E-ISSN 2149-9934
Carbon Monoxide Poisoning Due to Water Pipe Smoking: Case Series
1 Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey  
JEMCR 2017; 8: 27-30
DOI: 10.5152/jemcr.2016.1706
Key Words: Water pipe smoking, carbon monoxide poisoning, hyperbaric oxygen therapy

Introduction: Water pipe is a different form of tobacco consumption. In recent years, water pipe usage has become increasingly widespread. The thought that it is less harmful than cigarettes increases its usage. Long-term exposure to high carbon monoxide levels due to water pipe   consumption may cause carbon monoxide poisoning.


Case Report: We present four patients aged 18–29 who consulted our emergency department with complaints regarding fainting, blackout, and headache. While three of them consumed water pipe, one who was a non-consumer, was in an environment in which water pipe was consumed. Carboxyhemoglobin values of the patients were between 18.7%-35.5%. Our patients received one session of hyperbaric oxygen treatment. Patients with improved clinical situations after treatment were discharged.


Conclusion: Water pipe consumption is the most observed form of tobacco consumption in the Eastern-Mediterranean Region, followed by in the US. Although it is considered that all toxic agents are filtered while water pipe smoke passes through water, water pipe consumption increases levels of carcinogens, carbon monoxide, nicotine, and tar in the blood compared to smoking. It is striking that carboxyhemoglobin values of our cases are as high as, or even higher than, that in stove poisoning cases. It must be kept in mind that non-specific symptoms following water pipe consumption may be symptoms of carbon monoxide poisoning.

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