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DRAEGER SAFETY

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HYDROGEN CYANIDE IN FIRE OPERATIONS Captain Rick Rochford Jacksonville Fire Rescue Department Incident Safety Officer Craig Rogers- Draeger Safety – PowerPoint PPT presentation

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Title: DRAEGER SAFETY


1
HYDROGEN CYANIDE IN FIRE OPERATIONS Captain Rick
Rochford Jacksonville Fire Rescue
Department Incident Safety Officer Craig Rogers-
Draeger Safety
2
PRESENTATION CONTENT
  • Toxic Gases Generated by Fire
  • Hydrogen Cyanide in Smoke
  • Health Effects of HCN
  • Gas Detection Options
  • Questions Answers

3
TOXIC GASES GENERATED BY FIRE
Toxic Gases Generated by Fire
4
Clark County Fire Fighter Fatality
  • Crews operating at the scene of a commercial dice
    factory fire
  • Heavy smoke and fire conditions
  • All crews are instructed to utilize standard PPE
  • SCBA are used by all responders

5
Clark County Fire Fighter Fatality
  • What are some of the hazards present?
  • As a Incident Commander, what types of injuries
    or conditions may you expect?

6
Clark County Fire Fighter Fatality
  • All crews are ordered out of the structure.
  • As crews leave the factory, they remove their
    SCBA masks.
  • A Fire Captain removes his mask as he walks out
    of the smoke. He collapses outside the structure.
  • He is in cardiac arrest.

7
Clark County Fire Fighter Fatality
  • The Captain did not survive his injuries
  • Coroner ruled this fatality due to cyanide
    toxicity.
  • Clark County Fire Department
  • Captain Frank E. Testa, April 11, 1970

8
2005 FIRE STATISTICS
  • In 2005, there were 1,602,000 fires reported in
    U.S.
  • 511,000 structure fires
  • 3,105 civilian deaths
  • 15,325 civilian injuries
  • 9.2 billion in property damage
  • 87 firefighter deaths in all types of fires
  • gt4000 firefighters injured by smoke inhalation
  • It is estimated up to 80 of all fire fatalities
    are attributable to smoke inhalation

9
ANATOMY OF FIRE SMOKE
  • Toxic composition of smoke varies from fire to
    fire
  • Nature of the burning materials
  • Temperature
  • Oxygen level
  • Ventilation
  • Conditions of high temperature and low oxygen
    enhance degradation of synthetics quickening
    chemical release

10
Partial List of Fire Produced Gases and Vapors
TOXIC GASES GENERATED BY FIRE
  • Carbon Monoxide
  • Carbon Dioxide
  • Hydrogen Cyanide
  • Hydrogen Chloride
  • Nitrous Gases
  • Phosgene
  • Hydrogen Sulfide
  • Sulfur Dioxide
  • Acrolein
  • Ammonia
  • Formaldehyde
  • Glutaraldehyde
  • Acetaldehyde
  • Benzaldehyde
  • Benzene
  • Various PNAs (polynuclear aromatic hydrocarbons)

11
CYANIDE TOXICITY IN SMOKE
  • Historically, carbon monoxide asphyxiation has
    been considered the primary cause of deaths of
    those overcome by smoke
  • Focus of gas monitoring
  • There is mounting evidence that hydrogen cyanide
    is directly responsible for many more deaths than
    previously assumed
  • Cumulative effect with CO worse than either
    individually

12
  • Cyanide toxicity from
    smoke inhalation in a structural or enclosed
    space fire is the most likely cause of
    cyanide toxicity that EMS fire
    professionals will encounter
  • JEMS Communications Summer 2004

13
HYDROGEN CYANIDE IN SMOKE
Hydrogen Cyanide in Smoke
14
CYANIDE PRODUCING MATERIALS
  • Cyanide production in a fire
  • Hydrogen cyanide is produced by incomplete
    combustion of nitrogen and carbon containing
    substances (-CN)
  • Natural Fibers (wool, silk, cotton, paper)
  • Synthetic polymers (nylon, polyurethane)
  • Synthetic rubber
  • Melamine (resins for molding, laminating, etc.)

15
HCN RELEASING POLYMERS
  • Synthetic polymers found extensively in
    structures
  • Insulation
  • Cushioning
  • Carpets
  • Bedding (mattresses and pillows)
  • Building materials
  • Materials can burn up to 2-3 times hotter and
    faster than natural materials
  • Quicker flashovers increase speed of HCN release
    ---

16
Sources of Cyanide
  • Other small scale uses
  • - Photography labs - Blue printing -
    Engraving computer chips - Cleaning or
    reconditioning of jewelry - Found at clandestine
    drug labs - manufacturing phencyclidine (PCP)

17
Key Cyanide Studies
  • Two independent studies performed on CN
    toxicity - Paris France (1988-89) - 109
    fire victims( 66 survivors and 43 fatalities)
    144 controlled individuals(drug intoxication
    and CO poisoning) - Dallas County
    Texas - 144 smoke inhalation patients at
    University of Texas Health Science Center
    Emergency Department - 43
    deceased individuals at Dallas County
    medical examiners office.

18
KEY CYANIDE STUDIES
  • Final Conclusion - Cyanide and
    carbon monoxide were both important
    determinants of smoke inhalation-associated
    morbidity and mortality. - Cyanide
    concentrations were directly related to the
    probability of death. - Cyanide may have
    dominated over CO as a cause of death in some
    fire victims. - Cyanide and CO may have
    potentiated the toxic effects of one
    another

19
THE STATION NIGHTCLUB FIRE
  • Most notorious incident of deaths from toxic mix
    of hydrogen cyanide and carbon monoxide was at
    West Warwick Rhode Island nightclub fire Feb
    20,2003
  • Pyrotechnics instantly set substandard sound
    suppressing foam to sheet of flame
  • HCN and CO levels soar and people are quickly
    overcome by the smoke
  • 100 deaths and 200 injuries

20
The Station Night Club Fire
  • National Institute of Standards and
    Technology the high temperatures, low oxygen,
    high carbon monoxide, and high HCN levels within
    the test room in the absence of a sprinkler all
    contributed to a non-tenable condition within 90
    seconds after ignition.
  • Health care providers at all levels of this
    tragedy did not consider HCN exposure during
    course of treatment for the surviving victims.
  • New England Journal of Medicine published
    report despite the signs and symptoms
    indicating CN poisoning, the victims were
    treated with standard modalities for burns and
    CO toxicity

21
Cyanide Poisoning Of Providence Rhode Island
Firefighters March 2006
  • Thursday March 23 2006 1031 hrs 1197 Broad
    Street
  • Providence Rhode Island Firefighters responded to
    a fast food restaurant relatively
    uneventful Engine 3s crew member
    experienced symptoms of headache,
    dizziness, difficulty breathing a cough, and at
    times talking incoherently. Transported to
    Rhode Island Hospital Level 1 Trauma
    Center. Tested for HCN to find high levels of
    blood cyanide at 57 ug/dl Placed on antidote
    therapy
  • Upon learning of Engine 3s firefighter
    department contacted all members responding to
    the call 16 members sought medical
    attention. 14 members went to Rhode Island
    Hospital 4 found to have whole blood cyanide
    levels above 20 ug/dl

22
Cyanide Poisoning of Providence
Firefighters March 2006
  • March 23, 2006 1735 hrs. 125 Knight Street
  • Providence Rhode Island firefighters
    responded to a fire in a six-unit residential
    apartment Fire in a different part of the
    city after shift change. Most of the personnel
    from fast food restaurant relived No injuries
    reported
  • March 24, 2006 0207 hrs. 70 Ralph Street
  • Providence Rhode Island firefighters responded
    to a house fire All firefighter responding to
    Ralph St. had previously responded to Knight
    Street fire. At 0223 hrs. Firefighter
    Kenneth Baker collapsed at the scene suffering a
    heart attack. Immediately resuscitated and
    transported to Rhode Island Hospital

23
Cyanide Poisoning of Rhode Island
Firefighters March 2006
  • In light of the cyanide cases from the previous
    day testing was conducted on Firefighter
    Baker. Lab test showed that FF. Baker had
    whole blood cyanide level of 66ug/dl
  • After consulting with doctors at Rhode Island
    Hospital, all members who responded to any of the
    three fires were instructed to go to Rhode Island
    Hospital if they experienced any symptoms to
    cyanide poisoning. 28 members sought
    medical care 27 had their cyanide levels
    tested 8 members tested high (above 20 ug/dl)
    for cyanide
  • Fire Chief David Costa appointed a five member
    committee to investigate the causes of cyanide
    poisoning, review existing policies and
    procedures, and make recommendations to prevent
    this from happening again.

24
HEALTH EFFECTS OF HCN
Health Effects of HCN
25
CYANIDE DOSES
  • Small amounts of cyanide are present in the
    environment and in humans.
  • Normal levels of whole blood are believed to be
    between 0 to 20 micrograms per deciliter
    (ug/dl).
  • Cyanide levels as low as 50 ug/dl in the blood
    have proven to be toxic, and blood cyanide levels
    of 250 300 ug/dl fatal.
  • With a half-life of one hour, cyanide is short
    lived in the blood stream. Standards in the
    procedures for collection of whole blood
    samples such as -carboxyhemog
    lobin saturation
    -methemoglobin content of sampled blood
    -time between blood sampling and assay
    storage temperature of blood samples on
    the measured concentration of cyanide can
    complicate the interpretation of assay results
    or introduce sources of errors.

26
ACUTE CYANIDE POISONING
  • Hydrogen cyanide is a cellular asphyxiant
  • Inhaled HCN inhibits enzyme system responsible
    for cell respiration (oxygen utilization by cell)
  • Cessation of cell respiration makes normal cell
    function impossible, leading to cell mortality
  • There is no quick test that allows on-site
    confirmation of HCN toxicity
  • There are some signs that can lead to assumption
    of HCN exposure and administration of
    countermeasures
  • Disorientation and weakness/Drowsiness
  • Shortness of breath and chest tightness(Tachypnea,
    Dyspnea Tachycardia)
  • Headache
  • Bright red discoloration in skin
  • Smell of almonds on breath
  • Soot around mouth and nose/burns
  • Carbonaceous sputum

27
CHRONIC EFFECTS OF HCN
  • Chronic effects of hydrogen cyanide
  • Breathing problems/Respiratory Depression to
    Respiratory Arrest
  • Chest pain / Cardiac arrhythmia/Cardiovascular
    collapse
  • Eye irritation/vision dimming
  • Palpitations
  • Headaches
  • Loss of appetite
  • Weakness in extremities/ Paralysis
  • Enlargement of thyroid gland

28
Acute Cyanide Poisoning
  • Significance for advocates of sucking the
    carpet - carpet fibers are a large source of
    HCN - fumes develop long before carpet catches
    fire.
  • Quantitative decomposition - long period of
    time when gas is emitted without the warning
    presence of flame. - decomposition stage of
    the fire is more toxic than those emitted
    during actual burning. - decomposition stage
    is the real killer because of its high
    toxicity and long period of time between
    attainment of quantitative decomposition
    temperature and ignition temperature

29
Acute Cyanide Poisoning
  • Narcotic effects of HCN -blamed for bizarre
    and irrational behavior - instances where
    victims, including firefighters fought with
    rescuers until becoming totally overcome by
    the smoke.
  • Southwest Supermarket fire Phoenix Arizona -
    Brett Tarver - rescue teams were hampered on
    several occasions - succumbed to the
    environment and pulled through debris and out
    of the building.

30
HCN LETHALITY
DOSE MAKES THE POISON
Concentrations mg/m3 PPM Effect
300 mg/m3 270 ppm Immediately Lethal
200mg/m3 180 ppm Lethal after 10 minutes
150mg/m3 135 ppm Lethal after 30 minutes
120-150mg/m3 108-135 ppm Highly dangerous (Fatal) after 30-60 minutes
20-40mg/m3 18-36 ppm Light symptoms after several hours
31
HCN LEALITY NOISH Chemical Pocket Guide
  • HCN is 35 times more toxic than CO
  • TWA HCN 4.7 ppm CO 35 ppm
  • IDLH HCN 50 ppm CO 1200 ppm
  • LEL HCN 5.6 CO 12.5
  • UEL HCN 40 CO 74
  • Fl P. 0 F
  • VD 0.94 air 1
  • BP 78 F
  • Sp. Gr. 0.69 water 1

32
ACUTE CYANIDE POISONING
  • Recently has there been first FDA approved
    cyanide treatment, Hydroxocobalamin, that can
    safely be administered at fire scene
  • Detoxifies CN by binding it to form
    cyanocobalamin (B12)
  • Marketed as Cyanokit
  • Used in France for 10 years
  • Previously, only supportive measures were
    available on site
  • 100 oxygen application
  • Sodium bicarbonate to counter metabolic acidosis
  • Cardiopulmonary support and anticonvulsants
  • Existing antidote involved nitrates that needed
    to be monitored under hospital care to avoid
    lethality when combined with CO
    Taylor Kit Lilly
    Kit Pasadena Kit

33
PHOENIX OVERHAUL STUDIES
  • Removal of respiratory equipment during overhaul
    can potentially expose firefighters to a variety
    of toxic gases
  • Overhaul phase of fire lasts an average of 30
    minutes
  • Liberated gases, vapors and particulates may
    remain in overhaul environment for extended
    periods of time
  • Vapors may use airborne respirable particulates
    as entry vehicle into firefighters lungs
  • Maximum concentrations of selected contaminants
    can exceed occupational exposure limits
  • Adverse health effects may occur from exposure to
    mixture of products even if individual components
    are below exposure limits
  • Monitoring CO concentrations alone should not be
    used to predict presence of other contaminants
    found in the overhaul environment
  • Bolstad-Johnson, et al

34
PHOENIX OVERHAUL STUDIES
  • Conclusions of Phoenix Studies
  • Without the use of respiratory protection,
    firefighters are overexposed to irritants,
    chemical asphyxiates and carcinogens
  • Respiratory protection is recommended during fire
    overhaul
  • SCBA should be utilized in atmospheres with CO gt
    150 ppm
  • APRs may be considered when CO lt 150 ppm, but
    additional studies to confirm effectiveness in
    overhaul operations are recommended
  • NIOSH cartridges for APR dont provide CO
    protection
  • 150 ppm equates to avg. 18.75 ppm exposure based
    on 60 minute exposure and 8-hour working day
    (TLV 25 ppm)
  • - Post-fire fuels are still off-gassing, SCBAs
    should be used.

35
Recommendations for prevention of cyanide
exposures
  • Training - Explanation why cyanide is
    more significant today than ever
    before. - Chemistry of cyanide -
    Identification of cyanide containing fuels -
    Medical concerns of cyanide - Why
    firefighters cannot merely rely on their past
    experiences to determine whether or not a
    particular atmosphere is safe.
  • Equipment - Deploy cyanide detection
    equipment into the field for use at fires.

36
Recommendations for prevention of cyanide
exposures
  • Compliance - There needs to be enhanced
    compliance with the existing mandatory mask
    regulation. - Enhanced compliance will require
    a cultural change on the part of
    firefighters. - Company officers must focus on
    the protection of their members, and ensure
    that SCBAs are utilized when necessary
    and face pieces removed outside the
    contaminated area when exiting the structure.

37
Recommendation for prevention of cyanide exposures
  • SCBA Training for difficult operations - All
    personnel need physical training with SCBA to
    enhance the comfort level of members when
    engaged in difficult operations such as -
    climbing ladders - operating on roofs -
    operating in confined spaces - communicating
    on air
  • SCBA Air Management SCBA alarms activated
    during initial extinguishment and during overhaul

38
Recommendations for Prevention of Cyanide
Poisoning
  • Post-Fire Decontamination - Wash turnout gear
    after each fire - Shower and change their
    clothes - Issue second set of gear

39
Recommendations for Prevention of Cyanide
Poisoning
  • Fire Research - How much cyanide is
    generated at fire scenes?
  • - What conditions yield higher verses lower
    concentrations of CN? - Whether CN that is
    released in a fire remains localized (in a
    area around the fuel that is off gassing)
    or does it spread out throughout the
    building? - Is CN released only under
    certain fire conditions or is it released more
    commonly whenever CN containing products
    burn?

40
Recommendations for Prevention of Cyanide
Poisoning
  • Public Education - General public, media
    and legislators need to be educated about the
    dangers of smoldering and burning plastics and
    other cyanide containing fuels. - Public needs to
    know the dangers associated with CN may be
    present before the presence of any flames and
    possibly incapacitated by the invisible gases
    during the incipient stage which could
    prevent them from escaping.

41
Clark County Fire Fighter Fatality
  • Crews operating at the scene of a commercial dice
    factory fire
  • Heavy smoke and fire conditions
  • All crews are instructed to utilize standard PPE
  • SCBA are used by all responders

42
Clark County Fire Fighter Fatality
  • What are some of the hazards present?
  • As a Incident Commander, what types of injuries
    or conditions may you expect?

43
GAS DETECTION OPTIONS
Gas Detection Options
44
DETECTION TECHNOLOGY AND HCN
  • DETECTION TECHNOLOGY AND HCN
  • Colorimetric Chemistry
  • Short-term Detector Tubes
  • Long-term Detector Tubes
  • Chip Measurement System
  • Electrochemical Sensors
  • Infrared Sensors
  • Gas Chromatographic Methods
  • Flame Ionization (FID)
  • Thermionic
  • Ion Mobility Spectrometry (IMS)
  • Photo Ionization (PID)
  • NO High IP 13.9 eV

45
COMMON MONITORING OPTIONS
  • There are 2 commonly available detection
    technologies that can measure hydrogen cyanide
    and other non-organic toxics at TLV
  • Portable instruments with electrochemical sensors
  • Colorimetric detector tubes

46
ADVANTAGES OF DETECTOR TUBES
  • Inexpensive
  • Simple to use
  • No calibration
  • Wide variety of gases vapors

47
ELECTROCHEMICAL SENSORS
  • Based on a chemical reaction that produces an
    electrical response/signal.
  • The more gas that is present, the larger the
    signal that is generated by the sensor.
  • This signal is directly proportional to the gas
    that is present.

48
SINGLE GAS OPTIONS
  • Standard Version
  • Accepts all Draeger EC Sensors (Toxic O2)
  • Full Menu
  • Hygiene Version
  • Standard Datalogging

49
SINGLE GAS OPTIONS
  • PAC 7000 has a simple menu structure
  • Fresh Air, Span Cal
  • STEL, TWA, Peak Value
  • Bump Test
  • COHb option with CO version (set w/PC)
  • Calibration On-board
  • Calibrate w/o a PC
  • No life limiting feature
  • Replaceable sensors
  • Not exchangeable to different gases
  • Dedicated to the original gas purchased
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