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Updated: Aug 13, 2026
07:52
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Emergency department screening for unsuspected carbon monoxide exposure
T L Turnbull1, R G Hart, G R Strange
1University of Illinois Affiliated Hospitals Emergency Medicine Residency, Mercy Hospital and Medical Center, Chicago, Illinois 60616.
Annals of Emergency Medicine
|May 1, 1988
Summary
Routine screening for carbon monoxide (CO) exposure in emergency departments is not practical. Even targeted screening in high-risk patients yielded low rates of CO toxicity, suggesting it is not cost-effective.
Area of Science:
- Toxicology
- Emergency Medicine
- Public Health
Background:
- Carbon monoxide (CO) is a leading cause of toxic death in the US.
- Undiagnosed CO toxicity can result from unsuspected exposures.
- Screening high-risk populations for CO exposure may be beneficial.
Purpose of the Study:
- To evaluate the utility of screening emergency department (ED) patients for unsuspected CO exposure.
- To assess the effectiveness of CO breath analysis and COHGB levels in identifying CO toxicity.
Main Methods:
- A two-part study involving prospective CO breath screening of ED patients.
- Retrospective review of carboxyhemoglobin (COHGB) levels from arterial blood gas analyses.
- Analysis of a subgroup of patients selected based on chief complaint.
Main Results:
- Only 2.8% of 1,038 screened patients showed abnormal CO breath or COHGB levels.
- In a subgroup of 152 patients selected by chief complaint, 5.3% had abnormal values.
- Low yield suggests limited effectiveness of routine or selective screening.
Conclusions:
- Routine screening for unsuspected CO exposure in ED patients is not practical.
- While selective screening increases yield, it may not justify the screening process.
- Further research may be needed to identify cost-effective screening strategies for CO toxicity.
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