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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 project to purchase and field deploy forty Masimo Rad-57 carboxyhemoglobin oximeters at a cost of $3500.00 per unit. Unlike traditional non-invasive pulse oximeters, the Rad-57 carboxyhemoglobin oximeter utilizes multiple wavelengths of visible and infrared light to differentiate between hemoglobin that is saturated with oxygen (oxyhemoglobin) and hemoglobin that has been saturated with carbon monoxide (carboxyhemoglobin). Each year in the United States, Carbon monoxide claims the lives of nearly 3,800 Americans, and is the most commonly reported form of poisoning each year; (Mott JA, Wolfe MI, Alverson CJ, MacDonald SC, Bailey CR, Ball LB, Moorman JE, Somers JH, Mannino DM, Redd SC. National Vehicle Emissions policies and practices and declining US carbon monoxide-related mortality. JAMA 2002;288:988-995).

Carbon monoxide represents a grave threat to public health for both our inhabitants and emergency response personnel. Carbon monoxide is a colorless, odorless, tasteless gas that is liberated from the incomplete combustion of any carbon based material. CO binds readily with hemoglobin which creates carboxyhemoglobin, a dysfunctional hemoglobin which is incapable of transporting oxygen, this deficit results in a systemic hypoxemia. This innovative new technology would allow our personnel the ability to routinely provide screening of patients and firefighters alike for both occult and suspected CO intoxication. Until recently, the value which represents the level of carbon monoxide in the blood (COHb) could only be obtained by hospital personnel by obtaining an arterial blood sample and performing sophisticated laboratory analysis. The Masimo Rad-57 carboxyhemoglobin oximeter has been FDA validated to measure COHb saturation in the range of 0 - 40% with an accuracy of +/- 3% (1 S.D) In addition to the obvious benefit of routinely screening our patients for occult CO intoxication, the Rad-57 carboxyhemoglobin oximeter 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.

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. Ratio’s from this study demonstrate that a patient has a 3 times higher likelihood of cardiac death (within a 7 year follow-up period) from even one moderate to severe toxic CO exposure, when compared to a control group; (Myocardial Injury and Long-Term Mortality Following Moderate to Severe Carbon Monoxide Poisoning. Henry CR, Satran D, Lindgren B, Adkinson C, Nicholson C, Henry TD. JAMA. 2006;295(4):398-40)

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. 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 carboxyhemoglobin oximeter to our existing response capabilities would greatly enhance our personnel’s ability expeditiously make the proper field diagnosis and render the appropriate care, thus reducing morbidity and mortality from CO intoxication.