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  • Carbon Monoxide is known as the “silent killer” because it is a colorless, odorless, tasteless and non-irritating gas.
  • Many times there are multiple patients with similar complaints
  • 2% for non-smokers (normal) >9% for smokers

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  • 1. Carbon Monoxide Poisoning – Symptoms – Treatment - Prevention Risk Communication AdvanceMed Hanford Updated January 29, 2010
  • 2. Goal
    • Enhance recognition of carbon monoxide poisoning
  • 3. Objectives
    • Describe CO poisoning
    • How CO poisoning happens
    • Signs & symptoms of CO poisoning
    • Treatment of CO poisoning
  • 4. Males Exposed to CO
    • During high risk activities such as working in enclosed garages with generators or power tools, or at a guard station with high volumes of traffic
    • Age range is 25-44 years old
  • 5. At Risk Populations
    • Anyone, but particularly
      • People with chronic heart disease, anemia, or respiratory illness
      • Those over 75 years old (Death rate highest among that group)
      • Pregnant Women
  • 6. Sources of CO Poisoning
    • Motor Vehicles
    • Fires
    • Boats, power washers and other gas-powered tools
    • Forklifts
  • 7. CO Poisoning – Hurricane Katrina
    • 27 incidents of CO poisoning resulting in 78 non-fatal cases and 10 deaths
    • Nearly all caused by gasoline-powered generators
    • Most occurred within the first week after a hurricane
  • 8. How CO poisoning happens
    • CO enters through the lungs where it binds to the hemoglobin in the blood
    • Reduces the blood’s oxygen carrying capacity
    • Binds to the iron sites on the red blood cell with an affinity 200-250 times that of oxygen
  • 9. Symptoms of CO Poisoning
    • Headache
    • Dizziness
    • Confusion, slowed thought processing
    • Fatigue
    • Nausea/vomiting
    • Altered mental status
    • No fever
  • 10. Severe CO Poisoning
    • Neurological disorders may include confusion, irritability, ataxia, seizures, and loss of consciousness
    • Cardiovascular disorders
    • Respiratory disorders
  • 11. % of Carboxyhemoglobin (COHb) in Blood
    • 0-10% - may be no symptoms
    • 10-20% - tightening across forehead or headache, dilation of blood vessels
    • 20-30% - throbbing headache, nausea, vomiting, fatigue and irritability
    • 30-40% - dizziness, fatigue and weakness
    • 40-50% - confusion, risk of collapsing, pulse & respiration increasing
    • 50-60% - respiratory failure, collapse, convulsions or seizures, comatose state
    • 60-70% - respiratory failure, comatose, may be fatal
    • >70% - comatose, becoming rapidly fatal
    Normal COHb: 2% - Non-smokers >9% - Smokers
  • 12. Treatment of CO poisoning
    • Evacuate the area
    • Ventilate environment
    • Determine and eliminate the source
    • Administer 100% oxygen
    • Continue until patient is symptom-free, about 4-5 hours for most
  • 13. Treatment of Severe CO poisoning
    • ~6% of CO poisoning patients
    • Hyperbaric Oxygen therapy for those when:
      • COHb is >25-35%
      • Evidence of cardiac problems
      • Unconsciousness
      • Neurological Impairment
      • Pregnant Women
  • 14. Prevention of CO Poisoning
    • Install a CO alarm
    • Have all gas, oil or coal burning appliances serviced yearly
    • Allow for appropriate venting of gas appliances in the home, cabin or camper
    • Chimneys should be cleaned every year