Exhaled carbon monoxide concentration in correlation to clinical parameters to detect carbon monoxide poisoning among fire victims in an Egyptian Emergency Department

Background

Fire victims are at risk of inhaling potentially toxic gases contained within smoke. Carbon monoxide gas (CO) is the most significant and may contribute to morbidity and mortality of patients. Early detection of CO poisoning by measuring exhaled CO in correlation to the clinical parameters suggestive of CO poisoning in mild to moderate burn injuries among fire victims was our aim.

Methods

Case-control study involving 40 fire victims presenting with flame burn injuries within 24 h who were assessed for CO poisoning. Control group involved 40 healthy nonsmoker individuals. Exhaled CO level was measured using a CO Check Pro Device, which was correlated to clinical parameters suggestive of CO poisoning in addition to elevated lactate level.

Results

The median exhaled CO level was significantly higher in cases compared to controls (4.5 ppm vs. 1.5 ppm, p < 0.001). Among fire victims, 37.5 % had mild CO poisoning. Significant positive correlations were found between exhaled CO levels and lactate levels (r = 0.54, p < 0.001), duration of flame exposure (r = 0.59, p < 0.001), and crowding index (r = 0.49, p = 0.009).

Discussion

Exhaled carbon monoxide levels is a valuable diagnostic tool for the early detection of CO poisoning among fire victims with mild to moderate burn injuries. The correlation between elevated exhaled CO levels and clinical symptoms, alongside serum lactate level, supports their use as reliable indicator of CO exposure in fire victims, thereby optimizing emergency response strategies.