| Learning Objective #1: Describe the various types of products considered hydrocarbons and why an exposure is a serious event | |||
| Learning Objective #2: Correlate the use of pulse oximetry in assessing patients who are suspected to have a hydrocarbon pneumonitis |
Objective: To evaluate pulse oximetry in predicting pulmonary toxicity as compared to chest radiograph in the emergency department(ED)of patients with suspected hydrocarbon pneumonitits. Methods: a retrospective review of hydrocarbon exposures, inhalation or ingestion, evaluated in an ED were eligible for the study. Patients that had pulse oximetry as part of their overall evaluation were selected. Charts were reviewed for the following variables: demographics, nature of the exposure, clinical presentation, laboratory studies, ED management, and outcome. Symptoms of toxicity were classified as; respiratory (dyspnea, choking, wheezing, tachypnea), oral irritation (coughing), and neurological (dizziness, drowsiness,loss of consciousness). Presence of pulmonary toxicity symptoms were summed and the differences between the two groups (pulse oximetry values and chest radiograph results) were assessed with a 2-tail t-test (p<0.05). Results: There were 171 patients collected over a 42 month period. Seventy-nine patients(46%) had symptoms of pulmonary toxicity in the ED. One-hundred and sixteen patients (68%) were < or = to 12 years of age. Fifty-five patients (32%) were >12 years of age. Patients with pulse oximetry < or = to 93% (n=18) had more symptoms (p 0.001) than patients with pulse oximetry >93% (n=153)\. Nine patients (5%) had a positive chest radiograph with a pulse oximetry < or = to 93%. Symptoms of toxicity correlated best with chest radiograph results (p 0.0001). Pulse oximetry correlated with chest radiograph results (p 0.001). Arterial Blood gas results did not correlate with: symptoms of toxicity in the ED, chest radiographs, or pulse oximetry readings. Forty-two patients (24.6%) were admitted to the hospital. Conclusion: Patients seen in the ED with suspected hydrocarbon pneumonitis with a pulse oximetry of < or = to 93% had more symptoms and were more likely to have a positive chest radiograph.
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