Carbon Monoxide Poisoning: A Review
Carbon monoxide (CO) is an odorless and colorless gas that is produced when fuels such as wood, coal, gasoline, natural gas, and propane are burned. It is known as a major environmental pollutant and is also a major cause of accidental poisoning in humans. Carbon monoxide poisoning (COP) occurs when CO accumulates in the body and causes the hemoglobin in the blood to bind more strongly to the oxygen, making it difficult for the body to take up oxygen. This article reviews the epidemiology, clinical features, diagnosis, and treatment of COP.
Epidemiology
Carbon monoxide poisoning is one of the leading causes of accidental poisoning in the United States. According to the Centers for Disease Control and Prevention (CDC), there were an estimated 20,000 emergency room visits and 4,000 deaths due to unintentional CO poisoning in 2013. Of these, approximately 50% of the deaths occurred in the home. The highest rates of death from unintentional CO poisoning occur in the winter months, when people are more likely to use heating sources that burn fuel and produce CO.
Clinical Features
The clinical features of COP vary depending on the concentration of exposure and the duration of exposure to the gas. In mild cases, symptoms may include headache, dizziness, confusion, nausea, and vomiting. In more severe cases, symptoms may include seizures, loss of consciousness, and even death. Additional symptoms of COP may include chest pain, palpitations, shortness of breath, and weakness.
Diagnosis
The diagnosis of COP is typically made based on the history of exposure and the presence of symptoms. The level of carboxyhemoglobin in the blood can also provide confirmation of the diagnosis. The diagnosis can also be made using pulse oximetry, which measures the amount of oxygen in the blood, or with an electrocardiogram (ECG), which can detect changes in heart rate and rhythm.
Treatment
The treatment for COP depends on the severity of the poisoning. In mild cases, the patient may be given oxygen therapy to increase the amount of oxygen in the blood. In more severe cases, the patient may need to be intubated and placed on a ventilator to help them breathe. In some cases, hyperbaric oxygen therapy may be used to reduce the amount of CO in the blood.
Conclusion
Carbon monoxide poisoning is a serious and potentially life-threatening condition that can occur when CO accumulates in the body. It is a major cause of accidental poisoning in the United States and can cause a wide variety of symptoms. The diagnosis is typically made based on the history of exposure and the presence of symptoms, and the treatment depends on the severity of the poisoning.
References
Centers for Disease Control and Prevention (CDC). (2016). Carbon Monoxide Poisoning. Retrieved from https://www.cdc.gov/co/faqs.htm
Hampson, N. B. (2008). Carbon Monoxide Poisoning. American Family Physician, 78(5), 617-622.
Vilke, G. M., & Chan, T. C. (2015). Carbon Monoxide Poisoning. Emergency Medicine Clinics of North America, 33(3), 463-474.