It has been a few days since our last blog and two more news stories have hit the national news about carbon monoxide poisoning. The first involved what seems to be good news, the second tragedy. Both may have far more tragic results than appears at present. The good news story involves a family of six in Anchorage, Alaska, who hit a snow bank when the driver succumbed to carbon monoxide poisoning. All lived. The tragic story involves a case of hotel negligence in Allentown, PA where one died and nine were sickened by carbon monoxide exposure.

While it doesn’t now appear to be what happened here, the Anchorage story highlights a serious risk this time of year: keeping a car running when it isn’t moving in hopes of staying warm. Any time car exhaust is not properly vented, there is some risk of carbon monoxide exposure. Of course, if you are sitting in a car in severe cold, the need may exist to keep the engine running to avoid freezing to death. But if something could obstruct the tailpipe, such as the snow, the moderate risk of danger and could become potentially catastrophic. Click here for the latest on the Anchorage story.

The Allentown, Pennsylvania story is all too familiar. A hotel does something stupid with the maintenance or design of their HVAC system, fumes go the wrong place, and a building full of people are at risk. In this case, workers doing construction on the outside of the hotel had erected a plastic tent-like canopy near the spot where the heaters were vented. http://ap.google.com/article/ALeqM5gH8Dl-4pgpAT5njFHZuEQVlCzLjwD8U8I1MO1

Making the hotel exposure cases even more outrageous, hotels refuse to put carbon monoxide protectors in each room. Only four states currently require carbon monoxide detectors in hotels, and none in each room. A recent study showed that only 11% of hotel chains that had had a carbon monoxide poisoning incident, had put in CO detectors, in each room, AFTER THE EXPOSURE. Such foolish risking of human lives must stop.

Perhaps even more troubling about these two incidents, is that the good fortune of the 15 survivors, may be an illusion. Carbon monoxide poisoning comes with it the risk of something called Delayed Neurological Sequelae, or DNS. Despite the apparent full recovery at the time of discharge from the hospital, the CO gases continue to attack the brain. Behavioral and neurologic deficits can arise or worsen two to 40 days after the exposure. Often times a patient is discharged from the hospital after initial evaluation, to have a severe relapse of symptoms, from this escalating pathology. The toxic effects of CO poisoning continue to attack the neurological system and particularly the brain, for many weeks after the initial exposure. This syndrome can materialize as almost any neurological or behavioral symptom, including memory loss, confusion, seizures, urinary incontinence, loss of bowel function, disorientation, hallucinations, psychosis and balance and dizziness. Click here for more information on DNS.

We don’t know what discharge warnings were given to these 15 individuals, but in our opinion, they should be required to follow up periodically with experts in CO exposure and have a repeat MRI done, at least once, to see if they have any signs of DNS. This is particularly true if the CO exposure caused a loss of consciousness, which it appeared to do in each case. As said in the Anchorage Daily New Story: “When officers arrived, the six occupants were either unconscious or unresponsive.” That is not the time to treat at the scene and send on their way. It is time to begin a careful monitoring to fully assess and possibly head off, the severe neurological attack that may lie in wait.

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