Intoxication with carbon monoxide (carbon monoxide) is a great danger to human life. This substance has neither color nor odor, so it is almost impossible to feel its presence in the air. In such cases, it is necessary to provide first aid to the victim as soon as possible and introduce an antidote. In case of carbon monoxide poisoning , the drug Atsizol is used as an antidote. How does this remedy work? And what other measures must be taken to save the patient? We will answer these questions in the article.
The effect of carbon monoxide on the body
Carbon monoxide (formula - CO) has a negative effect on many organs and systems. A person can get poisoning with this substance, taking only a few breaths. Let us consider in more detail what happens in the body after inhalation of carbon monoxide:
- Carbon monoxide reacts chemically with a blood protein called hemoglobin. In this case, a substance is formed - carboxyhemoglobin. It creates obstacles to the saturation of tissues and organs with oxygen, which causes hypoxia. This has an extremely negative effect on brain neurons.
- CO interacts with muscle protein - myoglobin. This negatively affects the work of the myocardium. It becomes very difficult for the heart to pump blood and supply other organs with oxygen.
- Carbon monoxide disrupts the metabolism and biochemical processes in the body.
Intoxication leads to severe oxygen deficiency. First of all, it affects the functioning of the brain. In severe poisoning, damage to the central nervous system may be irreversible.
Causes of poisoning
A person can be poisoned by carbon monoxide both in domestic conditions and in the workplace. Toxicologists identify the following causes of poisoning:
- Inhalation of gaseous substances resulting from combustion. Carbon monoxide is one of the products of combustion. Quite often, people get intoxication during fires or staying in a smoky room.
- Gas leak. Carbon monoxide is used in chemical plants as a raw material and a reagent. If safety rules are violated, workers may be poisoned by this substance.
- Inhalation of car exhaust. A fairly large amount of carbon monoxide is contained in the exhaust gas. If the car’s engine runs in a closed and unventilated space, then a person can very quickly get severe poisoning.
- Improper use of furnaces for heating. The use of faulty furnace equipment becomes a fairly common cause of poisoning. Late closure of the damper in the furnace also leads to CO accumulation.
ICD code
The international classification of diseases considers this intoxication as the effect of a toxic substance of non-medical use. Such pathologies are indicated by codes T51 - T65. The complete code for carbon monoxide poisoning according to ICD-10 is T58.
The degree and symptoms of intoxication
Doctors distinguish several degrees of carbon monoxide poisoning:
The severity of intoxication depends on the concentration in the blood of the product of the binding of carbon monoxide to blood proteins - carboxyhemoglobin. The higher the rate of this substance, the more pronounced signs of poisoning.
With a mild degree of intoxication, the content of carboxyhemoglobin in the blood of the victim does not exceed 30%. At the same time, the patient is conscious, but his condition noticeably worsens. Mild poisoning is accompanied by the following symptoms:
- squeezing headaches;
- nausea and vomiting;
- tinnitus;
- increased lacrimation;
- runny nose;
- cough without sputum;
- sore throat.
Since carbon monoxide is odorless, the victim does not always associate this symptomatology with poisoning. Often patients take intoxication symptoms for manifestations of a respiratory disease.
In case of moderate poisoning, the level of carboxyhemoglobin in the blood plasma is from 30 to 40%. The resulting hypoxia adversely affects the state of the cells of the central nervous system. A person either loses consciousness for a short period of time, or becomes excessively sleepy, depressed, weakly reacts to stimuli. Intoxication of moderate severity is also characterized by the following symptoms:
- severe shortness of breath;
- dilated pupils;
- heart pain;
- heart palpitations;
- redness of the skin and eyes;
- hearing and vision impairment;
- cramps
- mental disorders.
Severe intoxication occurs when the level of carboxyhemoglobin increases to 40 - 50%. Due to severe oxygen starvation, the patient falls into a coma. A dangerous degree of poisoning is accompanied by the following manifestations:
- cyanosis of the skin;
- shallow breathing;
- weak pulse;
- cramps
- involuntary discharge of urine and feces.
If the CO content in the environment exceeds 1.2%, then a person develops a fulminant form of poisoning. The level of carboxyhemoglobin in the blood rises to 75%. In this case, the victim dies from severe hypoxia within 3-4 minutes.
Complications
The risk of complications depends on the severity of intoxication. Often, negative consequences occur even in cases where the victim was helped on time and an antidote was administered. Carbon monoxide poisoning can affect the body of the victim for a long time after recovery. The process of restoring health is often very slow.
If the patient has suffered mild or moderate poisoning, then after a detoxification, the following symptoms may persist:
- Frequent headaches. This is a consequence of hypoxia. Pain can be aggravated by changes in weather and atmospheric pressure.
- Emotional lability. After recovery, patients often complain of frequent mood swings, irritability, and tearfulness.
- Cognitive impairment. It becomes difficult for the patient to absorb and memorize new information.
- Visual disturbances. After recovery, visual acuity may decrease. Often patients complain of flickering of black small dots in front of their eyes.
Severe intoxication can have serious long-term effects. Due to damage to the heart muscle, the risk of myocardial infarction increases. After suffering hypoxia, small hemorrhages often remain in the brain tissues, which cause neurological disorders. In addition, inhaling CO negatively affects the state of the lung tissue, and pneumonia may occur after recovery.
Help before the doctors arrive
If carbon monoxide poisoning is suspected, an ambulance crew must be called in immediately. A complete detoxification at home is not possible. However, before the doctors arrive, the victim must be given first aid. This will help to somewhat reduce the harmful effects of CO on the body.
It is necessary to adhere to the following algorithm for the provision of first aid for carbon monoxide poisoning:
- At the entrance to the room where the victim is located, you need to hold your breath. You can also cover your nose and mouth with a wet cloth. This will help protect yourself from inhaling toxic gas.
- The victim must be taken out of the poison zone as soon as possible.
- If the patient is in the building, then after the evacuation he needs to be given a sweet caffeinated drink (sweet tea or coffee). This will help activate respiratory function and cardiac activity.
- If the victim lost consciousness, then he is laid on his side. This will help prevent vomiting from entering the respiratory system. Then you need to moisten the cotton wool in ammonia and let the patient smell it.
- If the pulse is not palpable, and there is no breathing, then it is necessary to conduct resuscitation measures (artificial respiration and indirect heart massage).
Doctors should not leave the injured person alone until the doctors arrive. It is necessary to constantly monitor the patient's heartbeat and breathing.
Health care
Further first aid measures for carbon monoxide poisoning are undertaken by a team of doctors and paramedics. It is necessary to reduce the harmful effects of CO on the body, conduct antihypoxic therapy, and restore normal breathing and heart function. The algorithm for emergency medical care is as follows:
- As an antidote for carbon monoxide poisoning, it is necessary to introduce the drug Atsizol. This tool helps cleanse the body of the toxin and reduce the formation of carboxyhemoglobin.
- If the patient is conscious, then he is shown inhalation of oxygen. O 2 is supplied using a special balloon or oxygen pad. Oxygen therapy helps to reduce hypoxia and reduce the concentration of carboxyhemoglobin in the blood.
- If the victim does not have a pulse and breathing, then an adrenaline injection is given. This hormone helps activate cardiovascular activity. Only after this can further resuscitation measures be carried out.
- Then they begin artificial ventilation of the lungs (IVL) with the help of a reusable Ambu bag (adult or child). This is a special device for resuscitation by hand. Air is supplied directly to the patient's lungs through a tube or mask by rhythmically pressing the reservoir with air.
- If after the above measures the patient did not recover heart function, then a precardial stroke is performed. From a height of about 20 cm, the doctor punches the victim’s sternum with his fist. This measure is contraindicated if the patient retains respiratory movements and has a pulse on the carotid artery.
- If the precardial stroke did not lead to the desired result, then a defibrillator is used to restore the heart.
After providing first aid, the doctor decides on the need for hospitalization of the patient in a hospital.
Antidote description
Let's consider in more detail the drug "Atsizol". The antidote for carbon monoxide poisoning is administered intramuscularly in an amount of 1 ml. This medicine reduces the binding of hemoglobin to carbon monoxide. As a result, the formation of toxic carboxyhemoglobin is suppressed. This reduces hypoxia and eases the patient's condition. In addition, the drug contributes to the speedy removal of toxic substances from the body.
The instructions for the use of "Atsizol" indicate that the antidote after poisoning must be entered as soon as possible. This will help to avoid an increase in the concentration of carboxyhemoglobin in the blood and the development of severe intoxication.
There are no serious contraindications to the use of the antidote. In case of CO poisoning, the drug is administered in any case, since it is a question of saving the patient's life.
The price of Atsizol in the form of a solution is from 800 to 1100 rubles (for 10 ampoules). This form of medication is used to relieve carbon monoxide poisoning.
The drug is also available in capsule form. This form of antidote is used mainly for the prevention of poisoning. One capsule of antidote is recommended for firefighters and rescuers 30 minutes before entering the carbon monoxide exposure zone. The protective effect of the drug lasts about 2 hours. The price of Atsizol in encapsulated form is from 500 to 600 rubles.
Introduction scheme
1 ml of “Acizole” is administered immediately after the patient is evacuated from the lesion. After 1 hour, the injection is repeated in the same dosage.
It is important to remember that an adrenaline injection is allowed to be done only after the introduction of the antidote. Indeed, before activating the work of the heart, it is necessary to neutralize toxins and stop the production of carboxyhemoglobin. Therefore, the provision of medical care should always begin with the introduction of an antidote.
In case of carbon monoxide poisoning, the antidote continues to be administered during treatment in a hospital. A full course of intoxication therapy takes about 7 to 12 days.
When is hospitalization necessary?
If a person is poisoned with carbon monoxide, then treatment at home is possible only with a mild degree of intoxication. In most cases, the patient has to be placed in a toxicology department of the hospital. Indications for hospitalization are as follows:
- loss of consciousness (even short-term);
- mental disorders on the background of poisoning;
- impaired coordination of movements;
- a drop in body temperature below normal;
- short termination of the heart and breathing.
Mandatory hospitalization of children, pregnant women and patients with cardiovascular pathologies.
After discharge from the hospital, the patient needs to remain under the supervision of a doctor for some time and undergo all necessary examinations. This will help in time to identify possible complications of intoxication.
Poison Prevention
How to prevent carbon monoxide poisoning? To do this, observe the following safety rules:
- Do not allow the car engine to work in a closed, unventilated area.
- Monitor the health of gas and furnace equipment.
- Ensure the correct position of the furnace flap during space heating.
- Observe safety precautions when working with carbon monoxide in production.
- It is useful to keep a special sensor (gas analyzer) at home that shows the concentration of CO in the air.
These simple measures will help to avoid dangerous poisoning.