NEWS IN BRIEF
“Use of cyanide antidotes in smoke inhalation injury is potentially dangerous,” study says
The following, submitted by David J. Barillo, M.D., presents another perspective on the issue of using anticyanide medication to treat victims of smoke inhalation (see “Anticyanide medication urged for smoke inhalation victims.” News in Brief, March 1994). Dr. Barillo is clinical assistant professor of surgery at the University of Texas Health Science Center at San Antonio, a member of the adjunct faculty at the National Fire Academy, and a consultant to the U.S. Fire Administration. He served in various fire departments as a fire-fighter/ EMT, engineer, fire surgeon, deputy chief, and co-director of a fire death investigation team and taught EMT courses at the University of Medicine & Dentistry of New Jersey and at various police and fire academies and technical schools.
Dr. Barillo’s statement:
… The theory that cyanide plays a role in smoke inhalation injury has persisted for years despite scientific evidence to the contrary. In my opinion, the use of cyanide antidotes in smoke inhalation injury is potentially dangerous and almost never warranted.
it is true that hydrogen cyanide can be produced by the combustion of natural or synthetic household materials such as wool, silk, nylon or polyurethane. What is often overlooked, however, is the fact that cyanide is very flammable and is rapidly consumed in house fires. Hydrogen cyanide has a NFPA 704 flammability index of 4, a flash point of 0°F, and an autoignition temperature of 1,000°F.
One study of cyanide in smoke from a structure fire found cyanide levels of 250 parts per million at ignition that decreased to 10 parts per million at eight minutes after ignition. This suggests that the cyanide was burned up by the fire. The Harvard School of Public Health studied cyanide levels in smoke from structure fires by attaching sampling devices to turnout gear. Cyanide was found only in trace quantities, and only in 27 of 253 samples. The study concluded that cyanide posed no health risk to firefighters.
Cyanide can be found in the blood of fire victims but also can be found in the blood of normal individuals as a by-product of normal metabolism. Blood or tissue samples stored under the correct conditions actually can produce cyanide, at levels considered “forensically significant.”
The science behind the “cyanide antidote kit” recommended for treatment of smoke inhalation dates back to a dog experiment performed in 1934. Literature reviews of human cyanide poisoning treated with the cyanide antidote kit demonstrate that in virtually all cases, actual cyanide poisoning was never documented or confirmed by cyanide measurement in blood or other body fluids. Thus, the reports of “miracle saves” may represent cases where poisoning never occurred.
Blood cyanide levels are not easily obtainable in most hospitals, and treatment based only on symptoms is advocated. Unfortunately, the signs and symptoms of cyanide poisoning mimic those of acute anxiety, carbon monoxide poisoning, or hypovolemic shock from a thermal bum. Metabolic acidosis unresponsive to fluid and oxygen administration should suggest either an inadequate burn resuscitation or a missed traumatic injury, rather than a need for cyanide treatment. The misguided administration of sodium nitrite (part of the cyanide antidote kit) in this setting can result in a profound and possibly fatal drop in blood pressure.
A victim with smoke inhalation injury serious enough to consider cyanide treatment urgently requires the expertise of a burn center. If immediate transfer to a burn center is not feasible, then treatment of suspected cyanide poisoning should be undertaken only in consultation with an experienced burn center physician….
Note: A reprint of the study Cyanide Poisoning in Victims of Fire: Analysis of 364 Cases and Review of the Literature conducted by David J. Barillo. M.D.: Robert Goode, M.D.: and Victor Esch, M.D. may be requested from David J. Barillo. MD; U.S. Army Institute of Surgical Research. Brooke Army Medical Center; Ft. Sam Houston. TX 78234 (please enclose a stamped, self-addressed legal-size envelope). The study, presented at the 22nd Annual Meeting of the American Burn Association in Las Vegas, Nevada, from March 26-30, 1990, suggests a treatment scheme and includes references for the studies quoted above. The study was copyrighted in 1994 by Bum Science Publishers, Inc. and was published in the Journal of Burn Care and Rehabilitation. 1994; 15:1,46-57.
Computer monitor and hair dryer among potential fire hazards cited
The U.S. Consumer Product Safety Commission (CPSC) has announced that the following items are being voluntarily recalled by their manufacturers, since they may be potential fire hazards.
- Item: Dell Model DL-1460NI 14-inch SVGA color computer monitors. Approximately 63,000 have been sold by Dell, Sam’s Club, Costco, Price Club, and CompUSA. The monitors were imported from Taiwan in 1992 and 1993.
Problem: The internal components may overheat, presenting a fire hazard. The company received 32 reports of monitors that overheated, some of which caught fire. None of the reported incidents involved personal injury, and the fires did not spread.
USFA designates Fire Engineering’s World Trade Center issue as its official report
The December 1993 issue of Fire Engineering. “SPECIAL ISSUE: World Trade Center Bombing,” has been included in the United States Fire Administration’s Major Fires Investigation Project as Report 076. Copies of Report 076 may be obtained from the USFA. Fire Management Programs; 16825 South Seton Avenue; Emmitsburg, MD 21727.
Action: Owners of monitors with the above model number should call Dell at (800)913-3355.
- Item: Hartman Products hair dryers, model PRO 1600. Approximately 900 were sold by Wal-Mart stores between January 1992 and April 1993. The appliances are beige and have the model number embossed on the handle. All hair dryers involved have black fans. (Dryers manufactured after August 7, 1993, have gray fans and are not involved in the recall.)
Problem: When plugged in and even when turned to the “OFF,” position, the hair dryer’s heater could turn itself on without turning on the fan. Some of the dryers have heater motor mounts molded from flammable material and could catch fire. Three alleged fire incidents have been reported to the manufacturer; no injuries have been reported.
Action: Return to Hartman Products, 4949 W. 147th Street. Hawthorne, CA 90250 for a full refund or new redesigned hair dryer. Postage will be reimbursed. For more information, call (800) 423-3007 Monday through Friday between 11 a.m. and 7 p.m. EST.
- Item: Ground fault interrupter extension cord manufactured by Columbia Wire & Cable Corporation and sold by Consolidated Stores in 1992 from its Odd Lots/Big Lots retail outlet stores in the midwestern and southeastern United States. The extension cord is white and 12 feet long.
Additional identification: There is a red button labeled “RESET” on the top side of the white two-prong plug, along with the embossed labeling. The bottom of the plug includes the embossed labeling “Cat. .No, 6575, E-96425”. The three-hole white receptacle at the other end has the embossed labeling “JC.” The core in part may be labeled “…E90165…I8AWX3C Da Tung” or “E56274… 18AWG/3C Cableton.”
Problem: The extension cord has no ground fault circuit interrupter, as advertised, but instead has a built-in immersion detection circuit interrupter (1DCI) plug. The plug will not provide protection from severe electric shock or electrocution if a short circuit or ground fault occurs. The cord may also create a shock hazard when connected to three-wire electrically grounded appliances such as metal drills or circular saws.
In addition, approximately 14,000 extension cords are unaccounted for, and the CPSC believes that some of these cords may have been sold to unidentified dealers.
Action: Cords purchased from Odd Lots/Big Lots may be returned to the stores. Consumers who purchased these cords from other stores should contact the retailers and the CPSC at (800) 638-2772. Call Consolidated Stores Corporation at (800) 877-1253 for more information.
Heart attacks, accidents chief causes of on-duty firefighter deaths
Seventy-seven firefighters died while on duty during 1993, less than a three percent increase over 1992, according to the National Fire Protection Association.
Approximately 44 percent of the fatalities occurred on the foreground; 18 of the deaths were due to heart attacks. Twenty occurred while the firefighters were responding to or returning from alarms, eight occurred at nonfire emergencies, six during training, and nine during participation in nonemergency assignments.
Rita F. Fahy, manager of the NFPA Fire Data Bases and Systems and co-author of the report, noted that deaths of on-duty firefighters in 1993 were the second lowest since the NFPA began its study of this issue in 1977. She attributed the drop from “so many years of averaging more than 100 firefighter deaths annually” to improved protective equipment, apparatus design, and firefighter fitness and training. She cited, however, the need for paying more attention to the following areas: firefighters’ participating in active firefighting after “experiencing health problems that should preclude this activity,” motor vehicle accidents, and training accidents.
More information on the report, which includes a 10-year analysis of firefighter deaths involving training accidents and summaries of individual incidents illustrating classic hazards for firefighters, is available from the NFPA, One Batterymarch Park, Quincy, MA 02269-9101, (617) 984-7270.
Senate passes Arson Prevention Act
President Clinton signed the Arson Prevention Act of 1993 (HR 1727, S 798) into law on May 19, 1994, according to the International Association of Fire Chiefs. The legislation authorizes $4.5 million in training grants during 1994 and $6.5 million during 1995. The competitive grants will be awarded on the basis of merit and must be related to arson research, prevention, or control.
HR 1727, introduced by Rep. Rick Boucher (D-VA) and S 798, introduced by Sen. Richard Bryan (D-NV), were supported by virtually all of the major fire service organizations, according to the 1AFC.
A copy of HR 1727 may be obtained from the House Document Room at (202) 225-3456.
COFSA invites U.S. fire service to join in aiding firefighters in poorer nations
The Commonwealth and Overseas Fire Services Association (COFSA), a nonprofit registered charity founded in 1958 and based in the United Kingdom, has expanded its international membership to include members of the U.S. fire service.
The organization helps poorer countries to develop professional and efficient fire services and provides a forum for the exchange of ideas. Currently, COFSA is concentrating its efforts on Eastern Europe and the old Soviet bloc countries, which, it explains, are poorly organized, lack modem equipment, and are in need of training. COFSA offers scholarships to firefighters, coordinates donations of redundant fire engines and surplus equipment, and establishes training courses.
Three categories of membership are offered. Service membership—$150 a year— is open to all fire departments and similar organizations connected with any aspect of fire protection, prevention, or firefighting. Individual membership—$45 a year—for senior members and $30 for junior members is open to tire chiefs; firefighters; advisers; consultants; and members of academic, scientific, or research organizations connected with Fire protection services. Associate membership—$150 a year—is open to manufacturers of fire protection equipment and other suppliers of goods and services to the fire protection services. Members receive a free quarterly copy of Fire International Magazine, COFSA’s official organ.
More information is available from COFSA, Ken Coules, M.l.Fire.E.. The General Secretary COFSA, c/o Norfolk Fire Service, Whitegates, Hethersett, Norwich NR9 3DN, United Kingdom; 24-hr. fax/answerphone +44 (0) 603-488873.
NFPA announces new officers/board directors
Officers and board directors were elected at the annual meeting of the National Fire Protection Association held in San Francisco in May. The following officers were elected: chair—Jack Weils, vice president of marketing & corporate development for Pass & Seymour/Legrand Company, Syracuse, New York; vice chair—G. Richard Morris, chairman of Cerberus Pyrotronics. Inc., Richmond Hill, Ontario, Canada; treasurer—John A. Love, formerly the chief executive officer and president of Factory Mutual, Westwood, Massachusetts; and secretary— Frank J. Fee, III. president. The Reliable Automatic Sprinkler Company, Mount Vernon, New York.
The following will serve three-year terms on the NFPA board: Richard G. Biermann, president, Biermann Electric Company, Inc., Des Moines, Iowa; Chief Herman W. Brice, fire-rescue administrator. Palm Beach County Fire Rescue, West Palm Beach, Florida; Jan Gratton, public fire education specialist, Covina, California; David A. Lucht. director. Center for Fire Safety, Worcester Polytechnic Institute, Worcester, Massachusetts; Thomas M. Moses, vice president, administration, Walt Disney World, Reedy Creek Improvement District, Lake Buena Vista, Florida; Douglas G. Pendergras, president, Convalescent Enterprises, Inc., Austin, Texas; and Martin H. Reiss, president, Rolf Jensen & Associates, Inc., Boston, Massachusetts.
Congressional staff members participate in “CPR Across America”
In May, some 60 members of congressional office staffs participated in cardiopulmonary resuscitation (CPR) training sponsored by the Congressional Fire Services Institute (CFSI), the International Association of Fire Chiefs EMS Section, and the Washington (DC) Fire Department. Instructors from the Virginia fire departments of Alexandria, Fairfax County, Frederick County, Loudoun County, and Montgomery County, as well as from Washington, D.C., presented the course, which its sponsors plan to offer again in the future.
Fire service and emergency mana~ers move toward nationwide partnership
The International Association of Fire Chiefs (IAFC) and the National Emergency Management Agency (NEMA) recently signed an official memorandum of understanding (MOU) described as “a starting point…for beginning a partnership by working cooperatively toward mutual emergency management goals.”
Present at the MOU signing were IAFC President Chief Philip McGouldrick, NEMA President Dave McMillion, IAFC Executive Director Garry L. Briese, FEMA Senior Policy Director Harvey Ryland, and FEMA Director James Lee Witt.
For more information, contact Sylin Bynoe at the IAFC, (703) 273-0911, ext. 308.
Last call for Ben Franklin Commemorative Medal
Minting of the Ben Franklin Firefighter National Memorial Commemorative Medal ceased on July 31. More than 105.000 medals have been sold. The remaining medals are available on a first-come, firstserved basis. Cost is $36 for proof medals and $32 for uncirculated medals. Order forms are available from the International Association of Fire Chiefs at (703) 2730911.
