16% CO level per life pack 15

[Iowa Medic]

Called to a seizure today (patient has hx of seizure) and nothing out of the ordinary with regard to the seizure.

Patient was postictal upon our arrival, vitals normal minus an elevated pulse but when I put the Pulse Ox on the patient which is equipped to read CO levels as well it registered at 16%.

Patient came around and was alert/oriented x 4

I called the FD to come down and test the levels at the scene which were normal. Continued to monitor the patient with our LP 15 in the hospital and it did decrease but remained above 10 throughout my shift. (I was only there about 20 minutes after dropping patient off)

I apologize as I have no ABG's to report.

Sinus Tach on the monitor, 12 lead showed no abnormalities minus sinus tach, Blood glucose 147, Patient was african american but mucous membranes were not red, patient denies head aches, incontinence or other S/S of CO poisoning.

I placed the pulse ox on myself and it read 0% CO, I then placed it on a smoker at the hospital and it read 4% which indicates to me the machine was working appropriately.

Any ideas what may have caused the elevated CO levels?

Patient had been at the location where she had the seizure and the CO levels were reported to be normal for approximately 6 hours.

Any ideas?

[island emt]

History of Sickle Cell ???

[Iowa Medic]

Patient is African American but did not include Sickle Cell in past medical history and by the time we arrived at the hospital patient was a decent historian with regard to her medical history.

[island emt]

Just a thought as sickle cell anemia would alter the red blood cells that the masimo rad technology uses to measure CO.

[Iowa Medic]

Wow, thanks for the information... I was unaware of that

[island emt]

I think it was when they were testing the Masimo waveform they found that some blood diseases would alter their results.

I remember reading something about it years ago before we bought a RAD -57 monitor.

[systemet]

I think there's a fairly poor correlation between the RAD-57 cooximetry and SpCO on ABG, so this may have been a false positive. The troube is, when you see that sort of number, you have to assume that something real is happening until you get a clean ABG.

AaOX4, and in no distress, at an SpO2 of 84% doesn't quite jive, even if the patient had pre-existing pulmonary disease. So, at the very least, it's probably false-high. Any chance that you can follow up with the ER and see what they got on ABG?

[systemet]

AaOX4, and in no distress, at an SpO2 of 84% doesn't quite jive, even if the patient had pre-existing pulmonary disease.

I realised that this sentence is confusing. What I meant, was --- if you consider that there's 16% dysfunctional CO-Hgb, then the patient has an effective SpO2 of 84%. If you had a chronic lung disease patient with an SpO2 of 84%, you might expect the odd patient to still be GCS 15, but they would likely be showing signs of distress at this point.

If you take someone healthy and acutely drop their SpO2 to 84% they're going to be all sorts of sick. Sorry for any confusion.

[Just Plain Ruff]

Have you checked the machine on multiple other people?

That reading may have been an anomaly on that patient only.

I would do a control on two or three of your machines.

Test it on your department members documenting the readings.

If this suspect machine is the only machine showing off whack readings then send it to the manufacturer for repair or recalibration.

If it's showing consistent high CO readings for all your staff then call physio and ask them what could be causing it.

[Iowa Medic]

Sorry, been working the last couple days...

Took readings of multiple other people to find 0 % on non smokers and 4-6% on smokers. I also tried a different machine to get similar readings with the reading only changing a % or 2 on other machines.

I did speak with a physician that stated the exhaust fan that leaks will cause the person to be subjected to relatively high CO levels but only when the exhaust fan is kicked on which could lead to a normal CO level when readings were taken if said exhaust fan wasn't on at the time.