![]() CO is lighter than air and rises from the point of origin. Carbon Monoxide PoisoningĬarbon monoxide (CO) is a byproduct of incomplete combustion that acts as an asphyxiant: it competitively binds with hemoglobin, eventually displacing all oxygen and causing systemic hypoxia. An antidote kit containing intravenous hydroxocobalamin (Cyanokit) is also available. Treatment of cyanide poisoning includes high-flow oxygen, inhaled amyl nitrite and a combination of intravenous sodium nitrite and sodium thiosulfate. ![]() The resultant histotoxic hypoxia causes lactic acidosis and greatly inhibits production of adenosine triphosphate (ATP), the fuel for our body’s metabolic processes. When inhaled, cyanide binds to hemoglobin and circumvents the process of cellular respiration it does not allow off-loading of oxygen at the cellular level.Ĭyanide inhibits oxidative phosphorylation, the metabolic pathway essential for aerobic metabolism. Hydrogen cyanide and its analogues, such as cyanogen chloride, are colorless gases that result from the incomplete combustion of plastic-containing products – particularly polyvinyl chloride (PVC), vinyl or polyurethane – common in many households. Care for electrical and thermal burns could spawn a series of articles in themselves, but in this article, we’ll confine ourselves to assessing and treating three types of toxic inhalations: It doesn’t matter the source all EMS providers, whether they are part of a fire department or not, need to be prepared to assess and treat patients poisoned with the byproducts of combustion. The suspected culprit in the Bronx fire was a malfunctioning electric space heater, but it could have just as easily been a dry Christmas tree, carbon monoxide poisoning from a faulty propane heater, running a gas range for heat, a curling iron left on in the bathroom, or someone forgetting to blow out a scented candle before they went to bed. Most of the victims died of smoke inhalation, which is the leading cause of death in structure fires. Hand-in-hand with the cold and flu season and miserable weather comes a particularly nasty hazard we’ll also frequently encounter: structure fires.Ī fire in a high-rise apartment building in the Bronx on January 9 killed 17 people, including eight children. Whether we’ll be faced with a yet another variant or hybrid (flurona, anyone?) remains to be seen. 2012 Dec 1 186(11):1095-101.It’s the winter season, and you know what that means: not only are we moving into our third year of the COVID-19 pandemic, it’s the cold and flu season as well. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Hampson NB, Piantadosi CA, Thom SR, et al. Ashcroft J, Fraser E, Krishnamoorthy S, et al. CO poisoning can present in patients as a wide range of acute and chronic symptoms. ![]() The binding of CO results in tissue hypoxia and impairment of cellular respiration, and direct effects of CO toxicity at the cellular level. When inhaled in large quantities, CO enters the bloodstream and binds to hemoglobin molecules with a much greater affinity than oxygen, creating carboxyhemoglobin. DefinitionĬarbon monoxide (CO) is a poisonous gas produced through burning fuel. Hyperbaric oxygen therapy should be considered in select patients.Īround 40% to 50% of survivors of CO poisoning suffer from delayed neurocognitive deficits that can become permanent. High-flow oxygen therapy and supportive therapy are key treatments. Neurologic symptoms include acute stroke-like symptoms, altered mental status, confusion, coma, and syncope. Severe poisoning may result in cardiovascular manifestations (e.g., myocardial ischemia, myocardial infarction, cardiac dysfunction, dysrhythmias, cardiac arrest). If symptoms of CO poisoning are suspected, individuals should leave the building or space immediately and call the emergency medical services.ĭiagnosis is based on a clinical triad: history of CO exposure, elevated carboxyhemoglobin levels, and symptoms/signs consistent with CO poisoning. ![]() It can also occur due to endogenous production by the liver after inhalational exposure to methylene chloride, a component of some paint strippers.Įarly symptoms are nonspecific and include headache, dizziness, and nausea. Poisoning can occur following exposure to a variety of fire or nonfire sources, including gas and charcoal grills, motor vehicle exhaust and other engine exhausts in poorly ventilated spaces, and various industrial sources. Carbon monoxide (CO)poisoning results in significant morbidity and mortality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |