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ReplyCorrespondence

SpCO: Let's Not Throw the Baby Out With the Bath Water—Reply

Lindell K Weaver, Susan K Churchill and Kayla Deru
Respiratory Care October 2013, 58 (10) e130; DOI: https://doi.org/10.4187/respcare.02760
Lindell K Weaver
Hyperbaric Medicine LDS Hospital Salt Lake City, Utah
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Susan K Churchill
Hyperbaric Medicine LDS Hospital Salt Lake City, Utah
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Kayla Deru
Hyperbaric Medicine LDS Hospital Salt Lake City, Utah
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In reply:

We thank Dr McEvoy for his thoughtful reply to our report. He is correct that our definition of false positive was restrictive; however, we based this definition on the manufacturer's stated accuracy specification, and, indeed, found that the RAD-57 functioned as specified. When broadened to include 2 standard deviations (95% of the data), the accuracy range would be ± 6%, a range that is challenging for the purpose of diagnosing CO poisoning.

We readily acknowledge that technician technique may play a role in obtaining accurate data, even though our technicians and study team were trained by the manufacturer on probe placement. Our concern is that, whether by technical limitations or operator error, the RAD-57 may provide an erroneously low SpCO measurement in a patient with CO poisoning. We agree that SpCO technology can be valuable in broadly screening for occult CO poisoning. We offer that an elevated SpCO should raise concern about CO poisoning, especially if the evaluating clinician has not considered CO exposure. However, we strongly caution against using SpCO measurement to rule out CO poisoning when symptoms and circumstances suggest it. Returning a misdiagnosed patient to the scene of the poisoning can have devastating and even deadly consequences.

Footnotes

  • The authors have disclosed relationships with SciMetrika and Masimo.

  • Copyright © 2013 by Daedalus Enterprises
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Respiratory Care: 58 (10)
Respiratory Care
Vol. 58, Issue 10
1 Oct 2013
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SpCO: Let's Not Throw the Baby Out With the Bath Water—Reply
Lindell K Weaver, Susan K Churchill, Kayla Deru
Respiratory Care Oct 2013, 58 (10) e130; DOI: 10.4187/respcare.02760

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SpCO: Let's Not Throw the Baby Out With the Bath Water—Reply
Lindell K Weaver, Susan K Churchill, Kayla Deru
Respiratory Care Oct 2013, 58 (10) e130; DOI: 10.4187/respcare.02760
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