel  and
Olivier Hugli
Mathieu Pasquier*
Affiliation:
Department of Emergency Medicine, University Hospital Centre (CHUV), Lausanne, Switzerland
Fabrice Dami
Affiliation:
Department of Emergency Medicine, University Hospital Centre (CHUV), Lausanne, Switzerland
Pierre-Nicolas Carron
Affiliation:
Department of Emergency Medicine, University Hospital Centre (CHUV), Lausanne, Switzerland
Bertrand Yersin
Affiliation:
Department of Emergency Medicine, University Hospital Centre (CHUV), Lausanne, Switzerland
Rodrigue Pignel
Affiliation:
Department of Emergency Medicine, Hyperbaric Unit, University Hospital Centre (HUG), Geneva, Switzerland
Olivier Hugli
Affiliation:
Department of Emergency Medicine, University Hospital Centre (CHUV), Lausanne, Switzerland
*
Correspondence and reprint requests to Mathieu Pasquier, MD, Emergency Service, University Hospital Centre, BH 09, CHUV, 1011 Lausanne, Switzerland (email: [email protected]).
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Abstract

Carbon 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 monoxidehyperbaric chamberintoxicationoxygen treatmenttriage
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 3 , June 2018 , pp. 373 - 378
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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