Monthly Archives: December 2010

Protect Your Family and Yourself from Carbon Monoxide Poisoning

Carbon Monoxide Can Be Deadly

You can’t see or smell carbon monoxide, but at high levels it can kill a person in minutes. Carbon monoxide (CO) is produced whenever any fuel such as gas, oil, kerosene, wood, or charcoal is burned. If appliances that burn fuel are maintained and used properly, the amount of CO produced is usually not hazardous. However, if appliances are not working properly or are used incorrectly, dangerous levels of CO can result.

Hundreds of people die accidentally every year from CO poisoning caused by malfunctioning or improperly used fuel-burning appliances. Even more die from CO produced by idling cars. 

CO Poisoning Symptoms

Know the symptoms of CO poisoning. At moderate levels, you or your family can get severe headaches, become dizzy, mentally confused, nauseated, or faint. You can even die if these levels persist for a long time. Low levels can cause shortness of breath, mild nausea, and mild headaches, and may have longer term effects on your health. Since many of these symptoms are similar to those of the flu, food poisoning, or other illnesses, you may not think that CO poisoning could be the cause.

If you experience symptoms that you think could be from CO poisoning:

  • GET FRESH AIR IMMEDIATELY. Open doors and windows, turn off combustion appliances and leave the house.
  • GO TO AN EMERGENCY ROOM and tell the physician you suspect CO poisoning. If CO poisoning has occurred, it can often be diagnosed by a blood test done soon after exposure.

Be prepared to answer the following questions:

  • Do your symptoms occur only in the house? Do they disappear or decrease when you leave home and reappear when you return?
  • Is anyone else in your household complaining of similar symptoms? Did everyone’s symptoms appear about the same time?
  • Are you using any fuel-burning appliances in the home?
  • Has anyone inspected your appliances lately? Are you certain they are working properly?

Prevention is the Key to Avoiding Carbon Monoxide Poisoning

Have your fuel-burning appliances — including oil and gas furnaces, gas water heaters, gas ranges and ovens, gas dryers, gas or kerosene space heaters, fireplaces, and wood stoves — inspected by a trained professional at the beginning of every heating season. Make certain that the flues and chimneys are connected, in good condition, and not blocked.

Choose appliances that vent their fumes to the outside whenever possible, have them properly installed, and maintain them according to manufacturers’ instructions.

Read and follow all of the instructions that accompany any fuel-burning device. If you cannot avoid using an unvented gas or kerosene space heater, carefully follow the cautions that come with the device. Use the proper fuel and keep doors to the rest of the house open. Crack a window to ensure enough air for ventilation and proper fuel-burning.

  • DON’T idle the car in a garage — even if the garage door to the outside is open. Fumes can build up very quickly in the garage and living area of your home.
  • DON’T use a gas oven to heat your home, even for a short time.
  • DON’T ever use a charcoal grill indoors — even in a fireplace.
  • DON’T sleep in any room with an unvented gas or kerosene space heater.
  • DON’T use any gasoline-powered engines (mowers, weed trimmers, snow blowers, chain saws, small engines or generators) in enclosed spaces.
  • DON’T ignore symptoms, particularly if more than one person is feeling them. You could lose consciousness and die if you do nothing.

CO Detectors

Carbon Monoxide Detectors are widely available in stores and you may want to consider buying one as a back-up – but not as a replacement for proper use and maintenance of your fuel-burning appliances.

  • Do not let buying a CO detector lull you into a false sense of security. Preventing CO from becoming a problem in your home is better than relying on an alarm. Follow the checklist of DOs and DON’Ts above.
  • If you shop for a CO detector, do some research on features and don’t select solely on the basis of cost. Non-governmental organizations such as Consumers Union (publisher of Consumer Reports), the American Gas Association, and Underwriters Laboratories (UL) can help you make an informed decision. Look for UL certification on any detector you purchase.
  • Carefully follow manufacturers’ instructions for its placement, use, and maintenance.

If the CO detector alarm goes off:

  • Make sure it is your CO detector and not your smoke detector.
  • Check to see if any member of the household is experiencing symptoms of poisoning.
  • If they are, get them out of the house immediately and seek medical attention. Tell the doctor that you suspect CO poisoning.
  • If no one is feeling symptoms, ventilate the home with fresh air, turn off all potential sources of CO — your oil or gas furnace, gas water heater, gas range and oven, gas dryer, gas or kerosene space heater and any vehicle or small engine.
  • Have a qualified technician inspect your fuel-burning appliances and chimneys to make sure they are operating correctly and that there is nothing blocking the fumes from being vented out of the house.



Source: U.S. Environmental Protection Agency, Centers for Disease Control and Prevention

Winter Safety Tips

Preventing Hypothermia and Frostbite

  • Dress for the Weather
    • Wear several layers of loose-fitting, lightweight, warm clothing rather than one layer of heavy clothing. The outer garments should be tightly woven and water repellent.
    • Wear mittens over gloves. Layering works for your hands as well.
    • Always wear a hat and cover your mouth with a scarf to protect your lungs.
    • Dress children warmly and set reasonable time limits on outdoor play.
    • Restrict infants’ outdoor exposure when it is colder than 40 degrees Fahrenheit.
  • Signs and Symptoms
    • Watch for signs of frostbite. These include loss of feeling and white or pale appearance in extremities such as fingers, toes, ear lobes, and the tip of the nose. If symptoms are detected, get medical help immediately.
    • Watch for signs of hypothermia. These include uncontrollable shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness, and apparent exhaustion.
    • If you or someone you know shows any of these symptoms, get in touch with a healthcare provider immediately. If symptoms are severe, call 911.

 Snow Shoveling Tips

  • Avoid overexertion when shoveling snow. Overexertion can bring on a heart attack – a major cause of death in the winter.
    • Stop shoveling if you have shortness of breath, heavy sweating, or any kind of pain.
    • Avoid shoveling if you are elderly or have a heart condition.
  • Stretch before going outside to shovel.
  • Use a smaller shovel and make sure your shovel isn’t bent, tilting, or damaged.
  • Drink plenty of fluids.
  • Be smart! Take frequent breaks, even if only for a couple of minutes.

 Snow Blower Safety Tips

  • Always start your snow blower in a well ventilated area to avoid possible carbon monoxide poisoning.
  • If you haven’t used your snow blower in a while, remember that gasoline may still be inside from the last time you used it. Gasoline is only good for about 30 days, unless you’ve added a fuel stabilizer.
  • Always make sure that the snow blower is completely turned off before replacing any parts.
  • Fix clogs carefully. If your snow blower becomes clogged, turn it off, and remove the key before trying to clear it. Use a stick and NOT your hands to clear debris.
  • If your snow blower hasn’t been checked up by a professional in a while, have it serviced before you use it.

Winter Fun and Sports Safety

  • Helmet Safety
    • Kids should always wear helmets when they ski, sled, snowboard, and play ice hockey.
    • There are different helmets for different activities.
    • Parents should wear helmets too. Remember, your children learn safety habits by watching you.
  • Skating Safety  
    • Skate only in areas that have been approved for skating.
    • Teach children to skate in same direction as the crowd to avoid collision. Avoid darting across the ice and never skate alone.
  • Sledding Safety
    • Teach children to only sled on terrain that is free of obstacles. Make sure the bottom of the slope is far from streets and traffic.
    • Always use a sled with a steering mechanism.
    • Avoid lying flat on the sled while riding downhill.
    • Do not overload a sled with children.
  • Skiing Safety
    • Never ski alone.
    • Use caution around lifts, control speed, and be aware of other skiers.
    • Wear eye and sun protection. Ski helmets are recommended.

 Pedestrian Safety

  • Dress children in bright colors (not white) for snowy weather. 
  • Keep slippery driveways and sidewalks well-shoveled.
  • Apply material for traction such as rock salt to avoid slips and falls.



Source: Boston Public Health Commission

    American Heart Association’s New CPR Guidelines

    The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

    Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).

    In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally.

    All victims in cardiac arrest need chest compressions. In the first few minutes of a cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compressions can pump that blood to the victim’s brain and heart sooner. Research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.

    The change in the CPR sequence applies to adults, children and infants, but excludes newborns.

    Other recommendations, based mainly on research published since the last AHA resuscitation guidelines in 2005:

    • During CPR, rescuers should give chest compressions a little faster, at a rate of at least 100 times a minute.
    • Rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants.
    • Between each compression, rescuers should avoid leaning on the chest to allow it to return to its starting position.
    • Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
    • All 9-1-1 centers should assertively provide instructions over the telephone to get chest compressions started when cardiac arrest is suspected.

    Since 2008, the American Heart Association has recommended that untrained bystanders use Hands-Only CPR — CPR without breaths — for an adult victim who suddenly collapses. The steps to Hands-Only CPR are simple: call 9-1-1 and push hard and fast on the center of the chest until professional help or an AED arrives.



    Source: American Heart Association (AHA)


    Tracey Dechert, MD, recognized as future leader in Eastern Association for the Surgery of Trauma (EAST)

    Tracey Dechert, MD, Division of Trauma Surgery and Critical Care at Boston Medical Center has been selected as a Leadership Development Workshop scholarship recipient from the Eastern Association for the Surgery of Trauma (EAST), a not for profit organization structured to furnish leadership and foster advances in the care of injured patients.

    EAST affords a forum for the exchange of knowledge pertaining to the care and rehabilitation of the injured patient. Additionally, the organization stimulates investigation and teaching in methods of treating and preventing injury from all causes. EAST is dedicated to the study of the practice of surgery of trauma patients by establishing lectureships, scholarships, and foundations to promote, reward, and recognize individuals working in the field of injury and injury control.

    Inside New England’s Busiest Trauma Center

    MedFlight paramedics wheel the patient into the trauma bay. He is awake and lucid, his right leg elevated on ice packs. Blood seeps through the bandages below his knee. No case is ever the same at Boston Medical Center’s Trauma Unit, and today is no different. Paramedics allow the patient, a former emergency medical technician, to brief the staff.

    He clears his throat. “Alright folks, is everybody ready?!” Lying on the trauma stretcher, he barks out the specifics of the incident (a fall from a 30-foot ladder), his suspected injuries (open tibia fracture and pain in the sacral region of his spine) and his detailed medical history (including a recent hip surgery). Everyone listens carefully to him and then to the paramedics, who provided pain medications en route, before snapping into action.

    Tracey Dechert, MD, trauma and critical care surgeon, and Thea James, MD, emergency medicine physician, and a handful of nurses and emergency and surgical residents work swiftly to make clinical decisions. Orthopaedic Surgery is called, Radiology prepares to take images of his chest and pelvis, technologists are informed to keep a CT scanner open.


    Staff from BMC’s trauma team review a pelvic x-ray of a patient suffering from multiple injuries after a fall from a ladder. BMC’s Level 1 Trauma Program has earned a reputation as one of the country’s finest.

    Falls are the second most common cause of trauma seen at BMC, which admits more than 2,200 trauma patients per year. Collaborating closely with the emergency department, the trauma team (staffed around the clock), rapidly triages, admits and follows patients with complex multi-system injuries though their hospital stay.

    “The trauma service is like primary care for critical injuries. We decide what referrals need to be done to what specialty services and in what priority they will occur. We’re like the quarterback on a football team,” explains Joseph Blansfield, RN, MS, NP, trauma program manger.

    Founded 36 years ago at Boston City Hospital, BMC’s Level I Trauma Program has earned a reputation as one of the country’s finest. The hospital triages and treats the majority of the city’s most critical injuries, including victims of motor vehicle crashes, head injuries, stabbings and shootings.

    BMC, in partnership with Boston University School of Medicine, conducts cutting-edge research on trauma interventions focusing on wound repair and healing, gene regulation after injury and mechanical ventilator impact on traumatic brain injury. Residents and attending physicians share interesting case studies with other teaching hospitals during monthly trauma video teleconferences.

    As trauma cases continue to rise, the team is also deeply committed to injury prevention. Twelve unique programs provide outreach to trauma patients, family members and at-risk community residents. Advocacy ranges from violence prevention and intervention initiatives to seatbelt and helmet programs.

    Back in trauma bay 2, Dr. Dechert and Dr. James observe the patient’s x-rays. His chest is clear but he will need further imaging for his spine. Dr. Dechert and her team shuttle the patient to a nearby CT scanner. Neurosurgery is called for a consult. Beyond his obvious leg injury, a burst fracture of his 12th thoracic vertebrae is found. Radiology takes the patient for more images of his right leg. His injuries are serious and he is admitted to a monitored bed to be followed by the Surgical Critical Care Service while he awaits surgery for both his leg and spine.

    In the hours that have passed, the trauma team has consulted on four other patients in the emergency department. Some critical, others less so. Being a Friday night, more cases are sure to follow. It’s all in a day’s work for Dr. Dechert and her team.

    Learn more at


    Ladder Safety Tips

    One of the most common mechanisms of injury admitted to Boston Medical Center’s Trauma Center is falls. In fact, last year alone we saw 598! We typically see a spike during the holiday season, particularly when one of the first tools homeowners reach for is a ladder to string those lights. Ladders are useful tools, but if you do not follow the proper safety tips, you could hurt yourself.

    Tips for Injury Prevention

    Follow these safety tips from the American Academy of Orthopaedic Surgeons and soon, you will be on your way to successfully and safely completing your holiday chores.

    Inspect the Ladder

    • Check the ladder for any loose screws, hinges or rungs that you might not have fixed before you put it away for the winter.
    • Clean off any mud or other liquids that might have accumulated on the ladder.

    Properly Set Up the Ladder

    • Every ladder should be placed on a firm, level surface. The ground may be very bumpy because of the freezing and thawing during the winter.
    • Never place a ladder on ground that is uneven. The same is true for uneven flooring.
    • Remember always to engage the ladder locks or braces before you climb.

    Do Not Use a Ladder as a Seat Between Tasks

    • You might want to take a break, but never use a step ladder’s top or pail shelf as a seat. It is not designed to carry your weight.

    Move Materials With Caution When On the Ladder

    • Be careful pushing or pulling anything from shelves while standing on a ladder. You could lose your balance and fall off.

    Always Reposition the Ladder Closer to the Work

    • Over-reaching or leaning far to one side when you’re on the ladder could make you lose your balance and fall.

    Be Careful When Climbing and Get Help If You Need It

    • Be safe. Ask someone to hold the ladder while you climb. Stay in the center of the ladder as you climb, and always hold the side rails with both hands.