Carbon monoxide poisoning cases presenting with non-specific symptoms

Toxicol Ind Health. 2017 Jan;33(1):53-60. doi: 10.1177/0748233716660641. Epub 2016 Aug 19.

Abstract

Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with non-specific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED) due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.

Keywords: Clinical toxicology; carbon monoxide toxicity; carboxyhaemoglobin; clinical symptoms; emergency department.

MeSH terms

  • Adolescent
  • Carbon Monoxide Poisoning / diagnosis*
  • Carbon Monoxide Poisoning / therapy*
  • Carboxyhemoglobin / metabolism
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Oximetry
  • Seasons

Substances

  • Carboxyhemoglobin