User:Mr. Ibrahem/Carbon monoxide poisoning
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Carbon monoxide poisoning | |
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Other names | Carbon monoxide intoxication, carbon monoxide toxicity, carbon monoxide overdose |
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Carbon monoxide | |
Specialty | Toxicology, emergency medicine |
Symptoms | Headache, dizziness, weakness, vomiting, chest pain, confusion[1] |
Complications | Loss of consciousness, arrhythmias, seizures[1][2] |
Causes | Breathing in carbon monoxide[3] |
Diagnostic method | Carboxyl-hemoglobin level: 3% (nonsmokers) 10% (smokers)[2] |
Differential diagnosis | Cyanide toxicity, alcoholic ketoacidosis, aspirin poisoning, upper respiratory tract infection[2][4] |
Prevention | Carbon monoxide detectors, venting of gas appliances, maintenance of exhaust systems[1] |
Treatment | Supportive care, 100% oxygen, hyperbaric oxygen therapy[2] |
Prognosis | Risk of death 1–31%.[2] |
Frequency | >20,000 emergency visits for non-fire related cases per year (US)[1] |
Deaths | >400 non-fire related a year (US)[1] |
Carbon monoxide poisoning typically occurs from breathing in carbon monoxide (CO) at excessive levels.[3] Symptoms are often described as "flu-like" and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion.[1] Large exposures can result in loss of consciousness, arrhythmias, seizures, or death.[1][2] The classically described "cherry red skin" rarely occurs.[2] Long term complications may include feeling tired, trouble with memory, and movement problems.[5] In those exposed to smoke, cyanide toxicity should also be considered.[2]
Carbon monoxide poisoning can occur accidentally, as an attempt to end one's own life, or as an attempt to end another's life.[6][7] CO is a colorless and odorless gas which is initially non-irritating.[5] It is produced during incomplete burning of organic matter.[5] This can occur from motor vehicles, heaters, or cooking equipment that run on carbon-based fuels.[1] It can also occur from exposure to methylene chloride.[8] Carbon monoxide primarily causes adverse effects by combining with hemoglobin to form carboxyhemoglobin (HbCO) preventing the blood from carrying oxygen.[5] Additionally, myoglobin and mitochondrial cytochrome oxidase are affected.[2] Diagnosis is based on a HbCO level of more than 3% among nonsmokers and more than 10% among smokers.[2]
Efforts to prevent poisoning include carbon monoxide detectors, proper venting of gas appliances, keeping chimneys clean, and keeping exhaust systems of vehicles in good repair.[1] Treatment of poisoning generally consists of giving 100% oxygen along with supportive care.[2][5] This should generally be carried out until symptoms are no longer present and the HbCO level is less than 10%.[2] While hyperbaric oxygen therapy is used for severe poisonings, the benefit over standard oxygen delivery is unclear.[2][6] The risk of death among those affected is between 1 and 30%.[2]
Carbon monoxide poisoning is relatively common, resulting in more than 20,000 emergency room visits a year in the United States.[1][9] It is the most common type of fatal poisoning in many countries.[10] In the United States, non-fire related cases result in more than 400 deaths a year.[1] Poisonings occur more often in the winter, particularly from the use of portable generators during power outages.[2][8] The toxic effects of CO have been known since ancient history.[11] The discovery that hemoglobin is affected by CO was made in 1857.[11]