Eberhardt Mary, Powell Andrew, Bonfante Gary, Rupp Valerie, Guarnaccia Joseph R, Heller Michael, Reed James
Emergency Medicine Residency, St. Luke's Hospital, 801 Ostrum Street, Bethlehem, PA 18015, USA.
J Med Toxicol. 2006 Sep;2(3):89-92. doi: 10.1007/BF03161015.
Carbon Monoxide (CO), the third most common cause of acute poisoning death, is easily overlooked in the emergency department (ED). Nonspecific complaints such as headache, weakness, or malaise may easily result in misdiagnosis. The objectives of this study are to determine the frequency of CO poisoning in patients presenting to the ED complaining of headaches and to determine the feasibility of using noninvasive CO analyzers as a screening tool.
This prospective controlled study examined, during the winter months, adult patients presenting with a complaint of atraumatic, afebrile headaches. All subjects submitted a sample for a CO breath analyzer. Participants with elevated carboxyhemoglobin (COHb) levels (nonsmokers >2%, smokers >5%) underwent venous COHb testing. Control patients, without headaches, presenting to the ED were similarly studied.
We enrolled 170 subjects and 98 controls. Of the 170 subjects, 12 (7.1%) had elevated COHb levels confirmed by venous COHb levels. Of the 98 controls, 1 (1.0%) had an elevated COHb level (p < 0.05). There were no differences in demographic factors between the two groups (p > 0.16).
Noninvasive measurement of CO levels in ED patients with headaches is rapid and specific. During winter months, elevated CO levels are present in over 7% of ED patients with headaches.
一氧化碳（CO）是急性中毒死亡的第三大常见原因，在急诊科（ED）很容易被忽视。诸如头痛、虚弱或不适等非特异性症状可能很容易导致误诊。本研究的目的是确定因头痛到急诊科就诊的患者中一氧化碳中毒的发生率，并确定使用无创一氧化碳分析仪作为筛查工具的可行性。
这项前瞻性对照研究在冬季对主诉无创伤性、无发热性头痛的成年患者进行了检查。所有受试者都提交了一份用于一氧化碳呼气分析仪检测的样本。碳氧血红蛋白（COHb）水平升高的参与者（非吸烟者>2%，吸烟者>5%）接受了静脉血碳氧血红蛋白检测。对到急诊科就诊的无头痛症状的对照患者进行了类似的研究。
我们纳入了170名受试者和98名对照。在170名受试者中，有12名（7.1%）经静脉血碳氧血红蛋白检测确认碳氧血红蛋白水平升高。在98名对照中，有1名（1.0%）碳氧血红蛋白水平升高（p<0.05）。两组之间的人口统计学因素没有差异（p>0.16）。
对急诊科有头痛症状的患者进行无创一氧化碳水平检测快速且具有特异性。在冬季，超过7%的有头痛症状的急诊科患者碳氧血红蛋白水平升高。
