Developing best practice response to carbon monoxide incidents: A toolkit for health protection frontline staff

Objectives: Carbon monoxide (CO) poisoning represents a significant public health burden. CO incidents require multiple responders, including the Health Protection Agency (HPA). However, best practice guidance does not yet exist in the UK for chemicals. Since CO is a good template for chemical incidents, the authors aimed to develop an electronic 'best practice' CO incident response toolkit which could serve as a blueprint for chemicals in general, and have compatibility with HPZone, the electronic decision support system being implemented across the HPA. Study design: Public health guidance development. Methods: (1) Literature review of CO incidents, risk management, public health, toxicology and environmental guidance; (2) expert opinion; (3) synthesis of information; (4) writing the toolkit; and (5) consultation and toolkit testing. Results: The draft toolkit was designed integrating a best practice algorithm, risk assessment, links to CO guidance, and template incident forms. The risk assessment model is in development but key intermediate outcomes of this were proposed case definitions for CO exposure. Conclusion: The toolkit has been successfully piloted and further consultation and refinement will follow. It provides a platform for the expansion of electronic decision support tools in chemical incidents management with the potential for HPZone functionality. (C) 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.