Availability of Bedside and Laboratory Testing for Carbon Monoxide Poisoning in the Upper Midwestern United States

West J Emerg Med. 2019 May;20(3):506-511. doi: 10.5811/westjem.2019.2.41428. Epub 2019 Apr 16.

Abstract

Introduction: The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states.

Methods: We surveyed hospitals in three states. Telephone queries assessed processes for measuring carboxyhemoglobin, including capacity for real-time vs send-out testing. Facilities were separated based on their location's population size for further analysis. Descriptive statistics are reported.

Results: Of the 250 hospitals queried, we ultimately excluded 25. Nearly all (220, 97.8%) reported a process in place to test for CO exposure. Over 40% (n=92) lacked real-time testing. Testing ability was positively associated with increasing population size quartile (range 32.6% - 100%). Hospitals in the lowest-quartile population centers were more likely to report that they were unable to test in real time than those in the largest-quartile population centers (67.4% vs 0%).

Conclusion: In a large geographic region encompassing three states, hospital-based and real-time capacity to test for CO exposure is not universal. Hospitals in smaller population areas are more likely to lack real-time testing or any testing at all. This may have significant public health, triage, and referral implications for patients.

MeSH terms

  • Carbon Monoxide Poisoning* / diagnosis
  • Carbon Monoxide Poisoning* / epidemiology
  • Clinical Laboratory Techniques* / standards
  • Clinical Laboratory Techniques* / statistics & numerical data
  • Health Services Accessibility / standards*
  • Health Services Needs and Demand
  • Hospitals* / standards
  • Hospitals* / statistics & numerical data
  • Humans
  • Midwestern United States / epidemiology
  • Point-of-Care Testing* / standards
  • Point-of-Care Testing* / statistics & numerical data
  • Surveys and Questionnaires