Carbon monoxide (CO) poisoning is the most common fatal poisoning in the Un
ited States, The circumstances often involve an unsuspected increase of CO
in an enclosed environment. Victims often are unaware that their activity o
r environment placed them at risk for CO poisoning. The possibility of open
air CO poisonings was first reported in 1987, We present a case of open ai
r CO poisoning resulting in neurologic depression and a markedly elevated c
arboxyhemoglobin level in a child who had been swimming behind a house boat
. Emergency physicians and pediatricians should be aware of the possibility
of accidental open air CO poisoning in children and adults: who swim aroun
d recreational boats.