Diagnosis and Treatment of Carbon Monoxide Poisoning: A Study among Emergency Physicians in Québec

Abstract

A questionnaire was sent to all members of the Associa tion des médecins d'urgence du Québec during March 1997 to estimate their abilities to diagnose, treat and fol low-up carbon monoxide (CO) poisoning. The question naire comprised case histories about frequent or impor tant types of poisoning of which four were related to CO. Questions were asked about diagnosis, investigation, treatment or follow-up. Of the 450 members of the Asso ciation, 109 responded to the questionnaire (24.2%). In the physicians' answers to three case histories that were presented to measure their ability to identify CO poison ing, this diagnosis was correctly identified by 80.7, 97.2 and 71.6% of physicians, respectively, for each case his tory. Concerning the investigation, 97.2% of physicians chose one good answer and 25.7% chose two among two possible, carboxyhaemoglobin level being the most frequent one (87.2%). Concerning treatment, 99.1% of physicians chose one good answer and 57.8% chose two among two possible, immediate prescription of 100% oxygen by mask being the most frequent one (98.2%) and transfer of the patient to the hyperbaric chamber the second one (58.7%). Concerning the follow-up of the patient, 61.5% of physicians chose the good answer, which was to see the patient in 2 weeks. In conclusion, more than 70% of the physicians were able to identify this diagnosis and deficiencies in the management were main ly noted in the treatment and follow-up phases. These results may represent an overestimate of the reality.