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. 2019 May;20(3):506-511.
doi: 10.5811/westjem.2019.2.41428. Epub 2019 Apr 16.

Availability of Bedside and Laboratory Testing for Carbon Monoxide Poisoning in the Upper Midwestern United States

Thomas Masters  1 , Brian Willenbring  1 , Bjorn Westgard  1 , Jon Cole  1 , Stephen Hendriksen  1 , Joseph Walter  1 , Christopher Logue  1 , Travis Olives  1
Affiliations

Availability of Bedside and Laboratory Testing for Carbon Monoxide Poisoning in the Upper Midwestern United States

Thomas Masters et al. West J Emerg Med. 2019 May.

Abstract

Introduction: The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states.

Methods: We surveyed hospitals in three states. Telephone queries assessed processes for measuring carboxyhemoglobin, including capacity for real-time vs send-out testing. Facilities were separated based on their location's population size for further analysis. Descriptive statistics are reported.

Results: Of the 250 hospitals queried, we ultimately excluded 25. Nearly all (220, 97.8%) reported a process in place to test for CO exposure. Over 40% (n=92) lacked real-time testing. Testing ability was positively associated with increasing population size quartile (range 32.6% - 100%). Hospitals in the lowest-quartile population centers were more likely to report that they were unable to test in real time than those in the largest-quartile population centers (67.4% vs 0%).

Conclusion: In a large geographic region encompassing three states, hospital-based and real-time capacity to test for CO exposure is not universal. Hospitals in smaller population areas are more likely to lack real-time testing or any testing at all. This may have significant public health, triage, and referral implications for patients.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure 1
Figure 1
Study flow diagram of hospital capability to test for carbon monoxide poisoning.
Figure 2
Figure 2
Distribution of responding hospitals and real-time carboxyhemoglobin monitoring by community size. CO, carbon monoxide.
See this image and copyright information in PMC

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