Carbon Monoxide Poisoning
Carbon Monoxide Poisoning
Riqqil Isfazila Marlia Maarof Siti Farah Nurul Izzati Halimah Mohamed Sharifah Norjurina Hanizah Libon Jessica Anyap Norul Farah Ain
Definition
Poisoning with carbon monoxide, a tasteless odorless gas that is a byproduct of combustion. Carbon monoxide acts as a poison by competing with oxygen for binding sites on hemoglobin, the molecule in red blood cells that carries oxygen from the lungs to the more remote tissues of the body and returns carbon dioxide from the tissues to the lungs.
Sources
Gas water heaters Kerosene space heaters Charcoal grills Propane heaters and stoves Gasoline and diesel powered generators Cigarette smoke Propane-fueled forklifts Gasoline powered concrete saws Indoor tractor pulls Any boat with an engine Spray paint, solvents, degreasers, and paint removers
Clinical Manifestation
Headache Dizziness Nausea Flu-like symptoms, fatigue Shortness of breath on exertion Impaired judgment Chest pain Confusion Depression Hallucinations Agitation Vomiting Abdominal pain Drowsiness Visual changes Fainting Seizure Memory and walking problems
Assessment
ABC (airway, breathing, circulation) LOC (Loss of consciousness) Any complaint Vital sign Physical examination Measure HgCO by testing a sample of arterial or venous blood. Measure saturation pulse oximetry (Spo2)
Physical Examination Vital sign Tachycardia Hypertension or hypotension Hyperthermia Marked tachypnea (rare; severe intoxication often associated with mild or no tachypnea) Skin: Classic cherry red skin is rare (ie, "When you're cherry red, you're dead"); pallor is present more often. Ophthalmologic Flame-shaped retinal hemorrhages Bright red retinal veins (a sensitive early sign) Papilledema Homonymous hemianopsia
Management
Remove the patient away from the site of CO exposure as soon as safely possible Continue 100% oxygen therapy until the patient is asymptomatic and HbCO levels are below 10%. breathing oxygen through a tight-fitting mask Cardiac monitor - ECG Sudden death has occurred in patients with severe arteriosclerotic disease at HbCO levels of only 20%. Pulse oximetry