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Three Part Question

In [adult burns patients with no factors suggestive of smoke inhalation] is [measuring COHb levels] [necessary]?

Clinical Scenario

A 65 year old female arrives to the emergency department following burns after falling asleep in front of a gas fire. She shows no signs suggestive of smoke inhalation, you wonder if it is necessary to measure her COHb levels.

Search Strategy

Medline using the OVID interface 1966-06/05
[exp BURNS, INHALATION/ or exp BURNS or burn$.mp or thermal burn$.mp] AND [exp Carbon Monoxide or carbon monoxide.mp] AND [carboxyhaemoglobin.mp or exp Carbon Monoxide/ or exp Carbon Monoxide Poisoning/ or exp Carboxyhemoglobin] LIMIT to human AND English language
EMBASE 1980-06/05
[exp BURNS, INHALATION/ or exp BURNS/ or burn$.mp. or thermal burn$.mp.] AND [exp Carbon monoxide/ or carbon monoxide.mp.] AND [carboxyhaemoglobin.mp. or exp Carbon monoxide/ or exp Carbon monoxide poisoning/ or exp Carboxyhemoglobin] LIMIT to Humans AND English Language

Search Outcome

183 papers were found in Medline of which none were relevant. 184 papers were found in Embase, none were relevant.

Comment(s)

It has been shown that in patients with factors suggestive of inhalation injury such as stridor or soot in the airway, COHb levels are elevated. This indicates it is necessary to measure COHb levels in these patients. Research needs to be carried out in adult patients with burns who have no factors suggesting inhalation injury to ascertain if it is necessary to measure COHb levels.

Clinical Bottom Line

There is no evidence available that answers this question.