Question

Jack had been working on his gas furnace all afternoon. He finally thought that he fixed the old, dilapidated furnace. It was going to get really cold that evening so he wanted to make sure that the furnace would keep them warm all night.

Jack went to bed at 11:00 p.m. as usual but he noticed that he had a slight headache before going to bed. He just thought that he needed to sleep. His wife and kids also had complained of having a headache that evening.

Jack woke up at 4:00 a.m. feeling extremely nauseous and his head was pounding. He got out of bed to go get some aspirin. When he got up, he stumbled about, feeling as if he was going to pass out. He nudged his wife to see if she would get him some aspirin. She didn’t move. He called out her name and nudged her again. She still didn’t move.

In a panic, he grabbed the phone and dialed 911. The operator answered and Jack yelled, “It’s my wife, she won’t get up!”

The operator replied, “Sir, what is your address?”   There was no response.   “Sir?!?”

The emergency personnel arrived at the scene. Upon entering the house, they found 4 individuals unconscious in 3 different bedrooms. They were still breathing but barely.

As the emergency personnel were assessing the situation, they themselves started to feel nauseous and felt as if they were going to pass out. They moved quickly and made sure that everyone was out of the house.

As soon as everyone was out of the house, the emergency personnel started to feel better again.   Jack and his family were given oxygen on their way to the hospital. At the hospital they did a battery of tests and everything looked fine except for their COHb levels which were 30%.

1. What was wrong with Jack and his family?

2. What are normal COHb levels?

3. What treatment should Jack and his family be given?

4. What may be the cause of their high COHb levels?

5. Why does high COHb levels cause the symptoms that Jack and his family experienced?

Answer 1

a) Jack and his family were badly affected by the release of gas inside their house from the dilapidated furnance which jack was working on the whole day to make it workable during night. Because of inhalation of gas the COHb levels of all the family members increased which causes lack of oxygen in blood and causes them to suffocate and fainted them finally.

b) Normal COHb levels: Best evidence quoted by the experts suggests that the upper limit of normal COHb should be set at between 2 and 3 % for non-smokers and between 7 and 9 % for non-smokers.

c) Treatment : Jack and his family should be provided with adequate amount of oxygen to fulfill the requirements of oxygen in the entire body to suffice the areas lacking oxygen in the blood. once there will be more oxygen then COHb level will be reduced and patient will come back to normal state.

d) Cause of high COHb levels: Breathing air polluted with high CO content – carbon-monoxide poisoning. This is clinically the most significant cause of increased COHb for two reasons. First it is a more common cause of increased COHb than endogenous production of CO, and secondly it can result in a much more severe increase in COHb.

e) Symptoms: Abnormally high or low COHb can cause symptoms like exhaustion, dizziness, or shortness of breath. Jack and his family experienced shortness of breath and dizziness because of high level of COHb in the blood.