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=====B-3 Carbon Monoxide Exposures=====
===Non-Emergency Manual===
==Date Revised: 02/01/2018==
<sub>Last Modified: ~~LASTMOD~~ </sub>

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**Policy/Procedure**

Patients suffering from exposure to byproducts of combustion or other suspected sources of carbon monoxide should, when feasible, have a carboxyhemoglobin (COHB) level recorded, using a RAD-57 meter or LifePack 15. This includes victims of smoke inhalation, persons suffering from exposure to “fumes”, and firefighters undergoing rehab at fires or hazardous materials incidents.

The Massimo RAD-57 is a device for non-invasive measuring of carbon monoxide in the bloodstream. It also accurately measures the blood oxygen level of persons exposed to carbon monoxide. The device is located on the Safety Officers’ vehicle and is available for use in assessing firefighters and civilian patients. LifePack 15’s, carried on all Life Squads and most first responder vehicles have the same capability.

In assessing patients, the following guidelines shall apply:

^COHB %	^SYMPTOMS	^EMS CARE	^TRANSPORT	^HOSPITAL
|0-12	|NONE	|SUGGEST CORRECTIVE ACTION	|N/A	|N/A
|0-12	|MILD HEADACHE	|NON- REBREATHER MASK	|BLS	|ANY
|13-24	|ANY	|NON- REBREATHER MASK	|ALS/BLS	|CLOSEST
|> 25	|ANY	|NON- REBREATHER MASK	|ALS	|NEAREST HYPERBARIC FACILITY

**Note:** Smokers may have baseline CO levels as high as 5-6%.



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