Citation

Chua IS, Tan KB, Ponampalam R. Singapore Med. J. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Singapore Medical Association)

DOI

10.11622/smedj.2021217

PMID

34823325

Abstract

Carbon monoxide (CO) is dubbed the silent killer as it is colourless, odourless and tasteless. Clinical symptoms are non-specific and many patients are unaware that they have been exposed until a CO detector alarms or when the patient presents to the hospital and is found to have an elevated carboxyhaemoglobin (CoHb) level. CO is produced from the incomplete combustion of hydrocarbons and malfunctioning heating systems, improperly ventilated vehicles, generators, grills, stoves and residential fires are common sources of CO poisoning.(1) Anybody is at risk of CO poisoning and vulnerable groups like infants, elderly and those with chronic medical issues are especially at risk. More than 400 Americans die from unintentional CO poisoning not linked to fire annually, more than 20000 end up in the emergency department and more than 4000 are hospitalised.(2) An American study found that majority (72.8%) of CO exposure occurred in homes; only 13.4% of CO poisoning were work related.(3) Locally, the most common cause of accidental CO poisoning was smoke inhalation from faulty vehicles (33%), followed by house fire (25%).(4)

The incident described here occurred in a restaurant in Singapore in 2016, where some workers suffered CO poisoning due to a malfunctioning ventilation system in the kitchen. Thirty patients were sent to our Emergency Department (ED) which was closest to the incident site and which also houses the only Burns Unit in Singapore. Box 1 summarises the learning points from this incident...

Language: en