Author(s): Crocker PJ, Walker JS
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Abstract We report a series of 28 pediatric carbon monoxide exposures. Sixteen patients (57\%) were judged to have potentially toxic carboxyhemeglobin (COHb) levels (greater than 15\%). In this group the range of COHb blood levels was 16.7\% to 44.0\% (mean = 26.5\%). An unusually high incidence of syncope (56.3\%, 9/16) and lethargy (68.7\%, 11/16) was observed. Every patient with a COHb level greater than or equal to 24\% experienced syncope; a marked departure from published adult values. Lethargy was reported at a mean COHb concentration of 25.9\%. All patients with levels over 25\% COHb, neurologic findings, acidosis, or syncope were considered candidates for hyperbaric oxygen therapy (HBOT). No morbidity from HBOT was encountered. Eighty-nine percent (25/28) of the patients are reportedly doing well, with no late sequelae identified. Delayed neurologic sequelae in three patients include chronic headaches, memory difficulties, or decline in school performance.
This article was published in J Emerg Med
and referenced in Journal of Clinical Toxicology