The fire alarm went off in the machine room on a small ferry. A member of the deck crew ran down to check why; the machine room was filled with smoke and he breathed some in. Just over an one hour later he had a headache, nausea, poor vision and high blood pressure. He was taken to the emergency ward at a hospital, where it was found that he had carbon monoxide poisoning. One way to avoid this type of incident is to be aware of the risks associated with smoke and fire, to have clear procedures and equipment that is readily available.