Noninvasive measurement of carbon monoxide levels in ED patients with headache.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Eberhardt
Mary
M
Emergency Medicine Residency, St. Luke's Hospital, 801 Ostrum Street, Bethlehem, PA 18015, USA. eberham@slhn.org
Powell
Andrew
A
Bonfante
Gary
G
Rupp
Valerie
V
Guarnaccia
Joseph R
JR
Heller
Michael
M
Reed
James
J
D000328:Adult; D002248:Carbon Monoxide / Q000097:blood*; D002249:Carbon Monoxide Poisoning / Q000150:complications; D004636:Emergency Service, Hospital; D005260:Female; D006261:Headache / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D002248:Carbon Monoxide