{"id":495,"date":"2021-02-15T16:39:22","date_gmt":"2021-02-15T16:39:22","guid":{"rendered":"https:\/\/www.bedfont.com\/wp\/?p=495"},"modified":"2021-02-15T16:39:22","modified_gmt":"2021-02-15T16:39:22","slug":"breath-analysis-to-screen-for-carbon-monoxide-poisoning-with-the-toxco","status":"publish","type":"post","link":"https:\/\/www.bedfont.com\/de\/breath-analysis-to-screen-for-carbon-monoxide-poisoning-with-the-toxco\/","title":{"rendered":"Breath Analysis to Screen for Carbon Monoxide Poisoning with the ToxCO\u00ae."},"content":{"rendered":"\n

Carbon monoxide (CO) poisoning is the most common cause of fatal accidental poisoning in the world. However, as it is colorless, odorless and tasteless, it can be difficult to detect. The standard procedure is to analyze the CO concentration in a blood sample, but this process is invasive and time consuming. The ToxCO\u00ae<\/sup> from Bedfont Scientific analyzes the concentration of CO in the breath to determine the CO concentration in the blood and enables rapid, non-invasive measurement at the scene. In addition, it has proven to be as accurate as the standard procedure and so has the potential for mass screening of CO poisoning either by use of the emergency services at the scene or by clinical professionals in hospitals to speed up diagnosis.<\/strong><\/p>\n\n\n\n

The Dangers of CO Poisoning<\/strong><\/h2>\n\n\n\n

Many homes still\nuse coal, oil and gas fires as a heating source, but these appliances can pose\na risk to life if they are not properly maintained or do not have sufficient\nventilation. Burning these fuels produces carbon dioxide and water, however, if\nthere is not a good enough supply of oxygen in the combustion process, carbon\nmonoxide can also be formed. CO is poisonous as it binds strongly to hemoglobin\nin the blood, blocking oxygen from attaching and stopping this essential gas\nfrom being transported around the body, which in severe cases can lead to\ndeath. One study found that at least 6% of gas appliances emit dangerous levels\nof CO and exposure is not limited to household items, idling vehicles and house\nfires also emit high levels of this poisonous gas. Unfortunately, CO is difficult\nto detect as it is a colorless, odorless and tasteless gas and so has been\nnicknamed \u201cthe silent killer\u201d.<\/p>\n\n\n\n

Low-level\nexposure to CO (>70 parts per million (ppm)) causes shortness of breath,\nmild nausea and headaches and is easy to mistake for the flu. Moderate levels\nlead to severe headaches, nausea, mental confusion and syncope. While, high\nlevels (>200 ppm) can result in seizures and death. Due it\u2019s difficult\ndetection and similarity with flu symptoms at low levels, it is often the\ncircumstances that give the clue towards diagnosis e.g. the symptoms abate when\nthe patient is outside. CO is the most common cause of fatal accidental\npoisonings around the world, with 50 people killed each year in the UK, but\nthese numbers are thought to be an underestimate as CO levels are not assessed\nin the 3,500 unexplained deaths that occur every year in the UK. Therefore,\nspeed and accuracy of CO poisoning is vital. <\/p>\n\n\n\n

Analysis of CO Levels<\/strong><\/h2>\n\n\n\n

Currently, the\nstandard method for diagnosing CO poisoning is to take blood from the patient\nand analyze the sample in a laboratory using a co-oximeter. A co-oximeter\nmeasures the absorption of light passing through the blood at several different\nwavelengths in order to determine the percentage of carboxyhemoglobin (%COHb). However,\nthis method is invasive as it requires a blood sample to be drawn from the\npatient, it takes a relatively long time to get the results and cannot be\nperformed at the scene by emergency services.<\/p>\n\n\n\n

Since 2010, the funding to the NHS in\nEngland has seen a decrease compared to historical norms, and with the cost of\ninpatient care ranging from \u00a3128 to \u00a39,892 per person (depending on the type of\npatient admitted), there is a strong drive to find initiatives that reduce\ncosts or improve the efficiency of health care services. A recent study published\nby the National Audit Office on the NHS ambulance services stated that the\nimplementation of new models of care avoided costs of admitting patients to hospitals\nby around \u00a363 million in 2015\u20132016. Therefore, the use of rapid, non-invasive\ninstruments to measure CO poisoning at the scene by first responders could\nreduce cost, time, and pressure on the inpatient health care. Pulse CO-Oximeters\u00ae<\/sup>\nwork in a similar way to standard co-oximeters as they also analyze the\nabsorption of the blood with different wavelengths of light, but by using the\npulse in a patients\u2019 finger. Masimo produce two Pulse CO-Oximeters\u00ae<\/sup>: The Rad-57\u00ae<\/sup>\nand Radical-7\u00ae<\/sup>. Another device, the ToxCO\u00ae<\/sup>, manufactured by Bedfont\u00ae<\/sup> Scientific\nLtd, is also able to non-invasively analyze CO levels by measuring the\nconcentration of CO in expelled breath as this correlates closely to the %COHb.\nBoth types of device eliminate the need to draw blood and produce results in\nseconds, enabling rapid assessment of CO poisoning by the first responders of\nthe emergency services, potentially reducing the number of admissions to\nhospitals. <\/p>\n\n\n\n

It is essential that these non-invasive\ninstruments deliver accurate data that can be trusted by the emergency services\nand clinicians. In 2014, Tseona compared the accuracy of these non-invasive\ndevices to the standard CO blood analysis using a Siemens RapidPoint 500\nmachine. Each patient that took part in the study had a blood sample drawn,\nfollowed immediately assessment with the Rad-57\u00ae<\/sup>, Radical-7\u00ae<\/sup> and ToxCO\u00ae<\/sup> to\nensure the %COHb data for each technique was taken at the same time point and\ncould be compared. The results found that the %COHb ToxCO\u00ae<\/sup> data was comparable\nto the RapidPoint 500 invasive CO blood analysis, whereas the Rad-57\u00ae<\/sup> and\nRadical-7\u00ae<\/sup> gave significantly different results. These data indicate the ToxCO\u00ae<\/sup>\nis more statistically accurate for determining CO levels in potential poisoning\ncases compared to the Rad-57\u00ae<\/sup> and Radical-7\u00ae<\/sup>.<\/p>\n\n\n\n

The Non-Invasive ToxCO\u00ae<\/sup><\/strong><\/h2>\n\n\n\n

The ToxCO\u00ae<\/sup> is designed to determine CO\nlevels in all possible environments as it comes with three sampling modes; a\nmouthpiece for conscious patients, a face mask for unconscious patients and\nambient monitoring to allow potentially fatal levels of CO in the air to be\ndetected. In addition, the device monitor has SteriTouch\u00ae<\/sup> technology and single-use\nSteribreath™<\/sup> mouthpieces are used\nto improve infection control. <\/p>\n\n\n\n

The ToxCO\u00ae<\/sup> has been designed to be quick\nand easy to use, with visual prompts to ensure accurate results are obtained.\nThe results are given as a green\/amber\/red signal, along with audible beeps for\neasy interpretation. In 2016, Smereka assessed the ability of 47 firefighters\nto identify potential CO poisoning and their use of the ToxCO\u00ae<\/sup> to examine\npatients. After training, the firefighter knowledge of CO poisoning increased, and all firefighters were proficient with\nimplementing the ToxCO\u00ae<\/sup> if CO poisoning was suspected. In\naddition, the device is small, portable and does not need to be plugged in\nduring analysis. <\/p>\n\n\n\n

Rapid Assessment of CO Poisoning <\/strong><\/h2>\n\n\n\n

As most cases of CO poisoning occur in the home and high levels can be fatal, it is essential that levels of this toxic gas can be assessed by first responders from the emergency services. The use of the ToxCO\u00ae<\/sup> enables an accurate, rapid and non-invasive method of determining a patient\u2019s CO levels at the scene, allowing treatment to be administered quickly and appropriately, and potentially reducing the number of admissions to hospitals. Due to the comparable accuracy of the ToxCO\u00ae<\/sup> to the standard invasive CO blood analysis, it could also be beneficial in clinical settings to increase the speed of analysis and reduce the burden on hospital laboratories. Furthermore, ToxCO\u00ae<\/sup> is able to perform environmental sampling and could be placed in residential housing to warn individuals if CO levels reach dangerous levels. A 2009 study by the UK Department of Communities and Local Governments found if CO detectors were installed in a dwellings containing a combustion device, in a similar approach to smoke detectors, the cost to roll out this initiative would be outweighed by the reduction in  incidents. Therefore, the implementation of a non-invasive, rapid, and accurate CO measurement in any or all of these settings can reduce the time, cost, and pressure placed on NHS emergency and inpatient services.<\/p>\n\n\n\n

References and Further Reading<\/strong><\/h2>\n\n\n\n
  1. Bebout D.E et al. <\/em>(2009). Performance Observations of the Rainbow\n\u201cPulse CO-Oximeter\u201d. Neonatal Intensive Care. https:\/\/www.nicmag.ca\/pdf\/NIC-22-1-JF09-web.pdf<\/a><\/li>
  2. West Yorkshire Health Protection Unit (2010). Silent Killer.<\/li>
  3. Smereka J. et al.<\/em>\n(2016). The Ability of Firefighters to Recognize Carbon Monoxide Poisoning.\nAmerican Journal of Emergency Medicine. Doi: https:\/\/www.ajemjournal.com\/article\/S0735-6757(16)30238-8\/fulltext<\/a><\/li>
  4. United States Consumer Product Safety Commission. (2020). Carbon\nMonoxide Questions and Answers. https:\/\/www.cpsc.gov\/Safety-Education\/Safety-Education-Centers\/Carbon-Monoxide-Information-Center\/Carbon-Monoxide-Questions-and-Answers<\/a><\/li>
  5. Tseona S.S. (2014). Carbon\nMonoxide Monitoring. Millersville University Respiratory Therapy.<\/li>
  6. ToxCO\u00ae<\/sup>. (2020). Bedfont\u00ae<\/sup>\nScientific Ltd. https:\/\/www.bedfont.com\/toxco<\/a> <\/li>
  7. NICE Guidelines for Carbon Monoxide Poisoning https:\/\/cks.nice.org.uk\/carbon-monoxide-poisoning#!scenario<\/a><\/li>
  8. CO-gassafety.co.uk. (2020). Statistics of Deaths and Injuries. https:\/\/www.co-gassafety.co.uk\/information\/co-gas-safetys-statistics-of-deaths-and-injuries\/<\/a><\/li>
  9. Dreyer K. (2019). A Descriptive Analysis of Health Care Use by\nHigh-Cost, High-Need Patients in England. https:\/\/www.health.org.uk\/sites\/default\/files\/upload\/publications\/2019\/Health-care-use-by-high-cost-high-need-patients-WP07.pdf<\/li>
  10. Nao.org.uk. (2017). NHS Ambulance\nServices. National Audit Office. https:\/\/www.nao.org.uk\/wp-content\/uploads\/2017\/01\/NHS-Ambulance-Services.pdf<\/a><\/li>
  11. Communities.gov.uk. (2009). Study\non the Provision of Carbon Monoxide Detectors Under the Building Regulations.\nDepartment for Communities and Local Government. webarchive.nationalarchives.gov.uk\/20120919132719\/http:\/\/www.communities.gov.uk\/documents\/planningandbuilding\/pdf\/1324663<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    Carbon monoxide (CO) poisoning is the most common cause of fatal accidental poisoning in the world. However, as it is colorless, odorless and tasteless, it can be difficult to detect. The standard procedure is to analyze the CO concentration in a blood sample, but this process is invasive and time consuming. The ToxCO\u00ae from Bedfont […]<\/p>\n","protected":false},"author":6,"featured_media":496,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-495","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nBreath Analysis to Screen for Carbon Monoxide Poisoning with the ToxCO\u00ae. - Bedfont Scientific Ltd.<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bedfont.com\/de\/breath-analysis-to-screen-for-carbon-monoxide-poisoning-with-the-toxco\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Breath Analysis to Screen for Carbon Monoxide Poisoning with the ToxCO\u00ae. - Bedfont Scientific Ltd.\" \/>\n<meta property=\"og:description\" content=\"Carbon monoxide (CO) poisoning is the most common cause of fatal accidental poisoning in the world. However, as it is colorless, odorless and tasteless, it can be difficult to detect. The standard procedure is to analyze the CO concentration in a blood sample, but this process is invasive and time consuming. 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