Carbon monoxide poisoning resident survival guide: Difference between revisions
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* [[Fire]] | * [[Fire]] | ||
===Common Causes=== | ===Common Causes=== | ||
* Boats | * Boats | ||
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* Electrical cable fires | * Electrical cable fires | ||
* Immediately after hurricanes and other natural calamities<ref name="Cukor-2007">{{Cite journal | last1 = Cukor | first1 = J. | last2 = Restuccia | first2 = M. | title = Carbon monoxide poisoning during natural disasters: the Hurricane Rita experience. | journal = J Emerg Med | volume = 33 | issue = 3 | pages = 261-4 | month = Oct | year = 2007 | doi = 10.1016/j.jemermed.2007.02.043 | PMID = 17976553 }}</ref> | * Immediately after hurricanes and other natural calamities<ref name="Cukor-2007">{{Cite journal | last1 = Cukor | first1 = J. | last2 = Restuccia | first2 = M. | title = Carbon monoxide poisoning during natural disasters: the Hurricane Rita experience. | journal = J Emerg Med | volume = 33 | issue = 3 | pages = 261-4 | month = Oct | year = 2007 | doi = 10.1016/j.jemermed.2007.02.043 | PMID = 17976553 }}</ref> | ||
* Motor vehicles | * Motor vehicles | ||
* Poorly functioning heating systems | * Poorly functioning heating systems | ||
* Power washers & other gas powered tools | * Power washers & other gas powered tools <ref name="emergency.cdc.gov">{{Cite web | last = | first = | title = CDC Natural Disasters | Clinical Guidance for Carbon Monoxide (CO) Poisoning After a Disaster | url = http://emergency.cdc.gov/disasters/co_guidance.asp | publisher = | date = | accessdate = 1 December 2013 }}</ref> | ||
==Management== | ==Management== | ||
Revision as of 18:25, 1 December 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]
Definition
Carbon monoxide (CO) is a colorless, odorless, tasteless, non-irritating gas, that is toxic to humans at concentrations more than 100ppm.[1]
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Death can occur from almost all causes of CO poisoning and depends on CO levels in blood.
Common Causes
- Boats
- Charcoal grills, propane stoves, charcoal briquettes
- Gas powered generators
- Electrical cable fires
- Immediately after hurricanes and other natural calamities[2]
- Motor vehicles
- Poorly functioning heating systems
- Power washers & other gas powered tools [3]
Management
Shown below is an algorithm summarizing the approach to [[Acute carbon monoxide poisoning]].
| CO Poisoning | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HPI: headache, dizziness, weakness, nausea, vomiting, chest pain & altered mental status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secure airway, breathing, circulation Intubate as needed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Check labs : CO levels in inspired air COHb levels in blood by CO-oximeter Pulse CO-oximeter Conventional oximeter not helpful Check pregnancy status in women | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Strongly suggestive of poisoning[3]
>2% COHb levels in non smokers >9% COHb levels in smokers | Check for concomitant cyanide poisoning | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Check EKG, troponins & cardiac enzymes for cardiac involvement | Assess for: COHb levels > 25% Cardiac involvement Severe acidosis, prolonged unconsciousness Neurological impairment or abnormal neuropsychiatric testing Pt. > 36 yrs in age Pregnancy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| [[Hyperbaric O2 therapy]] Initiate with in 6 hrs Atleast one treatment at 2.5 to 3.0 atm | Administer normobaric 100% O2 till pt is symptom free | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| look out for complications | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Educate pt before discharge Instruct for possible delayed neurological complications | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Repeat medical & neurological exam in 2 weeks | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Prockop, LD.; Chichkova, RI. (2007). "Carbon monoxide intoxication: an updated review". J Neurol Sci. 262 (1–2): 122–30. doi:10.1016/j.jns.2007.06.037. PMID 17720201. Unknown parameter
|month=ignored (help) - ↑ Cukor, J.; Restuccia, M. (2007). "Carbon monoxide poisoning during natural disasters: the Hurricane Rita experience". J Emerg Med. 33 (3): 261–4. doi:10.1016/j.jemermed.2007.02.043. PMID 17976553. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 "CDC Natural Disasters". Retrieved 1 December 2013. Text " Clinical Guidance for Carbon Monoxide (CO) Poisoning After a Disaster " ignored (help)