First aid for carbon monoxide poisoning:symptoms and treatment effects

Update: October 2018

Carbon monoxide poisoning refers to acute
pathological conditions that develop as a result of hitting
in the human body a certain concentration of carbon monoxide. Such
the condition is life threatening and without qualified help
Doctors can be fatal.

Carbon monoxide (CO, carbon monoxide) is the product of combustion
and enters the atmosphere in all its forms. Without smell and taste,
the substance does not manifest its presence in the air,
penetrates walls, soil and filter materials easily.

Therefore, an excess of CO concentration can be detected only with
using special devices, and in the worst case – rapidly
developing clinic. In urban air, the main contribution to
the concentration of this hazardous substance is introduced by exhaust gases from
automotive internal combustion engines.

Action on the body

  • СО в 200 раз быстрее О2 поступает в кровяное русло и
    enters an active relationship with hemoglobin. Therefore
    carboxyhemoglobin is formed – a substance with a stronger
    connection with hemoglobin, rather than oxyhemoglobin (oxygen in the compound
    with hemoglobin). This substance blocks the transfer of oxygen.
    tissue cells, causing hypoxia of hemic type.
  • CO binds to myoglobin (skeletal and cardiac protein
    muscle), reducing the pumping function of the heart and causing muscle
    weakness.
  • In addition, carbon monoxide enters into oxidative
    reactions and disrupts biochemical balance in tissues.

Where are possible cases of CO poisoning?

  • On fires.
  • In production, where CO is used in the reactions of synthesis of substances
    (phenol, acetone).
  • In gasified premises, operating gas
    equipment (gas stoves, water heaters, heat generators) with
    insufficient ventilation or insufficient supply
    air required for burning gas.
  • Garages, tunnels and other rooms with insufficient ventilation,
    where possible accumulation of vehicle exhaust.
  • With a long stay near busy highways.
  • At the time of leakage of luminous gas at home.
  • In case of untimely (early) closed furnace stoves home
    stoves, stoves in the bath, fireplace.
  • Prolonged use of a kerosene lamp in an unventilated
    indoors.
  • Use of poor-quality air in devices for
    breathing.

Groups at risk (with increased sensitivity to CO)

  • Depleted people
  • People with asthma and bronchitis
  • Pregnant women
  • Kids and teens
  • Smokers
  • Alcoholics
  • The defeat of organs and systems occurs faster in men than in
    women.

Signs of poisoning depending on the concentration of CO

CO concentration,% The time of onset of clinical manifestations Signs of
Up to 0,009 3-5 h
  • Reducing the speed of psychomotor reactions
  • Compensatory enhancement of blood circulation in vital
    organs
  • Chest pain and shortness of breath in persons with severe cardiac
    failure
Up to 0.019 6 h
  • Degradation of performance
  • Slight headache
  • Shortness of breath on exertion moderate
  • Visual impairment (perception)
  • У лиц с тяжелой степенью сердечной failure и у плода
    can cause death
0,019-0,052 2 h
  • Severe pulsating headache
  • Dizziness
  • Emotional instability, irritability
  • Attention and memory impairment
  • Nausea
  • Fine motor dysfunction
 Up to 0.069  2 h
  • Strong headache
  • Blurred vision
  • Confused consciousness
  • General weakness
  • Runny nose
  • Nausea и рвота
 0,069-0,094  2 h
  • Hallucinations
  • Severe motility disorder (ataxia)
  • Shallow breathing
0.1 2 h
  • Fainting
  • Weak pulse
  • Convulsions
  • Tachycardia
  • Rare shallow breathing
  • Coma
0.15 1.5 h
0.17 0.5 h
 0.2-0.29  0.5 h
  • Convulsions
  • Depression of cardiac and respiratory activity
  • Coma
  • Possible death
0.49-0.99 2-5 min
  • Lack of reflexes
  • Arrhythmia
  • Threaded pulse
  • Deep coma
  • Death
1.2 0.5-3 min
  • Convulsions
  • Loss of consciousness
  • Vomiting
  • Death

Symptoms of carbon monoxide poisoning

Easy poisoning:

Moderate poisoning:

Severe poisoning:

  • headache and dizziness;
  • knock on the temporal region;
  • chest pain, dry cough;
  • lacrimation;
  • nausea and vomiting;
  • redness of the scalp, face and mucous membranes;
  • hallucinations (visual and auditory);
  • tachycardia;
  • hypertension.
  • weakness and drowsiness;
  • muscle paralysis on the background of preserved consciousness.
  • loss of consciousness;
  • convulsions;
  • respiratory failure;
  • coma;
  • uncontrollable urination and defecation;
  • dilated pupils with a weak reaction to light
    stimulus;
  • significant blueing of the mucous membranes and skin.

The mechanism of symptoms

Neurological symptoms

  • The brain and nerve cells are most sensitive to
    hypoxia, so headache, nausea, dizziness, etc. I
    are a signal that nerve cells suffer from oxygen
    fasting
  • More severe neurological symptoms (convulsions, loss
    consciousness) occur on the background of a deep lesion of nerve structures
    down to irreversible.

Cardiovascular the symptoms

Lack of oxygen begins to be compensated for more intense
cardiac activity (tachycardia), but the occurrence of pain in
the heart says that the heart muscle is also experiencing
hypoxia. Acute pain indicates complete cessation
intake of oxygen to the myocardium.

Дыхательные the symptoms

Rapid breathing also applies to compensatory mechanisms, but
damage to the respiratory center in severe poisoning leads to
superficial, ineffective respiratory movements.

Кожные the symptoms

The red-blue tint of the scalp and mucous speaks of
enhanced compensatory blood flow to the head.

Consequences of carbon monoxide poisoning

With mild to moderate degrees of severity of patient poisoning
time may be disturbed by headaches, dizziness, decreased
memory and intelligence, emotional instability that is associated with
lesion of gray and white matter of the brain.

Severe complications are often irreversible and
often lead to death:

  • skin and trophic disorders (edema followed by necrosis
    tissues);
  • subarachnoid hemorrhage;
  • violation of cerebral hemodynamics;
  • swelling of the brain;
  • polyneuritis;
  • impaired vision and hearing until complete loss;
  • myocardial infarction;
  • severe pneumonia, complicating coma.

First aid for carbon monoxide poisoning

First Aid Assistance Means Terminating Contact
injured with poison gas and recovery of vital
functions. First aid for carbon monoxide poisoning should
eliminate the poisoning of someone who is trying to provide this very help. AT
ideally, you should wear a gas mask and only then go into the room,
where is the victim.

  • ATывести или вынести пострадавшего человека из помещения, где
    there is an increased concentration of CO. This is the event that
    should be performed first because with every breath
    pathological changes in the body are intensified.
  • ATызвать скорую помощь при любом состоянии пациента, даже если
    he jokes and laughs. ATозможно, это является следствием действия СО
    on vital CNS centers, not a sign of health.
  • With a mild degree of poisoning give a person strong sweet
    tea, warm and provide peace.
  • In the absence or confusion of consciousness – lay on a flat
    surface on the side, unbutton the collar, belt, ensure the influx
    fresh air. Give sniff cotton wool with ammonia on
    distance 1 cm
  • With no cardiac or respiratory activity
    do artificial respiration and massage of the sternum in the projection
    hearts.

What to do in case of poisoning in case of fire?

If it happened that there were people in the burning room,
you can’t try to save them yourself – it will lead to
increase the number of victims of an emergency and no more!
It should immediately call the MOE.

Even 2-3 breaths of poisoned CO can end.
lethal, so no wet cloths and filtering masks
will protect the person who came to the rescue. Only a gas mask can
protect from the deadly effects of CO!

Therefore, saving people in such a situation should be trusted.
professionals – the brigade MOE.

Treatment

If the person is in critical condition, an ambulance team
assistance is carried out complex resuscitation. AT первые
minutes antidote Acizol 6% is administered by intramuscular injection in
volume of 1 ml. The patient is delivered to the hospital (resuscitation).

AT условиях стационара пациенту обеспечивается полный покой.
Organize breathing with pure oxygen with partial pressure.
1.5-2 atm or carbogen (95% oxygen and 5% carbon dioxide) in
течение 3-6 hасов.

Further therapy is aimed at restoring the work of the CNS and
other organs and depends on the severity of the condition and reversibility
occurred pathological reactions.

Prevention of CO poisoning

  • ATсе работы, связанные с риском отравления СО, осуществлять
    only in well ventilated areas.
  • Check stove flames and fireplaces. Never close them when
    incomplete firewood burning
  • Install autonomous gas detectors in rooms with
    potential risk of CO poisoning.
  • In case of possible contact with CO, take 1 capsule of Arizola as
    half an hour before likely contact with gas. Protection lasts 2-2.5
    hours after taking the capsule.

Atsizol – domestic drug, fast and effective antidote
against acute carbon monoxide poisoning in lethal doses.
Interferes with formation of substance of carboxyhemoglobin and accelerates
removal of CO from the body. As early as possible intramuscular injection
Arizola affected significantly increases their chances of survival
and increase the effectiveness of subsequent resuscitation and medical
events.

Автор: врач-гигиенист, эпидемиолог

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