2.50
Hdl Handle:
http://hdl.handle.net/10755/198341
Title:
Fighting Against a Known Killer: Screening for Carbon Monoxide
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Fighting Against a Known Killer: Screening for Carbon Monoxide

Purpose: To routinely screen all Emergency Department adult patients for carbon monoxide exposure. Carbon monoxide screening can identify patients with unsuspected carbon monoxide toxicity and provide an opportunity to educate patients about this odorless, colorless known killer.

Design: Patient Safety Initiative

Setting: Teaching, urban ED with over 52,000 annual visits.

Participants/Subjects: Adult patients presenting to the emergency department.

Methods: Emergency department nurses participated in a research study that was published in the Journal of Emergency Medicine in May 2008 titled “Non-Invasive Pulse CO-oximetry Screening in the Emergency Department Identifies Occult Carbon Monoxide Toxicity”. In this study, all patients presenting to the ED were screened using a non-invasive CO-oximeter which measures carbon monoxide and pulse oximetry. The study suggested that cases of carbon monoxide toxicity could be caught if ED patients routinely were screened for carbon monoxide. The study was concluded and the CO-oximeter was still available for use. Triage nurses began to routinely screen for both pulse oximetry and carbon monoxide. When the screening result is 10 or above, a carboxyhemaglobin is drawn to confirm carbon monoxide toxicity.

Results/Outcomes: When new unsuspected cases of carbon monoxide exposure were discovered, it invigorated the screening process. Nurses saw the value in screening everyone knowing that they didn’t send that patient or family back into an unsafe environment. The local fire departments gladly assist in evaluating homes when carbon monoxide is suspected. Since it does not take any longer to get a carbon monoxide level while obtaining a pulse oximetry reading, nurses aren’t hesitant to record both. It is a simple non invasive way to screen for a deadly killer. The research showed that this is a valid screening tool. Our results validate that lives can be saved by providing this screening. A patient presented with nausea and vomiting screened above 10. His wife asked if she could be screened and her result was high. The fire department was notified and found that there were toxic carbon monoxide levels in the house due to a faulty heating system. In another case a patient screened positive, the fire department confirmed high levels. The furnace was functioning fine, but the collapsed chimney lining was causing a build up of carbon monoxide. One woman was living in a basement apartment and the fire department found that exhaust fumes were entering her apartment. Screening was originally done during the winter months. When a new case was discovered inadvertently during the summer, screening became year round. In this case, the patient had a faulty oil-fired hot water heater. More CO-oximeters have been purchased to help meet the goal of screening all ED patients.

Implications: Carbon monoxide can kill. Carbon monoxide screening can save lives. Until there is a carbon monoxide detector in each home, ED nurses can provide a valuable way to both identify carbon monoxide toxicity and open a dialogue with the patient about the importance of having carbon monoxide detectors.


Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleFighting Against a Known Killer: Screening for Carbon Monoxideen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198341-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Fighting Against a Known Killer: Screening for Carbon Monoxide<br/><br/>Purpose: To routinely screen all Emergency Department adult patients for carbon monoxide exposure. Carbon monoxide screening can identify patients with unsuspected carbon monoxide toxicity and provide an opportunity to educate patients about this odorless, colorless known killer. <br/><br/>Design: Patient Safety Initiative<br/><br/>Setting: Teaching, urban ED with over 52,000 annual visits. <br/><br/>Participants/Subjects: Adult patients presenting to the emergency department. <br/><br/>Methods: Emergency department nurses participated in a research study that was published in the Journal of Emergency Medicine in May 2008 titled “Non-Invasive Pulse CO-oximetry Screening in the Emergency Department Identifies Occult Carbon Monoxide Toxicity”. In this study, all patients presenting to the ED were screened using a non-invasive CO-oximeter which measures carbon monoxide and pulse oximetry. The study suggested that cases of carbon monoxide toxicity could be caught if ED patients routinely were screened for carbon monoxide. The study was concluded and the CO-oximeter was still available for use. Triage nurses began to routinely screen for both pulse oximetry and carbon monoxide. When the screening result is 10 or above, a carboxyhemaglobin is drawn to confirm carbon monoxide toxicity.<br/><br/>Results/Outcomes: When new unsuspected cases of carbon monoxide exposure were discovered, it invigorated the screening process. Nurses saw the value in screening everyone knowing that they didn’t send that patient or family back into an unsafe environment. The local fire departments gladly assist in evaluating homes when carbon monoxide is suspected. Since it does not take any longer to get a carbon monoxide level while obtaining a pulse oximetry reading, nurses aren’t hesitant to record both. It is a simple non invasive way to screen for a deadly killer. The research showed that this is a valid screening tool. Our results validate that lives can be saved by providing this screening. A patient presented with nausea and vomiting screened above 10. His wife asked if she could be screened and her result was high. The fire department was notified and found that there were toxic carbon monoxide levels in the house due to a faulty heating system. In another case a patient screened positive, the fire department confirmed high levels. The furnace was functioning fine, but the collapsed chimney lining was causing a build up of carbon monoxide. One woman was living in a basement apartment and the fire department found that exhaust fumes were entering her apartment. Screening was originally done during the winter months. When a new case was discovered inadvertently during the summer, screening became year round. In this case, the patient had a faulty oil-fired hot water heater. More CO-oximeters have been purchased to help meet the goal of screening all ED patients. <br/><br/>Implications: Carbon monoxide can kill. Carbon monoxide screening can save lives. Until there is a carbon monoxide detector in each home, ED nurses can provide a valuable way to both identify carbon monoxide toxicity and open a dialogue with the patient about the importance of having carbon monoxide detectors. <br/><br/><br/>en_GB
dc.date.available2011-12-21T12:46:26Z-
dc.date.issued2011-12-21T12:46:26Z-
dc.date.accessioned2011-12-21T12:46:26Z-
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