An elderly couple is taken by ambulance to the emergency department after their son noticed that they were both acting “strangely”. The couple had been in good health prior to the weekend. Their son usually visits or calls them daily, but because of a terrible blizzard was not able to make it to their house. They had been snowed in their house until the snowplows cleared the roads. They had plenty of food and kept warm by a furnace and blankets. When the son was able to see them for the first time in two days, he noticed that they both were complaining of bad headaches, confusion, fatigue and some nausea. On arrival in the emergency department, both patients were afebrile (without fever) with normal vital signs. Their lips appeared to be very red. Both patients were slightly confused but otherwise oriented. The physical examinations were within normal limits. Carboxyhemoglobin levels were drawn and were elevated.
1.
What is the most likely cause of these patients’ symptoms??
2.
What is the biochemical rationale for 100% oxygen being the treatment of choice??
© Dr. Noel Sturm 2014