News | March 19, 2008

Study Finds Pulse CO-Oximetry Effective at Screening Unsuspected CO Poisoning in ERs

March 20, 2008 - A new clinical study recently published in the Journal of Emergency Medicine found the Masimo Rainbow SET Rad-57 Pulse CO-Oximeter to be an easy-to-use tool at triage to identify cases of unsuspected elevated levels of carbon monoxide (CO) poisoning that would otherwise have gone undetected.

Researchers at the Rhode Island Hospital, where the study was conducted, also concluded that universal SpCO screening may prevent morbidity through early identification and treatment intervention. The study's authors pointed to several cases where patient outcomes were different based upon availability of SpCO, recorded at triage.

The study titled "Noninvasive Pulse CO-Oximetry Screening in the Emergency Department Identifies Occult Carbon Monoxide Toxicity" was conducted over a nine-month period on more than 10,850 patients presenting to the Rhode Island Hospital Emergency Department in Providence, RI. It was conducted by a research team of emergency medicine physicians from the Warren Alpert Medical School at Brown University and the Emergency Department of Rhode Island Hospital, headed by Dr. Selim Suner.

Doctors tested the ability to screen for CO toxicity in a busy tertiary center ED using the Masimo Rainbow SET Rad-57 Pulse CO-Oximeter and found 28 cases of CO toxicity (SpCO of > 9 percent for nonsmokers and >13 percent for smokers), of which 11 were unexpected, and were identified only with the aid of universal SpCO screening. In all CO toxicity cases identified, venous or arterial COHb confirmations of elevated SpCO measurements were verified by lab analysis of blood samples taken with data results showing a good correlation between SpCO from the Masimo Rad-57 and COHb from the lab analysis.

The research team noted that identification of CO toxicity in the ED is often challenging because many patients may not know or suspect that they were exposed to CO and are unable to provide clinicians with sufficient history to prompt testing for carboxyhemoglobin (COHb). In addition, the symptoms of CO poisoning can be similar to the flu. However, missing the opportunity to diagnose CO poisoning at the ED because screening large populations of patients by invasive blood testing for CO toxicity is not practical and not routinely performed in the ED setting can lead to inadvertently returning a patient to the site of CO exposure.

Using data extrapolated from the study at Rhode Island Hospital's level-1 trauma center ED, researchers suggest that potentially as many as 11,000 occult poisoning cases go undetected annually.

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