Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota.
West J Emerg Med. 2019 May;20(3):506-511. doi: 10.5811/westjem.2019.2.41428. Epub 2019 Apr 16.
The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states.
We surveyed hospitals in three states. Telephone queries assessed processes for measuring carboxyhemoglobin, including capacity for real-time vs send-out testing. Facilities were separated based on their location's population size for further analysis. Descriptive statistics are reported.
Of the 250 hospitals queried, we ultimately excluded 25. Nearly all (220, 97.8%) reported a process in place to test for CO exposure. Over 40% (n=92) lacked real-time testing. Testing ability was positively associated with increasing population size quartile (range 32.6% - 100%). Hospitals in the lowest-quartile population centers were more likely to report that they were unable to test in real time than those in the largest-quartile population centers (67.4% vs 0%).
In a large geographic region encompassing three states, hospital-based and real-time capacity to test for CO exposure is not universal. Hospitals in smaller population areas are more likely to lack real-time testing or any testing at all. This may have significant public health, triage, and referral implications for patients.
本研究的目的是评估在美国中西部三个州的所有医院中检测患者一氧化碳（CO）暴露情况的能力。
我们调查了三个州的医院。电话查询评估了测量碳氧血红蛋白的过程，包括实时测试和送检测试的能力。根据所在地的人口规模对设施进行了进一步分析。报告描述性统计数据。
在被调查的 250 家医院中，我们最终排除了 25 家。几乎所有（220 家，97.8%）医院都报告了检测 CO 暴露的流程。超过 40%（n=92）缺乏实时测试。检测能力与人口规模四分位（范围 32.6% - 100%）呈正相关。人口中心处于最低四分位数的医院比处于最大四分位数的医院更有可能报告无法实时检测（67.4%比 0%）。
在一个包含三个州的大型地理区域内，基于医院的 CO 暴露实时检测能力并不普遍。人口较少地区的医院更有可能缺乏实时检测或根本不进行任何检测。这可能对患者的公共卫生、分诊和转诊产生重大影响。
