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01-21-13 What was the role of Tennessee Poison Center in the recent mass exposure of school children to carbon monoxide?

Question of the Week

January 21, 2013

What was the role of Tennessee Poison Center in the recent mass exposure of school children to carbon monoxide?

In the late morning of Monday, January 14, Drexel School was closed due to the concern of a carbon monoxide (CO) leak.  Initially, the parents were not sure why there had been an early school closure, but the school subsequently sent a telephone announcement alerting the parents that the children had been exposed to carbon monoxide.  Parents began flooding to local Emergency Departments (ED).

 Tennessee Poison Center (TPC) received a call around noon asking what one should do if one was exposed to carbon monoxide, but an actual exposure was not relayed.  A couple of hours later, TPC received a call from Vanderbilt Pediatric Emergency Department regarding a number of children that were presenting to the ED from Drexel School.  The likelihood was that there would be many more.

There are a number of issues that need to be addressed in this setting.  First is ensuring that the patients are evaluated and treated.  Once the exposure is known, then an assessment must be made to determine if the hospital has the required resources to treat these patients.  This allows for triage of patients to the hospitals that have the available resources.  The treatment for CO exposure is oxygen, and since all hospitals have the ability to confirm exposure to CO and have oxygen, the patients can be distributed throughout hospitals in the community.  This distribution prevents one or two hospitals from becoming overwhelmed and other ED patients can still get adequate care.

The media, already on standby, assisted in getting the message to the community.  They transmitted the message that if the child did not have symptoms, families should call the Poison Center to determine if he/she needed to go to the ED.  If you were going to take your child to the Emergency Department, call the Poison Center to determine which hospital you should attend.  Thus, many ED visits were avoided altogether and hospitals throughout the city received the patients, preventing a few hospitals from being overloaded with patients. 

At TPC, the Certified Specialists in Poison Information, nurses, doctors and pharmacists who answer the hotline phones, rose to the challenge.  They responded to more than one hundred calls regarding carbon monoxide (in addition to the usual calls) over the next few hours. 

Not only does Tennessee Poison Center help in an everyday poison emergency, we are ready to respond in any type of disaster involving poisons. When things work well, and a disaster is avoided, it is easy to overlook the efforts that made things work so efficiently and effectively.  Whew!

This question prepared by: Donna Seger, MD  Medical Toxicologist

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