Carbon Monoxide Poisoning

Carbon monoxide or carbonous oxide is a gas that appears to be colorless and odorless. It is also tasteless and non-irritant to people when inhaled but it can be poisonous and life threatening. This is usually difficult to detect because it can be mixed with the air and people can just inhale it. In chemistry, carbon monoxide is a result of the incomplete combustion. This is due to the fact that there is not enough oxygen so it will not be able to oxidize into carbon dioxide.

Carbon monoxide can be found in the combustion of cars, stoves, heating systems and gas range. Because it is odorless and colorless, it is considered as the “silent killer” and according to the Center for Disease Control, an estimate of about 15,000 emergency cases found in the hospitals and about 500 of these died. Home appliances are the usual sources of carbon monoxide. This can be found in: propane heaters, cigarette smoke, and spray paints, saws which use gasoline as a source of power, boat with engine, gas water heaters, and others.

Signs & Symptoms

Carbon monoxide poisoning does not happen then are there right away. There are two types of poisoning from carbon dioxide – the acute and chronic poisoning.

Acute Phase

With the acute phase, the person will experience headache and body malaise. This can be mistaken as a simple problem but increase in exposure can lead to more conclusive symptoms like

1. hallucinations
2. unsteady gait or imbalance when standing
3. seizure
4. dizziness
5. hypotension or low blood pressure
6. unconsciousness which can lead to cardiac arrest.

Chronic Phase

For chronic symptoms, the patient is exposed to carbon monoxide but these are low level carbon monoxide. However later on, the person will

1. feel lightheadedness
2. confusion
3. nausea and vomiting
4. depression
5. memory loss and sometimes
6. permanent neurological problems.

In the long run, it can also lead to cardiac problems resulting to heart failure and even cardiac arrests.

Mechanism

Oxygen is the only gas that should combine with the hemoglobin and transport these to all parts of the body. But if carbon monoxide pairs with oxygen in the hemoglobin, it will result to formation of carboxyhemoglobin (COHb). When this is formed, it will no longer be transported to the other parts of the body.

Effects

The effects of the poisoning can lead to permanent or temporary damage on the vital organs like the brain and heart. But this depends on the exposure of the person to the poisonous gas.

The possible effects of carbon monoxide poisoning can be broken down into this:

1. 10% of COHb will no produce symptoms immediately. Even the heavy smokers, carbon monoxide only consists of about 9%.
2. 15% of COHb can produce mild headache while
3. 25% can lead to nausea and vomiting and headache but it can be quickly recovered if there is oxygen or even a breath of fresh air
4. 30% of COHB will intensify the first few symptoms. But in pregnant women, elderly and even infants, it can lead to permanent damage of the vital organs
5. 45% COHb content can lead to lusciousness
6. 50% + can lead to death.

Diagnosis

Assessment of patients

Diagnosing the problem can be difficult especially if the patient is brought unconscious on the emergency room. So the health care team needs to gather important details such as work, lifestyle and prior activity before bringing them to the hospital.

Luckily, there are some gadgets that measure the level of carbon monoxide in the body such as the CO-oximeter. This is like a pulse oximeter only that it measures the level of carbon monoxide or carbon dioxide in the body. A breathing carbon monoxide gadget can also be used to detect the CO level.

Treatment

The treatment of carbon monoxide poisoning can be tricky.

Oxygenation

The first step is to provide a high dose of oxygenation via the oxygen tank with the use of a face mask. This will show improvement of the breathing pattern of the patient when bought to the hospital. However, if the patient is bought unconsciously, they may have cardiac arrest so a CPR on site may be done.

Treating Underlying sickness

If there are further involvement of vital organs like the heart and the brain, then the patient needs hospitalization to treat the underlying sickness. If the patient has metabolic or respiratory acidosis, then the patient may be given a bolus of sodium bicarbonate. This will help increase the oxygen in the tissues thus improving the breathing pattern of the patient. And before sending the patient home, their carbon monoxide level should be checked first to avoid complications.