Doctors Gates: Carbon monoxide poisoning in 20-year old fireman

Carbon monoxide poisoning in 20-year old fireman

A 20-year-old fireman comes to the emergency room complaining of headache and dizziness after helping to put out a garage fire. He does not complain of shortness of breath, and the arterial blood gas shows a normal partial pressure of oxygen. Which of the following is the best first step in the management of this patient?

a.Begin oxygen therapy
b.Obtain chest x-ray
c.Obtain carboxyhemoglobin level
d.Obtain CT scan

The answer is c.

With symptoms of headache and dizziness in a fireman, the diagnosis of carbon monoxide poisoning must be addressed quickly. A venous or arterial measure of car-boxyhemoglobin must first be obtained, if possible, before oxygen therapy is begun.
The use of supplementary oxygen prior to obtaining the test may be a confounding factor in interpreting blood levels. Oxygen or even hyperbaric oxygen is given after blood for carboxyhemoglobin is drawn.

Chest x-ray should also be obtained. It may be normal or show a pattern of nonpulmonary edema, or aspiration in severe cases. Central nervous system imaging would not be indicated, and there are no diagnostic patterns that are specific to carbon monoxide poisoning.

Carbon monoxide poisoning in 20-year old fireman

A 20-year-old fireman comes to the emergency room complaining of headache and dizziness after helping to put out a garage fire. He does not complain of shortness of breath, and the arterial blood gas shows a normal partial pressure of oxygen. Which of the following is the best first step in the management of this patient?

a.Begin oxygen therapy
b.Obtain chest x-ray
c.Obtain carboxyhemoglobin level
d.Obtain CT scan

The answer is c.

With symptoms of headache and dizziness in a fireman, the diagnosis of carbon monoxide poisoning must be addressed quickly. A venous or arterial measure of car-boxyhemoglobin must first be obtained, if possible, before oxygen therapy is begun.
The use of supplementary oxygen prior to obtaining the test may be a confounding factor in interpreting blood levels. Oxygen or even hyperbaric oxygen is given after blood for carboxyhemoglobin is drawn.

Chest x-ray should also be obtained. It may be normal or show a pattern of nonpulmonary edema, or aspiration in severe cases. Central nervous system imaging would not be indicated, and there are no diagnostic patterns that are specific to carbon monoxide poisoning.

A 20-year-old fireman comes to the emergency room complaining of headache and dizziness after helping to put out a garage fire. He does not complain of shortness of breath, and the arterial blood gas shows a normal partial pressure of oxygen. Which of the following is the best first step in the management of this patient?

a.Begin oxygen therapy
b.Obtain chest x-ray
c.Obtain carboxyhemoglobin level
d.Obtain CT scan

The answer is c.

With symptoms of headache and dizziness in a fireman, the diagnosis of carbon monoxide poisoning must be addressed quickly. A venous or arterial measure of car-boxyhemoglobin must first be obtained, if possible, before oxygen therapy is begun.
The use of supplementary oxygen prior to obtaining the test may be a confounding factor in interpreting blood levels. Oxygen or even hyperbaric oxygen is given after blood for carboxyhemoglobin is drawn.

Chest x-ray should also be obtained. It may be normal or show a pattern of nonpulmonary edema, or aspiration in severe cases. Central nervous system imaging would not be indicated, and there are no diagnostic patterns that are specific to carbon monoxide poisoning.