An Invisible Killer

doi:10.1017/9781009279024.023

Case 17 - An Invisible Killer

Carbon Monoxide Toxicity from Gasoline Generator Use during a Winter Storm

from Section 3 - Meteorological Natural Disasters

Published online by Cambridge University Press: 06 February 2026

Daniel Saltzman

Edited by

Andrew Milsten and

John Broach

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Andrew Milsten: Affiliation:
University of Massachusetts Medical Center
John Broach: Affiliation:
University of Massachusetts Medical Center

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Summary

A severe winter storm has caused widespread power outages in the area. Temperatures are in the 20s Fahrenheit. To power their multifamily home, a group of families has set up a gasoline-powered generator in the basement, which has been running overnight. This has caused elevated carbon monoxide (CO) levels in the home as the CO has permeated the drywall and reached every part of the home. Multiple members of the families have begun feeling ill. One of them, a 75-year-old grandfather with multiple medical problems, is confused, lethargic, and cannot walk. He has a carboxyhemoglobin level of 30%, ischemic changes on his ECG, and an elevated troponin. If high-flow oxygen is not applied, the patient will have unstable ventricular tachycardia requiring synchronized cardioversion. He will stabilize with appropriate therapy. Family members will complain of symptoms, and this should prompt their evaluation or referral to be evaluated. If this does not happen, one of them will collapse on the floor.

Keywords

carbon monoxide poisoning carbon monoxide toxicity CO toxicity CO poisoning carboxyhemoglobin combustion odorless tasteless colorless hyperbaric treatment oxygen therapy soak time

Information

Type: Chapter
Information: Cases in Simulated Disaster Medicine , pp. 120 - 124
DOI: https://doi.org/10.1017/9781009279024.023 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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