Some first responders have the ability to measure carboxyhemoglobin in the blood using a device called a pulse carbon monoxide oximeter. It uses light waves usually shone through the fingertips to measure carbon monoxide saturation noninvasively. Another form of noninvasive measurement uses exhaled air to determine levels of carbon monoxide. Some research has found exhaled CO to be inaccurate as a determinate of carbon monoxide poisoning. SpCO is not universally measured by all first responders, so history and physical examination is still the gold standard at the scene.
Traditional pulse oximetry, used to measure only whether hemoglobin is saturated with oxgyen or not, is fooled by carbon monoxide poisoning into showing artificially high saturation of oxygen when carboxyhemoglobin is present. This makes it even more important to obtain a good history and physical examination of the patient. In the hospital, a more invasive but more accurate test is used.
It is called blood gas. Blood gas tests measure the amount of atmospheric gases—usually oxygen and carbon dioxide —in the bloodstream by drawing blood from the arteries. Most other blood tests draw blood from the veins, which is easier and safer for the patient. Arterial blood gas tests are the standard for oxygen and carbon dioxide because those gases change significantly before and after blood flows through body tissues. Arterial gases—rather than venous—measure the potential for hemoglobin to supply oxygen and to remove carbon dioxide.
Since carbon monoxide is neither used by nor easily removed from the bloodstream, it can be tested through either arterial or venous blood.
Blood gas tests are considered more accurate than pulse CO-oximetry. Even though oximetry is useful for identifying patients at the scene who potentially have carbon monoxide poisoning, blood gases should be obtained to confirm carboxyhemoglobin levels. Acute carbon monoxide poisoning that comes from high concentrations of carbon monoxide in relatively short periods of exposure is not the only effect of carbon monoxide exposure.
Chronic long-term carbon monoxide exposure at much lower concentrations may cause tissue damage, especially to the heart and brain. Even though the levels of carboxyhemoglobin in chronic exposure patients might be lower than in acute patients, there are other ways to identify damage.
The most common is to look at the tissues through medical imaging. Magnetic resonance imaging MRI is the best way to examine the brain for potential injury from carbon monoxide poisoning. Due to the vagueness of most signs and symptoms associated with carbon monoxide poisoning —nausea, vomiting, headache, fatigue, chest pain—other diagnoses are regularly suspected.
A high concentration of carbon monoxide at a patient's home will suggest the possibility of carbon monoxide poisoning, but other causes still have to be ruled out. The list of differential diagnoses is too broad to identify. Each case is different and should be evaluated based on the patient's presentation, history, and tests.
To determine how much carbon monoxide might be in a person's body, a doctor will measure the levels of carboxyhemoglobin COHgb in their blood. The length of time it takes to recover from carbon monoxide poisoning will depend on how much carbon monoxide you have been exposed to and how long you have been exposed to it.
Prolonged significant exposure to carbon monoxide can cause serious complications, including brain damage and heart problems. It can also cause vision loss and hearing loss. In rare cases, severe carbon monoxide poisoning can cause Parkinsonism, which is characterised by tremors , stiffness and slow movement. Parkinsonism is not the same as Parkinson's disease , which is a degenerative neurological condition linked to ageing.
Coronary heart disease is another serious condition that can develop as a result of long-term carbon monoxide exposure. Coronary heart disease is where the heart's blood supply is blocked or interrupted by a build-up of fatty substances atheroma in the coronary arteries.
If the blood supply is restricted, it can cause angina chest pains. If the coronary arteries become completely blocked, it can cause a heart attack. It's important to be aware of the dangers and identify any appliances in your house that could potentially leak carbon monoxide.
Boilers, cookers, heating systems and appliances should be installed and regularly serviced by a reputable, registered engineer. Anyone carrying out work on installations and appliances in your home must be registered with a relevant association, such as the:. It's very important to be aware of the risk of carbon monoxide poisoning and to look out for warning signs.
Investigate the possibility of a carbon monoxide leak if your pet suddenly becomes ill or dies unexpectedly and their death is not related to old age or an existing health condition. Page last reviewed: 10 April Next review due: 10 April Carbon monoxide poisoning.
Symptoms of carbon monoxide poisoning The symptoms of carbon monoxide poisoning are not always obvious, particularly during low-level exposure. Other symptoms include: dizziness feeling and being sick tiredness and confusion stomach pain shortness of breath and difficulty breathing The symptoms of exposure to low levels of carbon monoxide can be similar to those of food poisoning and flu.
But unlike flu, carbon monoxide poisoning does not cause a high temperature. Your symptoms may be less severe when you're away from the source of the carbon monoxide. If you burn fuel in vehicles, small engines like lawnmowers, water heaters, clothes dryers, grills, gas fireplaces, gas ranges or gas furnaces, you have come in contact with carbon monoxide. Sounds pretty harmless, right? Not always. Carbon monoxide indoors or without proper ventilation can result in carbon monoxide poisoning and can be deadly.
Each year in the US, more than people die from unintentional CO poisoning, more than 20, end up in the emergency room and more than 4, are hospitalized. The fact that CO is odorless and invisible makes it even more dangerous, because people often do not suspect exposure until they have already become ill.
If they are not familiar with the risks and CO poisoning symptoms, they may mistake those symptoms for other illnesses. This is why CO is often referred to as "the silent killer. Keep reading to find out if your family may be at risk for carbon monoxide poisoning and the steps you can take to eliminate that risk. Read more: How often should I replace my fire extinguisher? A proactive approach is always better than a reactive approach when it comes to a potentially deadly hazard. If you have fuel-burning appliances or an attached garage, the proactive approach is to install one depending on the home carbon monoxide detector near every sleeping area and on each floor of your home.
These detectors are calibrated to industry safety standards determined by Underwriters Laboratories and are made to detect the unusual build-up of CO over time. If CO levels exceed industry safety standards, the detector will sound to alert you. This is the best way to determine if you have a CO leak.
We'll talk more about how to buy a carbon monoxide detector later. Even if CO levels are not high enough to be fatal, they can produce serious illness. Where does carbon monoxide come from?
Carbon monoxide is produced by devices that burn fuels. Vehicle exhaust fumes from attached garages also can become CO hazards. How do I know if carbon monoxide is present? For these reasons, CO is called the silent killer. What are some symptoms of carbon monoxide poisoning?
How do I protect myself and my family from carbon monoxide poisoning? Your garage Always back your car out of the garage to let it warm up. Never leave it running in the confined space of a garage, particularly if the garage is attached to the home. Never run lawnmowers, snowblowers, or other gas-powered engines in confined areas like garages or sheds.
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