Carbon monoxide poisoning

Carbon monoxide (CO) is an odorless, colorless gas, and poisoning can cause hypoxia, cell damage, and death. Approximately one third of severe poisonings are fatal.

Poisoning can occur following exposure from fire or nonfire sources.

Early symptoms are nonspecific and include headache, dizziness, and nausea.

Increasing exposure results in cardiovascular effects such as myocardial ischemia, infarction, dysrhythmias, and cardiac arrest.

Neurologic symptoms include acute stroke-like symptoms, altered mental status, confusion, coma, and syncope.

Diagnosis is based on the history, carboxyhemoglobin levels and the patient’s symptoms.

High-flow oxygen therapy, hyperbaric oxygen, and supportive therapy are the key treatments.

Complications of hyperbaric treatment include seizures related to oxygen toxicity, barotraumas, and pulmonary edema.

Carbon monoxide (CO) poisoning can occur following exposure to a variety of sources. The increased affinity of CO with hemoglobin results in tissue hypoxia and impairment of cellular respiration, and direct effects of CO toxicity at the cellular level. The symptoms of CO poisoning can be acute or chronic, depending on dose and duration of the exposure. They are mostly nonspecific, and vary from headache, nausea, and dizziness to severe cardiovascular and neurologic symptoms. People who are most at risk of having adverse outcomes after CO poisoning are those with coronary heart disease, vascular disease, or anemia; pregnant women and their fetuses; infants; and older people. About one third of severe poisonings are fatal.[1]Varon J, Marik PE. Carbon monoxide poisoning. Internet J Emerg Intensive Care Med. 1997;1(2).[2]Tomaszewski C. Carbon monoxide poisoning: early awareness and intervention can save lives. Postgrad Med. 1999;105:39-40,43-48,50. http://www.ncbi.nlm.nih.gov/pubmed/9924492?tool=bestpractice.com