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Noninvasive CO-Oximeter Project Description
In keeping with our unwavering desire to provide the highest level of service possible, it is the intention of our 2007 AFGP Operations and Safety Program to purchase and field deploy forty Masimo Rad-57 Pulse CO-Oximeters at a cost of $3,500.00 per unit. This breakthrough medical device is the only product in the world that can noninvasively measure the level of carbon monoxide (CO) in the bloodstream in seconds without drawing blood or performing a time-intensive and costly laboratory test. It is portable (a small, hand-held unit), accurate, extremely easy to use and can be deployed to test carbon monoxide levels of firefighters in the field to determine whether or not they have been exposed to dangerous levels of carbon monoxide. It can also be used to quickly and easily triage patients on the scene to determine the proper course of treatment.

Carbon monoxide represents a grave threat to public health for both our citizens and emergency response personnel— especially firefighters. Carbon monoxide is a colorless, odorless, tasteless gas that is caused by the incomplete combustion of any carbon-based material. CO binds readily with hemoglobin which creates carboxyhemoglobin, a dysfunctional hemoglobin incapable of transporting oxygen; this deficit results in a systemic hypoxemia. Each year, carbon monoxide claims the lives of nearly 3,800 Americans and is the most commonly reported form of poisoning in the United States.

This innovative new technology would give our personnel the ability to routinely provide screening of patients and firefighters alike for both occult and suspected CO intoxication. Until the introduction of the Masimo Rad-57, it was impossible to determine the level of carbon monoxide in the blood (COHb) without a hospital clinician obtaining a blood sample and performing sophisticated laboratory analysis. The Masimo Rad-57 has been FDA cleared to noninvasively measure COHb saturation in the range of 1–40% with an accuracy of +/- 3 digits (1 S.D.) in seconds.

In addition to the obvious benefit of routinely screening our patients for unsuspected CO intoxication, the Masimo Rad-57 represents an enormous breakthrough in the area of firefighter rehabilitation/safety. Firefighters entering the rehab sector can now be screened for CO exposure within seconds, significantly diminishing the potential for CO-related injury
and long-term neurological and cardiac damage.

In a recent study published in the Journal of the American Medical Association (JAMA), the Minneapolis Heart Institute found a strong link between carbon monoxide poisoning and myocardial injury resulting in increased mortality and morbidity. Ratios from this study demonstrate that a patient has a three times higher likelihood of cardiac death (within a seven-year follow-up period) from even one moderate to severe toxic CO exposure, when compared with a control group.

The addition of the Masimo Rad-57 Pulse CO-Oximeter to our existing response capabilities would greatly enhance our ability to safeguard the lives of both our citizens and our personnel.

Statement of Effect
As previously stated, carbon monoxide represents a grave threat to public health. CO toxicity is the most frequently reported form of poisoning in the United States each year. The pervasive nature of CO toxicity is further complicated by our inability to easily detect its presence and determine the level of exposure in patients and first responders alike. This silent killer attacks without warning. Signs and symptoms of CO toxicity mimic those commonly associated with the flu, which often results in an improper diagnosis. The chain of CO exposure must be broken in order to prevent further injury and death.

The addition of the Masimo Rad-57 Pulse CO-Oximeter to our existing response capabilities would greatly enhance our ability to expeditiously make the proper field diagnosis and render the appropriate care, thus reducing morbidity and mortality from CO intoxication.

References
• Mott JA, Wolfe MI, Alverson CJ, et al: “National vehicle emissions policies and practices and declining US carbon
monoxide-related mortality.” Journal of the American Medical Association. 288(8):988–995, 2002.
• Henry CR, Satran D, Lindgren B, et al: “Myocardial injury and long-term mortality following moderate to severe carbon
monoxide poisoning.” Journal of the American Medical Association. 295(4):398–402, 2006.
• Hampson NB: “Emergency department visits for carbon monoxide poisoning.” Journal of Emergency Medicine.
16(5):695–698, 1998.