Severe winter weather, such as ice storms, that results in loss of electrical power, is frequently mentioned as a contributing factor in acute carbon monoxide (CO) poisoning. However, in our literature review, such events are infrequently reported. This article reports on such an event in which more than 200 patients were evaluated and treated at a single facility because of the crippling effects of an ice storm leading to prolonged loss of power and subsequent catastrophes with alternative heating and cooking sources. One hundred seventy-six patients were treated and subsequently released after Emergency Department-based treatment for CO exposure, and three patients were admitted. Eighteen patients were treated with hyperbaric treatments and discharged. Three others left before treatment was completed. Three cases representing varying levels of severity at presentation leading to differing treatment algorithms are discussed to demonstrate a suggested clinical decision pathway in the treatment of unintentional CO poisoning.
* A North Carolina ice storm of 2002 resulted in the presentation of more than 200 patients with carbon monoxide poisoning to the Duke University Medical Center Emergency Department.
* Three cases illustrating the varying severities of presentations and differing treatments are presented.
* A potential algorithm for triage and treatment of carbon monoxide poisoning using current recommendations is discussed.
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