Fife Caroline E, Smith Latisha A, Maus Erik A, McCarthy James J, Koehler Michelle Z, Hawkins Trina, Hampson Neil B
Department of Medicine, Division of Cardiology, University of Texas Health Science Center, 6431 Fannin St, MSB 1.247, Houston, TX 77030, USA.
Pediatrics. 2009 Jun;123(6):e1035-8. doi: 10.1542/peds.2008-3273.
Carbon monoxide (CO) poisoning is common after major storms because of loss of electrical power and use of alternate fuel sources for heat and electricity. In past epidemics of hurricane-related CO poisoning, the source has typically been gasoline-powered electrical generators. Although it is typically believed that generators were used to power air conditioning and refrigeration, this report demonstrates an unsuspected reason for their use.
After Hurricane Ike's landfall in September 2008, major power outages were associated with an epidemic of CO poisoning from electrical generators, as expected. Staff at Memorial Hermann Hospital-Texas Medical Center treated or telephone-triaged cases from the Houston area. A review of the details of those cases forms the basis of this report.
Memorial Hermann Hospital-Texas Medical Center staff treated or triaged 37 individuals exposed to CO from gasoline-powered electrical generators in 13 incidents in the first 36 hours after landfall of the hurricane. Notably, 54% (20 of 37) of the patients were under the age of 18 years. Symptoms ranged from mild to severe, with 1 child dying at the scene. Eleven patients were treated with hyperbaric oxygen. Among 9 incidents in which the reason for generator use was determined, 5 were due to generators powering video games or televisions to watch movies or programs. These 5 incidents in which video games were being powered accounted for 75% (15 of 20) of the pediatric poisonings.
Generator-related CO poisoning is indeed common during power outages after hurricanes. However, generators are commonly being used to provide electricity to power entertainment devices for children, such as video games. Additional public education about CO risk is needed, perhaps directed at older children and teenagers through the schools in regions susceptible to hurricanes.
由于停电以及使用替代燃料供热和发电,重大风暴过后一氧化碳(CO)中毒事件很常见。在过去与飓风相关的CO中毒流行中,中毒源通常是汽油驱动的发电机。尽管通常认为发电机是用于驱动空调和制冷设备,但本报告揭示了其使用的一个意想不到的原因。
2008年9月飓风艾克登陆后,正如预期的那样,大面积停电与发电机导致的CO中毒流行相关。德克萨斯医疗中心纪念赫尔曼医院的工作人员对休斯顿地区的病例进行了治疗或电话分诊。对这些病例细节的回顾构成了本报告的基础。
在飓风登陆后的头36小时内,德克萨斯医疗中心纪念赫尔曼医院的工作人员在13起事件中治疗或分诊了37名因汽油驱动发电机接触CO的人员。值得注意的是,54%(37人中的20人)的患者年龄在18岁以下。症状从轻度到重度不等,有1名儿童在现场死亡。11名患者接受了高压氧治疗。在9起确定使用发电机原因的事件中,有5起是因为发电机为电子游戏或电视供电以观看电影或节目。这5起为电子游戏供电的事件占小儿中毒病例的75%(20例中的15例)。
飓风过后停电期间,发电机相关的CO中毒确实很常见。然而,发电机通常被用于为儿童的娱乐设备供电,如电子游戏。或许需要通过飓风易发生地区的学校,针对年龄较大的儿童和青少年开展更多关于CO风险的公众教育。