Case Conclusion
Through the rapid identification of CO poisoning in this elderly patient with altered mental status, EMS was able to evacuate the building while bringing the elderly tenant and her home attendant to the ED.
Based on the elderly patient’s elevated HbCO level, she was treated with O2 and discharged from the hospital the following day feeling well. In addition to the patient’s symptoms, when the aide was interviewed, she reported that she had been experiencing daily headaches, which she said soon resolved on departure from her client’s house. Her symptoms had been bothersome, but not so severe as to prompt her to seek medical attention. The aide was found to have an HbCO level of 12.5% and was discharged from the ED after 6 hours of observation and O2 therapy. The third occupant of the building, a tenant, was also brought to the ED and found to have an HbCO level of 12%. The tenant was treated with O2 therapy and discharged to home.
Dr Caldwell is an assistant professor of medicine in the department of emergency medicine, New York Presbyterian Hospital/Weill Cornell Medical Center, New York. Dr Rao is an assistant professor of emergency medicine; and the chief in the division of medical Toxicology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York. Dr Stern is an assistant professor of medicine, department of emergency medicine; chief of geriatric emergency medicine; and codirector of geriatric emergency medicine fellowship at New York Presbyterian Hospital/Weill Cornell Medical Center, New York.