Carbon Monoxide Poisoning


A 15 year old girl was sleeping in a room above a closed garage in which an automobile was accidently left running. The family dog was found dead 5 hours later at 4:30 a.m. The girl was discovered on the bed limp and unresponsive. She was immediately brought outside. Cardiopulmonary resuscitation was begun at the scene, including oxygen. She vomited and was described as limp.
Physical exam in the ER showed the patient to be unconscious and unresponsive to deep pain, with decerebrate posturing. Her vital signs were as follows:

Blood Pressure 110 / 80 mmHg
Heart Rate 120 per min.
Respiration Intermittent with occasional periods of apnea
Body Temperature 97.3o F

Her pupils were moderately constricted and reactive to light. There were decreased breath sounds and scattered ronchi were heard bilaterally. A sinus tachycardia was present without other cardiac abnormalities.

The Laboratory Values at Admission were as Follows:

Hemoglobin 13.9 g/dL
Hematocrit 42.3%
Platelets 473,000 per mm3
Leucocytes 9,000 per mm3
Serum Sodium 135 mEq. per L
Serum Potassium 3.7 mEq. per L
Bicarbonate 20 mEq. per L
Glucose 122 mEq. per L
COHb 37%
[ COHb (dog) ] [ 56% ]

The Patient's Arterial Blood Gases determined at Admission were as Follows:

PO2 90 mmHg
PCO2 35 mmHg
pH 7.38

Mofenson, H.C., Caraccio, T.C., Brody, G.B. (1984) Carbon monoxide poisoning, Am. J. Emerg. Med., 2; 254-261.

...... last changed 12/25/99

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