The day the emergency ward called 911

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During a cold afternoon in mid-December 2013, a young patient walked in the emergency department at Hôpital Montfort in Ottawa. She had nausea, vertigo, and was feeling disorientated.

The team handling the patient, which included emergency nurses Yan Landry-Bruneau RN, Geneviève Falardeau RN and Marjolaine Eckert RN, as well as Dr. Charles-Antoine Breau, was puzzled.

“We regularly see patients with nausea at the emergency, but to see a young patient with signs of confusion, now that was odd,” says Dr. Breau, emergency physician at Montfort, a Francophone academic health care institution that provides quality care in both official languages.

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While talking with the patient, members of the team learnt that she had recently moved into a new apartment building, which was equipped with gas heating. “That’s when the light bulb went on,” adds Dr. Breau.

The patient was showing signs of carbon monoxide (CO) poisoning.

Carbon monoxide is an odorless, colorless and tasteless gas which reduces the body’s ability to transport oxygen through the blood. Exposure can cause headaches, fatigue, dizziness, chest pain, and at high levels, coma or death

The emergency staff immediately thought of the other tenants of the building: their lives may be in danger, too. Unsure of what to do next, nurse Eckert contacted her husband, a fireman. He suggested they call 911 immediately.

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The 911 operator may have been surprised to receive a call from the hospital emergency room, as things usually go the other way around. Dr. Breau certainly recognized it was the first time he had to take such a measure. But it moved swiftly from there.

Firefighters rushed to the eight-apartment building to check on people residing at the address and test the air quality. Indeed, levels of CO were very high and could have caused the deaths of some of the tenants within a few hours. Tenants were immediately evacuated and some were sent for further CO testing.

In the meantime, technicians were called in to check on the heating system – they suspect that a chimney blockage caused the CO leak – and new CO detectors were installed. The Ottawa Fire authorities later recognized that Hôpital Montfort staff likely prevented a tragedy.

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“Emergency department practitioners see a wide range of patients with an even wider range of presenting complaints in a single day. This case illustrates just how these skilled professionals need to always use their well-honed assessment and critical thinking skills at all times,” says Carl Balcom, Clinical director of emergency and critical care services at Hôpital Montfort.  “We are very happy that the quick-thinking reflexes of our team saved lives that day.”

In February 2014, the four members of the emergency team were honoured by Eve Adams, Parliamentary Secretary to the Minister of Health, as part of an awareness campaign on the dangers of carbon monoxide.

“Health teams are always on the lookout for symptoms of carbon monoxide poisoning, but the best defense remains prevention,’’ says Dr. Breau. ‘’Carbon monoxide detectors are precious allies in protecting your family.”

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