NON-ACCIDENTAL CARBON MONOXIDE POISONING BY BURNING CHARCOAL
Lee
ACW1, Ou Y1, Lam SY1, So KT1,
Kam CW2.
1Department
of Paediatrics and 2Accident & Emergency Department, Tuen
Mun Hospital, Hong Kong, China
Objective:
To describe an emerging form of serious child abuse in Hong Kong in which
children were poisoned with carbon monoxide when their parents attempted
suicide by burning charcoal in an enclosed apartment.
Methods:
This is a retrospective hospital chart review on the children who had been
exposed to carbon monoxide when their parents attempted suicide by burning
charcoal were retrieved. The clinical features, social background,
interventions and outcome were described.
Results:
Eight children, 3 girls and 5 boys, from four families were identified.
They had a mean age of 7.8 (range 0.5 – 11) years. A 7-year-old boy died on
arrival. His 5.6-year-old sister and a 6-month-old boy had symptoms and
signs of cerebral hypoxia on admission. The other children were
asymptomatic. Carboxyhaemoglobin was elevated in both of the symptomatic
children. Concomitant use of sedatives was also detected in the comatose
girl and another two apparently normal children. Hyperbaric oxygen therapy
was given to both of the symptomatic cases with rapid neurological improvement,
although the girl showed signs of neurological deficit on discharge. All
children came from functionally single-parented families. Two of the
parents had acute depressive illnesses, and another had depression and
alcohol abuse. The immediate precipitating events were apparently related
to an impending break down of an existing intimate relationship.
Conclusions:
Non-accidental poisoning with carbon monoxide appears to be a new means of
child abuse with potentially serious consequences. Clinical management may
be complicated by the use of psychotropic agents.