Assessment of carbon monoxide inhalational poisoning in flame burned patients at a Kenyan National Hospital

Abstract

Background: Victims of flame burns invariably inhale smoke which contains potentially toxic gases that may contribute to their morbidity and mortality. The most significant inhalational toxin in many fires is carbon monoxide (CO). This study aimed to assess clinical evidence for possible CO poisoning and measure Carboxyhemoglobin (COHb) levels on fire casualties presenting to a tertiary teaching and referral hospital in Kenya. The gold standard, serum COHb spectrophotometry was unavailable hence pulse CO-oximetry was utilised to measure carboxyhemoglobin saturation (SpCO). Methodology: This was a prospective descriptive study. It was approved by institutional ethics committee. Eighty non-pediatric patients presenting with acute (10% indicating CO toxicity. However, the majority recorded nontoxic levels of <10% on a background of a relatively long time lapse. Neither clinical symptoms nor mortality could be ascribed to carbon monoxide exposure. %TBSA, GCS and oropharyngeal injury correlated significantly with mortality.

Keywords

• Carbon monoxide
• Smoke inhalation
• Poisoning
• Flames
• Burns