Saturday, July 23, 2011

Carbon Monoxide Poisoning

Overview, Causes, & Risk Factors

Carbon monoxide, also called CO, is a poisonous gas. It has no odor, no taste, and no color . Carbon monoxide poisoning is a life-threatening condition caused by inhaling too much CO.
What is going on in the body?
CO is produced when a fuel is burned. Fuels include gas, oil, kerosene, charcoal, or wood. CO may be found in a number of items that people come in contact with each day. These include:
  • leaking exhaust systems from internal-combustion engines or motor-powered vehicles

  • sewers

  • cellars

  • mines

  • faulty gas stoves or heating systems without good ventilation

  • fires

  • industrial plants

  • cigarette smoking, or breathing in secondhand smoke
    If fresh air is limited and CO is released in the air, it can reach a dangerously high level. When CO is inhaled, it enters the bloodstream and attaches to a blood cell protein called hemoglobin. Hemoglobin helps blood cells carry oxygen from the lungs to the rest of the body. If CO attaches to hemoglobin, the blood cells can't carry oxygen. The body then can't function in a healthy way.
    What are the causes and risks of the condition?
    CO poisoning can occur when small amounts of CO are inhaled over a long time. It can also occur when large amounts of CO are absorbed over a short time, especially in a closed setting such as a garage or car.

    • Symptoms & Signs

    What are the signs and symptoms of the condition?
    Symptoms linked with CO poisoning include:
  • a cherry-red skin color due to the mixture of hemoglobin and CO in the blood

  • confusion

  • dilated pupils and visual impairments

  • dizziness

  • headache

  • a heartbeat that is either too fast or too slow

  • muscle spasms, paralysis, twitching, or convulsions

  • muscle weakness

  • nausea and vomiting

  • palpitations, which is when a person can feel the heart beating in the chest

  • ringing in the ears

  • trouble breathing, called shortness of breath

  • loss of consciousness, known as coma

    • Diagnosis & Tests

    How is the condition diagnosed?
    A history of activity or illness as well as a complete physical exam help the doctor to diagnose this condition. A series of blood tests called an arterial blood gas test can measure the oxygen and CO levels in the blood. Other blood or X-ray tests can check the extent of the CO poisoning and rule out other conditions.

    Prevention & Expectations

    What can be done to prevent the condition?
    Since CO is odorless and colorless, a person may not realize he or she is around harmful levels of CO. The following actions can help prevent CO poisoning:
  • keep appliances in proper working order

  • use appliances in the right way and have them checked regularly

  • make sure there is lots of fresh air before using gas-powered engines or chemicals such as paint remover

  • have chimneys checked to be sure the flue is open and connected in the correct manner before using a fireplace

  • never leave a car in idle when it is inside a garage

  • don't sleep in a room with a gas or kerosene space heater if it is not properly vented

  • install CO detectors in the house as a backup

  • move into a well-ventilated area if any CO poisoning symptoms develop

  • call the local gas company if there is a suspected gas leak in the home
    What are the long-term effects of the condition?
    Long-term effects of CO exposure depend on the extent of the poisoning and how quickly it is treated. Long-term effects may include damage to the brain, heart, or lungs. There may also be short-term memory loss. These effects usually improve over time but may be lasting.
    What are the risks to others?
    Any persons near the person who has CO poisoning may also have been exposed to the CO, and should be checked by their doctors.

    • Treatment & Monitoring

    What are the treatments for the condition?
    First, the person needs to be moved away from the CO and into fresh air. Further treatment depends on the extent of poisoning, but may include:
  • Oxygen through a tight-fitting mask

  • intravenous fluids

  • medicines such as steroids

  • a ventilator, which is an artificial breathing machine

  • sedatives to decrease any excitability caused by the CO buildup in the body
    What are the side effects of the treatments?
    Side effects will depend on the treatments used. For instance, steroids may cause irritability, weight gain, or stomach upset. A ventilator can cause lasting lung problems.
    What happens after treatment for the condition?
    Often a person will get better with no need for further treatment. Physical therapy or other treatments may be needed for problems such as paralysis and memory loss.
    How is the condition monitored?
    Close monitoring is needed in cases of CO poisoning. Some people experience delayed symptoms, such as:

  • confusion

  • fatigue

  • memory loss

  • weakness
    Any new or worsening symptoms should be reported to the doctor.

    • Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:09/30/02
    Reviewer:Adam Brochert, MD
    Date Reviewed:07/27/01
    Sources
    http://www.epa.gov/iedweb00/coftsht.html
    Tabers Cyclopedic Medical Dictionary, F A Davis, 1993
    Complete Guide to Symptoms, Illness & Surgery, H. Griffith, M.D., 2000
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