Category: Causes of Carbon monoxide

Providing oxygen to reduce the levels of carbon monoxide in the bloodstream is just one part of treatment. Damage to the brain and heart from a lack of oxygen in the blood during carbon monoxide poisoning requires treatment as well.

Depending on the severity of the poisoning, patients could need support for brain and cardiac function. Some patients will need treatment for brain swelling, which could include medications and admission to the intensive care unit.

The heart is sensitive to a lack of oxygen. Patients could experience cardiac arrhythmias (irregular heartbeats), which could be treated in the hospital with medication or electrical therapy.

High levels of free oxygen in the bloodstream—oxygen molecules that are not bound to hemoglobin, also known as free radicals—can also increase inflammation. This adds to the potential need for cardiac intervention.

Another option is to administer oxygen under pressure in a hyperbaric chamber. You lie in the chamber and breathe 100% oxygen at a pressure that’s about two times higher than normal atmospheric pressure.

In a hyperbaric chamber, oxygen therapy can reduce the elimination half-life of carbon monoxide to about 20 minutes.

Unfortunately, hyperbaric chambers are not always readily available, especially in rural areas. Even in areas that have access to hyperbaric oxygen therapy, it can take a couple of hours to arrange the treatment.

Considering the patient will receive traditional oxygen administration during the waiting period, the benefit of a slightly faster treatment might already be lost. Plus, if multiple patients are affected by carbon monoxide exposure, only one at a time can be treated in the hyperbaric chamber.

There is clear evidence that hyperbaric oxygen therapy clears carbon monoxide from the blood faster. However, evidence is conflicting on whether patients are better off because of it.

One analysis of randomized trials found mixed results looking at the neurological outcomes of carbon monoxide patients receiving hyperbaric oxygen therapy.

Another review of studies showed that hyperbaric oxygen therapy could be more effective than traditional oxygen therapy. It had greater advantages for those with life-threatening carbon monoxide levels or with neurological symptoms.

However, the review noted that traditional oxygen therapy was a reasonable alternative because of its cost-effectiveness and widespread availability.

Hyperbaric therapy could possibly be helpful, especially in cases of severe poisoning, but there’s no reason to fret if it isn’t readily available.

The basic treatment for carbon monoxide poisoning is to administer high-flow oxygen using a non-rebreather mask. This is a face mask with a plastic bag hanging off it connected to a supply of high-concentration oxygen. A one-way valve keeps the air you exhale out of the bag.

You’ll wear the mask as long as it takes to replace the carbon monoxide in your blood with oxygen. Oxygen therapy allows your body to get rid of carbon monoxide faster than just breathing the air around you.

For instance, if you receive 100% oxygen, the elimination half-life of carbon monoxide in your blood would take 74 minutes. Half-life is a measurement of the time it takes to eliminate half of a substance in the body. For complete elimination of the carbon monoxide, it would take 370 minutes —about six hours.

In contrast, the half-life of carbon monoxide without using oxygen is 320 minutes—more than five hours to reduce levels by half.

 At that rate, it would take about a day for the carbon monoxide to be completely removed.

If you’re brought to the hospital with carbon monoxide poisoning, you’ll spend several hours in the emergency department breathing pure oxygen.

Treating carbon monoxide poisoning requires, at a minimum, breathing 100% oxygen concentration for several hours to rid the bloodstream of carbon monoxide.

Always call 911 without delay if you suspect you or someone else has carbon monoxide poisoning.

Carbon monoxide poisoning is a life-threatening emergency. If you suspect that someone has signs of carbon monoxide poisoning, get them outside into fresh air immediately. Call 911.

Symptoms of carbon monoxide poisoning may include headache, fatigue, nausea, chest pain, shortness of breath, dizziness, confusion, irregular heartbeats, or blurry vision.

If you can quickly and safely do so, turn off the source of carbon monoxide.

If the person is unresponsive and isn’t breathing, start CPR right away. Continue until they breathe on their own, someone else can take over CPR, or paramedics arrive. If you’re alone with the person, do CPR for two minutes and then call 911.

Oxygen therapy is the main treatment for carbon monoxide poisoning. That’s because when you breathe carbon monoxide, it binds with and blocks hemoglobin, a protein in your blood that carries oxygen throughout your body. This starves your body of oxygen.

It doesn’t take much carbon monoxide in the air you breathe to get carbon monoxide poisoning. However, it takes a lot of oxygen to get rid of it.

This article discusses the emergency treatment needed for carbon monoxide poisoning. This includes first aid steps, oxygen therapy at the hospital, and other treatment for complications.

Due to the vagueness of most signs and symptoms associated with carbon monoxide poisoning—nausea, vomiting, headache, fatigue, chest pain—other diagnoses are regularly suspected. A high concentration of carbon monoxide at a patient’s home will suggest the possibility of carbon monoxide poisoning, but other causes still have to be ruled out.

The list of differential diagnoses is too broad to identify. Each case is different and should be evaluated based on the patient’s presentation, history, and tests.

Acute carbon monoxide poisoning that comes from high concentrations of carbon monoxide in relatively short periods of exposure is not the only effect of carbon monoxide exposure. Chronic (long-term) carbon monoxide exposure at much lower concentrations may cause tissue damage, especially to the heart and brain.

Even though the levels of carboxyhemoglobin in chronic exposure patients might be lower than in acute patients, there are other ways to identify damage. The most common is to look at the tissues through medical imaging.

In the hospital, a more invasive but more accurate test is used. It is called blood gas.

Blood gas tests measure the amount of atmospheric gases—usually oxygen and carbon dioxide—in the bloodstream by drawing blood from the arteries. Most other blood tests draw blood from the veins, which is easier and safer for the patient.

Arterial gases—rather than venous—measure the potential for hemoglobin to supply oxygen and to remove carbon dioxide. Since carbon monoxide is neither used by nor easily removed from the bloodstream, it can be tested through either arterial or venous blood.

Blood gas tests are considered more accurate than pulse CO-oximetry. Even though oximetry is useful for identifying patients at the scene who potentially have carbon monoxide poisoning, blood gases should be obtained to confirm carboxyhemoglobin levels.

Some first responders have the ability to measure carboxyhemoglobin in the blood using a device called a pulse carbon monoxide oximeter. Specifically, the pulse CO-oximeter measures the saturation of carbon monoxide in the hemoglobin (SpCO). It uses light waves (usually shone through the fingertips) to measure carbon monoxide saturation noninvasively.

Another form of noninvasive measurement uses exhaled air to determine levels of carbon monoxide. Some research has found exhaled CO to be inaccurate as a determinate of carbon monoxide poisoning.

Traditional pulse oximetry, used to measure only whether hemoglobin is saturated with oxgyen or not, is fooled by carbon monoxide poisoning into showing artificially high saturation of oxygen when carboxyhemoglobin is present. This makes it even more important to obtain a good history and physical examination of the patient.