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Carbon monoxide monitoring and response in long-term care facilities (LTCFs) Carbon monoxide monitoring and response in long-term care facilities (LTCFs)

Carbon monoxide monitoring and response in long-term care facilities (LTCFs) - PowerPoint Presentation

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Carbon monoxide monitoring and response in long-term care facilities (LTCFs) - PPT Presentation

Overview Carbon Monoxide What are the health risks Who is at risk CO in LTCFs What are the issues What is being done to address these issues CO Monitoring and Response Framework CARBON MONOXIDE ID: 913502

monoxide monitoring health carbon monitoring monoxide carbon health staff ltcfs levels response framework maintenance sources exposure saskatchewan elevated care

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Presentation Transcript

Slide1

Carbon monoxide monitoring and response in long-term care facilities (LTCFs)

Slide2

Overview

Carbon Monoxide

What are the health risks?Who is at risk?

CO in LTCFs

What are the issues?

What is being done to address these issues?CO Monitoring and Response Framework

Slide3

CARBON

MONOXIDE

Slide4

CARBON MONOXIDE

Typical sources of CO are

(but not limited to

)

:Fuel-burning (propane, oil, wood, gasoline) appliances BoilersLaundry equipment

Water heaters

Fireplaces

Kitchen equipment, gas-stoves

Generators

Exhaust from cars, delivery trucks (garages, loading bays)

A gas that you cannot see, smell, or

taste

A combustion by-product

Must

be monitored by a CO detector

Slide5

CO impairs oxygen delivery to cells in the bodyBinds tightly to hemoglobin, competing with oxygen

Particularly affects high-oxygen demand organs like the heart and brain

You may not experience symptoms (or not obvious) and still be exposed to unsafe CO levelsExposure to low levels of CO for long periods

CARBON MONOXIDE

Slide6

What are the health risks?If inhaled at sufficient levels, for sufficient period of time…

Slide7

Who is at risk?

Everyone

, all agesResidents and staffParticularly among young, pregnant, and

elderly

Lower tolerance to CO

Individuals with chronic lung and cardiovascular conditions are more susceptibleCoronary heart diseaseRespiratory disease

Slide8

Examples in the media

Regina, Saskatchewan

– Fire department and gas utility provider responded to elevated CO levels detected by security and maintenance personnel. CO levels from approx. 20 to 33 ppm were reported on all three floors of the facility.

CBC News. Carbon monoxide leak at Regina seniors residence. 2016 Available from:

http://www.cbc.ca/news/canada/saskatchewan/carbon-monoxide-regina-seniors-residence-1.3564003

Wakaw, Saskatchewan – Code brown (hazardous releases) activated in response to elevated CO levels detected in a boiler room and service wing; three staff and one resident reported feeling unwell.

Giles, D. ‘Code Brown’ alerts staff to CO leak at care home. 2013. Available from:

http://globalnews.ca/news/771806/code-brown-alerts-staff-to-co-leak-at-care-home/

Slide9

CO IN LTCFs

Slide10

Background

CO incident in Humboldt, Saskatchewan, 2010

Staff and residents were exposed to CO from an improperly ventilated appliance in a long-term care facility

Resulted in evacuation of one wing

Contributed to 3 deaths

Slide11

CO is colourless, odourlessCan only be detected through monitoring

CO detectors are not routinely required to be installed, especially in older buildingsInitial symptoms may be non-specific

mimic other diseases (especially low-level exposure)

What are the issues?

Slide12

CO detectors do not alarm or notify at low levels They are designed to prevent CO poisoning

(acute, high level exposure) and are not designed to prevent

sub-acute exposures*Installation of CO detectors alone is

not enough

to mitigate this risk

Residents at long-term care facilities may have conditions which make them more susceptible to the effects of low-level CO exposure (10-25 ppm)

What are the issues?

Slide13

What is being done to address CO risks in LTCFs?

Saskatoon Heath Region (SHR) has developed and implemented a CO monitoring, reporting, and response framework in their LTCFs

Adopted by the province of Saskatchewan in 2014

Health Canada, BC Centre for Disease Control, and National Collaborating Centre for Environmental Health were involved in evaluating the CO framework and promoting the implementation of the

CO Monitoring and Response Framework

in LTCFs.This work is built upon a stakeholder consultation meeting in 2013 to promote the development of a health-protective CO management framework that incorporates education, monitoring, prevention, and mitigation, with practical means to support program implementation and evaluation.

Slide14

CO MONITORING AND RESPONSE FRAMEWORK

Slide15

Objectives

Implement a health-protective CO management framework

that incorporates education, monitoring, prevention, and mitigation Enhance the capacity of health regions and LTCFs

to prevent and reduce CO exposure in LTCFs

Reduce the risk of harmful CO exposure

among residents and staff

Slide16

EDUCATION

Increase staff awareness

of CO health effects, sources, and importance of monitoring

Train staff

on established CO monitoring and response protocols

Slide17

MONITORING

Develop protocols

for CO monitoring

Installation of CO detectors near sources of CO

Identify all potential sources

Daily monitoring and recording of detector readings (instant and peak level)

Identify elevated CO levels (>10 ppm)

Slide18

REPORTING

Data to be recorded on weekly log

Facility Maintenance personnel

Other team members as required for coverage when Facility Maintenance not available

Submit weekly logs on a monthly basis to regional management

Retention of monitoring records for 12 months

Slide19

PREVENTION AND MITIGATION

Develop resources related to identification and maintenance of CO sources

Maintenance plans, schedules, etc.Perform routine maintenance on combustion appliances

Establish protocols for

responding to elevated CO levels

Respond to elevated readings or alarmsInvestigate potential sources, procedures in placeMount instructions by all CO monitors Familiarize staff with procedures, including actions taken depending on level of CO

Slide20

Resources

BC Safety Authority

Licensed gas fitters in BChttp://safetyauthority.ca/contact/find-contractor

Health Canada Residential Indoor Air Quality Guideline for Carbon Monoxide:

http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/carbon-monoxide-carbone/index-eng.php

US EPA CO fact sheets (information for older adults and their caregivers)http://www2.epa.gov/healthresearch/aging-factsheets-carbon-monoxide-poisoning-prevention