title: Toxic CO-ingestions in intentional carbon monoxide poisoning.
abstract: BACKGROUND
  Intentional carbon monoxide (CO) poisoning is responsible for two-thirds of the deaths from CO poisoning in this country and an estimated 15,000 Emergency Department visits annually.
  
  
  OBJECTIVE
  In an attempt to optimize medical management of such patients, this study was conducted to examine the frequency and types of toxic co-ingestions that may accompany CO inhalation.
  
  
  METHODS
  Records of all patients treated with hyperbaric oxygen for acute, intentional CO poisoning at a regional referral center for hyperbaric medicine in Seattle from 1980 to 2005 were reviewed. For those where co-ingestions were identified, information about type of poison(s) and results of toxicology screens was recorded and analyzed.
  
  
  RESULTS
  Over the 25-year period examined, 433 patients were treated for intentional CO poisoning and records were available for 426. Of those, 188 (42%) had ingested one or more poisons in addition to CO. Ethanol was most common, but a wide variety of other drug classes were also identified. Toxicology screening studies of some type were performed in 49 patients.
  
  
  CONCLUSIONS
  Toxic co-ingestions seem to be relatively common in patients treated for intentional CO poisoning. For this reason, providers should be vigilant and open to clinical signs that can't be explained with CO exposure alone, and ready to treat clinical issues that arise from co-ingestions.
authors.affiliation: Center for Hyperbaric Medicine, Virginia Mason Medical Center, Seattle, Washington, USA.
authors.forename: Neil B
authors.initials: NB
authors.lastname: Hampson
authors.forename: Diana
authors.initials: D
authors.lastname: Bodwin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000506:poisoning*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D033182:Intention; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000209:etiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide