Gaseous poisons
Carbon monoxide
Carbone monoxide
silent killer
colorless
Odorless
Co Tasteless
Non-
irritating
Sources
Exogenous Endogenous
• Cars exhaust fumes • The human body
• Cigars & cigarettes continuously produces a
• Fires small amount of CO
originating from catabolism
• Coal mines
of hemoglobin
• Charcoal burning
Condition of poisoning
• People (fires)
• Workers (coalmines )
Accidental • Passengers (car exhaust fumes due inadequate ventilation .
• Accidental deaths occur near lime kilns is due to Co2 Poisoning.
• Painless death due to inhalation of automobile exhaust in
Suicidal closed garage
Homicidal • Rare
Mechanism of action
• CO has a high affinity to Hb( 210 to 270 times
the affinity of O2 to Hb) this lead to ;
• Formation of carboxyhemoglobin (COHb)
Red asphyxia (Sherry pink).
• Decreased association of O2 and Hb.
• Decreased dissociation of O2 from unaltered
oxyhemoglobin .
Mechanism of action
• CO binds to myoglobin which may cause
direct myocardial depression .
• CO binds to cytochrome oxidase causing its
blocked and altered cellular respiration
• Fetus is more vulnerable to Co. poisoning than
adult because.
– Greater content of hemoglobin.
– Lower partial pressure of oxygen.
– Tendency to cause greater tissue hypoxia.
Clinical presentation
• Depends upon
• Concentration of CO
• Duration of exposure
• COHb level
• The target organs
• Brain
• Heart (sensitive to hypoxia )
Signs &symptoms
20% COHb 30% COHb
• CNS headache • CNS
• CVS Dyspnea • Throbbing headache
• Confusion
• Tinnitus
• CVS
• Dyspnea
• Tachypnea
• Tachycardia
• GIT
• Nausea &vomiting
Sings &symptoms
40% COHb 50 % COHb
• CNS • CNS
• Headache • Headache
• Drowsiness • Severe Drowsiness
• Ataxia
• Disorientation & Ataxia
• CVS
• CVS
• Dyspnea
• GIT • Arrhythmia
• Nausea &vomiting • Hypotension
• Muscles – incoordination with • Pulmonary edema
impairment of vision &hearing
(fail to escape)
Sings &symptoms
• 60% COHb
• CNS
• Convulsion &coma
• Skin
• Erythema
• Edema
• Blister formation
Complications
• Pneumonia
• Liver damage
• Permanent brain damage.
Treatment;
• Prophylactic preventing accumulation of CO.
• Curative:
– Remove patient immediately into fresh air.
– Care of respiration: Its better to give under
pressure (3 atmospheric pressure).
– General warmth.
– Complete rest, to minimize the amount of utilized.
– After recovery the patient must be kept under
observation he may be confused.
