By Jamie Thompson
FireRescue1 Editor

PHILADELPHIA — When a Philadelphia engine company was dispatched to a children's birthday party Saturday, the CO gas meter attached to their first-in bag did its job.

Several of the guests were swiftly taken to the hospital with CO poisoning — and into the care of the person whose research helped to put the meter policy in place.

FireRescue1 columnist David Jaslow, director of the Division of EMS and Disaster Medicine within the Department of Emergency Medicine at Albert Einstein Medical Center in Philadelphia, managed the incident in the ED.

It was his 2001 study, "Routine carbon monoxide screening by emergency medical technicians," that recommended fire apparatus and ambulances have CO meters attached to first-in bags.

"The medical director in Philadelphia has told me before that he encouraged the fire commissioner to spend the money to do that after our research," Jaslow said.

"As soon as they walked through the door on Saturday, the meter went off and they knew something was up."

A gasoline-powered generator running a fan for inflatable playhouses is believed to have been the cause of the poisoning.

Children were playing in two large Moonbounce balloon playhouses that were being kept inflated by the fan, Jaslow said.

Reports said six of those sickened at the party were ages 3 to 16 but none of the cases were life threatening.

In total, 17 people were treated at the ED at the Albert Einstein Medical Center, which is just 10 blocks away from the community center hall where the party took place. Two of the children were transferred to the Children's Hospital of Philadelphia, where they were treated in a hyperbaric chamber.

Jaslow said medical staff at the center detected higher volumes of CO in children compared to the adults who were treated, confirming the fact youngsters can be more susceptible to CO poisoning than older people.

"As children generally breathe faster than adults and have a smaller volume of distribution, more carbon monoxide gets into their system," he said.

"The kids all had levels of 22 to 23 percentage of hemoglobin saturated with carbon monoxide, while the adults were not that high."

One of the most challenging aspects of the incident, Jaslow said, was the fact only some of the people were transported to the center directly from the scene. Others went home before responders arrived and were only admitted later that day after complaining of sickness.

It led Jaslow and the fire department to set up a press conference, urging the 70-plus people who had been at the party to get themselves checked out.

"From a public health standpoint, we needed to get information out over the airwaves," Jaslow said.

"Although we couldn't do it in time to the make the news that night, it was the lead story on Philadelphia news outlets the following morning."

The 2001 survey focused on the fact screening is usually limited to instances in which there are symptoms of CO poisoning or activation of a home CO detector.

Jaslow said the objective was to determine whether emergency medical services personnel could perform routine CO screening during 911 calls.

As part of the research, a prospective observational study was conducted in an urban EMS system using EMTs to screen for elevated CO levels during emergency responses.

In a three-month convenience sample of emergency responses, there were 264 residential CO readings obtained. There were nine (3.4 percent) positive residential readings, all with chief complaints initially believed to be unrelated to CO toxicity.