The evaluation level of carboxyhemoglobin in children blood<3y-14y> with chief complainofheadache, nausea, and dizziness referringto pediatric clinics of Loghman hakim hospital in year 2018-2019

Carbon monoxide poisoning is common, challenging and serious poisoning with wide range of non-specific flu-like clinical manifestations that leads to misdiagnosis.This cross-sectional descriptivecontrolled study conducted in Loghman Hakim Hospital on 3-14 year-old patients presenting with non-specific Flu-like(headache, dizziness, nausea, vomiting, malaise)symptoms from November 2018 to May2019. In all subjects carboxyhemoglobin level measured via noninvasive pulse CO-oximetry (Massimo Company, USA).Demographic data, cigarette, shisha, opium smoke exposure, type of home heater,carboxyhemoglobin level were collected and statistically analyzed via SPSS v16.0.A total of 93 children 3-14 year-old were enrolled the study. Their mean age was 4.6+4.3 years, 46% were male and54% female. Mean carboxyhemoglobin level was 27.8+9.7 %( range 2.7% to 44%). The most frequently encountered symptoms were nausea &vomiting (44%), dizziness (36%), headache (32%) and myalgia (23%). We obtained the COHb levels using noninvasive pulse oximeter for all study patients and their mother, and the levels>5% for non-smokers were considered as CO poisoning.Of the 93 study patients, 49%had normal carboxyhemoglobinlevels(CoHb level< 5%). Of the remaining 51% study patients, 47 patients had CoHblevels between 5% and 10%, and seven patients > 10%.Closer attention to early and nonspecific signs and symptoms of CarbonMonoxidepoisoning andhigher clinical suspicion could reduce the rate of misdiagnosis and therefore minimize complicationsin this serious poisoning.