Using a gas-powered generator? Know the risks
Two sisters are dead in Trenton. So are an elderly woman in Upper Merion and a grandfather in the Lehigh Valley. The rest of his family was taken for emergency treatment to the Hospital of the University of Pennsylvania and the children's hospital next door.
The culprit in these deaths - and hospitalizations too numerous to count - is carbon-monoxide poisoning from home generators whose use mushrooms during power outages.
"There is a real public-health emergency going on," said Fred Henretig, senior toxicologist at the regional Poison Control Center at Children's Hospital of Philadelphia.
Most people realize that running gasoline-powered generators (and charcoal grills) inside the house can be dangerous; the instructions say so in big type. "So they put the generator in their garage, maybe, with the door open and think it's going to be OK," said Henretig.
"But it isn't."
Carbon-monoxide fumes are invisible and odorless. Symptoms can easily be mistaken for something else: headache, light-headedness, nausea, vomiting, and, in more serious cases, chest pain and loss of consciousness as the brain and heart are starved of oxygen.
The mechanism for poisoning by carbon monoxide is simple. "It binds to hemoglobin" - the blood protein that normally carries oxygen - "and there is no oxygen delivery, and you die," said Stephen Thom, an emergency medicine physician at Penn.
Thom deals with the cases that are bad, but not quite that bad.
The first treatment for carbon-monoxide poisoning is to get the person away from the source. More serious cases are given oxygen under pressure in emergency rooms. The ER staff at Doylestown Hospital saw at least 10 patients on Tuesday alone, most related to power generators.
"We had several in our emergency department for several hours receiving high-flow oxygen," said Lawrence Brilliant, the department's medical director.
The most serious case was transferred to Penn, where the hyperbaric-medicine program headed by Thom got a dozen of the most serious cases from the region.
They are placed in sealed chambers, some that are the size of a bedroom but look more like a submarine, with the pure oxygen pumped up to nearly three times normal air pressure.
The high pressure, given in three treatments over 24 hours, essentially helps the patient detox from carbon-monoxide poisoning. There also is evidence that it can help prevent permanent cognitive problems.
"A lot of times, six or eight weeks later, they will get headache, memory loss, coordination problems, it's very subtle," said David Lambert, a Penn physician who specializes in hyperbaric and undersea medicine.
Carbon monoxide is the single leading cause of poisoning deaths worldwide, said Thom, much of it from poorly ventilated heating and cooking in underdeveloped countries. In the United States, it has been overtaken by skyrocketing numbers of deaths due to overdoses of prescription painkillers.
But spikes are reported after major storms, with generators used during power outages playing a big role. Patterns vary by region. Several doctors in the Mid-Atlantic said blizzards could be the worst, especially if they come early in the season, when a combination of hazards - defective furnaces turned on, generators to produce electricity, and high snows blocking exhausts of idling parked cars - can come together in, well, a perfect storm.
"We're getting bombed with calls," said Steven M. Marcus, director of the Newark-based New Jersey Poison Information and Education System, who said he had not had time to add up hospitalizations.
Four deaths in New Jersey appear to be linked to generators, two of them placed outside. They may have involved Bernoulli's principle, he said, which describes how gases flowing across a small opening, perhaps a slightly open window, can get sucked inside.
He urged anyone with possible carbon-monoxide-poisoning symptoms to call the poison centers' national hotline, 1-800-222-1222, or go to its website, www.aapcc.org. The hotline routes calls by location; New Jersey residents may also go to www.njpies.org for chat capability and 8002221222@njpies.org for real-time e-mail and texting.
Cynthia Maulick and her husband have used their standby generator - installed in the basement by an electrician and vented outside - numerous times during power outages at their home in woodsy Upper Black Eddy.
She thought nothing of her headache while cooped up Tuesday. She was a little woozy, but hadn't eaten. Her heart started pounding; then she fainted.
She had been preparing for bed a few minutes earlier.
"I could so easily have ignored this and been dead in the morning," said Maulick, 53, who finished hyperbaric oxygen treatment Thursday at Penn and was hoping to find her four cats alive when she arrived home.
Contact Don Sapatkinat 215-854-2617 or dsapatkin@phillynews.com.
