Carbon Monoxide Poisoning: From the Perspective of Ten Years and 2417 Cases

Abstract

Objective: Carbon monoxide (CO) poisoning is a common problem in various countries, especially in Winter months. CO exposure results in the formation of carboxyhemoglobin (COHb), which is responsible for toxicity symptoms. In this study, we aim to demonstrate the demographic features and seasonal variations of this particular public health problem. Materials and Methods:We retrospectively evaluated hospital police reports and medical records of 2417 ED patients diagnosed with CO poisoning between 1999 and 2009. Sources of exposure, seasonal variation and demographic characteristics were analyzed. Results: The mean age of the patients, of whom 1418 (58.7%) were female, was 29±18 years. While 1708 patients (70.7%) were admitted to adult ED, 709 (29.3%) patients were admitted to pediatric ED. January and subsequent Winter months represented the most dangerous periods for CO exposure. No intentional (suicidal attempt) exposure to CO intoxication was reported and the major cause for intoxication included unsecured stoves and gas heaters. Conclusion: Emergency physicians should be familiar with symptoms and remedies of CO intoxication, which still constitutes a serious health problem. (JAEM 2012; 11: 157-60)

Karbon monoksit zehirlenmelerinde, serum laktat düzeyleri ve tedavinin etkinliğinin belirlenmesinde laktatklirenslerinin kullanılması

“…Carbon monoxide (CO) poisonings are among the clinical problems seen in emergency departments (ED) with significant mortality and morbidity rates. CO poisoning causes hypoxia because the CO molecule binds to hemoglobin with high affinity of oxygen, reduces the oxygen-carrying capacity of the blood, and finally damages delivery of the oxygen to tissue (1,2).…”

The role of lactic acid in carbon monoxide poisoning and the difficulty of defining the worse outcome

“…In this population, immediate or delayed neurologic sequelae was an important concern in evaluating patients with CO exposure; however, mortality was quite low, particularly if the patients could reach to the emergency department with unintentional poisoning. 2,3 The referral for hyperbaric oxygen (HBO) treatment was considered an important sign of severe intoxication in many centers, with the decision to referral depends not only on established criteria but also on overall clinical picture and subjective decision of clinicians. The severity of the symptoms, which was defined by the authors (e.g.…”

“…In this population, immediate or delayed neurologic sequelae was an important concern in evaluating patients with CO exposure; however, mortality was quite low, particularly if the patients could reach to the emergency department with unintentional poisoning. 2,3…”