Carbon monoxide poisoning resident survival guide: Difference between revisions
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===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | 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. | ||
* [[Fire]] | |||
* [[ | |||
===Common Causes=== | ===Common Causes=== | ||
* | |||
* | * Boats | ||
* | * Charcoal grills, propane stoves, charcoal brianelles | ||
* | * Gas powered generators | ||
* | * Motor vehicles | ||
* Power washers & other gas powered tools | |||
==Management== | ==Management== |
Revision as of 18:17, 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 brianelles
- Gas powered generators
- Motor vehicles
- Power washers & other gas powered tools
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[2]
>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
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ignored (help) - ↑ "CDC Natural Disasters". Retrieved 1 December 2013. Text " Clinical Guidance for Carbon Monoxide (CO) Poisoning After a Disaster " ignored (help)