poisoned by carbon monoxide
Introduction
Introduction to carbon monoxide poisoning Carbon monoxide poisoning is a poisoning caused by inhalation of the product through the respiratory tract when the carbonaceous material is incompletely burned. CO is a colorless, odorless, odorless gas. Any carbon or carbonaceous material that burns when oxygen is insufficient can produce CO. When using wood stoves and coal stoves, such as the ventilation system is not smooth, especially in recent years, improper use of gas heaters and gas water heaters has greatly increased CO poisoning. Because CO is a colorless, odorless gas, it is called a "silent killer." After inhaling CO, the human body is often unaware, and even after some serious symptoms, it still does not know why, and continues to be in a high concentration of CO environment until death. When CO enters the body, part of it binds to hemoglobin, causing a significant decrease in hemoglobin oxygen transport. The other part directly binds to cytochrome a3 in the mitochondria of cells, inhibiting intracellular respiration. Therefore, the clinical manifestations of CO poisoning may be inconsistent with the level of HbCO in blood. basic knowledge The proportion of illness: 3% Susceptible people: no special people Mode of infection: non-infectious Complications: shock, disseminated intravascular coagulation
Cause
Causes of carbon monoxide poisoning
Cause of the disease (80%):
CO is a colorless, odorless, odorless gas. Any carbon or carbonaceous material that burns when oxygen is insufficient can produce CO.
Pathogenesis:
CO + Hb HbCO hypoxemia tissue hypoxia (mainly), CO + myoglobin, cytochrome 3 damage mitochondrial function, block the electron transport chain, delay the oxidation of NADH, inhibit tissue respiration.
Prevention
Carbon monoxide poisoning prevention
1. It should be widely publicized that there should be safety settings (such as chimneys, small ventilation windows, wind buckets, etc.) when using coal fire indoors, indicating the possible symptoms and first-aid knowledge of gas poisoning, especially the harm and seriousness of gas to small infants. The coal stove chimney should be installed reasonably, and the coal stove without chimney should be placed outdoors at night.
2, do not use the elimination of water heaters, such as in-line water heaters and flue-type water heaters, these two water heaters are prohibited by the state regulations for production and sales, do not use over-service water heaters, the installation of water heaters is best to install professional, not self Install, dismantle, and modify the burning appliance. Do not close the bathroom doors and windows when showering in winter, do not take too long shower time.
3. When driving, do not let the engine idle for a long time. When the car is stopped, do not open the air conditioner for a long time. Even when driving, you should always open the window to make the air inside and outside the car convect. If you feel uncomfortable, stop and rest. When driving or taking an air-conditioned car, if you feel dizzy, sunk, or limb weakness, you should open the window and breathe fresh air in time.
4. Install a carbon monoxide alarm in a place where carbon monoxide may be produced. The carbon monoxide alarm is a device specially designed to detect the concentration of carbon monoxide in the air. It can alarm when the concentration of carbon monoxide exceeds the standard, and some can forcibly open windows or exhaust fans to keep people away from carbon monoxide.
Complication
Carbon monoxide poisoning complications Complications, diffuse intravascular coagulation
Concurrent pneumonia and cerebral edema.
Symptom
Symptoms of carbon monoxide poisoning Common symptoms Nausea cerebral hypoxia, dizziness, fatigue, chest tightness, hyperventilation, palpitations, convulsions, coma
The signs and symptoms of CO poisoning vary greatly, depending on many factors, such as exposure concentration, exposure time, etc., the symptoms are not strong, can be expressed as flu-like, mental state changes, convulsions, coma, gastrointestinal symptoms, shortness of breath, Hyperventilation, headache, arrhythmia, angina and polycythemia, symptoms and signs of cerebral hypoxia and poisoning are the main manifestations of CO poisoning. Mild cerebral hypoxia can manifest as dizziness, vertigo, headache, general fatigue, nausea and vomiting. Chest tightness, palpitations, etc., severe cerebral hypoxia patients with coma accompanied by increased muscle tone and cortical rigidity, patients with circulatory function in the state of compensation may be the first symptoms, and most serious, such as patients with coronary heart disease, after severe poisoning Acute myocardial infarction.
Examine
Carbon monoxide poisoning check
Laboratory examination: Plasma HbCO levels provide a clear basis for diagnosis of CO poisoning. HbCO has a reliable clinical significance only after being measured immediately after poisoning.
Other auxiliary examinations: EEG, diffuse low-wavelength slow waves often occur in CO poisoning.
Diagnosis
Diagnosis and identification of carbon monoxide poisoning
diagnosis:
Acute poisoning can be diagnosed according to the following conditions: exposure history (especially similar symptoms and signs of more than two people), clinical manifestations of central nervous system damage and exclusion of other neurological disorders, if necessary, blood HbCO2 determination. It is not possible to judge the prognosis or formulate a plan accordingly. There is also a lack of correlation between clinical symptoms and HbCO2 levels. Arterial blood gas examination has no special clinical significance.
Differential diagnosis:
Acute CO poisoning must be differentiated from diseases such as mental illness, upper respiratory tract infection, alcoholism, cerebrovascular accident, heart disease, food poisoning, diabetic ketoacidosis, hypoglycemia and coma.
