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Carbon monoxide poisoning in narghile (water pipe) tobacco smokers

Published online by Cambridge University Press:  11 May 2015

Giovanna La Fauci ,
Giora Weiser ,
Ivan P. Steiner  and
Itai Shavit
Giovanna La Fauci*
Affiliation:
Pediatric Department, Arcispedale S. Anna Hospital, Ferrara University, Ferrara, Italy
Giora Weiser
Affiliation:
Emergency Department, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
Ivan P. Steiner
Affiliation:
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
Itai Shavit
Affiliation:
Emergency Department, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
*
Emergency Department, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel; i_shavit@rambam.health.gov.il

Abstract

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Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO). We present an acutely confused adolescent patient who had CO poisoning after narghile tobacco smoking. She presented with syncope and a carboxyhemoglobin level of 24% and was treated with hyperbaric oxygen. Five additional cases of CO poisoning after narghile smoking were identified during a literature search, with carboxyhemoglobin levels of 20 to 30%. Each patient was treated with oxygen supplementation and did well clinically. In light of the increasing popularity of narghile smoking, young patients presenting with unexplained confusion or nonspecific neurologic symptoms should be asked specifically about this exposure, followed by carboxyhemoglobin measurement.

Keywords

carbon monoxideintoxicationnarghile
Type
Case Report • Rapport de Cas
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 1 , January 2012 , pp. 57 - 59
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

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