EYE ON DIAGNOSTICS: Identifying carbon monoxide poisoning

November 2004 
Volume 34  Number 11
Pages 68 - 69
  PDF Version Available!


  • Diagnosing the problem

  • Treatment priorities

  • Successful outcome

  • Quick facts about CO poisoning



  • Table. No caption av...

    CHARLES HENDERSON, 60, lives alone in an older home not far from his niece. One morning, she can't contact him by phone. Knowing he's been having a problem with his furnace, she rushes to his home and finds him lying in bed, somewhat confused and complaining of dizziness, nausea, and a severe headache. She helps him outside and then immediately calls 911 on her cell phone.

    When the emergency medical technicians (EMTs) arrive, they put Mr. Henderson on 100% oxygen via non-rebreather mask, transfer him to the ambulance, and start an infusion of 0.9% sodium chloride solution.

    When the EMTs take his history, they learn that he doesn't smoke or take any medications. They test his blood glucose level, which is within normal limits. Because his niece tells them about his malfunctioning furnace, they suspect carbon monoxide (CO) poisoning.

    Mr. Henderson has many of the early, mild signs and symptoms of CO poisoning, including headache, nausea, and dizziness. (See Quick Facts about CO Poisoning .) He arrives at the local ED about 20 minutes after starting treatment.

    Diagnosing the problem

    On admission, Mr. Henderson's mental status has improved and his oxygen saturation appears normal at 98% via pulse oximetry. He's placed on a cardiac monitor, and a 12-lead ECG is performed.

    Specimens are drawn for tests, including serum cardiac biomarkers, complete blood cell count, and arterial blood gas analysis with carboxyhemoglobin measurement.

    Most test results are within normal limits, with no evidence pointing to acute myocardial ischemia or infarction. But the arterial carboxyhemoglobin level is elevated at ...

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