Medical Surgical Carbon monoxide poisoning #4

Question

An emergency department nurse overhears on dispatch that over 20 children from a local school are being brought in for flu-like symptoms while on their way to a field trip on a school bus. Symptoms include headache, dizziness, nausea, vomiting, and chest pain. The nurse suspects which most probable illness?

Answers

  1. An outbreak of influenza.
    • Rationale:

      This answer is not correct because all of these children are experiencing the same symptoms at the same time. It is unlikely it is an outbreak of influenza due to the time onset. The facts point to poisoning.

  2. Rocky mountain spotted fever.
    • Rationale:

      This answer is not correct because signs and symptoms of this illness do not usually show up until after 3 days. Rocky mountain spotted fever is a bacterial infection caused by a bite from an infected tick.

  3. Carbon monoxide poisoning.
    • Rationale:

      This answer is correct because these are symptoms of carbon monoxide poisoning. The children riding the bus have most likely been exposed to carbon monoxide. The question mentions the children were “on their way” to a field trip by bus. Carbon monoxide poisoning can happen in a short period of time.

  4. Food poisoning.
    • Rationale:

      This answer is not correct because food poisoning symptoms usually occur within a few hours to a few days, and chest pain is not a symptom. These children started experiencing symptoms on the bus on their way to a field trip. These factors indicate carbon monoxide exposure most likely from the exhaust system of the bus.

Overview

Carbon monoxide poisoning can occur in vehicles with an exhaust leak. Symptoms of carbon monoxide poisoning are similar to those of the flu.

Explanation

Learning Outcomes

Carbon monoxide is an invisible and odorless gas that can come from a leak from an exhaust system of a vehicle, such as a bus. Particularly in buses, the engine and exhaust system tend to be located in the back, where the passengers sit. In addition, the heater of the bus may create a negative pressure when the doors open, and suck outside exhaust from other vehicles. Symptoms of carbon monoxide poisoning are similar to those of the flu. When there is a large amount of people experiencing the same symptoms in the same time-frame, usually some type of poisoning is suspected. Carbon monoxide is the leading cause of accidental non-drug poisoning.

Test Taking Tip

Remember that carbon monoxide poisoning is the leading cause of accidental non-drug poisoning.

Video Rationale