title: Dying to play video games: carbon monoxide poisoning from electrical generators used after hurricane Ike.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Texas Health Science Center, 6431 Fannin St, MSB 1.247, Houston, TX 77030, USA. caroline.e.fife@uth.tmc.edu
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Fife
authors.forename: Latisha A
authors.initials: LA
authors.lastname: Smith
authors.forename: Erik A
authors.initials: EA
authors.lastname: Maus
authors.forename: James J
authors.initials: JJ
authors.lastname: McCarthy
authors.forename: Michelle Z
authors.initials: MZ
authors.lastname: Koehler
authors.forename: Trina
authors.initials: T
authors.lastname: Hawkins
authors.forename: Neil B
authors.initials: NB
authors.lastname: Hampson
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002249:Carbon Monoxide Poisoning / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D004196:Disease Outbreaks; D011211:Electric Power Supplies / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005742:Gasoline; D006266:Health Education; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013690:Television / Q000706:statistics & numerical data; D013781:Texas; D018910:Video Games / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D005742:Gasoline