We popped in to see Mum and to drop Barney off, before we went away for the weekend, and everything seemed fine. But when we got back, both Mum and Barney were on the floor. Mum had a mark on the side of her head, she was unconscious, and Barney wasn't breathing. It was shocking. My wife called an ambulance straight away. I went to check around the house because we didn't know what had happened. There was no sign of an intruder, but the house felt a bit stuffy because all the doors and windows were shut. Thinking about it, before we went away, she did say she wasn’t feeling right – maybe coming down with flu or something – perhaps we shouldn’t have gone – then none of this would have happened.

Whenever we go away Nan looks after Barney, she likes the company. Mum always checks the whole house before we leave. Everything seemed fine this time. She just had to turn down the gas fire cos Nan always has it on too high. It makes me feel sick when I’m there, it even leaves sooty marks on the wall. It’s like her temperature gage has broken. Anyway, my Aunt who lives next door comes in everyday to check in on her and give her dinner. When we got back, the food was all over the floor, I think Barney had eaten some of it.

A&E Final Report
Patient Name: Mrs. Adler
Age: 70
Gender: Female
Ethnicity: White/UK
Date of Admission: 3rd October 2024
Attending Physician: Dr. A. Bennett

Presenting Complaint:
Unconscious collapse at home.

History and Examination:
Mrs Adler was found unconscious by her family at home, along with the family's deceased dog. Upon examination, she presented with a minor bruise on her forehead, which was suspected to have occurred during the collapse.Initial evaluation indicated slow heart rate (bradycardia) and low blood oxygen saturation levels. A high suspicion of carbon monoxide (CO) poisoning was raised due to the circumstances.

Investigations:
A blood sample was taken, and elevated carboxyhemoglobin levels (35%) confirmed carbon monoxide poisoning. There were no significant findings related to trauma beyond the minor bruise on the head.

Treatment and Progress:
The patient was immediately treated with 100% oxygen via a non-rebreather mask. Over the course of several hours, she regained consciousness and showed signs of steady improvement. Her vital signs stabilized, and she remains under observation for potential delayed neurological effects.

Outcome:
The patient is progressing well and will continue to be monitored. Family members were advised on addressing the cause of high environmental CO levels at home (new boiler? inadequate ventilation) preventive measures, including the installation of a carbon monoxide detector at home. Family were advised that the fire service will be able to support with such advice.

Signed:
Dr. A. Bennett
Consultant, Emergency Department
General Hospital Cityville