Case studies on carbon monoxide intoxication
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A husband and wife presented with vomiting, abdominal pain, and headache after eating fish. Their vitals were stable. Blood tests found elevated carboxyhemoglobin. A father and son were found unconscious at home along with the dead body of the father's brother. They had low blood pressure and pulse and abnormal blood gases. The document provides several case studies about patients presenting with carbon monoxide poisoning. It asks a series of questions about differential diagnoses, emergency treatments, complications, and follow up recommendations for patients with varying symptoms and test results.
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Case studies on carbon monoxide intoxication
- 1. By Kerolus Ekram Gad Shehata • PGY-III IM Resident, Ain Shams University • ECFMG certified Case studies on Carbon Monoxide Intoxication
- 2. A husband and his wife presented via the EMS C/O vomiting 2 times, abdominal pain and headache after eating a fish meal at home. Abdominal PE was WNL. Chest was clear without fever. Both are A/O TPP B.P: 120/75, Pulse: 75, RR: 19 ABG: PH: 7.32, PCO2: 36, HCO3: 18, PO2: 91, SaO2: 95 What is your differential? What is the first thing to do? What medication would you give? What if the husband had a HX of IHD? What if the husband was dizzy and confused? What if the B.P of the husband was 140/90? What if the B.P of the wife was 80/50? What if the PH: 7.29, HCO3: 16, Pco2: 34? Will you recommend HBO afterwards? Will you recommend follow up?
- 3. M and F were found in a coma at home while husband’s older brother was bathing (later found dead at the scene). The father have vomited twice before passing out. GCS: 7, chest: Bilateral crepitations, pulse is faint, Pupils: mid-dilated and non-reactive B.P: 80/50, Pulse: 74, RR: 14 ABG: PH: 7.19, PCO2: 54, HCO3: 14, SaO2: 92, PO2: 89 What is the first thing to do for both of them? What is the main reason for ICU admission? How would you correct this metabolic acidosis? What if you find depressed T- wave on the ECG? Will you administer nitroglycerine? What is the complication that may have already occurred in the lungs? What if you find the PO2/Fio2 < 200/300? What if the GCS didn’t improve for 6 days in the ICU? You suspect……… If both are improved, will you recommend HBO?