We read with concern the letter by Doctors O'Malley and Chudnofsky. The calculation
of sensitivity and specificity in our manuscript is accurate. We clearly indicated
that this calculation was based upon patients with paired COHb and SpCO measurements
and that this constituted a small portion of the study population. The aim of this
study was not to assess the accuracy of this device compared to blood COHb measurements,
which was the subject of earlier studies. We discuss the implementation of a screening
program using this device to capture occult cases of CO toxicity, which we suspected
were in the population at large. In this regard, we have accomplished our goal. We
do not suggest that this device replace blood COHb measurements, but rather believe
that this device is a good screening tool for identifying unsuspected cases. We do
not exclusively use this device on patients who we suspect, for any reason, of having
CO toxicity. Instead, we use the standard co-oximetry to determine toxicity in this
group of patients. Since the publication of our article, we have continued to use
SpCO as an adjunct in triage screening and we continue to identify about 1 patient
each month with unsuspected CO toxicity.
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Reference
- Finding needles in a haystack: a case series of carbon monoxide poisoning detected using new technology in the emergency department.Clin Toxicol (Phila). 2008; 46 (To link to this article: DOI: 10.1080/15563650701725110 URL: http://dx.doi.org/10.1080/15563650701725110): 461-469
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Publication history
Published online: January 09, 2009
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© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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