International Association of Fire Fighters (IAFF) advocates screening firefighters for carbon monoxide poisoning using pulse CO-oximetry

Masimo, the inventor of pulse CO-oximetry and read-through motion and low perfusion pulse oximetry, announced Jan. 8 that the International Association of Fire Fighters (IAFF) has issued education materials to more than 3,000 local union presidents in the United States and Canada calling for routine carbon monoxide (CO) screening using a pulse CO-oximeter for all fire fighters potentially exposed to CO. The IAFF, representing more than 287,000 fulltime, professional firefighters and emergency medical personnel who protect 85 percent of the nation’s population, is the primary advocate for providing firefighters and paramedics the tools they need to perform their jobs, including implementation of new training programs and equipment.

In a letter to all local union presidents in North America, the IAFF highlighted the need for a new protocol whereby any firefighter potentially exposed to CO and exhibiting headache, nausea, shortness of breath or gastrointestinal symptoms should be assessed using a pulse CO-oximeter. IAFF General President Harold A. Schaitberger acknowledged the prevalence, severity and frequency of the detrimental effects of CO: “We believe that many of the cardiac arrests firefighters are experiencing may well be attributable to CO exposure,” Schaitberger said.

Because CO is present in every fire and its symptoms are nonspecific and easy to miss, the dangers of acute and prolonged CO poisoning are more pronounced for firefighters. According to the IAFF, the risk of prolonged CO exposure during a fire does not end once the fire is controlled. The “overhaul” phase of fire control, when firefighters seek out and extinguish any remaining fires to eliminate rekindles and stabilize both the structure and scene, can be time consuming and expose firefighters to CO levels high enough to cause death or permanent impairment. Additionally, repeated or accumulated exposures present an even greater risk to firefighters.

Even a single high-level exposure or prolonged exposure to low levels of CO has the potential to cause long-term cardiac, neurocognitive and psychiatric damage. The long-term effects of CO—include Parkinson-like syndromes affecting motor skills and speech, dementia, cortical blindness, acute renal failure, muscle cell death and more—can be devastating for firefighters and their families.
Mike McEvoy, EMS Director, NYS Association of Fire Chiefs said: “Two facts are widely known—CO is the most common poison in the world today, and dead firefighters often have significantly elevated CO levels. The proactive use of the pulse CO-oximeter advocated by IAFF will help to ensure that no firefighters slip through the system with undetected CO poisoning in the line of duty.”

The IAFF is the driving force behind nearly every advance in the fire and emergency services in the 20th century, from the introduction of shift schedules early in the last century to the enactment of SAFER in 2003. With recognized experts in the fields of occupational health and safety, fire-based emergency medical services and hazardous materials training, the IAFF has established professional standards for the North American fire service. In addition to city and county firefighters and emergency medical personnel, the IAFF represents state employees, federal workers and fire and emergency medical workers employed at certain industrial facilities, including more than 3,000 local unions in more than 3,500 communities throughout the United States and Canada.

The National Association of EMS Educators (NAEMSE) issued similar guidance to its membership recommending that EMS professionals “screen patients for carbon monoxide poisoning that have had a suspected exposure, or present with any of the signs or symptoms of carbon monoxide poisoning.” These two organizations are examples of a growing trend in which industry-leading emergency services associations converging toward a new standard of care for the proactive screening of CO-exposed patients and emergency services personnel by pulse CO-oximetry.

Joe E. Kiani, Chairman and CEO of Masimo, said: “Firefighters and EMS personnel are among our greatest heroes. They fight tirelessly to save our lives, homes, property and land from the ravages of fire-often sacrificing their own lives and health in the process. The Masimo Rad-57 Pulse CO-Oximeter was designed with saving lives and preserving health in mind. We applaud IAFF for taking this proactive step to ensure the health and well-being of the heroes who care for us all.”