Les;
I do a lot of post mortem HbCOs. When you get levels of >60% on both of an
elderly couple found dead at home in June, it tend to give you a VERY low
threshold for suspicion. If someone complains of the non specific symptoms
of CO poisoning at home and the hare is raised, the possibility should be
totally excluded. The Gas suppliers will be very helpful, also a lot of
CCDC's may be prepared to help.
Also don't forget CO in the differential diagnosis of silent MI or stroke in
the elderly.
Robert Forrest
> -----Original Message-----
> From: clinical biochemistry discussion list
> [mailto:[log in to unmask]]On Behalf Of Les Culank
> Sent: 20 June 2002 12:15
> To: [log in to unmask]
> Subject: Re: COHb
>
>
> Dear Mike,
>
> Like you (& many others) we also get the odd query about GPs' patients'
> exhaust fumes as a CO risk factor.
>
> Occasionally it is appreciated if we suggest additional measures eg:-
>
> 1) they can seek advice from the gas people etc
>
> 2) they can get CO testing devices, both cheap ones & more sophisticated,
> from their local supermarket &/or DIY store.
>
> Best wishes,
>
> Les
>
>
>
> > From: "Guillain Mike (RTF) NHCT"
> > <[log in to unmask]>
> > Reply-To: "Guillain Mike (RTF) NHCT"
> > <[log in to unmask]>
> > Date: Thu, 20 Jun 2002 11:00:46 +0100
> > To: [log in to unmask]
> > Subject: Re: COHb
> >
> > We often receive samples from GP's taken because the patient
> believes that
> > they have a faulty flue, a common problem in rural Northumberland. The
> > problem here is the time it takes for the patient to see the GP. The
> > elimination half life for HbCO is about 250 minutes, breathing
> room air. So
> > although the patient describes plausible symptoms the HbCO is often less
> > than 5%.
> >
> > We have never encountered stability problems with delayed transit of the
> > specimen, taken from patients. PM samples are a different
> storey. There is
> > often significant anaerobic oxidation after death which may give rise to
> > slight elevations in cadaveric blood samples.
> >
> > Mike Guillain
> > Principal Biochemist
> > Wansbeck General Hospital
> > +44(0)1670529713 (voice)
> > +44(0)8701358380 (fax)
> > [log in to unmask]
> >
> > -----Original Message-----
> > From: [log in to unmask] [mailto:[log in to unmask]]
> > Sent: 20 June 2002 10:39
> > To: [log in to unmask]
> > Subject: COHb
> >
> >
> > Is there a time limit within which a sample taken for COHb should be
> > analysed
> > eg if a GP suspects CO poisoning and the sample takes a few
> hours to get to
> > the lab in the van!?
> >
> > Thanks
> >
> > Rob L
> > Dr Robert Lord
> > Department of Clinical Biochemistry
> > Rotherham District General Hospital
> > Moorgate Road
> > Oakwood
> > Rotherham
> > S60 2UD
> >
> > Tel 01709 820000
> >
> > E mail [log in to unmask]
> >
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