Carbon Monoxide (CO)
Poisoning
What is CO?
chemical compound of
carbon and oxygen with the
formula CO. It is a colorless,
odorless gas, about 3 percent
lighter than air, and is
poisonous to all warmblooded animals and to many
other forms of life.
Carbon monoxide is formed
whenever carbon or
substances containing carbon
are burned with an
insufficient air supply. Even
when the amount of air is
theoretically sufficient, the
reaction is not always
complete, so that the
combustion gases contain
some free oxygen and some
carbon monoxide.
What is CO poisoning?
Occurs when there is a
buildup of inhaled Carbon
monoxide in the blood
stream
When inhaled it combines
with hemoglobin in the blood,
preventing absorption of
oxygen and resulting in
asphyxiation.
Carbon Monoxide has no
smell, taste or colour. This is
why it is sometimes called
the "Silent Killer".
Sources of CO
furnaces
gas or kerosene space
heaters
boilers
gas cooking stoves
water heaters
clothes dryers
fireplaces
charcoal grills
wood stoves
lawn mowers
power generators
camp stoves
motor vehicles
Smoking
Causes
The main cause of accidental
exposure to carbon monoxide (CO)
is household appliances, such as
cooking and heating devices,
which have been damaged,
incorrectly installed or badly
maintained.
The risk of exposure to carbon
monoxide from portable devices
may also be higher in caravans,
boats and mobile homes.
Other possible causes of carbon
monoxide poisoning include:
blocked flues and
chimneys this can stop
carbon
monoxide escaping, allowing
it to reach dangerous levels
burning fuel in an
enclosed or unventilated
space for example, running
a car engine, petrol-powered
generator or barbecue inside
a garage, or a faulty boiler in
an enclosed kitchen
faulty or blocked car
exhausts a leak or a
blockage in the exhaust pipe,
such as after heavy snowfall,
could lead to a build-up of
carbon monoxide
paint fumes some
cleaning fluids and paint
removers contain methylene
chloride (dichloromethane),
which can cause carbon
monoxide poisoning
if breathed in
smoking shisha pipes
indoors shisha pipes burn
charcoal and tobacco, which
can lead to a build-up of
carbon monoxide in enclosed
or unventilated rooms
Risk factors
Unborn babies. Fetal blood
cells take up carbon
monoxide more readily than
adult blood cells do. This
makes unborn babies more
susceptible to harm from
carbon monoxide poisoning.
Children. Young children
take breaths more frequently
than adults do, which may
make them more susceptible
to carbon monoxide
poisoning.
Older adults. Older people
who experience carbon
monoxide poisoning may be
more likely to develop brain
damage.
Smoking
Chronic heart disease
Anemia-- a reduced number
of healthy red blood cells
Respiratory problems such as
asthma
Occupational risk( chef and
smoking)
Symptoms
Complications can arise even from
minor cases of carbon monoxide;
these include:
brain damage
organ damage, including
heart damage
death
Diagnosing CO Poisoning
A member of the hospital
staff will take a blood
sample to test the amount
of carbon monoxide in your
blood. In parts per million
(ppm), CO levels above 70
ppm in the blood can
produce symptoms, and
levels above 150 to 200 can
result in dizziness,
unconsciousness, and even
death.
Medical Management
Oxygen Treatment
Dull headache
Weakness
Dizziness
Nausea or vomiting
Shortness of breath
The most important aspect of
treating carbon monoxide
poisoning is breathing in pure
oxygen to increase oxygen
levels in the blood. To do this,
your healthcare provider will
place an oxygen mask over
your mouth and nose and ask
you to inhale. If you are
unable to breathe, youll
receive oxygen through a
ventilator.
Confusion
Oxygen Chamber
Blurred vision
Your healthcare provider may
have you placed temporarily
in a pressurized oxygen
chamber. The air pressure in
the oxygen chamber is twice
the pressure of normal
atmospheric air. This
treatment increases blood
oxygen levels rapidly, so it is
Signs and symptoms of carbon
monoxide poisoning may include:
Loss of consciousness
Carbon monoxide poisoning can be
especially dangerous for people
who are sleeping or intoxicated.
People may have irreversible brain
damage or even be killed before
anyone realizes there's a problem.
Complications
used in severe cases of
carbon monoxide poisoning
or to treat carbon monoxide
poisoning in pregnant
women.
3.
Nursing intervention
Assessment
1. Assess immediately for
airway. If it is due to
carbon monoxide smoke
inhalation, stridor may be
assessed. This is due to
the formation of laryngeal
edema from thermal
injury.
2. Check for airway
obstruction if client is
unconscious. Muscles
around air passages may
relax if the client turned
unconscious due to
prolonged exposure or
massive poisoning.
3. Assess for
breathing. Client may
manifest respiratory
depression (5-10 per
minute).
INITIAL INTERVENTIONS
Position to semi-Fowlers if
not contraindicated.
Secure safety through side
rails.
Administer 100% via face
mask. Make sure the mask
fits the clients face to
deliver desired amount.
Monitor for signs on the
necessity for intubation.
1.
2.
1.
2.
Emergency intervention
1. Call 911
2. Get the Person to Fresh Air
Move the person away
from carbon monoxide area.
If the person is unconscious,
check for injuries before moving.
Turn off carbon monoxide
source if you can do so safely.
3. Call 911
FOLLOW-UP ASSESSMENT
1. Gather incident history
from the patient or any
person, particularly the
type and length of
exposure.
2. Determine clients
underlying health status
that would cause higher
risk, especially for
presence of anemia,
pulmonary disease, and/or
cardiac disease.
Monitor vital signs.
Expect for an elevated
respiratory and pulse
rates.
Be alert for altered
breathing pattern and
episodes of apnea.
Recheck for the level of
consciousness. Monitor
signs of cerebral hypoxia
(confusion), for it has the
possibility of rapid
progression to coma.
Assess for other
neurologic and other
systemic signs like:
Dizziness
Headache
Muscular weakness
Palpitations
Assess for signs of acute
respiratory distress
syndrome (rales and/or
wheezes).
Monitor skin for signs of
severity with the
perfusion.
4. Begin CPR, if Necessary
If the person is not breathing
normally:
Perform CPR for one minute
before calling 911 if you are alone.
Otherwise, have someone else call
and begin CPR.
For a child, start CPR for
children.
Continue CPR until the
person begins breathing or
emergency help arrives.
Prevention
Carbon monoxide can kill without
warning because it has no color,
odor or taste. Here are some
suggestions to reduce your risk:
Install carbon monoxide
detectors in your home in
hallways near bedrooms and in
garaged attached to living areas.
Open the flue when you use
a fireplace.
Never use charcoal grills or
hibachis indoors.
Buy appliances that vent to
the outside.
Have fuel-burning appliances
professionally installed. After
installation, periodically check
the vents for blockages or cracks.
Before turning on your heater
for the winter season, have your
heating system, flues and
chimneys professionally
inspected. If necessary, have
chimneys and flues professionally
cleaned.
Never heat your home by
using an oven, stovetop or
clothes dryer.
Never operate gas-powered
tools or engines inside, even if
windows are open and ventilation
seems good.
Never leave your car running
inside an attached garage. Also,
when your car idles outdoors,
keep one or two windows slightly
open.
