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Non-Invasive Carboxyhemoglobin Monitoring: Screening Emergency Medical Services Patients for Carbon Monoxide Exposure

Published online by Cambridge University Press:  28 June 2012

Douglas Nilson ,
Robert Partridge ,
Selim Suner  and
Gregory Jay
Douglas Nilson*
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Robert Partridge
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Selim Suner
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island, USA Department of Surgery, Brown Medical School, Providence, Rhode Island, USA Division of Engineering, Brown University, Providence, Rhode Island, USA
Gregory Jay
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island, USA Division of Engineering, Brown University, Providence, Rhode Island, USA
*
Brown Emergency Medicine Residency Program, Rhode Island Hospital, 593 Eddy Street, Claverick Building 274, Providence, Rhode Island 02903, USA E-mail: dougnilson@gmail.com
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Abstract

Introduction:

Carbon monoxide (CO) toxicity is a significant health problem. The use of non-invasive pulse CO-oximetry screening in the emergency department has demonstrated that the rapid screening of numerous individuals for CO toxicity is simple and capable of identifying occult cases of CO toxicity.

Objective:

The objective of this study was to extend the use of this handheld device to the prehospital arena, assess carboxyhemoglobin (SpCO) levels in emergency medical services (EMS) patients, and correlate these levels with clinical and demographic data.

Methods:

This was a retrospective, observational, chart review of adult patients transported to hospital emergency departments by urban fire department EMS ambulances during a six-week period. Each ambulance used a non-invasive pulse CO-oximeter (Rad-57, Masimo Inc.) to record patients' COHb concentrations (SpCO) along with the standard EMS assessment data. Spearman's Rank Correlation tests and Student's t-tests were used to analyze the data and calculate relationships between SpCO and other variables (age, gender, respiratory rate, heart rate, mean arterial pressure, and oxygen saturation measured by pulse oximetry).

Results:

A total of 36.4% of the patients transported during the study had SpCO documented. Of the 1,017 adults included in this group, 11 (1.1%) had an SpCO >15%. There was no correlation between SpCO and heart rate, ventilatory rate, mean arterial pressure, and oxygen saturation.

Conclusions:

Screening for CO toxicity in the EMS setting is possible, and may aid in the early detection and treatment of CO-poisoned patients.

Keywords

carbon-monoxide toxicitycarboxyhemoglobinemergency medical servicesmonitoringpatient
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 3 , June 2010 , pp. 253 - 256
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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