Q:
Dear Your ER Doc:
I have seen you write about the dangers of carbon monoxide poisoning before. I recently read an article where victim’s were taken to a hospital that had specialized facilities for treating this condition. Can you explain what these are and if they are common at most hospitals?
A:
Carbon Monoxide poisoning is usually treated by high-flow (100%) oxygen. All hospitals have the capability for administering oxygen to patients who have been exposed to carbon monoxide. Occasionally, severe cases of carbon monoxide poisoning are treated in Hyperbaric chambers.
Patients can be placed in these chambers where they can breath oxygen that is at higher than atmospheric pressure. Most hospitals do not have hyperbaric chambers, but patients may be transferred to a hyperbaric center if necessary.
In a new, landmark study in the New England Journal of Medicine, medical doctors in England were determined to have substandard IQ’s.
According to Niles Schmitty, MD, the study’s lead author, “Most British docs are basically as dumb as a box of rocks.” Thanks for the heads up Dr. Schmitty.
YourERdoc is under attack. Apparently my posting “British Doctors are Lardos” struck some kind of a nerve with my chubby colleagues from across the pond. They are demanding a retraction forthwith, or will retaliate by flying over the United States dropping used fast food wrappers on us until we suffocate.
So, let me waste no time in saying that I sincerely apologize to the Brits for any offense given. Although we are separated by thousands of miles of ocean, our hearts are one.
Several media sources have been reporting on the high probability of post-traumatic stress disorder (PTSD) occurring in those passengers who were on board the US Air jet that recently crashed into the Hudson river. Clearly, some of the passengers will have problems with anxiety, depression and insomnia after such a horrifying near death experience, but which ones?
The passengers who are most at risk are women, those with substance abuse problems, and believe it or not, a family history of post traumatic stress. Also, individuals who were able to assist other passengers and generally help out in the emergency situation are less likely to suffer from PTSD. Most of the people who end up with PTSD symptoms will develop them within about 3 months, but it could happen later.
Fortunately, there are very effective treatments for PTSD, including medications and counseling, so these passengers should seek assistance for any problems they may have, rather than simply “toughing it out.”
Q:
Can you tell me more about sulfite sensitivities and any symptoms which may accompany a reaction? Thanks for your insight into ER medicine. Always informational and some times quite humerous.
Shelly
West Covina , CA
A:
Great question Shelly!
In the ER we see patients with allergic reactions all the time, and a large percentage of the time, we can’t figure out what caused it. This is because there are so many different potential sources of allergy out there (food, medications,plants, animals, detergents, mold, etc.). Sulfites are yet another possible source of allergic reaction, and one that we often forget to consider.
People can develop sensitivities to sulfites at any point, and about 1 percent of the population tends to be affected. It used to be common to spray fresh produce with sulfites and this practice has now been banned. Food that contains sulfites must have it listed on the ingredient label now. Those who are sensitive might develop asthma symptoms, GI upset, rash, or even severe allergic reactions like anaphylaxis. If you suspect you may have a sensitivity to sulfites, or other allergies, I would recommend evaluation by an allergist. They can help identify what is causing your symptoms and suggest a treatment plan.
Thanks for the question!
