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Carbon monoxide poisoning (carbon monoxide) is a dangerous condition for human health and life. In case of carbon monoxide poisoning, first aid is required as soon as possible and qualified treatment is required. Carbon monoxide is dangerous because it is colorless, odorless and tasteless. Therefore, it is very difficult, and sometimes impossible, to determine its presence in the atmosphere.

First aid for carbon monoxide poisoning

If a person has been poisoned with carbon monoxide, it is necessary to immediately provide him with first aid.

It is mandatory to call an ambulance team, even if the patient's condition does not cause concern.

In case of carbon monoxide poisoning, it is necessary to provide first aid:

• Stop contact of the victim with toxic air. To do this, it is necessary to immediately withdraw or remove a person from the zone of pollution by combustion products. However, the person who provides assistance must take care of himself. That is, to protect your respiratory tract from the penetration of poison. To do this, put on a gas mask or cover your mouth and nose with a cloth moistened with water;
• When a person is outside the infection zone, assess his condition;
• If a person is conscious, then it is necessary to wrap him up, warm him up and give him hot sweet tea to drink. Wait with him for the arrival of the Ambulance, do not leave him alone;
• If the patient is unconscious or confused, then lay him on his side. This will prevent aspiration of vomit, if any. Control the pulse and breathing and give a sniff of a cotton swab moistened with ammonia;
• If there is no pulse or breathing, perform cardiopulmonary resuscitation. Mouth-to-mouth or mouth-to-nose is carried out, and mouth-to-nose for children under one year old. Resuscitation measures are carried out until the pulse and breathing resume, or until the arrival of doctors.

For first aid for carbon monoxide poisoning, see the video:

Emergency assistance to the victim

Upon arrival of the ambulance team, first aid is provided in case of carbon monoxide poisoning.

First aid for carbon monoxide poisoning:

Groups of patients who are subject to mandatory hospitalization in a hospital:

• Patients who have had loss of consciousness, even for a short time;
• Hypothermia, that is, a person's body temperature is below normal (36.6 degrees);
• The presence of such alarming symptoms as hallucinations, delirium, impaired coordination and motor activity;
• Patients who have registered clinical death (respiratory and cardiac arrest);
• Children and pregnant women in any condition;
• People suffering from cardiovascular diseases.

Antidote for poisoning

An antidote is a remedy that significantly weakens or completely stops the toxic effect of a poison on the body.

Antidote for carbon monoxide poisoning is 6% Acizol. What is Azizol? It is a fast-acting drug that promotes:

• blocking the formation of carboxyhemoglobin. This is a substance that blocks the ability of the blood to carry oxygen throughout the body;
• Cleansing the body of a poisonous substance - carbon monoxide.

The antidote for poisoning with combustion products must be administered as early as possible, this will help to avoid dangerous complications.

Algorithm for the introduction of Acizol into the body of the victim:

• The introduction of the drug intramuscularly immediately or soon after the evacuation of the victim from the area of ​​contamination with combustion products. 1 milliliter of Acizol solution is introduced;
• Re-introduction of the antidote 1 hour after the first injection.

It is possible to use an antidote for prophylactic purposes. To do this, 1 milliliter of the drug is administered intramuscularly half an hour before entering the contaminated room.

How does carbon monoxide affect the body?

Carbon monoxide negatively affects the entire body. This substance quickly penetrates the blood of the victim, even after a couple of breaths.

The longer a person breathes poisoned air, the more severe his condition and the more likely the development of dangerous complications and death.

What happens in the body when carbon dioxide enters it?

• Carbon monoxide binds to hemoglobin in the blood. This creates carboxyhemoglobin. This compound prevents the binding and transfer of oxygen to the cells and tissues of the body. Which leads to hypoxia. First of all, the brain suffers, which is very sensitive to lack of oxygen;
• This toxic substance disrupts the biochemical balance and metabolic processes in tissues;
• It reacts with muscle protein- myoglobin. This leads to disruption of the heart muscle, as the muscle tissue weakens and cannot fully pump blood. Nutrition is disrupted in tissues and organs.

Signs and symptoms of intoxication

The clinical picture of poisoning depends on the severity of the patient's condition. Which, in turn, is closely related to the concentration of carbon monoxide in the air and the duration of its contact with a person. There are 3 degrees of severity of carbon monoxide poisoning: mild, moderate, severe.

Faster signs of poisoning occur in weakened people, children and pregnant women.

Causes of poisoning

You can get poisoned by carbon monoxide both at home and at work. In fact, danger can lie in wait anywhere at any moment. Intoxication can occur accidentally or intentionally (for the purpose of suicide).

Let's highlight some of the main causes of human poisoning with carbon monoxide:

• Inhalation of combustion products. Poisoning occurs during a fire, when a person is in a smoky room and inhales smoke;
• In production where this gas is actively used and safety precautions are violated. That is, gas leaks occur due to faulty equipment, poor ventilation or its complete absence, and so on;

• In places with a large congestion of cars. Exhaust gases accumulate there, and prolonged exposure to them leads to poisoning. These places include: garages, busy highways, underground parking lots, tunnels;
• Domestic gas leakage in apartments and houses;
• Prolonged use of kerosene lamps in an unventilated area;
• In houses and rooms with stove heating in case of its malfunction or untimely closing of the damper.

Possible Complications

Poisoning does not pass without a trace, and even with mild intoxication, certain consequences are observed.

Complications that can occur with mild and moderate intoxication:

• chronic headaches and meteosensitivity, that is, a person feels worse due to weather changes;
• Frequent dizziness;
• Decline in cognitive abilities. That is, memory, attention, perception of new information worsens;
• Deterioration of vision;
• Emotional instability(frequent outbursts of anger, anger, which are replaced by apathy).

Complications that occur with severe intoxication:

• Hemorrhages in the brain;
• swelling of brain tissue;
• Acute myocardial infarction against the background of hypoxia;
• Inflammation of the airways (severe bronchitis, pneumonia);
• Coma is the most severe consequence of poisoning, which can result in the death of the patient.

How to detect carbon monoxide indoors

It is not possible to detect carbon monoxide indoors without special devices, since it has no taste, no smell, no color.

You should be wary of smelling smoke (even barely perceptible) and feeling worse for no apparent reason (nausea, vomiting, weakness).

Gas analyzers are used to determine carbon monoxide in the air. Which can be purchased in specialized stores. However, most often they are installed in production or in private houses with stove heating.

Due to the difficulty of its detection, the Ministry of Emergency Situations recommends that all precautions be observed, namely:

• Keep ventilation in proper condition and periodically check its functionality;
• Monitor the serviceability of stoves, fireplaces, chimneys and gas equipment;
• Ventilate the room;
• Observe safety precautions at work.

Perhaps under conditions in which incomplete combustion of substances containing carbon occurs. The oxide is soluble in alcohol and benzene, poorly soluble in water.

Small amounts of carbon monoxide are present in the atmosphere, as well as in coal seams (in the form of inclusions). Carbon monoxide is toxic.

The component is present as a constituent in many aerosols and gases. So, for example, the share of carbon monoxide in generator gases is about 9-29%, explosive - about 60%, and in exhaust - about 6.3%.

Carbon monoxide enters the body and is excreted from it unchanged through the respiratory system. Possessing a high affinity for hemoglobin, it (carbon monoxide) provokes its blockade. In addition, carbon monoxide disrupts oxygen transport, inhibits tissue respiration, slows down the dissociation of oxyhemoglobin, and causes hypocapnia.

Carbon monoxide is able to quickly penetrate through. Poisoning is possible in foundries, boiler rooms, when testing motors, on vehicles, in garages, mines, and gas plants. In everyday life, with illiterate furnaces or improper operation of gas stoves, intoxication can also occur.

When it occurs the consequences can be very severe. To determine the degree of intoxication, you should be aware of the symptoms of the condition.

With mild intoxication, there is a headache (mainly in the forehead and temples), a feeling of "pulsation" in the temples, tinnitus, muscle weakness, vomiting, dizziness. Poisoning is also accompanied by increased heart rate and respiration. A person has fainting states, in particular, during physical exertion. One of the first signs is a violation of the reaction rate and a disorder in color perception.

With moderate poisoning, there are lapses in consciousness for several hours. There is a sharp adynamia, trembling. Carbon monoxide causes incoordination of movements. After the return of consciousness, a pronounced character develops.

In a severe form of intoxication, a person is in a protracted coma (for five to seven (or more) days). There are brain lesions, seizures, tonic and clonic convulsions, muscle rigidity. Urination and defecation occur involuntarily. There is also increased sweating. The complexion of the victim is bright scarlet. Intermittent breathing, hypotension, a tendency to collapse are noted. Probably the onset of death due to respiratory paralysis.

When leaving a coma, a person is in a state of stunning for a sufficiently long period. Apathy develops. In some cases, short-term delirium, motor excitation may occur.

The prognosis is based on the depth and duration of the coma. With an increase on the second day of symptoms of CNS depression, the prognosis is unfavorable.

After moderate and mild poisoning, the development of mononeuritis of the median, ulnar or peroneal nerve is possible, probably numbness, paralysis.

With chronic intoxication, the victim constantly complains of headaches, excessive fatigue, irritability, tinnitus. In addition, there is a regular short-term violation of orientation. Dizziness, shortness of breath, pain in the region of the heart are constantly observed.

Chronic intoxication contributes to the progression of atherosclerosis or complicates its course (if it was already present). Frequent consequences of carbon monoxide poisoning are endocrine disorders, thyrotoxicosis, in particular.

Carbon monoxide (CO) poisoning is a dangerous condition that can lead to death. It is frivolous to think that a modern person rarely encounters carbon monoxide in his life. After all, stove heating is a thing of the past, not everyone faces fires. And experts find signs of carbon monoxide poisoning in motorists, hookah lovers, fireplace owners, and workers in large factories.

What is the danger

Quickly and imperceptibly, carbon monoxide causes poisoning. Sometimes people do not have time to take action to save lives. Everything must be done in advance, but for this you need to know how dangerous this gas is:

1. the concentration of carbon monoxide can be small - only 1.2%, death occurs within 3 minutes;
2. the gas is colorless, odorless - no one feels that he is breathing a dangerous composition;
3. this gas passes through all barriers - solid walls, wet wipes, soil layers, all partitions;
4. porous products do not absorb carbon monoxide, that is, filter materials, for example, in protective equipment, will not save you from it.

The effects of the gas are imperceptible, but destructive. The properties of this inconspicuous killer must be remembered. Be careful where there is carbon monoxide.

Places of poisoning

In our modern world, there are many places where the effect of carbon monoxide will be on the human body permanently or temporarily. You can get poisoned:

1. in closed parking lots;
2. with close proximity to highways;
3. with a long stay in traffic jams;
4. in long tunnels;
5. in case of violation of the rules of use in cottages with fireplaces, in baths with stoves;
6. when working in hazardous industries;
7. in garages with poor ventilation;
8. on fire;
9. while smoking hookah.

Carbon monoxide poisoning shows symptoms after a few hours or a few days. Everything will depend on the concentration of harmful gas, the time of inhalation, the state of human health. For example, in a garage with poor ventilation, a person suddenly wants to sleep, although he had a good night's sleep. But this is a clear sign of poisoning with this gas.

Impact on a person

The effect of carbon monoxide on the body is amazing. It is 200 times faster than oxygen will join hemoglobin. In this case, carboxyhemoglobin is obtained, which will interfere with the distribution of oxygen through organs and tissues. Lack of oxygen will adversely affect the work of the whole organism.

Symptoms of carbon monoxide poisoning depend on the volume of the substance in the air, the time of inhalation, and human health. Sometimes they can be confused with signs of another disease or mistaken for a cheerful mood. Signs of poisoning:

• excruciating headache, more often in the temporal part;
• constant nausea;
• loss of concentration;
• drowsiness;
• soreness in the eyes;
• lacrimation;
• increased heart rate;
• dry throat, cough;
• soreness in the chest;
• increase in pressure;
• severe dizziness;
• blurred consciousness;
• hearing loss;
• possible hallucinations.

If a person has been in a gassed room for a long time, then acute carbon monoxide poisoning is possible. Then fainting will join the existing symptoms, in some cases even coma, paralysis. The victim begins convulsions, uncontrolled excretion of feces and urine. In severe cases, there is a violation of the upper respiratory tract.

With such signs, it is necessary to immediately deliver the poisoned to a medical facility.

Late effects of poisoning

When CO poisoning occurs, it is imperative to visit a doctor, even if the symptoms have disappeared. Complications will appear later, after about two days, the first consequences after poisoning begin. Victims sometimes do not associate them with carbon monoxide, this creates a difficulty in making a diagnosis. Signs of complications:

1. deterioration in the sensitivity of the legs;
2. dysfunction of the bladder;
3. diarrhea;
4. cerebral edema;
5. exacerbation of mental illness (if any);
6. pulmonary edema;
7. violation of the heart, it may stop.

Later manifestations of complications are noticeable a month after poisoning. It occurs in people with a weak heart, diseases of the central nervous system. They begin a significant deterioration in memory, apathy. In severe cases, paralysis, decreased intelligence. With weakness of the cardiovascular system, the development of myocardial infarction is possible. There is also rapidly developing pneumonia.

People with chronic diseases find it difficult to tolerate intoxication of the body with harmful gas. That is why the complications of poisoning are so severe for them.

Immediate action upon discovery of casualties

Quick competent first aid is needed for carbon monoxide poisoning.

1. Provide the patient with fresh air. We need to move it away from crowds.
2. Report to the hospital. If a person talks and laughs, it may be the influence of the gas.
3. When a person is conscious, adequately answers questions - drink tea with sugar.
4. If the poisoned person is unconscious, give a sniff of cotton wool with ammonia. Lay on its side (so that the tongue does not fall into the airways), unfasten clothing that interferes with breathing. Rub the chest, back.
5. If not breathing, give artificial respiration.

It is easy to understand that a person has had carbon monoxide poisoning if a fire is visible nearby, or if he lies in a car with the engine running. But if a person is unconscious, and there are no signs of poisoning nearby, it is better to bring him to his senses and take him to the doctors. By the symptoms it is difficult to determine the damage, their actions can make it even worse.

Help on the fire!

You have to be especially careful in case of a fire. In such an emergency, a large concentration of deadly gas can be poisoned by taking only 2 to 3 breaths. Wet rags, scarves, medical masks, and other improvised means will not help. Only modern gas masks are needed.

When there are burning rooms with people in a fire, you should not try to save them yourself, this will lead to an increase in the number of victims, you must call the Ministry of Emergency Situations by calling 112.

Carrying out treatment

Carbon monoxide poisoning is difficult to tolerate by the body, so first aid helps to preserve the health and life of a person. In the first three hours, you need to give the injured person a breath of pure oxygen, for example, through an oxygen bag. It’s good if doctors are nearby, as you need to quickly introduce an antidote. All these measures are aimed at reducing the effect of carbon monoxide on the body of the victim.
Further treatment is carried out in the hospital. The patient is provided with regular therapeutic oxygen breathing. All recreational activities are aimed at restoring the functions of damaged internal organs, the brain. The success of these measures depends on the severity of the condition.

Preventive measures

It is easier to prevent contact with carbon monoxide and poisoning than to correct the consequences later. You just need to follow the precautionary measures:

1. work where combustion is present will be performed in rooms with ventilation;
2. properly adjust the dampers of fireplaces and stoves;
3. in houses with gas water heaters, stoves, carry out routine inspections, cleaning of water heaters;
4. check the condition of ventilation in residential premises;
5. turn off the engine of the car in a closed garage;
6. put autonomous analyzers in rooms with a potential threat of CO leakage;
7. comply with fire safety rules;

Preventive measures will help reduce the consequences of fatal poisoning by harmful gas. It is necessary to learn to follow the elementary rules of fire safety from childhood. It is necessary not only to teach, but to work out in practice. The rules should be automatically followed when necessary, even if the person himself is confused in a difficult situation.

Conclusion

Any poisoning is dangerous for humans. The consequences of carbon monoxide poisoning are very difficult to tolerate. Significant damage is received by important organs of the human body. In many cases, these changes cannot be corrected.

Some people react particularly strongly to carbon monoxide. Walking along the polluted streets is especially dangerous for pregnant women and young children. People with pulmonary diseases do not tolerate smoky rooms. This applies to people with bronchitis, pneumonia.
It is harmful for older people to breathe air with a high content of harmful gas. Also, patients whose body is weakened by long-term chronic diseases find it difficult to stay in rooms with carbon monoxide. Carbon monoxide poisoning occurs faster in men than in women.

In the conditions of a modern city, the air is filled with automobile exhausts. People breathe carbon monoxide all the time, which is probably why health becomes so weak. Too much toxic effect is exerted by this gas on the human body. Slowly but surely destroying internal organs from within, disrupting the operation of all systems.

Update: October 2018

Carbon monoxide poisoning refers to acute pathological conditions that develop as a result of the ingestion of a certain concentration of carbon monoxide into the human body. This condition is life-threatening and without qualified medical assistance can be fatal.

Carbon monoxide (CO, carbon monoxide) is a product of combustion and enters the atmosphere in any of its forms. Having no smell and taste, the substance does not manifest its presence in the air in any way, it easily penetrates through walls, soil and filter materials.

Therefore, excess CO concentrations can only be detected with the help of special devices, and in the worst case, in a rapidly developing clinic. In urban air, the main contribution to the concentration of this hazardous substance is made by exhaust gases from automobile internal combustion engines.

Action on the body

• CO enters the bloodstream 200 times faster than O 2 and enters into an active bond with blood hemoglobin. As a result, carboxyhemoglobin is formed - a substance that has a stronger bond with hemoglobin than oxyhemoglobin (oxygen in combination with hemoglobin). This substance blocks the process of oxygen transfer to tissue cells, causing hemic type hypoxia.
• CO binds to myoglobin (a protein in skeletal and cardiac muscle), reducing the pumping function of the heart and causing muscle weakness.
• In addition, carbon monoxide enters into oxidative reactions and disrupts the biochemical balance in tissues.

Where are cases of CO poisoning possible?

• On fires.
• In production, where CO is used in the reactions of synthesis of substances (phenol, acetone).
• In gasified premises operating gas equipment (gas stoves, water heaters, heat generators) with insufficient ventilation or insufficient supply air required for gas combustion.
• Garages, tunnels and other poorly ventilated areas where vehicle exhaust fumes can accumulate.
• When you stay near busy highways for a long time.
• At the time of leakage of lighting gas at home.
• When untimely (early) closed stove barriers of the home stove, stove in the bath, fireplace.
• Prolonged use of a kerosene lamp in an unventilated area.
• The use of low-quality air in breathing apparatus.

Risk groups (with hypersensitivity to CO)

Signs of poisoning depending on the concentration of CO

Symptoms of carbon monoxide poisoning

The mechanism of occurrence of symptoms

Neurological symptoms

• The brain and nerve cells are most sensitive to hypoxia, so headache, nausea, dizziness, etc. are a signal that nerve cells suffer from oxygen starvation.
• More severe neurological symptoms (convulsions, loss of consciousness) occur against the background of deep damage to the nervous structures up to irreversible.

Cardiovascular symptoms

The lack of oxygen begins to be compensated by more intense cardiac activity (tachycardia), however, the occurrence of pain in the heart suggests that the heart muscle is also experiencing hypoxia. Acute pain indicates a complete cessation of oxygen supply to the myocardium.

Respiratory symptoms

Increased respiration also refers to compensatory mechanisms, but damage to the respiratory center in severe poisoning leads to superficial, ineffective respiratory movements.

Skin symptoms

The red-blue shade of the scalp and mucous membranes indicates an increased, compensatory blood flow to the head.

Consequences of carbon monoxide poisoning

With mild and moderate degrees of severity of poisoning, the patient may be disturbed for a long time by headaches, dizziness, decreased memory and intelligence, emotional instability, which is associated with damage to the gray and white matter of the brain.

Severe complications are most often irreversible and often lead to death:

• skin-trophic disorders (edema followed by tissue necrosis);
• subarachnoid hemorrhages;
• violation of cerebral hemodynamics;
• swelling of the brain;
• polyneuritis;
• impaired vision and hearing to complete loss;
• myocardial infarction;
• severe pneumonia complicating coma.

First aid for carbon monoxide poisoning

Pre-hospital care implies stopping the contact of the victim with poison gas and restoring vital functions. First aid for carbon monoxide poisoning should exclude the poisoning of someone who is trying to provide this very help. Ideally, you should put on a gas mask and only then go into the room where the victim is located.

• Remove or remove the injured person from the room where there is an increased concentration of CO. This is the measure that must be performed first of all, since pathological changes in the body intensify with each breath.
• Call an ambulance for any condition of the patient, even if he jokes and laughs. Perhaps this is a consequence of the action of CO on the vital centers of the central nervous system, and not a sign of health.
• With a mild degree of poisoning, give a person a strong sweet tea to drink, warm and ensure peace.
• In the absence or confusion of consciousness - lay on a flat surface on its side, unfasten the collar, belt, provide fresh air. Give a sniff of cotton wool with ammonia at a distance of 1 cm.
• In the absence of cardiac or respiratory activity, perform artificial respiration and massage the sternum in the projection of the heart.
  

What to do in case of fire poisoning?

If it so happened that people were left in the burning room, you should not try to save them on your own - this will lead to an increase in the number of victims of the emergency and nothing more! You should immediately call the Ministry of Emergency Situations.

Even 2-3 breaths of CO poisoned air can be lethal, so no wet rags and filtration masks can protect a person who comes to the rescue. Only a gas mask can protect against the deadly action of CO!

Therefore, the rescue of people in such a situation should be trusted to professionals - the EMERCOM team.

Treatment

If a person is in a critical condition, the ambulance team carries out a set of resuscitation measures. In the first minutes, the antidote Acizol 6% is administered by intramuscular injection in a volume of 1 ml. The patient is taken to the hospital (intensive care unit).

In a hospital, the patient is provided with complete rest. They organize breathing with pure oxygen with a partial pressure of 1.5-2 atm or carbogen (95% oxygen and 5% carbon dioxide) for 3-6 hours.

Further therapy is aimed at restoring the functioning of the central nervous system and other organs and depends on the severity of the condition and the reversibility of the pathological reactions that have occurred.

Prevention of CO poisoning

• All work associated with the risk of CO poisoning should be carried out only in well-ventilated areas.
• Check dampers for stoves and fireplaces. Never close them when the firewood is not completely burned.
• Install autonomous gas detectors in rooms with a potential risk of CO poisoning.
• In case of possible contact with CO, take 1 capsule of Acizol half an hour before the likely contact with gas. Protection lasts 2-2.5 hours after taking the capsule.

Azizol is a domestic drug, a quick and effective antidote against acute carbon monoxide poisoning in lethal doses. It prevents the formation of carboxyhemoglobin substance and accelerates the excretion of CO from the body. As early as possible, intramuscular administration of Acizol to victims significantly increases their chances of survival and increases the effectiveness of subsequent resuscitation and medical measures.

Carbon monoxide poisoning

Introduction

Carbon monoxide poisoning occurs when a person inhales too much carbon monoxide (CO, carbon monoxide), a colorless, odorless gas produced when carbon-containing fuels such as gasoline, diesel fuel, fuel oil, natural gas, coal, and wood are burned.

Symptoms include headache, dizziness, weakness, vomiting, chest pain, and confusion. Excessive exposure to CO can lead to severe palpitations, convulsions, loss of consciousness and even death.

Carbon monoxide poisoning can be diagnosed with a CO oximeter, a non-invasive device that measures the amount of CO in the blood. Treatment usually involves the administration of pressurized oxygen through a non-circulating mask. In severe cases, treatment in a hyperbaric oxygen chamber may be required.

Causes and risk factors

Carbon monoxide poisoning is caused by breathing in carbon monoxide (CO). The gas is colorless and odorless. It binds to hemoglobin, an iron-based protein in red blood cells that gives them their red color and carries oxygen. Only a small amount of carbon monoxide in the air is needed to displace oxygen molecules from hemoglobin, and this amount usually comes randomly from various combustion sources.

Carbon monoxide is a natural by-product of combustion. In most cases, poisoning occurs when the gas is inhaled, as it quickly accumulates in confined spaces (usually due to faulty ventilation).

Poor ventilation in confined spaces leads to poisoning. Some cases of accidental carbon monoxide poisoning are due to improper use of devices such as stoves, gas appliances, or generators inside homes or buildings. However, most incidents are due to equipment failure, usually related to ventilation problems in ovens or cars.

Common sources of CO include:

• wood stoves;
• house fires;
• vehicle exhaust gases;
• gas or propane stoves and grills;
• charcoal grills;
• unventilated propane, kerosene or gas heaters;
• gas electric generators;
• gas dryers for clothes.

The source of carbon monoxide (CO) in the vast majority of all intentional carbon monoxide poisoning comes from automobiles or other internal combustion engines.

Symptoms

Carbon monoxide poisoning is a chameleon in the medical world. Its symptoms mimic many other conditions, and there is not a single symptom that is the gold standard of all carbon monoxide poisoning. In other words, its signs are very difficult to identify, but there are several manifestations that you should be aware of.

Frequent symptoms

The most common symptoms of carbon monoxide poisoning are vague and associated with many conditions.

Early symptoms.

Carbon monoxide binds to hemoglobin, creating a molecule called carboxyhemoglobin (COHb), which interferes with the body's ability to transport and use oxygen, especially in the brain. Because of this, symptoms are similar to other conditions that affect the brain and cause decreased oxygenation (known as "hypoxia"):

• headache;
• nausea;
• dizziness;
• fatigue.

Because it is a gas that tends to affect everyone who is exposed to it, carbon monoxide is easier to spot when symptoms affect multiple people at once. Due to its chameleon-like nature, it's still not an easy task, but headaches and nausea in isolation rarely lead anyone to think of carbon monoxide poisoning as the most likely culprit.

However, when carbon monoxide affects multiple patients at once, it is often identified as an "infection or malnutrition" rather than a suggestion of carbon monoxide exposure.

progressive symptoms.

As gas poisoning progresses, the symptoms become more severe, but are still extremely vague and difficult to identify as specific to carbon monoxide exposure:

• confusion;
• erratic breathing;
• chest pain;
• vomit;
• blurring or double vision;
• loss of consciousness.

There is no clear time frame to show how long it takes to go from headache to blackout. Exposure to carbon monoxide is time and concentration dependent, meaning that the amount of carbon monoxide in the air is just as important as how long the patient is exposed to it.

Rare Symptoms

Dark red, flushed skin (often referred to as cherry red) is one of the most tell-tale signs of carbon monoxide poisoning. This is due to the high level of carboxyhemoglobin in the blood.

Unfortunately, this bright red coloration is often found on post-mortem examination. The level of carbon monoxide in the blood required to give the skin this color is so high that it is almost always fatal.

Thus, excessively reddened skin is too late a sign to be useful in determining whether a patient is suffering from carbon monoxide poisoning. For successful treatment, gas poisoning must be detected long before the patient's body turns bright red.

Complications and consequences

As common as gassing occurs, much is still not understood about the condition. Long-term exposure to elevated levels of carbon monoxide - even if levels are not as high, but exposure continues for many days or weeks - can lead to peripheral arterial disease, and long-term, poorly understood neurological problems.

Brain damage is a serious problem that many patients get from carbon monoxide poisoning. Patients may develop neurological complications (difficulty concentrating, memory loss, tremors, speech problems, etc.) at the same time as carbon monoxide poisoning or at a later time. When neurological signs and symptoms appear later, it is called delayed neurological sequelae.

Research into why this happens and how to spot potential symptoms is still ongoing. For example, pupil constriction in the eye can predict how the brain will react 30 days after exposure. One study that followed patients for many years after they were exposed to carbon monoxide showed that they were more likely to develop peripheral arterial disease than those without a history of carbon monoxide poisoning.

There is very little evidence for the treatment of carbon monoxide poisoning. Most therapy options focus on removing carbon monoxide from the body as soon as possible. These procedures range from basic high-precision oxygen delivery (15-25 liters per minute) at normal atmospheric pressure to the lungs and separation of carbon monoxide from hemoglobin to hyperbaric oxygen therapy at higher than normal atmospheric pressure.

When to See a Doctor

Carbon monoxide poisoning is a very serious condition and always requires medical attention. Carbon monoxide seeps into the bloodstream and takes up to several hours to remove.

Whenever carbon monoxide poisoning is suspected, call 112. Don't wait for help. Immediately move to fresh air. It's usually best to go outside while waiting for an ambulance.

When you see a doctor, please note that history is more important than symptoms. The most important way to recognize carbon monoxide poisoning is to recognize the signs of the dangerous behavior that led to the symptoms.

Faulty stoves, fireplaces, or wood burning appliances are usually the culprit for carbon monoxide poisoning in the home. Cars and trucks are common culprits when working in a garage.

Your doctor may ask you to describe how long it took for the symptoms to become severe enough to call for help. What happened at this time? Was the weather cool, and someone from the family decided to start cooking barbecue in the yard? This information can help confirm that your symptoms are indeed carbon monoxide poisoning.

Diagnostics

If carbon monoxide is not identified as the cause of the symptoms, the problem may be misdiagnosed upon arrival at the emergency room. Therefore, it is important to inform the ER of your suspicions if you think CO is involved.

Diagnosis is relatively simple. It involves a non-invasive test with a device called a CO oximeter that is placed on a finger, toe, or other parts of the body. The oximeter contains two diodes that emit light rays of different wavelengths. The amount of light absorbed by tissue can tell doctors how much carboxyhemoglobin (a compound created by the CO binder and hemoglobin) is in the blood.

Under normal circumstances, you would have less than 5 percent carboxyhemoglobin compared to free hemoglobin. Poisoning occurs if the level is between 10 and 30 percent. Death can occur at levels over 30 percent.

Conventional pulse oximeters are useless because they cannot distinguish between carboxyhemoglobin and oxyhemoglobin (a compound formed by the binding of oxygen and hemoglobin).

How is carbon monoxide poisoning treated?

Hemoglobin loves carbon monoxide and binds to it about 230 times more than it does to oxygen, which is a problem because carbon monoxide does not provide any benefit to the body. Carbon monoxide poisoning in the air you breathe doesn't take a lot of carbon monoxide, but it takes a lot of oxygen to get rid of it, and that's where the treatment comes in.

Traditional treatment

Carbon monoxide poisoning is not something you can treat at home. It takes at least 100% oxygen for several hours to clear carbon monoxide from the bloodstream. Carbon monoxide poisoning - this is a situation that always requires calling 112.

The main treatment for carbon monoxide poisoning is to administer high-precision oxygen using a breathing mask—an oxygen mask with a plastic bag hanging from it—until the carbon monoxide attached to the hemoglobin is replaced by oxygen.

Half-life is a measurement of the time it takes to eliminate half of a substance in the body. The half-life of carbon monoxide without the use of oxygen is 320 minutes - more than five hours for a level to be reduced by half. At this rate, the removal of carbon monoxide will take about a day.

Giving a patient 100 percent oxygen reduces the half-life to 74 minutes, meaning that a moderately exposed patient will still need more than five hours to reach acceptable levels of carbon monoxide in the blood. Patients with carbon monoxide poisoning spend a lot of time sitting in the emergency room breathing pure oxygen.

Hyperbaric Oxygen Therapy

Another therapy option is to administer pressurized oxygen in a hyperbaric chamber, which is essentially a circular chamber in which the patient lies and inhales 100% oxygen at pressures 1.5 to 2 times normal atmospheric pressure.

In a hyperbaric chamber, oxygen therapy can shorten the half-life of carbon monoxide to about 20 minutes.

Unfortunately, hyperbaric chambers are not always easily accessible, especially in rural areas. Even in areas where there is access to hyperbaric oxygen therapy, it can take a couple of hours to arrange treatment.

Considering that the patient will receive conventional oxygen treatment during the waiting period, the benefit of faster treatment may already be lost. Also, if multiple patients are exposed to carbon monoxide, only one patient at a time can be treated in a hyperbaric chamber.

Prevention

Proper use and maintenance of carbon monoxide emitting devices is the best way to avoid accidental carbon monoxide poisoning. In addition, recognizing the signs and symptoms of carbon monoxide poisoning, when available, can be life-saving.

The most effective home prevention tool is carbon monoxide alarms. They are readily available online and at most hardware stores for $20 to $80.