Document Detail

The use of exhaled carbon monoxide for the diagnosis of carbon monoxide poisoning. A case report.
MedLine Citation:
PMID:  9658657     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Carbon monoxide (CO) poisoning is difficult to confirm in small rural hospitals that lack easy access to a cooximeter. A small hand held device can be used to assess exhaled CO (ECO) in parts per million. This device is often used in smoking cessation clinics to confirm that a person has abstained from smoking. CASE SUMMARY: A 47-year-old white male became dizzy and had a near syncopal episode while working on his boat in the local marina. He was brought to the ER and was found to have an exhaled CO level of 180 ppm. The presence carboxyhemoglobin (HbCO) was confirmed later by an independent reference laboratory and the result was 26% HbCO. DISCUSSION: The patient's exhaled CO level dropped slower than expected while breathing oxygen delivered by a non-rebreather mask. This could be due to inadequate compliance to oxygen therapy and a fiO2 somewhat less than 1.0. Another limitation of the technique is the calibration gas (50-ppm CO). This concentration may be too low to assess ER patients. Therefore a confirmatory ABG with cooximetry should be obtained if available. Clinicians are cautioned that there is no safe level of HbCO (6). There is a simple formula to convert ECO to HbCO. The use of exhaled CO monitoring may be a promising alternative that is relatively less expensive than cooximetry in the ER setting, but more research is clearly indicated.
W Wallace
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Alaska medicine     Volume:  40     ISSN:  0002-4538     ISO Abbreviation:  Alaska Med     Publication Date:    1998 Apr-Jun
Date Detail:
Created Date:  1998-07-28     Completed Date:  1998-07-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370457     Medline TA:  Alaska Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  33-5     Citation Subset:  IM    
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MeSH Terms
Breath Tests*
Carbon Monoxide / analysis*
Carbon Monoxide Poisoning / blood,  diagnosis*
Middle Aged
Reg. No./Substance:
630-08-0/Carbon Monoxide

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