The largest occurrence of carbon monoxide poisoning in Britain demonstrates the potential for mass accidental poisoning. It emphasises the need for strict public health controls and the importance of good liaison between emergency services to ensure that such events are quickly recognised and that the necessary resources are organised. (+info)
Use of hyperbaric oxygen therapy in Hong Kong.
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The Recompression Treatment Centre on Stonecutters Island has been operating in Hong Kong for more than 5 years and has been used to treat a variety of diving-related and other conditions by means of hyperbaric oxygen therapy. Up to the end of December 1997, 295 treatment sessions had been conducted for 39 patients. This article reviews the usefulness of and indications for hyperbaric oxygen therapy. (+info)
Management of carbon monoxide poisoning using oxygen therapy.
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The management of carbon monoxide poisoning requires an accurate assessment of the extent of blood oxygenation. Measuring the fractional oxyhaemoglobin content by using co-oximetry gives a true picture of the oxygen-carrying capacity of blood in the presence of carboxyhaemoglobin. The use of readings from pulse oximetry or a standard blood gas analyser is insufficient and can be misleading. We report on a case of carbon monoxide poisoning to illustrate this potential pitfall. (+info)
Severe carbon monoxide poisoning: outcome after hyperbaric oxygen therapy.
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This paper reports the outcome after carbon monoxide poisoning in 31 consecutive patients treated with mechanical ventilation and hyperbaric oxygen therapy, compared with another study of mechanically ventilated patients treated with normobaric oxygen. We found 16.1% hospital mortality and 3.8% severe short-term memory loss, compared with 30% hospital mortality and 20% incidence of serious neurological deficit after treatment with normobaric oxygen; outcome was poor in 19.4% and 44.3% of those treated with hyperbaric and normobaric oxygen, respectively (P < 0.05). Cerebral oedema caused three of five deaths despite hyperbaric therapy, occurring at 24-48 h after poisoning. Intracranial pressure monitoring and CT scan of the head before wakening should be considered in any severely poisoned patient. (+info)
Carbon monoxide poisoning from gas water heater installed and operated in the bathroom.
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Two cases of carbon monoxide poisoning involving 3 victims occurred in Cameron Highlands in the months of August and September 1995. Two of the victims were found dead in the bathrooms where they were taking a bath while the other one survived. Blood toxicology from the post mortems revealed high levels of carbon monoxide. The only significant source of carbon monoxide in both cases were the gas water heaters which were installed in the bathrooms. A multigas detector was used to monitor the level of carbon monoxide in one of the bathrooms and carbon monoxide was found to be produced to 1200 ppm in 16 minutes during operation of the heater. Carbon monoxide poisoning from gas water heaters installed in bathroom is a significant hazard. (+info)
Incidence of severe unintentional carbon monoxide poisoning differs across racial/ethnic categories.
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OBJECTIVE: This study was conducted to test the hypothesis that the incidence of severe, acute, unintentional carbon monoxide (CO) poisoning differs across racial/ethnic categories. METHODS: The authors retrospectively reviewed medical records of all Washington State residents treated with hyperbaric oxygen for severe, acute, unintentional CO poisoning from December 1, 1987, through February 28, 1997. RESULTS: Among 586 Washington State residents treated with hyperbaric oxygen for severe, acute, unintentional CO poisoning, racial/ethnic designations could be determined from record review for 530 (90%). The black and Hispanic white populations of Washington State had higher relative risks for severe, acute, unintentional CO poisoning than the non-Hispanic white population. The most common sources of CO poisoning differed by racial/ethnic category. CONCLUSIONS: Members of certain groups in Washington State are at higher risk for severe, unintentional CO poisoning. Public education programs regarding CO exposure should be targeted to populations at risk. (+info)
Carbon monoxide stability in stored postmortem blood samples.
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Carbon monoxide (CO) poisoning remains a common cause of both suicidal and accidental deaths in the United States. As a consequence, determination of the percent carboxyhemoglobin (%COHb) level in postmortem blood is a common analysis performed in toxicology laboratories. The blood specimens analyzed are generally preserved with either EDTA or sodium fluoride. Potentially problematic scenarios that may arise in conjunction with CO analysis are a first analysis or a reanalysis requested months or years after the initial toxicology testing is completed; both raise the issue of the stability of carboxyhemoglobin in stored postmortem blood specimens. A study was conducted at the Bexar County Medical Examiner's Office to evaluate the stability of CO in blood samples collected in red-, gray-, and purple-top tubes by comparing results obtained at the time of the autopsy and after two years of storage at 3 degrees C using either an IL 282 or 682 CO-Oximeter. The results from this study suggest that carboxyhemoglobin is stable in blood specimens collected in vacutainer tubes, with or without preservative, and stored refrigerated for up to two years. (+info)
What is clinical smoke poisoning?
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In this 13-year study, 51 patients were admitted with the primary diagnosis of "smoke poisoning" "carbon monoxide (CO) poisoning" or "respiratory burns." Forty patients (78%) had diagnosis of smoke poisoning with minor or no skin burns. The study indicated that clinical diagnosis of CO poisoning cannot be made reliably without carboxyhemoglobin (COHg) determination and that smoke poisoning patients often had CO poisoning. Seventeen of 19 smoke poisoning patients (89%) had CO poisoning above COHb levels of 15% saturation. Carbon monoxide was successfully removed from the blood by improving alveolar ventilation and oxygen concentration. However, there were 2 smoke poisoning deaths as the result of gaseous chemical injury. There was a correlation coefficient of 0.87 between initial COHg levels and patients' hospital days primarily determined by patients' pulmonary complications. Since CO is non-irritating, COHb levels may be used as an additional indicator of suspected pulmonary injury by noxious combustion gases. (+info)