An Analysis of Patients With Carbon Monoxide Poisoning Transported by a Physician-Staffed Helicopter

Iroki Nagasawa,Youichi Yanagawa

doi:10.32861/ajls.57.43.47

Abstract

OBJECTIVE: We retrospectively investigated a series of patients with carbon monoxide (CO) poisoning transported by a physician-staffed helicopter (DH) to seek evidence supporting the daily management of patients with CO poisoning. STUDY DESIGN: Subjects were divided into two groups: the carboxyhemoglobin saturation (SpCO) (+) group, which included patients who had a pulse CO-oximeter attached during transportation; and the SpCO (-) group, which included all other patients. We compared the level of SpCO before and after transportation when the level was noted. RESULTS: The subjects were predominantly middle-aged and male. Seventeen subjects (53.1%) received a diagnosis of CO poisoning based on the situation in which the subjects were found, without the carboxyhemoglobin level being measured. No subjects show deterioration of their condition after transportation, and none ultimately died. The frequency of male gender, normobaric oxygen treatment and return to the base hospital in the SpCO (+) group was significantly greater than in the SpCO (-) group. The SpCO levels after transportation were significantly lower than they had been before transportation. CONCLUSION: This is the first study to show the results of the analysis of patients with CO poisoning transported by the DH. All patients with CO poisoning were safely transported.

Highlights

Open-type burning heating apparatuses achieve combustion using oxygen in the air and produce exhaust gases, including carbon monoxide (CO), through the incomplete combustion of substances containing carbon
[3] Administration of 100% oxygen as early as possible is recommended for all patients with CO poisoning, the higher the partial pressure of oxygen provided, the shorter the elimination period, so hyperbaric oxygen (HBO) therapy is recommend for patients with CO poisoning whenever possible
We retrospectively investigated the medical chart of the patients who were transported by the DH from March 2004, when the DH in eastern Shizuoka started service, to January 2019 and received a diagnosis of CO poisoning

Summary

Introduction

Open-type burning heating apparatuses achieve combustion using oxygen in the air and produce exhaust gases, including carbon monoxide (CO), through the incomplete combustion of substances containing carbon. CO diffuses rapidly through the alveolar membrane and binds with an affinity that is 230–300 times that of oxygen, preferably to the iron ion in heme. Et al [1], Rose, et al [2], Wu and Juurlink [3] Administration of 100% oxygen (normobaric oxygen [NBO]) as early as possible is recommended for all patients with CO poisoning, the higher the partial pressure of oxygen provided, the shorter the elimination period, so hyperbaric oxygen (HBO) therapy is recommend for patients with CO poisoning whenever possible. Some patients with CO poisoning receive just NBO therapy [5]

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Results

Conclusion