Wednesday, December 20, 1995 00:39:16
               Puget Sound EMSForum Item
       From:           Pete Suver, TCFD 14,TEMPO
       Subject:        CO Poisoning
       To:             Puget Sound EMSForum
                       
       Cc:             
Here's another offering from the Emergency Medicine Mailing List on the Internet.

>From: RWHartung@aol.com
>Date: Sun, 17 Dec 1995 16:48:35 -0500
>To: emed-l@itsa.ucsf.edu
>Subject: Re: emed-l CO Poisoning Stats
>Sender: owner-emed-l@itssrv1.ucsf.edu
>Precedence: bulk
>
>>At a
>recent symposium I was given a statistic that 24% of patients presenting
>at an ED with 'flu-like' symptoms are actually suffering from CO
>poisoning.  Unfortunately, this was given with no references and I am
>skeptical to include it without some level of verification.
>Brandon
>Chief, Hamel Vol. Fire Dept.<
>
>I'm a little behind on my mail so you may have already received this info.
>A pertinent reference is the study by Baker, et al. entitled
>Carboxyhemoglobin levels in children with nonspecific flu-like symptoms.
>(Journal of Pediatrics, September, 1988, pp. 501-504). They studied sublethal
>CO toxicity in a pediatric population presenting with headache, nausea,
>weakness, dizziness or altered mental status who were thought to have a flu
>syndrome. They excluded patients who had a fever, watery stools, or a viral
>rash and included patients who lived in homes with combustible fuel heat
>(oil, kerosene, wood stoves, etc.). In patients presenting between January 5
>and March 30, 24 out of 46 had COHb levels above 2%. Six had levels over 10%
>(up to 27.6%), seven had levels between 5% and 10%, and 11 had levels between
>2% and 5%. They cited studies which showed that smokers may have levels
>between 5% and 9%. Since none of the children were smokers, and since the
>average COHb level in controls was 1.3% (range 0.6% - 1.9%),  levels above 2%
>were considered abnormal and were treated with 100% oxygen. The number of
>smokers in the household did not differ between study groups.
> They state "It might be argued that children with COHb levels between 2% and
>5% have minimal symptoms and that their ill effects would likely be
>self-limited. We contend that the crucial importance of accurate diagnosis in
>this group is...the prompt recognition of a hazardous environment".
>
>Russ Hartung, MD
>EMS Medical Director
>CVPH Medical Center
>Plattsburgh, NY
Subject: Re: emed-l CO Poisoning Stats