Carbonmonoxide poisoning among patients presenting with nonspesific symptoms to the emergency department

Abstract

Introduction: Carbon monoxide poisoning is one of the leading cause of poisoning-related deaths all over the world. Many people die or suffer from serious health problems due to this poisoning in our country. Number of carbon monoxide poisonings increase markedly in winter. Varying carboxy-hemoglobin levels in blood may cause various symptoms in those who are exposed to carbon monoxide. Patients may present with various clinical pictures including nonspecific symptoms. Carbon monoxide inhalation can cause damage in the central nervous system, the myocardial tissue and all other organs.
Material and Method: This prospective study was conducted between November 1, 2003 and February 28, 2004. The symptoms considered as nonspecific were as follows: weakness, headache, dizziness/vertigo, nasal drainage, altered consciousness, shortness of breath and chest pain. All the patients were evaluated for carbon monoxide poisoning.
Results: A total of 230 patients having one or more of these symptoms were detected. Blood carboxyhemoglobin levels of these patients were analyzed. Thirty seven of the patients (16%) were diagnosed as carbon monoxide poisoning. Twenty four of these patients (10.4 %) presented to our triage desk through referral from a healthcare facility with suspected diagnosis of CO poisoning or by stating that they might have been poisoned with carbon monoxide. Thirteen patients (5.6%) were diagnosed during the survey.
Conclusion: Patients exposed to carbon monoxide inhalation may present with nonspecific symptoms which may cause misdiagnosis. Although it can be managed with simple treatment, it may be missed if a detailed history is not taken. Physicians must keep a high index of suspicion for accurate and rapid diagnosis of carbon monoxide poisoning in patients presenting with nonspecific symptoms particularly in winter season.