The detection of occult CO poisoning through noninvasive measurement of carboxyhemoglobin: A cross-sectional study

Am J Emerg Med. 2020 Jun;38(6):1110-1114. doi: 10.1016/j.ajem.2019.158383. Epub 2019 Aug 1.


Objectives: Carbon monoxide (CO) poisoning is one of the leading causes of preventable death in the world. Our primary objective was to identify and treat individuals who are unaware of their exposure to carbon monoxide in emergency departments (EDs). Our secondary goal was to reduce the costs of diagnosis and treatment by preventing unnecessary diagnostic testing in EDs.

Methods: In this cross-sectional study, carboxyhemoglobin (COHb) levels of patients presented with the signs of CO poisoning to the Emergency Department of Kayseri Training and Research Hospital between November 2012 and May 2013 were noninvasively measured during triage. Patients with elevated COHb levels were suspected of CO poisoning and subjected to further investigation.

Results: A total of 4073 patients were enrolled in the study, and 106 (2.6%) of them were diagnosed with CO poisoning. Initial evaluation revealed headache to be the most common presenting complaint in patients with occult CO poisoning. Further evaluations to determine the accuracy of noninvasive measurements showed that noninvasive pulse CO-oxymeter and arterial blood gas (ABG) measurement were compatible.

Conclusions: The use of noninvasive pulse CO-oxymeter might reduce the morbidity and mortality associated with occult CO poisoning in patients presented with suspected CO poisoning in emergency settings.

Keywords: Carbon monoxide poisoning; Emergency service; Noninvasive pulse CO-oxymeter; Occult.

MeSH terms

  • Adult
  • Blood Gas Analysis / methods
  • Carbon Monoxide Poisoning / blood
  • Carbon Monoxide Poisoning / diagnosis*
  • Carbon Monoxide Poisoning / epidemiology
  • Carboxyhemoglobin / metabolism*
  • Cross-Sectional Studies
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Morbidity / trends
  • Retrospective Studies
  • Survival Rate / trends
  • Triage / methods*
  • Turkey / epidemiology


  • Carboxyhemoglobin