title: Managing a Mass CO Poisoning: Critical Issues and Solutions From the Field to the Hyperbaric Chamber.
abstract: Carbon monoxide acute intoxication is a common cause of accidental poisoning in industrialized countries and sometimes it produces a real mass casualty incident. The incident described here occurred in a church in the province of Verona, when a group of people was exposed to carbon monoxide due to a heating system malfunction. Fifty-seven people went to the Emergency Department. The mean carboxyhemoglobin (COHb) level was 10.1±5.7% (range: 3-25%). The clinicians, after medical examination, decided to move 37 patients to hyperbaric chambers for hyperbaric oxygen (HBO) therapy. This is the first case report that highlights and analyses the logistic difficulties of managing a mass carbon monoxide poisoning in different health care settings, with a high influx of patients in an Emergency Department and a complex liaison between emergency services. This article shows how it is possible to manage a complex situation with good outcome. (Disaster Med Public Health Preparedness. 2017;11:251-255).
authors.affiliation: 1Department of Emergency and Intensive Care Unit,Operation Center SUEM,Azienda Ospedaliera Universitaria Integrata (AOUI),Verona,Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Valerio
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Verzè
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Marchiori
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Igor
authors.initials: I
authors.lastname: Rucci
authors.affiliation: 3Emergency Department, Mater Salutis Hospital,Legnago (Verona),Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: De Santis
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Aprili
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Antolini
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Sannino
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Canello
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Checchin
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazzola
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Garon
authors.affiliation: 1Department of Emergency and Intensive Care Unit,Operation Center SUEM,Azienda Ospedaliera Universitaria Integrata (AOUI),Verona,Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Schonsberg
authors.affiliation: 2Diagnostics and Public Health Department,University of Verona,Verona,Italy.
authors.forename: Stefano
authors.identifier: 0000-0002-9161-2189
authors.initials: S
authors.lastname: Tardivo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002249:Carbon Monoxide Poisoning / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006361:Heating / Q000009:adverse effects; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods / Q000706:statistics & numerical data*; D007223:Infant; D007558:Italy; D008297:Male; D054527:Mass Casualty Incidents; D008875:Middle Aged
keywords: emergency medicine; emergency service hospital; environmental exposure; health planning organizations; inhalation exposure