Currently, carbon monoxide poisoning is one of the most common fatal intoxications. Carbon monoxide is a substance that has no smell or taste. It inevitably enters atmospheric air for any type of combustion. With the penetration of carbon monoxide into the human body, an acute pathological process develops. In the absence of timely and qualified assistance, in most cases a fatal outcome occurs.
The mechanism of development of poisoning
Once in the body, carbon monoxide is very firmly bound to hemoglobin. Moreover, it takes the place of oxygen, displacing it. The resulting compound is called carboxyhemoglobin. The main task of the red blood pigment is to supply oxygen to every cell in the body. In acute carbon monoxide poisoning, this process is disrupted. As a result, tissues begin to experience oxygen starvation, and the brain is most affected.
When inhaling gas in high concentration, the pathological process develops very quickly. After a few seconds, the victim loses consciousness, and within the next minutes a fatal outcome occurs. As a rule, in such cases, any attempts to help are unsuccessful.
Penetration paths
Carbon monoxide enters the body exclusively when inhaled. Most of it is also excreted through the lungs. Only a tiny amount of it leaves the body along with feces, urine and sweat. The process of excretion (by inhalation of minor concentrations) takes an average of 12 hours.
Carbon monoxide is the strongest poison that people can face both in domestic and in industrial conditions. Its danger lies in the fact that it easily penetrates any obstacles: soil, walls, windows, etc. Protective household respirators also almost do not save from carbon monoxide poisoning.
Causes
The following carbon monoxide sources are most dangerous:
- Stoves, fireplaces. The development of intoxication occurs, as a rule, during their improper use.
- Car with a running engine. Often carbon monoxide poisoning occurs when the car is in a wound up state in a garage or other small room in which air is poorly ventilated.
- Propane home appliances. The risk of intoxication is great when it is malfunctioning.
- Apparatus designed to support the breathing process. Poisoning can occur when they are filled with a mixture of low-quality gases.
- Kerosene burning, especially if it occurs over a long period of time and in a poorly ventilated area.
- Gas equipment both at home and in production.
- Fires.
Poisoning can occur during accidents at industrial enterprises, as well as during large-scale explosions in warehouses of military ammunition.
The negative effects of carbon monoxide are most often affected by residents of megacities. This is due to the fact that urban air contains a high concentration of exhaust gases. Poisonous substances gradually accumulate in the body, causing irreversible pathological changes.
Symptoms
The severity of signs of poisoning by carbon monoxide (carbon monoxide) directly depends on the degree of exposure to harmful substances on the body. The following factors affect this indicator:
- The temperature of the environment.
- Carbon monoxide concentration.
- The duration of the negative effects of the poison.
- The state of the body's defenses.
- The presence of diseases of the blood, lungs, cardiovascular system.
- The degree of physical exhaustion.
Women are more resistant to carbon monoxide than men. In addition, the following categories of persons are especially difficult to tolerate poison, even in minor concentrations:
- Children.
- Pregnant women.
- Abusers of smoking and drinking alcohol.
The clinical picture depends on the degree of carbon monoxide poisoning. She may be:
- Easy. The concentration of carboxyhemoglobin in the blood of the victim is from 13 to 19%. In such cases, the following signs of carbon monoxide poisoning appear: a pronounced headache, a feeling of weakness in the lower extremities, fever, bright spots on the face (mainly on the cheeks), shortness of breath, tinnitus, and a decrease in the speed of psychomotor reactions. With a mild degree of intoxication, the patient is enough to bring to fresh air. The result of this action is the quick elimination of unpleasant symptoms.
- Average. The concentration of toxic compounds in the blood ranges from 30-35%. With this severity, the patient has the following symptoms of carbon monoxide poisoning: impaired motor function; the severity of a feeling of weakness in the lower extremities increases; nausea appears, turning into vomiting. Often a person experiences drowsiness or faints.
- Heavy. The level of carboxyhemoglobin in the blood of the victim is from 35 to 50%. Signs of poisoning: red skin (limbs are pale at the same time), rapid pulse (100-120 beats per minute), low blood pressure, impaired breathing, high body temperature, cramps. Often a severe degree of intoxication is accompanied by a prolonged loss of consciousness (10 or more hours). In the absence of help, the patient falls into a coma.
- Lightning fast. It is characterized by an extremely high concentration of poison. The clinical picture is as follows: a person loses consciousness; its mucous membranes, skin of the face, hands and feet acquire a bright red color; muscle cramps are observed. When the level of carboxyhemoglobin in the blood exceeds 50%, a lethal outcome occurs.
Diagnostics
Carbon monoxide poisoning is fairly easy to identify based on the history and available clinical picture. In the absence of consciousness, it is necessary to conduct differential diagnosis with other types of intoxication, myocardial infarction and stroke. In addition, if carbon monoxide poisoning is suspected, the patient is taken blood and examined for the presence of carboxyhemoglobin.
First aid
The patient must be taken out of the affected area as soon as possible. Then you need to immediately call an ambulance crew. In case of carbon monoxide poisoning, all measures to save the life of the victim should be performed according to the following algorithm:
- If the patient is unconscious, lay him on his side. Ensure that his airways are clear. Undo the upper buttons on his clothes, loosen the belt.
- Moisten a piece of cotton or cloth with ammonia. Bring to the victim’s nose. To rub the skin (this is necessary to stimulate the blood circulation process). Check for heart rate. In his absence, conduct an indirect heart massage.
- If the victim is conscious, put on his chest or a cold compress, or mustard. As often as possible, offer him hot, sweet drinks, such as tea.
- Provide the victim peace (both emotional and physical), but do not leave him alone until the arrival of doctors.
The antidote for carbon monoxide poisoning is the drug Atsizol. If you have medical skills, you must enter it intravenously.
Treatment
The victim is shown urgent hospitalization. All medical measures are carried out exclusively in a hospital setting.
In case of impaired or complete loss of consciousness, as well as with a level of carboxyhemoglobin in the blood above 25%, hyperbaric oxygenation is indicated. In addition, this method of treatment is applicable to children and pregnant women. The victim is placed in a pressure chamber, where he is for some time, inhaling pure oxygen. This type of therapy has a positive effect only in the first few hours after carbon monoxide poisoning.
The following procedures also apply to therapeutic measures:
- mechanical ventilation;
- transfusion of donated blood (whole or only red blood cell mass);
- intravenous administration of cardiotonic or hypertonic solutions.
Carbon monoxide poisoning rarely goes unnoticed. In most cases, people develop the following complications: memory lapses, frequent headaches, regular episodes of nausea, fainting, depression, mental disorders, and muscle tone disorders.
Prevention
Measures to prevent the occurrence of poisoning should be known first of all to persons whose activities are connected with staying at enterprises where carbon monoxide leakages are likely to occur due to an accident. In addition, people who are faced with dangerous poison in everyday life should be aware of them.
Preventive actions:
- Strictly observe the rules of conduct and safety in enterprises whose activities involve the use of carbon monoxide.
- Clean chimneys every year.
- Do not operate faulty heating equipment.
- Do not start the car engine for a long time if this vehicle is in the garage.
In addition, city dwellers need to avoid busy roads when walking, as there the concentration of exhaust gases in the air is extremely high.
Finally
Carbon monoxide is a dangerous poison that can be fatal if inhaled. The determining factor is the timeliness of first aid. In case of carbon monoxide poisoning, it is necessary to remove the victim to fresh air and call an ambulance crew.