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Carbon Monoxide Poisoning

Definition

Carbon monoxide poisoning can be a deadly condition. It results from inhaling carbon monoxide gas. Carbon monoxide is produced when gas, wood, charcoal, or other fuel is burned. It often builds up when fuel-burning heating and cooking devices are faulty or not properly vented. A car engine can also produce carbon monoxide, as can cigarette smoking. Carbon monoxide is an odorless, tasteless, and colorless gas. People can inhale it without knowing.

Once the gas is inhaled, it is easily absorbed through the lungs. Hemoglobin carries oxygen in the blood to the entire body. Carbon monoxide binds tightly with hemoglobin and takes the place of the oxygen. Tissue then becomes starved for oxygen. Brain tissue is very much at risk.

Carbon Monoxide Binding to Hemoglobin
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Causes

Inhaling carbon monoxide gas causes carbon monoxide poisoning.

People can be exposed to the gas when fuel-burning appliances are broken or are not vented properly. For instance:

  • If a vent pipe has a hole, carbon monoxide can escape into the house.
  • Using a barbecue grill or camp stove indoors can cause a build-up.
  • Running a car engine with the garage door closed will cause a build-up.

Risk Factors

Factors that may increase of your chance of carbon monoxide poisoning include:

  • Exposure to carbon monoxide through improperly vented or faulty appliances
  • Use of portable generators, especially after a natural disaster
  • Age:
    • Fetuses—maternal cigarette smoking is a major source of exposure
    • Infants
    • Older adults
  • Smoking—waterpipe tobacco smoking may put you at an even higher risk
  • Cold external enviroment
  • Blood, heart, or lung conditions

Symptoms

Symptoms related to carbon monoxide poisoning are usually vague. They can be split into acute and chronic symptoms.

Acute Symptoms

  • Headache
  • Rapid heart rate
  • Chest pain
  • Nausea or vomiting
  • Shortness of breath
  • Disturbed vision
  • Wheezing
  • Cough
  • Hoarse voice
  • Loss of balance
  • Joint pain

Chronic Symptoms

  • Rapid heart rate
  • Headache
  • Numbness and tingling
  • Disturbed vision
  • Loss of appetite
  • Disturbed sleep
  • Dizziness or vertigo
  • Tiredness
  • Memory loss
  • Mood disorder and emotional distress
  • Diarrhea and abdominal pain
  • Reduced sex drive

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. You will be asked questions about:

  • Whether symptoms come and go
  • If anyone else in the household feels ill
  • If you use fuel-burning appliances

Tests may include:

  • Blood tests—to measure oxygen level and electrolytes
  • Carboxyhemoglobin test—to help determine the severity of exposure and monitor treatment
  • Chest x-ray—to determine if pneumonia is present
  • Electrocardiogram—to check the heart's electrical activity and look for signs of heart damage

Treatment

Move away from the source of the carbon monoxide. Breathe fresh air outdoors. Mild symptoms usually start to resolve after getting away from the gas.

Seek medical care at the closest emergency room. Explain that you think you may have been exposed to carbon monoxide. The doctor will give you oxygen until your symptoms go away and carbon monoxide levels in your blood drop.

Other therapies may include:

  • Ventilator—to assist in breathing for people in a coma, or who have serious heart or nerve involvement
  • Hyperbaric oxygen therapy—a special chamber in which oxygen is given under greater pressure than normal

Prevention

Avoiding exposure to carbon monoxide is the key to preventing carbon monoxide poisoning. Since the gas has no odor or color, you will not know if it is present. The following suggestions can reduce your risk of exposure:

  • Have an expert check your fireplace chimney every year. Debris can block vents, causing a build-up of carbon monoxide.
  • Before the start of the heating season, have a professional check that your gas and kerosene appliances are working properly.
  • Make sure all gas and combustion appliances are vented to the outdoors through pipes with no holes.
  • Do not use your gas stove or oven for heating your house.
  • Do not use a barbecue grill, camp stove, or unvented kerosene heater inside your house or tent.
  • Do not use generators or other gasoline-powered engines indoors.
  • Only buy and use equipment that carries the seal of the American Gas Association or the Underwriters' Laboratory.
  • Do not rely exclusively on a carbon monoxide detector. Use one only as backup, in addition to preventive measures. Follow manufacturer's directions for installation and maintenance.
  • Ask a mechanic to check your car's exhaust system every year.
  • Do not run the car in the garage, especially with the door closed. Start the car and take it outside.
  • Do not leave the door from the garage to the house open when the car engine is running.

Revision Information

  • United States Consumer Product Safety Commission

    http://www.cpsc.gov

  • United States Environmental Protection Agency

    http://www.epa.gov

  • Health Canada

    http://www.hc-sc.gc.ca

  • Public Health Agency of Canada

    http://www.phac-aspc.gc.ca

  • Breimer LH, Mikhailidis DP. Could carbon monoxide and bilirubin be friends as well as foes of the body? Scand J Clin Lab Invest. 2010;70(1):1-5.

  • Carbon monoxide poisoning. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/co. Updated October 31, 2012. Accessed December 30, 2013.

  • Cecil RL, Goldman L, et al. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

  • Conn HF, Rakel RE, et al. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.

  • Ferri F, ed. Ferri’s Clinical Advisor 2010. Philadelphia, PA: Mosby Elsevier; 2009.

  • Goldman L, Ausiello D, eds Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

  • Harrison TR, Fauci AS. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: The McGraw-Hill Companies; 2000.

  • An introduction to indoor air quality: carbon monoxide (CO). Environmental Protection Agency website. Available at: http://www.epa.gov/iaq/co.html. Updated March 14, 2013. Accessed December 30, 2013.

  • Juurlink DN, Buckley NA, et al. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2005;(1):CD002041.

  • Marx J, Hockberger R, et al. Rosen's Emergency Medicine. 7th ed. St. Louis, MO: Mosby; 2009.

  • Rakel R. Textbook of Family Medicine 2007. 7th ed. Philadelphia, PA: Saunders Elsevier; 2009.

  • Rakel R, Bope E. Conn's Current Therapy. 60th ed. Philadelphia, PA: Saunders Elsevier; 2009.

  • Rosen P, Barkin RM, et al. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, MO: Mosby-Year Book, Inc.; 1998.

  • Weaver LK, Hopkins RO, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002; 347:1057-1067.

  • World Health Organization (WHO) Study Group on Tobacco Product Regulation. Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators. World Health Organization website. Available at: http://whqlibdoc.who.int/publications/2005/9241593857%5Feng.pdf. Published 2005. Accessed December 30, 2013.