Carbon monoxide poisoning: Symptoms, Precautions, Causes, Treatment

What is carbon monoxide poisoning?

“The silent killer” as it is commonly known, carbon monoxide is a toxic gas which is colorless, odorless, tasteless, and initially non-irritating. Carbon monoxide’s chemical symbol is CO and it is the product of incomplete combustion or burning of organic matter/fossil fuels due to insufficient oxygen supply which enables complete oxidation to carbon dioxide (CO2).

Carbon monoxide poisoning is an illness which is caused due to inhalation of Carbon Monoxide. As this poisonous gas is breathed in, it replaces the oxygen in the blood, which further diminishes the ability to absorb oxygen, leading to serious tissue damage and eventually death. This gas is found in combustion fumes made by cars, trucks, lanterns, stoves, gas ranges and heating systems. Other equipments or engines that can create carbon monoxide are portable generators, forklifts, floor buffers, gasoline-powered tools, concrete cutting saws, high-pressure washers,  power trowels, welders, solvents, spray paint, degreasers, paint removers, etc.

Carbon monoxide poisoning

Carbon monoxide poisoning Causes

The primary cause for carbon monoxide poisoning is when a household is not properly ventilated where the toxic gas emitted by the household appliances can gradually build up. Cigarette smoke, house fire, equipment used in buildings as well as semi-enclosed spaces are also the main source of carbon monoxide. Those at the risk of exposure to the carbon monoxide are Children riding at the back of enclosed pickup trucks, industrial workers at mills, plants or foundries especially those producing formaldehyde and coke, improper boat ventilation or those working indoors in the environment constituting of combustion engines or combustible gases. Carbon monoxide poisoning is usually associated with the malfunctioning,  obstructed exhaust systems or with suicide attempts.

Heavy smokers can start off with up to 9 percent of their hemoglobin already bound to CO, which they regularly inhale in cigarette smoke. This makes them much more susceptible to environmental CO.

Signs of carbon monoxide poisoning

As a person breathes in air it reaches the lungs, where oxygen gets trapped in the air binds with the molecule called hemoglobin (hb) which is found in the red blood cells. When this oxygen/hemoglobin complex reaches the muscles, oxygen is released. All cells need oxygen to live. By inhaling carbon monoxide gas this oxygen transport system is disturbed, because hemoglobin prefers Carbon monoxide to oxygen and accepts it 200 times more readily than it accepts oxygen. Thus it forms a more stable complex carboxyhemoglobin (cohb). This keeps life-sustaining oxygen from reaching the tissues and organs. As the cells in these organs do not receive enough oxygen, cellular metabolism is disrupted and eventually cells begin to die.

With exposure to carbon monoxide, symptoms like headache, dizziness, flu, shortness of breath, hallucinations, vomiting, drowsiness, fainting, seizure, etc. However it should be noted that since every person has a different tolerance level all symptoms may not be present and in very mild cases these symptoms could be mistaken for some other illness. Mild poisoning could have symptoms like vertigo, light headedness or flu, but over exposure can damage the central nervous system as well as the heart virtually leading to death.

Carbon monoxide poisoning could be dangerous for people who are sleeping or intoxicated. The fumes may prove to be fatal even before medical help arrives.

Carbon monoxide poisoning Diagnosis

Due to the reason that signs and symptoms of carbon monoxide poisoning are not specific, a blood test to look for it is the best way to proceed with the diagnosis. A carboxyhemoglobin test is a blood test that measures the amount of Carbon monoxide that is bound to hemoglobin in the body.

A person may be suspected of carbon monoxide poisoning when there is an evidence that fuel is being burned in a confined area. For example, a car running inside a closed garage, a charcoal grill burning indoors, or an unvented kerosene heater in a workshop. In the absence of any concrete evidence the symptoms especially in low level exposures could be misdiagnosed as any other illness like flu-like viral syndromes, chronic fatigue syndrome, depression,  chest pain, and migraine headaches.

Other tests that are useful as the best carbon monoxide poisoning detector are:

  1. measurement of other arterial blood gases and pH,
  2. a complete blood count,
  3. measurement of other blood components such as sodium, potassium, bicarbonate, urea nitrogen,
  4. lactic acid, an electrocardiogram (ECG); and a chest x ray.
  5. Breath CO monitoring offers a viable alternative.

Carbon monoxide poisoning Treatment

The first or initial treatment for carbon monoxide poisoning is to immediately remove the affected person from the source to fresh air and unconscious patients may require CRP on site.

In severe cases of CO poisoning, individuals are given hyperbaric oxygen therapy. This treatment involves placing the person in a chamber in which the person breathes 100 percent oxygen at a pressure more than one in atmosphere. This therapy hastens the dissociation of Carbon monoxide from carboxyhemoglobin. Hyperbaric oxygen therapy is used in very severe cases and is highly recommended for pregnant women because unborn babies are more susceptible to damage from carbon monoxide poisoning.

Alternate treatment includes breathing pure oxygen through a mask placed over the nose and mouth. No home therapy is available for carbon monoxide poisoning.

Prevention can be taken for averting this disaster by investing in carbon monoxide detectors and taking a few basic precautions like keeping the gas appliances, heaters and fireplace in good repair. Also it is recommended to use these appliances with the window open or when somebody is there to monitor them. Do not block or seal shut exhaust flues or ducts for appliances such as water heaters, ranges, and cloth dryers. It is very important to find the source of carbon monoxide poisoning and repair it. Most importantly it is vital to educate and spread awareness regarding the dangers that carbon monoxide poisoning can cause.

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