Experience with pulse carbon monoxide oximetry for prehospital assessment of patients exposed to smoke from fires in closed spaces in Catalonia
Ferrés-Padró V, Sequera VG, Vilajeliu A, Vidal M, Trilla A
Affiliation of the authors
Grup dEmergències Mèdiques. Direcció General de Prevenció, dincendis i Salvaments de la Generalitat de Catalunya, Barcelona, Spain. Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Centro de Investigación en Salud Internacional de Barcelona (CRESIB), Universitat de Barcelona, Spain.
Ferrés-Padró V, Sequera VG, Vilajeliu A, Vidal M, Trilla A. Experience with pulse carbon monoxide oximetry for prehospital assessment of patients exposed to smoke from fires in closed spaces in Catalonia. Emergencias. 2015;27:23-6
Summary
Objective.
To describe the clinical characteristics of fire smoke inhalation victims and carboxyhemoglobin values (Sp-CO) recorded with a portable pulse carbon monoxide (CO) oximeter at rescue sites in Catalonia. To assess the contribution of SpCO information to decision-making during emergency transfers.
Methods.
Retrospective observational study. We included records for patients exposed to smoke in closed spaces at fires. The patients had been attended by the Catalan Emergency Medical Group (GEM) from January 2010 to December 2012. A logistic regression model included the following independent variables: sex, age, smoking status, known medical history, signs and symptoms of intoxication, burns, SpCO, and oxygen saturation. The dependent variable was the decision to transfer the patient to a hospital.
Results.
The GEM attended 331 victims; 6 died at the scene of the fire and 43.8 % (135/308) were transferred to a hospital. The cohort included 178 men (57.8% of 308), and 73.0% were between the ages of 18 and 65 years (216/296). SpCO levels were over 10% in 11.4% (35/308); the mean SpCO was 4.33% (95% CI, 3.65%-5.12%). The regression model identified the following variables associated with the decision to transfer the patient to a hospital: presence of burns (P=.014), signs (P<.001) and symptoms (P=.011) of intoxication, and SpCO value (P<.001). The odds ratio for SpCO 10% was 12.59 (95% CI, 4.32-36.69) in relation to transfer to a hospital.
Conclusion. Pulse CO-oximetry contributed to the prehospital emergency care of these patients by influencing the decision to transfer the patient to a hospital.
