SlideShare a Scribd company logo
1 of 25
Download to read offline
CARBON
MONOXIDE
POISONING
What IS Carbon Monoxide?
 It is a byproduct of combustion reactions, or
the burning of certain fuels. CO can be emitted
from gasoline-powered engines, natural gas
heating systems, oil, coal, propane, wood and
other materials which may also release carbon
monoxide when burned.
Half-life of Carbon Monoxide
 Half-life – time required for half the quantity of a
drug or other substance to be metabolized or
eliminated
 CO half-life on 21% room air O2 – 4 - 6 hours
 CO half-life on 100% O2 – 80 minutes
 CO half-life with hyperbaric O2 – 22 minutes
Expected Carboxyhemoglobin Levels
 Non-smokers – 5%
 Smokers – up to 10%
5 – 6% for a 1 pack per day smoker
7 - 9% for a 2-3 pack per day smoker
Up to 20% reported for cigar smokers
 Urban commuter – 5%
Carbon Monoxide Absorption
 Minute ventilation
• Amount of air exchanged in the lungs within one minute
 Duration of exposure
• The longer the exposure, the more the absorption
 Concentration of CO in the environment
• The higher the concentration, the greater the toxicity
 Concentration of O2 in the environment
• The lower the O2 concentration to begin with, the faster the symptoms
will develop
o higher altitudes
o closed spaces
Increased Risks
Infants
Women who are pregnant
 Fetus at greatest risk because fetal hemoglobin has a greater affinity for
oxygen and CO compared to adult hemoglobin
Elderly
Physical conditions that limit the body’s ability to use
oxygen
 Emphysema, asthma
 Heart disease
Physical conditions with decreased O2 carrying capacity
 Anemia – iron-deficiency & sickle cell
Toxicokinetics
 Lungs absorb CO combines with Hb(85%) + myoglobin (15%)
eliminated through lungs
Effects of Carbon Monoxide
 CO binds more readily to hemoglobin (Hgb) displacing oxygen and
forming carboxyhemoglobin
 Premature release of O2 prior to reaching distal tissue leads to hypoxia at
the cellular level
 Inflammatory response is initiated due to poor and inadequate tissue
perfusion
 Myocardial depression from CO exposure
 Dysrhythmias, myocardial ischemia, MI
 Vasodilation – from increased release of nitric oxide; worsening tissue
perfusion and leading to syncope
Clinical Features
 Acute Poisoning
 Early: Non-specific
 2 classical features (rare):
Cherry red colour – blood + tissues
Cutaneous bullae/blisters
 Based on severity:
Mild (COHb <30%)
Moderate (30-40%)
Severe (>40%)
Acute Poisoning
 Mild Severity
 Headache
 Nausea
 Vomiting
 Dizziness
 Exertional Dyspnea
Acute Poisoning
 Moderate
 Chest pain
 Blurred vision
 Confusion
 Weakness
 Increasing dyspnea
 Tachycardia
 Tachypnea
 Ataxia
Acute Poisoning
 Severe
 Trismus
 Muscle Spasms
 Convulsions
 Palpitations
 Disorientation
 Vent arrhythmias
 Hypotension
 MI
 Respiratory failure
 Coma
Chronic Poisoning
 Headache, dizziness, confusion
 Weakness, nausea, vomiting, abdominal pain
 Paraesthesia
 Visual disturbances
 Hypertension
 Hyperthermia
 Cherry red skin
 Palpitations
 Aggravation of Angina
CO Levels with Related Signs and
Symptoms
 >5% - mild headache
 6-10% - mild headache, SOB with exertion
 11-20% - moderate headache, SOB
 21-30% - worsening headache, nausea, dizziness, fatigue
 31-40% - severe headache, vomiting, vertigo, altered
judgment
 41-50% - confusion, syncope, tachycardia
 51 – 60% - seizures, shock, apnea, coma
Carboxyhemoglobin levels of <15 – 20%
Mild severity
Headache – mild to moderate
Shortness of breath
Nausea and vomiting
Dizziness
Blurred vision
Carboxyhemoglobin levels of 21 – 40%
Moderate severity
Worsening headache
Confusion
Syncope
Chest pain
Dyspnea
Tachycardia
Tachypnea
Weakness
Carboxyhemoglobin levels of 41 - 59%
Severe
Dysrhythmias, palpitations
Hypotension
Cardiac ischemia
Confusion
Respiratory arrest
Pulmonary edema
Seizures
Coma
Carboxyhemoglobin levels of >60%
 Fatal
Death
Diagnosis
 Estimation of COHb level
 Pulse oximetry
 Arterial blood gases
 ECG
 Chest X-ray
 Bedside tests
DDX
 Alcoholic intoxication
 Hyperventilation syndrome
 Cerebrovascular accident
 Meningitis/encephalitis
 Migraine
 Epilepsy
 Food poisoning
Treatment
 Immediate removal from contaminated environment
 100% O2 – endotracheal tube
 Monitor C&D
 Neurologic exam + CAT scan + fundoscopic exam
 If ICT increased
 Hyperventilation
 Head elevation
 Mannitol
THANK YOU

More Related Content

What's hot (20)

Rat poisoning management
Rat poisoning managementRat poisoning management
Rat poisoning management
 
Organophosphate poisoning
Organophosphate poisoningOrganophosphate poisoning
Organophosphate poisoning
 
Carbon monoxide and cyanide poisoning
Carbon monoxide and cyanide poisoningCarbon monoxide and cyanide poisoning
Carbon monoxide and cyanide poisoning
 
Cyanide poisoning 2012
Cyanide poisoning 2012Cyanide poisoning 2012
Cyanide poisoning 2012
 
Co poisining
Co poisiningCo poisining
Co poisining
 
Snake bite
Snake biteSnake bite
Snake bite
 
Methyl alchohol poisoning
Methyl alchohol poisoningMethyl alchohol poisoning
Methyl alchohol poisoning
 
Organophosphorus poisoning final
Organophosphorus poisoning finalOrganophosphorus poisoning final
Organophosphorus poisoning final
 
Organophosphate poisoning
Organophosphate poisoningOrganophosphate poisoning
Organophosphate poisoning
 
Scorpion sting
Scorpion stingScorpion sting
Scorpion sting
 
Carbon monoxide poisoning
Carbon monoxide poisoningCarbon monoxide poisoning
Carbon monoxide poisoning
 
Mercury Poisoning
Mercury PoisoningMercury Poisoning
Mercury Poisoning
 
Lead poisoning
Lead poisoningLead poisoning
Lead poisoning
 
Cyanide poisoning_Forensic Medicine
Cyanide poisoning_Forensic MedicineCyanide poisoning_Forensic Medicine
Cyanide poisoning_Forensic Medicine
 
Snake bite management
Snake bite managementSnake bite management
Snake bite management
 
Electrical injuries
Electrical injuriesElectrical injuries
Electrical injuries
 
Strangulation (Hanging)
Strangulation (Hanging)Strangulation (Hanging)
Strangulation (Hanging)
 
Co Poisoning
Co PoisoningCo Poisoning
Co Poisoning
 
Asphyxia
Asphyxia Asphyxia
Asphyxia
 
Alcohol poisoning
Alcohol poisoningAlcohol poisoning
Alcohol poisoning
 

Viewers also liked

Carbon monoxide poisoning by dr Yasser Diab
Carbon monoxide poisoning by dr Yasser DiabCarbon monoxide poisoning by dr Yasser Diab
Carbon monoxide poisoning by dr Yasser DiabYasser Diab
 
Symptoms of Carbon Monoxide Poisoning in Adults
Symptoms of Carbon Monoxide Poisoning in AdultsSymptoms of Carbon Monoxide Poisoning in Adults
Symptoms of Carbon Monoxide Poisoning in AdultsLukman Nulhakiem
 
Renal replacement therapy in the ICU
Renal replacement therapy in the ICURenal replacement therapy in the ICU
Renal replacement therapy in the ICUmeducationdotnet
 
Carbon monoxide
Carbon monoxideCarbon monoxide
Carbon monoxidebri_kelly
 
Carbon monoxide
Carbon monoxideCarbon monoxide
Carbon monoxideRida Khan
 
Drugs modulating cholinesterase enzyme
Drugs modulating cholinesterase enzymeDrugs modulating cholinesterase enzyme
Drugs modulating cholinesterase enzymeDr. Pooja
 
16 Carbon Monoxide Sources In The Home
16 Carbon Monoxide Sources In The Home16 Carbon Monoxide Sources In The Home
16 Carbon Monoxide Sources In The HomeCO Detector
 
Pericardial disease
Pericardial disease Pericardial disease
Pericardial disease Gabi Cismaru
 
Death, Types of Death and Brain death
Death, Types of Death and Brain deathDeath, Types of Death and Brain death
Death, Types of Death and Brain deathArya Anish
 
Criteria of Brain Death
Criteria of Brain DeathCriteria of Brain Death
Criteria of Brain Deathwalid maani
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013Joel Topf
 
Infective endocarditis guidelines 2015
Infective endocarditis guidelines 2015Infective endocarditis guidelines 2015
Infective endocarditis guidelines 2015Rishi Bhargav
 

Viewers also liked (20)

Carbon monoxide poisoning by dr Yasser Diab
Carbon monoxide poisoning by dr Yasser DiabCarbon monoxide poisoning by dr Yasser Diab
Carbon monoxide poisoning by dr Yasser Diab
 
Symptoms of Carbon Monoxide Poisoning in Adults
Symptoms of Carbon Monoxide Poisoning in AdultsSymptoms of Carbon Monoxide Poisoning in Adults
Symptoms of Carbon Monoxide Poisoning in Adults
 
Renal replacement therapy in the ICU
Renal replacement therapy in the ICURenal replacement therapy in the ICU
Renal replacement therapy in the ICU
 
Carbon monoxide
Carbon monoxideCarbon monoxide
Carbon monoxide
 
Pharmacodynamics
PharmacodynamicsPharmacodynamics
Pharmacodynamics
 
Carbon monoxide
Carbon monoxideCarbon monoxide
Carbon monoxide
 
Drugs modulating cholinesterase enzyme
Drugs modulating cholinesterase enzymeDrugs modulating cholinesterase enzyme
Drugs modulating cholinesterase enzyme
 
16 Carbon Monoxide Sources In The Home
16 Carbon Monoxide Sources In The Home16 Carbon Monoxide Sources In The Home
16 Carbon Monoxide Sources In The Home
 
Toxicity of Asphyxians
Toxicity of AsphyxiansToxicity of Asphyxians
Toxicity of Asphyxians
 
Presentation on shock waves
Presentation on shock wavesPresentation on shock waves
Presentation on shock waves
 
pneumothorax in ICU
pneumothorax in ICUpneumothorax in ICU
pneumothorax in ICU
 
Pericardial disease
Pericardial disease Pericardial disease
Pericardial disease
 
Death, Types of Death and Brain death
Death, Types of Death and Brain deathDeath, Types of Death and Brain death
Death, Types of Death and Brain death
 
Metabolic response to injury
Metabolic response to injury  Metabolic response to injury
Metabolic response to injury
 
Arsenic poisoning
Arsenic poisoningArsenic poisoning
Arsenic poisoning
 
Nuclear reactor
Nuclear reactorNuclear reactor
Nuclear reactor
 
Criteria of Brain Death
Criteria of Brain DeathCriteria of Brain Death
Criteria of Brain Death
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013
 
Mercury Poisoning
Mercury PoisoningMercury Poisoning
Mercury Poisoning
 
Infective endocarditis guidelines 2015
Infective endocarditis guidelines 2015Infective endocarditis guidelines 2015
Infective endocarditis guidelines 2015
 

Similar to Carbon monoxide poisoning

COPD - Chronic Obstructive Pulmonary Disease
COPD - Chronic Obstructive Pulmonary DiseaseCOPD - Chronic Obstructive Pulmonary Disease
COPD - Chronic Obstructive Pulmonary DiseaseShashikiran Umakanth
 
carbon monoxide poisoning ppt forensic medicine
carbon monoxide poisoning ppt forensic medicinecarbon monoxide poisoning ppt forensic medicine
carbon monoxide poisoning ppt forensic medicineAnnaKhurshid
 
Copd overview and update 2016
Copd overview and update 2016Copd overview and update 2016
Copd overview and update 2016Ajay Kumar
 
Sleep disordered breathing and sleep apnea
Sleep disordered breathing and sleep apneaSleep disordered breathing and sleep apnea
Sleep disordered breathing and sleep apneaangleel
 
Mechanical ventilation, sedation and analgesia in pediatric burns
Mechanical ventilation, sedation and analgesia in pediatric burnsMechanical ventilation, sedation and analgesia in pediatric burns
Mechanical ventilation, sedation and analgesia in pediatric burnsSergey Shushunov
 
Respiratory acidosis and alkalosis
Respiratory acidosis and alkalosisRespiratory acidosis and alkalosis
Respiratory acidosis and alkalosisAnwar Siddiqui
 
COPD - Chronic obstructive pulmonary disease - Aby
COPD - Chronic obstructive pulmonary disease - Aby COPD - Chronic obstructive pulmonary disease - Aby
COPD - Chronic obstructive pulmonary disease - Aby Aby Thankachan
 
Physiology of High altitude and deep sea diving
Physiology of High altitude and deep sea divingPhysiology of High altitude and deep sea diving
Physiology of High altitude and deep sea divingSai Sailesh Kumar Goothy
 
Smoke And Burns
Smoke And BurnsSmoke And Burns
Smoke And Burnsjsgehring
 
Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Pallab Nath
 
Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Pallab Nath
 

Similar to Carbon monoxide poisoning (20)

carbonmonoxide.pptx
carbonmonoxide.pptxcarbonmonoxide.pptx
carbonmonoxide.pptx
 
COPD - Chronic Obstructive Pulmonary Disease
COPD - Chronic Obstructive Pulmonary DiseaseCOPD - Chronic Obstructive Pulmonary Disease
COPD - Chronic Obstructive Pulmonary Disease
 
carbon monoxide poisoning ppt forensic medicine
carbon monoxide poisoning ppt forensic medicinecarbon monoxide poisoning ppt forensic medicine
carbon monoxide poisoning ppt forensic medicine
 
Mahu copd
Mahu copdMahu copd
Mahu copd
 
COPD overview and update
COPD  overview and updateCOPD  overview and update
COPD overview and update
 
Copd overview and update 2016
Copd overview and update 2016Copd overview and update 2016
Copd overview and update 2016
 
Sleep disordered breathing and sleep apnea
Sleep disordered breathing and sleep apneaSleep disordered breathing and sleep apnea
Sleep disordered breathing and sleep apnea
 
Mechanical ventilation, sedation and analgesia in pediatric burns
Mechanical ventilation, sedation and analgesia in pediatric burnsMechanical ventilation, sedation and analgesia in pediatric burns
Mechanical ventilation, sedation and analgesia in pediatric burns
 
Respiratory acidosis and alkalosis
Respiratory acidosis and alkalosisRespiratory acidosis and alkalosis
Respiratory acidosis and alkalosis
 
copd.ppt
copd.pptcopd.ppt
copd.ppt
 
COPD.pptx
COPD.pptxCOPD.pptx
COPD.pptx
 
COPD - Chronic obstructive pulmonary disease - Aby
COPD - Chronic obstructive pulmonary disease - Aby COPD - Chronic obstructive pulmonary disease - Aby
COPD - Chronic obstructive pulmonary disease - Aby
 
COPD.pptx
COPD.pptxCOPD.pptx
COPD.pptx
 
Physiology of High altitude and deep sea diving
Physiology of High altitude and deep sea divingPhysiology of High altitude and deep sea diving
Physiology of High altitude and deep sea diving
 
Copd
CopdCopd
Copd
 
Asphyxiant poisons
Asphyxiant poisonsAsphyxiant poisons
Asphyxiant poisons
 
Asphyxiant poisons
Asphyxiant poisonsAsphyxiant poisons
Asphyxiant poisons
 
Smoke And Burns
Smoke And BurnsSmoke And Burns
Smoke And Burns
 
Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia
 
Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia Laparoscopy in COPD: Anaesthesia
Laparoscopy in COPD: Anaesthesia
 

More from Uma Chidiebere

More from Uma Chidiebere (9)

Schizophrenia & cigarette smoking
Schizophrenia & cigarette smokingSchizophrenia & cigarette smoking
Schizophrenia & cigarette smoking
 
Cervical cancer
Cervical cancerCervical cancer
Cervical cancer
 
Trait and psychodynamic theories
Trait and psychodynamic theoriesTrait and psychodynamic theories
Trait and psychodynamic theories
 
Optic pathway and lesions
Optic pathway and lesionsOptic pathway and lesions
Optic pathway and lesions
 
Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic Lateral Sclerosis (ALS) Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic Lateral Sclerosis (ALS)
 
Ovarian cancer
Ovarian cancerOvarian cancer
Ovarian cancer
 
Intussusception
IntussusceptionIntussusception
Intussusception
 
Zika virus
Zika virusZika virus
Zika virus
 
Ovarian teratoma
Ovarian teratomaOvarian teratoma
Ovarian teratoma
 

Recently uploaded

Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Mohamed Rizk Khodair
 
Nutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience ClassNutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience Classmanuelazg2001
 
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisVarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisGolden Helix
 
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxL1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxDr Bilal Natiq
 
Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Prerana Jadhav
 
Presentation on Parasympathetic Nervous System
Presentation on Parasympathetic Nervous SystemPresentation on Parasympathetic Nervous System
Presentation on Parasympathetic Nervous SystemPrerana Jadhav
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfDivya Kanojiya
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...MehranMouzam
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiGoogle
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..AneriPatwari
 
medico legal aspects of wound - forensic medicine
medico legal aspects of wound - forensic medicinemedico legal aspects of wound - forensic medicine
medico legal aspects of wound - forensic medicinethanaram patel
 
Screening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxScreening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxtadehabte
 
CCSC6142 Week 3 Research ethics - Long Hoang.pdf
CCSC6142 Week 3 Research ethics - Long Hoang.pdfCCSC6142 Week 3 Research ethics - Long Hoang.pdf
CCSC6142 Week 3 Research ethics - Long Hoang.pdfMyThaoAiDoan
 
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of: N...
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of:  N...HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of:  N...
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of: N...Divya Kanojiya
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxdrashraf369
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners
 
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamAkebom Gebremichael
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptkedirjemalharun
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxDr. Dheeraj Kumar
 

Recently uploaded (20)

Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)
 
Nutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience ClassNutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience Class
 
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisVarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
 
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxL1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
 
Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.
 
Presentation on Parasympathetic Nervous System
Presentation on Parasympathetic Nervous SystemPresentation on Parasympathetic Nervous System
Presentation on Parasympathetic Nervous System
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdf
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali Rai
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
 
medico legal aspects of wound - forensic medicine
medico legal aspects of wound - forensic medicinemedico legal aspects of wound - forensic medicine
medico legal aspects of wound - forensic medicine
 
JANGAMA VISHA .pptx-
JANGAMA VISHA .pptx-JANGAMA VISHA .pptx-
JANGAMA VISHA .pptx-
 
Screening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxScreening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptx
 
CCSC6142 Week 3 Research ethics - Long Hoang.pdf
CCSC6142 Week 3 Research ethics - Long Hoang.pdfCCSC6142 Week 3 Research ethics - Long Hoang.pdf
CCSC6142 Week 3 Research ethics - Long Hoang.pdf
 
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of: N...
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of:  N...HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of:  N...
HERBS AS HEALTH FOOD - Brief introduction and therapeutic applications of: N...
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
 
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.ppt
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptx
 

Carbon monoxide poisoning

  • 2. What IS Carbon Monoxide?  It is a byproduct of combustion reactions, or the burning of certain fuels. CO can be emitted from gasoline-powered engines, natural gas heating systems, oil, coal, propane, wood and other materials which may also release carbon monoxide when burned.
  • 3.
  • 4. Half-life of Carbon Monoxide  Half-life – time required for half the quantity of a drug or other substance to be metabolized or eliminated  CO half-life on 21% room air O2 – 4 - 6 hours  CO half-life on 100% O2 – 80 minutes  CO half-life with hyperbaric O2 – 22 minutes
  • 5. Expected Carboxyhemoglobin Levels  Non-smokers – 5%  Smokers – up to 10% 5 – 6% for a 1 pack per day smoker 7 - 9% for a 2-3 pack per day smoker Up to 20% reported for cigar smokers  Urban commuter – 5%
  • 6. Carbon Monoxide Absorption  Minute ventilation • Amount of air exchanged in the lungs within one minute  Duration of exposure • The longer the exposure, the more the absorption  Concentration of CO in the environment • The higher the concentration, the greater the toxicity  Concentration of O2 in the environment • The lower the O2 concentration to begin with, the faster the symptoms will develop o higher altitudes o closed spaces
  • 7. Increased Risks Infants Women who are pregnant  Fetus at greatest risk because fetal hemoglobin has a greater affinity for oxygen and CO compared to adult hemoglobin Elderly Physical conditions that limit the body’s ability to use oxygen  Emphysema, asthma  Heart disease Physical conditions with decreased O2 carrying capacity  Anemia – iron-deficiency & sickle cell
  • 8. Toxicokinetics  Lungs absorb CO combines with Hb(85%) + myoglobin (15%) eliminated through lungs
  • 9. Effects of Carbon Monoxide  CO binds more readily to hemoglobin (Hgb) displacing oxygen and forming carboxyhemoglobin  Premature release of O2 prior to reaching distal tissue leads to hypoxia at the cellular level  Inflammatory response is initiated due to poor and inadequate tissue perfusion  Myocardial depression from CO exposure  Dysrhythmias, myocardial ischemia, MI  Vasodilation – from increased release of nitric oxide; worsening tissue perfusion and leading to syncope
  • 10. Clinical Features  Acute Poisoning  Early: Non-specific  2 classical features (rare): Cherry red colour – blood + tissues Cutaneous bullae/blisters  Based on severity: Mild (COHb <30%) Moderate (30-40%) Severe (>40%)
  • 11.
  • 12. Acute Poisoning  Mild Severity  Headache  Nausea  Vomiting  Dizziness  Exertional Dyspnea
  • 13. Acute Poisoning  Moderate  Chest pain  Blurred vision  Confusion  Weakness  Increasing dyspnea  Tachycardia  Tachypnea  Ataxia
  • 14. Acute Poisoning  Severe  Trismus  Muscle Spasms  Convulsions  Palpitations  Disorientation  Vent arrhythmias  Hypotension  MI  Respiratory failure  Coma
  • 15. Chronic Poisoning  Headache, dizziness, confusion  Weakness, nausea, vomiting, abdominal pain  Paraesthesia  Visual disturbances  Hypertension  Hyperthermia  Cherry red skin  Palpitations  Aggravation of Angina
  • 16. CO Levels with Related Signs and Symptoms  >5% - mild headache  6-10% - mild headache, SOB with exertion  11-20% - moderate headache, SOB  21-30% - worsening headache, nausea, dizziness, fatigue  31-40% - severe headache, vomiting, vertigo, altered judgment  41-50% - confusion, syncope, tachycardia  51 – 60% - seizures, shock, apnea, coma
  • 17. Carboxyhemoglobin levels of <15 – 20% Mild severity Headache – mild to moderate Shortness of breath Nausea and vomiting Dizziness Blurred vision
  • 18. Carboxyhemoglobin levels of 21 – 40% Moderate severity Worsening headache Confusion Syncope Chest pain Dyspnea Tachycardia Tachypnea Weakness
  • 19. Carboxyhemoglobin levels of 41 - 59% Severe Dysrhythmias, palpitations Hypotension Cardiac ischemia Confusion Respiratory arrest Pulmonary edema Seizures Coma
  • 20. Carboxyhemoglobin levels of >60%  Fatal Death
  • 21. Diagnosis  Estimation of COHb level  Pulse oximetry  Arterial blood gases  ECG  Chest X-ray  Bedside tests
  • 22. DDX  Alcoholic intoxication  Hyperventilation syndrome  Cerebrovascular accident  Meningitis/encephalitis  Migraine  Epilepsy  Food poisoning
  • 23. Treatment  Immediate removal from contaminated environment  100% O2 – endotracheal tube  Monitor C&D  Neurologic exam + CAT scan + fundoscopic exam  If ICT increased  Hyperventilation  Head elevation  Mannitol
  • 24.