Carbon monoxide poisoning: how to recognize and what to do

Carbon monoxide poisoning

- an acute pathological condition that develops as a result of carbon monoxide entering the human body is dangerous to life and health, and without qualified medical care can be fatal.

Carbon monoxide enters the atmospheric air during any type of combustion. In cities, mainly as part of exhaust gases from internal combustion engines. Carbon monoxide actively binds to hemoglobin, forming carboxyhemoglobin, and blocks the transfer of oxygen to tissue cells, which leads to hemic hypoxia. Carbon monoxide is also included in oxidative reactions, disturbing the biochemical balance in tissues.

Risk groups [edit | edit code ]

• in case of fires;
• in production, where carbon monoxide is used for the synthesis of a number of organic substances (acetone, methyl alcohol, phenol, etc.);
• in gasified rooms in which gas-using equipment is operated (stoves, instantaneous water heaters, heat generators with an open combustion chamber) under conditions of insufficient air exchange, for example, when draft in chimneys and/or ventilation ducts is disrupted or there is a lack of supply air for gas combustion;
• in garages with poor ventilation [3][4][5], in other unventilated or poorly ventilated rooms, tunnels, since the car exhaust contains up to 1-3% CO according to standards and over 10% if the carburetor engine is poorly adjusted;
• when spending a long time on or near a busy road. On major highways, the average CO concentration exceeds the toxicity threshold; [6]
• at home in the event of a natural gas leak and untimely closed stove dampers in rooms with stove heating (houses, bathhouses);
• when using low-quality air in breathing apparatus;
• when smoking a hookah (a very large percentage of people experience headaches, dizziness, nausea, drowsiness after smoking a hookah, which is caused by carbon monoxide poisoning formed when there is a lack of oxygen supply to the hookah apparatus).

Consequences of poisoning

As I said in the previous article, the danger of CO is that it is colorless and odorless, which is why it is very easy to miss the onset of poisoning. The second danger is that even with medical care, a deterioration in well-being may occur some time after treatment - severe damage to the nervous system, even death.

This is due to the fact that carbon monoxide acts on the myelin sheath of nerve fibers and destroys it. The process is gradual, so the consequences may not be noticeable immediately, but after some time. Degenerative changes in the nervous tissue occur, as a result of which a person may well turn into a “vegetable” (in severe cases).

If the concentration of carbon monoxide is not lethal, then weakness and drowsiness may occur. If you frequently stay in rooms with a high CO content, chronic poisoning can begin. A person becomes lethargic, drowsy, lethargic, problems with concentration and thinking in general begin, and emotional changes in behavior appear. For example, irritability, a tendency to make impulsive and irrational decisions.

In some cases, it can even lead to hallucinations.

In this regard, I like the story that Alexander Panchin told in the book “Defense Against the Dark Arts.”

The girl thought that a ghost lived in her house, as she heard frightening sounds, felt anxiety, depression, tightness in the chest and other similar symptoms. The church servants carried out their rituals, but the situation did not change. Then the skeptics advised her to contact the gas service. As a result, it turned out that the concentration of carbon monoxide in the house significantly exceeds permissible levels, hence anxiety, hallucinations, etc.

Signs and symptoms [ edit | edit code ]

When the inhaled air contains 0.08% CO, a person feels a headache and suffocation.
When the CO concentration increases to 0.32%, paralysis and loss of consciousness occurs (death occurs within 30 minutes). At concentrations above 1.2%, consciousness is lost after two to three breaths, and the person dies in less than 3 minutes. Concentration of CO in the air, carboxyhemoglobin HbCO in the blood and symptoms of poisoning.
[7] [8]

• In case of mild poisoning the following appear:

• headache,
• knocking in the temples,
• dizziness,
• chest pain,
• dry cough,
• lacrimation,
• nausea,
• vomit,
• visual and auditory hallucinations are possible,
• redness of the skin, carmine-red coloring of the mucous membranes,
• tachycardia,
• increased blood pressure.

• in case of moderate poisoning:
• severe tinnitus
• drowsiness,
• possible motor paralysis with preserved consciousness
• in case of severe poisoning:
• loss of consciousness, coma
• convulsions,
• involuntary passage of urine and feces,
• breathing disorder that becomes continuous, sometimes Cheyne-Stokes type,
• dilated pupils with weakened reaction to light,
• sharp cyanosis (blue discoloration) of the mucous membranes and facial skin. Death usually occurs at the scene as a result of respiratory arrest and a drop in cardiac activity.

Severe complications are often observed:

• Cerebrovascular accident,
• Subarachnoid hemorrhages,
• Polyneuritis,
• Phenomena of cerebral edema,
• visual impairment,
• Hearing impairment
• Possible development of myocardial infarction,
• Skin trophic disorders (blisters, local edema with swelling and subsequent necrosis), myoglobinuric nephrosis,
• With a long coma, severe pneumonia is constantly observed.

First aid and emergency aid [ edit | edit code ]

Algorithm for providing emergency care at the site of the lesion

1. A gas mask is put on the victim (in combination with a hopcalite cartridge) and he is immediately evacuated from the affected area.

Algorithm for providing emergency care outside the affected area

1. The gas mask is removed from the victim and freed from clothing that restricts breathing.
2. The victim is given oxygen and warmed up. Modern treatment methods include oxygen therapy in a pressure chamber.
3. Since ultraviolet rays accelerate the breakdown of carboxyhemoglobin, it is advisable to irradiate the victim with a quartz lamp.
4. According to indications, artificial respiration is performed using hand-held breathing devices.
5. For heart failure, administration of 1 ml of cordiamine, as well as 1 ml of a 10% caffeine solution subcutaneously, is indicated.
6. The victim is immediately evacuated to the nearest medical facility.

Treatment [edit | edit code ]

In the first three hours, it is very important to provide a high-oxygen supplement. [9] It is necessary to immediately eliminate the source of polluted air and provide breathing with pure oxygen under an increased partial pressure of 1.5-2 atm [10] or, preferably, carbogen [11]. Treatment is carried out in a hospital.

World medicine does not know reliable antidotes for use in cases of carbon monoxide poisoning [12].

Russian scientists have developed an innovative drug "Acyzol", positioned as an antidote [ source not specified 343 days

] . It is administered intramuscularly in the form of a solution. Also suggested as a prophylactic.

Carbon monoxide poisoning (carbon dioxide poisoning) is an acute pathology that develops when toxic carbon monoxide enters the body. Without prompt, qualified first aid and high-quality medical treatment for carbon monoxide poisoning in the presence of primary symptoms, this problem often leads to death.

How exactly does carbon monoxide affect the body? What are the first symptoms of poisoning? What first aid can be provided to the victim? You will read about this and much more in our article.

The end result of poisoning

The outcome of carbon monoxide poisoning depends on several factors:

• duration of exposure;
• gas concentration around the victim;
• leak detection rates;
• After what period of time emergency assistance was provided for carbon monoxide poisoning.

This is also influenced by the individual parameters of a person and his state of health. The victim can get away with either mild or moderate symptoms, with further complications and a long rehabilitation period. Otherwise, inaction can cause death.

How does carbon monoxide affect the body?

Carbon monoxide is a special form of carbon monoxide and is most often formed during the incomplete combustion of various substances containing classical carbon. In modern conditions, the overwhelming majority of it is formed from the exhaust gases of cars with an internal combustion engine, but there are also household and natural sources of CO production.

Carbon monoxide itself, being odorless and colorless, has good penetrating ability, easily seeps through soil, partitions and even thin walls, while it is not absorbed by most simple porous materials, which makes the use of standard gas masks based on an atmospheric air filtration system ineffective (exception constitute complexes with the possibility of installing a hopcalite cartridge).

The main danger of CO for the body lies in the triple pathological effect of carbon monoxide on a number of systemically important processes:

• Blocking the delivery of oxygen to tissues and organs. CO actively interacts with hemoglobin in the blood, forming carboxyhemoglobin compounds, as a result of which the erythrocyte masses partially or completely cease to transfer oxygen to organs and tissues, which provokes almost immediate hypoxia;
• Disruption of the heart muscle. CO binds to myoglobin, which leads to a deterioration in heart function with characteristic manifestations - weakening of the pulse, the appearance of shortness of breath and arrhythmia;
• Formation of muscle weakness. Carbon monoxide pathologically affects the protein structures of smooth muscles, which leads to their weakness, sometimes partial or even complete paralysis of skeletal muscles.

The first signs of carbon monoxide poisoning

As modern medical statistics show, a person usually gets CO poisoning from prolonged inhalation of vehicle exhaust gases, especially in enclosed spaces, as well as at home against the background of improper operation of heating devices operating on combustion principles, due to leakage of household gas, and so on.

A significant portion of cases are associated with fires in enclosed spaces , transport cars, airplanes, and so on, when a person dies not from thermal effects as such, but due to very rapid CO poisoning with loss of consciousness and the inability to independently evacuate.

As the concentration of carbon monoxide in the blood increases, the following manifestations are noted:

• Decreased speed of psychomotor reactions;
• Deterioration in performance – both physical and mental;
• Dyspnea;
• Headache , increasing in intensity depending on the concentration of CO in the blood;
• Nausea, weakness, vomiting;
• Confusion and loss of coordination of small movements;
• Formation of hallucinations, fainting or unconsciousness, weakening of the pulse.

The above primary symptoms are characteristic of mild and moderate degrees of poisoning. In severe forms of pathology, the indicated symptoms can be combined and change almost at lightning speed.

Main symptoms of poisoning

The main symptomatic complex of carbon monoxide intoxication includes many different negative manifestations.

Mild to moderate degree of intoxication

Mild and moderate forms of pathology (with carboxyhemoglobin content in the blood from 20 to 50 percent) depending on the location of the lesion. Symptoms of mild to moderate carbon monoxide poisoning:

• From the central nervous system . Headache of a girdling nature, mild at first, and later of moderate strength and intensity. Tinnitus, decreased quality of vision and hearing, nausea with vomiting, impaired coordination of movement, fogged consciousness and short-term loss of consciousness may also occur. The above manifestations are almost always primary, since it is the central nervous system that first suffers from intoxication;
• From the cardiovascular system . Increased heart rate, up to 90 beats per minute. Pain and pressure in the heart area, arrhythmia. These symptoms are formed due to feedback from the intense work of the heart, trying to clear the bloodstream of carboxyhemoglobin and improve the delivery of oxygen to all systems of the body;
• From the respiratory system . Mostly shortness of breath and rapid breathing. With mild and moderate degrees of poisoning, compensation mechanisms still operate as the body’s reverse response to a progressive lack of oxygen. This is the main symptom of such poisoning;
• From the skin and mucous membranes . Their redness is observed, which is the result of increased blood flow speed.

Severe degree of intoxication

This category includes all pathological manifestations that form when the carboxyhemoglobin content in the blood is 50 percent or more.

Symptoms of severe carbon monoxide poisoning:

• From the central nervous system. Prolonged loss of consciousness, convulsions, uncontrolled bowel movements and urination, coma. Formed with deep lesions of nerve structures;
• From the cardiovascular system . Increased heart rate, up to 130 beats per minute, while it is faintly palpable. Severe arrhythmia against the background of a significant increase in the risk of myocardial infarction (with a complete stop in the delivery of oxygen to the heart muscle);
• From the respiratory system . Intermittent and shallow breathing caused by systemic damage to the center of regulation of this function in the brain against the background of the development of generalized decompensation processes;
• From the skin and mucous membranes. Pallor of these structures due to profound disruption of oxygen supply to peripheral systems.

Why and how carbon monoxide is dangerous

The strength of carbon monoxide on the human body and the severity of poisoning will depend on several reasons:

1. Real concentration of carbon monoxide.
2. Duration of damaging effect.
3. Ambient temperature.
4. State of health and immune system, including the presence of anemia, chronic or acute pathologies of the pulmonary and/or cardiovascular system.
5. The level of physical exhaustion of the body immediately at the moment of CO action - the greater the physical activity before the “contact”, the more severe the consequences will be.

Men are less resistant to the effects of CO than women. In addition, the category of particularly sensitive to the effects of carbon monoxide includes:

1. Heavy smokers and alcoholics - compared to others, they have a hard time withstanding even mild poisoning.
2. Pregnant and lactating women.
3. Children and teenagers.

Intoxication and its consequences for the unborn newborn are especially severe. The fetus suffers from tissue hypoxia more severely and for a longer period of time than the expectant mother herself.

The accumulation of carbon monoxide in a home, in the air of a work area or during a fire, equal to 14.08 mg/l, causes vomiting, loss of consciousness and death in just 1-3 minutes.

The lowest concentration of carbon dioxide at which the first disturbances occur in the body (light and color sensitivity of the eyes begins to fall) is 0.006 mg/l with an exposure time of 25 minutes.

The maximum permissible concentration (MAC) or maximum permissible level of CO is 7.04 mg/l. Within 1-2 minutes, a dull headache and severe dizziness will occur, and within 10-15 minutes, loss of consciousness will occur. However, if the necessary assistance is provided with such a PDC, the consequences and outcome can still be quite favorable.

Effect of CO on the human body

CO can enter the body only through inhalation - by inhalation. The overwhelming majority of carbon monoxide is also excreted through the lungs, and very small amounts leave the body with sweat, feces and urine. This cleansing occurs within 12 hours. Only a negligible amount of CO that does not have a harmful effect on health can remain dissolved in the blood plasma.

Carbon monoxide poisoning occurs due to the fact that it has a direct toxic effect on the body's cells:

• the combination of hemoglobin with carbon monoxide leads to the formation of carboxyhemoglobin, which cannot carry oxygen, and as a result, acute transport hypoxia develops, quickly leading to oxygen starvation of the body as a whole;
• the interaction of CO (up to 50%) with other hemoproteins leads to a blockade in the respiratory chains of mitochondria, which disrupts the utilization of O2 by the cell and causes acute tissue hypoxia;
• carbon monoxide disrupts the functioning of skeletal muscles and cardiac muscle by blocking myoglobin and the formation of carboxymyoglobin;
• due to reactively developing general hypoxia, multiple microhemorrhages quickly occur, disturbances in the tissues of the gray and white brain matter, and embryonic tissues are affected;
• oversaturation of the blood with free O2 leads to the development of oxidative stress;
• CO directly acts on cell membranes, which negatively affects the exchange of amino acids and catecholamines, thereby accelerating the rate of natural cell death.

Attention. Carbon monoxide intoxication, which causes disruption of the blood supply to the white matter of the brain, can cause delayed progressive demyelinating neuropathy.

Symptoms for atypical forms of poisoning

In some cases of carbon monoxide poisoning, atypical symptoms with a special mechanism of development are diagnosed:

• Instant fainting and severe drop in blood pressure . As modern researchers suggest, this combination of manifestations, which sometimes occurs even in cases of mild degrees of poisoning, develops due to a selective disruption of the center of regulation of vascular tone in the brain. The victim almost instantly loses consciousness due to a drop in blood pressure (parameters from 70 to 50 millimeters of mercury and below), pallor, sometimes “cyanosis” of the mucous membranes and skin is observed, with preservation of respiratory function;
• Euphoria . It is explained by the direct toxic effect of silicon monoxide on individual centers of higher nervous activity in the brain. As the concentration of CO in the blood increases, mental, sexual and physical arousal with euphoria is noted, which after a while is replaced by vivid hallucinations, delirium, loss of consciousness and disturbances in both respiratory and cardiac activity;
• Lightning poisoning . It is formed at very high concentrations of carbon monoxide in the air - from 1 percent in absolute equivalent and above. In the first minute, a person immediately loses consciousness and develops signs of severe CO poisoning, missing the classic primary symptoms. At 2-3 minutes, convulsions and vomiting are observed. By 3-5 minutes they are replaced by convulsions, respiratory paralysis and death.

Atypical forms of poisoning

Unlike common forms of carbon monoxide poisoning, atypical forms depend on several factors. Often this can be either a too large and rapid release of gas or a combination of a low concentration with the internal state of a person.

Euphoric degree

It is characterized by a relatively low concentration of CO, which flows near a person suffering from nervous fatigue. As a result, the victim may feel a state of euphoria, but then simply lose consciousness.

Chronic degree

This category most often includes people who encounter carbon monoxide in working conditions. These could be employees of boiler houses, factories, workshops, and so on. All this is accompanied by characteristic headaches, increased heart rate, rapid pulse, wear and tear of the heart and the body as a whole, not only during the entire period of work, but also after it.

Powder grade

The rarest category, since in this case poisoning occurs with the help of explosive gases formed from burning gunpowder. In this case, irritation of the mucous membranes, pain in the nasopharynx and respiratory system, lacrimation and cough may occur. As you can see for yourself, these symptoms of these forms differ somewhat from the main classification of poisoning, but they are no less deadly.

Complications and consequences

In addition to the pathological symptoms directly during the poisoning process, the victim may develop various complications in the post-reactive period, even with timely and complete provision of both first pre-medical and subsequent inpatient and resuscitation care.

Short term

Most of the consequences described below occur 1-2 days after carbon dioxide poisoning:

• CNS . Lesions of the nervous periphery with limitation of motor activity and sensitivity, constant pain in the head, brain swelling, disruptions in the gastrointestinal tract and urinary system, development of new and progression of chronic mental diseases, visual and hearing impairment;
• Respiratory system. Pulmonary edema ;
• The cardiovascular system. Violation of coronary circulation and heart rhythm;

Medium term

Most of the consequences described below occur 2-30 days after carbon monoxide poisoning:

• Central nervous system, paralysis, various chorea . Systemic psychoses with memory loss, alternating with attacks of apathy, are also diagnosed. Less commonly – blindness and parkinsonism;
• Respiratory system . Secondary bacterial pneumonia, obstructive bronchitis;
• The cardiovascular system. Myocarditis, angina pectoris, myocardial infarction, cardiac asthma.

First aid

Timely and qualified provision of first aid in the vast majority of cases of carbon monoxide poisoning saves the life of the victim and significantly reduces the risks of developing numerous complications in the post-reactive period of the pathology.

Basic algorithm of first aid actions:

• You might be interested.

  
  First aid for ammonia poisoning Immediate transportation of the victim from the CO affected area

  . It must be carried out quickly, preferably using personal protective equipment, both for the patient and for the person providing assistance. To temporarily neutralize the negative direct effects of carbon monoxide, you can use a gas mask with a hopcalite cartridge - the latter, due to the inclusion of a special catalyst (a combination of silver, copper and manganese oxides) in the porous substance, converts CO into carbon dioxide, thus filtering the poisonous gas for a short period of time. The hopcalite cartridge must be accompanied by an additional gasket with silica gas, which neutralizes the water vapor formed during the synthesis of silicon dioxide. All other types of gas masks based on air filtration are not effective! If a rescuer stays indoors for a long time (more than 5 minutes) with a high concentration of CO, the only acceptable personal protection system may be a completely self-contained mask with an independent balloon supply of the oxygen-air mixture;
• Preparing for resuscitation . After removing the victim from the scene of the incident, the gas mask is removed from him, the chest and neck are freed from clothing. An ambulance is called;
• Resuscitation measures . Oxygen is supplied directly to the lungs. In the absence of breathing, it is necessary to carry out resuscitation measures, ventilating the lungs manually or using breathing devices. In cases where there are clear signs of heart failure, 1 milliliter of cordiamin is administered intravenously and a similar dose of a ten percent caffeine solution is administered subcutaneously. In the absence of cardiac activity - indirect cardiac massage or use of a defibrillator with parallel administration of adrenaline and sodium bicarbonate intravenously;
• In the event of a long absence of an ambulance team and minimal independent restoration of the victim’s basic vital functions (breathing and heartbeat), priority hospitalization of the patient to the nearest intensive care unit on any transport.

Victor Systemov - expert of the 1Travmpunkt site

Carbon monoxide, or carbon monoxide (chemical formula CO), is an extremely poisonous, colorless gas. It is an obligatory product of incomplete combustion of carbon-containing substances: it is detected in automobile exhaust gases, cigarette smoke, smoke from fires, etc. Carbon monoxide has no odor, so it is impossible to detect its presence and assess the concentration in the inhaled air without instruments.

Once in the blood, carbon monoxide displaces oxygen from its connection with the respiratory protein hemoglobin and inhibits the functioning of active centers responsible for the formation of new hemoglobin, thereby causing acute oxygen starvation of tissues. In addition, carbon monoxide disrupts the flow of oxidative processes in the body.

Carbon monoxide, which has a high affinity for the respiratory protein, attaches to it much more actively than oxygen. For example, if the concentration of CO in the inhaled air is only 0.1% of the total volume (the ratio of carbon monoxide and oxygen is 1:200, respectively), hemoglobin will bind equal amounts of both gases, i.e. half of the respiratory protein circulating in the systemic bloodstream will be occupied by carbon dioxide gas.

How does carbon monoxide poisoning occur?

Carbon monoxide poisoning most often occurs in the following cases:

• improper operation or malfunction of furnace equipment, gas heating appliances;
• staying in an unventilated enclosed area with the car engine running;
• fire;
• smoldering electrical wiring, household appliances, interior parts and furniture;
• violation of safety regulations when working in chemical production where carbon monoxide is used.

The likelihood of poisoning is directly proportional to the concentration of carbon monoxide in the inhaled air and the time of its exposure to the body.

Causes

Carbon monoxide is more easily incorporated into the respiratory protein, displacing oxygen. It is not immediately possible to detect the effects of carbon monoxide on the body. Intoxication develops when the concentration of toxic carboxyhemoglobin is more than 10%. The time spent in gas-contaminated conditions is of great importance. When a person breathes smoke for a long time, brain tissue begins to starve.

The pathogenesis of the disease considers not only the manifestations of the influence of carbon monoxide, but also the causes of poisoning. Thus, a large proportion of people are poisoned in the garage when the car is running, incorrect operation of the stove, breakdown of heating and exhaust systems, geysers, etc.

You can get poisoned in a car if carbon monoxide accumulates in the body. The danger of intoxication lies in the fact that the injured person does not immediately realize that he has been exposed to toxic effects. The mechanism of intoxication involves the development of tissue hypoxia. The pathological condition in which shortness of breath and migraine pain appear is called second-degree poisoning. Interruptions in the functioning of the brain and cardiovascular system accompany chronic carbon monoxide poisoning. In severe cases of poisoning, when the CO content reaches 0.3% or higher, the person loses consciousness and dies.

The toxic component provokes conditions that occur with other forms of intoxication: weakness, apathy. If victims inhaled carbon monoxide in a sauna, steam room or bathhouse, they may confuse such manifestations with the relaxing effects of heat. The likelihood of CO intoxication is higher at high air temperatures; people with heart disease, who are more susceptible to poisoning, are also at risk.

Often, poisoning occurs in an apartment due to a fire that ignites. The fire spreads rapidly, the amount of carbon monoxide increases sharply. In this case, a significant number of people are exposed to poisoning: apartment residents, neighbors.

Symptoms of poisoning

The nervous system is most sensitive to changes in oxygen levels in the blood. The degree of damage can vary from mild, reversible to generalized, leading to temporary or permanent disability, and in especially severe cases, death of the victim.

In addition to the nervous system, the respiratory (tracheitis, tracheobronchitis, pneumonia) and cardiovascular (dystrophy and necrotization of the myocardium, degenerative changes in the walls of blood vessels) systems are most often involved in the pathological process.

Depending on the concentration of CO in the air and, accordingly, carboxyhemoglobin in the blood, several degrees of carbon monoxide poisoning are distinguished.

Symptoms of mild poisoning (carboxyhemoglobin content in the blood does not exceed 30%):

• consciousness is preserved;
• squeezing, pressing headache, reminiscent of being tied with a hoop;
• dizziness, noise, ringing in the ears;
• lacrimation, copious discharge from the nose;
• nausea, vomiting;
• mild transient visual impairment is possible;
• difficulty breathing;
• sore throat, dry cough.

Moderate poisoning (develops when the concentration of carboxyhemoglobin in the blood is from 30 to 40%):

• short-term loss or other disturbances of consciousness (stunning, stuporous state or coma);
• difficulty breathing, intense shortness of breath;
• persistent dilation of the pupils, anisocoria (pupils of different sizes);
• hallucinations, delusions;
• tonic or clonic seizures;
• tachycardia, pressing pain in the chest;
• hyperemia of the skin and visible mucous membranes;
• incoordination;
• visual impairment (decreased visual acuity, flickering spots);
• decreased hearing acuity.

In case of severe poisoning (carboxyhemoglobin concentration 40-50%):

• coma of varying depth and duration (up to several days);
• tonic or clonic convulsions, paralysis, paresis;
• involuntary urination and/or defecation;
• weak thready pulse;
• shallow intermittent breathing;
• cyanosis of the skin and visible mucous membranes.

In addition to the classic manifestations of carbon monoxide poisoning, atypical symptoms may develop in one of the following forms:

• fainting – characterized by a sharp decrease in blood pressure (up to 70/50 mmHg and below) and loss of consciousness;
• euphoric – sharp psychomotor agitation, decreased criticism, disorientation in time and space, hallucinations and delusions are possible;
• fulminant - develops when the concentration of CO in the inhaled air is 1.2% or more, the content of carboxyhemoglobin in the systemic circulation in this case exceeds 75%. The death of the victim occurs quickly, within 2-3 minutes.

First aid for carbon monoxide poisoning

If carbon monoxide poisoning is suspected, it is necessary to immediately evacuate the victim from the area exposed to CO, call an ambulance, and provide first aid while awaiting its arrival.

1. Ensure a flow of fresh air by unbuttoning tight clothing and opening the windows.
2. If the victim is conscious, give a warming caffeine-containing drink (tea, coffee) to activate the respiratory and vasomotor centers.
3. If the victim is unconscious, bring cotton wool soaked in ammonia to the nose; if there is no effect, vigorously rub the limbs, chest, and face to stimulate blood circulation.
4. If there are signs of clinical death (lack of consciousness, breathing and pulse in the carotid arteries, dilated pupils that do not respond to light), cardiopulmonary resuscitation must be started immediately.

It is important to remember: when entering a room where carbon monoxide poisoning is suspected of occurring, you must hold your breath and leave it as soon as possible after evacuating the victims.

Preventive measures

In factories where there is a high probability of an emergency CO leak, they not only necessarily sign safety instructions, but also regularly conduct practical training so that every person working at the plant knows what to do in case of carbon monoxide poisoning.

Prevention consists of the following measures:

1. If you work at an enterprise using CO, strictly adhere to established safety standards and rules of conduct in emergency situations.
2. Monitor the serviceability of heating equipment. If a malfunction is detected, do not continue to use it under any circumstances.
3. Clean stove chimneys annually.
4. Ensure there is sufficient air ventilation in rooms where open flame burning devices are operated.
5. Do not run the car engine in the garage for a long time.
6. Avoid spending a lot of time near roads with heavy traffic.

The last point should be paid special attention to those who live in large cities. Adhering to a healthy lifestyle, many people jog daily on paths along highways or located next to them and below, but at this time irreparable harm is caused to the body. You should engage in recreational jogging in specially equipped places or park areas.

Possible consequences

After carbon monoxide poisoning, the development of both early (in the first 2 days) and late (from 2 to 40 days) complications is possible.

The early ones include:

• cerebral edema;
• toxic pulmonary edema;
• heart rhythm disturbances;
• visual and hearing impairments;
• neuritis.

• decreased cognitive function;
• amnesia;
• psychoses;
• movement disorders, paralysis, paresis;
• pneumonia;
• myocardial infarction;
• myocarditis;
• acute heart failure.

Treatment

To make a diagnosis, a comprehensive examination is necessary. The gas composition of the mixture and acid-base balance are determined, and the hemoglobin level is assessed. Treatment and rehabilitation after carbon monoxide poisoning are determined by the intensity of the toxic effect.

Often, in case of severe carbon monoxide poisoning, an antidote is used - pure oxygen. It can hardly be called an antidote, but it is the only substance that the body needs in case of acute carbon monoxide poisoning. After resuscitation measures, an oxygen mask is connected. In the hospital, complex treatment is carried out to eliminate the consequences of hypoxia.

Based on the degree of poisoning, carbon monoxide detoxification is chosen. Intensive therapy for carbon monoxide poisoning involves the administration of the drug Azizol and a glucose solution, and the intake of absorbent tablets. In case of acute poisoning, oxygen inhalation is prescribed, the mucous membranes are moistened, and in case of hypotension, an ephedrine solution is administered.

Ascorbic acid is especially useful for patients. During the recovery phase, a healthy diet with a high content of antioxidants is prescribed. Vitamins B1 and B6 are prescribed intravenously. For painful attacks that occur due to burns, analgin is administered subcutaneously or intravenously. Treatment methods such as hemodialysis and lymphatic drainage are designed to revive oppressed cells.