Gómez Carrasco J A, López-Herce Cid J, Bernabé de Frutos M C, García de Frías E
Servicio de Pediatría, Hospital Príncipe de Asturias, Universidad de Alcalá de Henares, Madrid.
An Esp Pediatr. 1993 Nov;39(5):411-4.
The aim of this paper is to clinically describe a type of intoxication, mainly domestic, which still prevails today and which could even be increasing.
We present ten "toxic accidents" which involved seventeen patients, all under fifteen years of age. The diagnosis was confirmed upon obtaining a level of more than 5% carboxyhemoglobin (CO-Hb) in the blood.
The symptomatology included: a sensation described by the patients as dizziness (53%), headache (53%), nausea and vomiting (35%). Sleepiness, fainting, or a faint-like feeling were also frequent (23%). The CO-Hb levels at admission were 28.6% +/- 9 (7.1-39.8). Pulse oximetry was performed in three patients, resulting in normal values. In all of the cases with the exception of one, several members of the family were affected simultaneously and the sources of intoxication were the boilers and/or gas heaters that were installed in the homes. The exception occurred in a home were there was a traditional coal burner. All patients were treated by inhalation of 100% oxygen. This resulted in a mean fall of the CO-Hb level in a two-hour interval to 4.6% +/- 2.1 (0-7.8).
We emphasis the fact that since the symptoms are often nonspecific, a high level of suspicion is necessary in order to make this diagnosis. It is fundamental to keep this type of intoxication in mind when various members of a family present symptoms simultaneously and especially if it occurs during the colder time of the year. Only the determination of the CO-Hb can confirm this suspicion since gasometry and pulseoximetry are useless.
