Carbon monoxide poisoning

The symptoms of carbon monoxide poisoning are similar to those seen in flu, but unlike flu, it does not present with a high fever. The common signs of carbon monoxide poisoning are:

• Tension-type headache (continuous headache that lasts for hours) 
• Dizziness
• Fatigue
• Nausea and vomiting
• Confusion
• Stomach ache
• Shortness of breath
• The feeling of being sick

If a person inhales a large amount of carbon monoxide, they may present with severe symptoms of poisoning. The more severe signs of carbon monoxide poisoning include:

• Altered mental state 
• Vision problems
• Changes in the personality and behaviour
• Feeling extremely dizzy (vertigo)
• Slurred speech and loss of coordination (ataxia) 
• Difficulty breathing
• Rapid heart rate (tachycardia)
• Severe chest pain 
• Seizures (fits)
• Loss of consciousness which may result in death within minutes

Carbon monoxide poisoning may occur when a person accidentally inhales fumes from a fire.

Once a person inhales carbon monoxide, it replaces oxygen in his/her red blood cells. This prevents healthy oxygen from reaching the tissues and organs of the body.

Carbon monoxide is usually produced by various fuel-burning appliances. When the smoke produced by these sources gets locked in a closed or partially closed space, it can raise carbon monoxide to dangerous levels. Smoke inhalation during a fire also can cause carbon monoxide poisoning. 

Carbon monoxide is also produced by the household appliances that use gas, oil, coal or wood. Inaccurately installed or poorly ventilated household appliances such as cookers, heaters, and boilers can lead to accidental exposure to carbon monoxide. Other reasons for carbon monoxide poisoning include:

• If your chimneys and flues are blocked, it can stop carbon monoxide from escaping, thus allowing it to reach dangerous levels inside the house or office.
• Burning fuel in an unventilated space such as running a car engine, petrol-powered generator or barbecue inside a closed space can lead to an increase in the levels of carbon monoxide in that space.
• Blocked exhausts can also store a large amount of carbon monoxide in the exhaust pipes.
• Inhaling methylene chloride (present in most paint removers) can be dangerous to the body as it gets broken down into carbon monoxide in the body, thus leading to carbon monoxide poisoning.
• Smoking shisha pipes (which use burning charcoal and tobacco) can lead to a build-up of carbon monoxide in unventilated or poorly ventilated houses.

People who are in occupations like welding, garage mechanics, firefighters, engine operators and others are at an increased risk of carbon monoxide poisoning.

Though anyone who comes in contact with carbon monoxide is at risk of carbon monoxide poisoning, infants, the elderly and people with heart disease, anaemia, or breathing difficulty are at an increased risk of carbon monoxide poisoning.

Also, people who smoke already have higher than normal levels of carboxyhaemoglobin in their blood, which makes them more prone to carbon monoxide poisoning. Normally the haemoglobin in our blood carries oxygen, but when the body gets exposed to carbon monoxide it binds with carbon monoxide and is called carboxyhaemoglobin.

Carbon monoxide can be highly dangerous as it can lead to a silent death. These are some of the ways in which you can prevent carbon monoxide poisoning: 

• Do not burn charcoal inside your house as it releases high levels of carbon monoxide on burning.
• You can instal a battery-operated carbon monoxide detector in your home which will wake you up with an alarm if the levels of carbon monoxide increase inside the house.
• Get your heating systems, water heaters and other gas and oil appliances serviced every year.
• Try to avoid using chemical heaters indoors. 
• Do not use ovens or gas ranges to heat up your home.
• Clean your chimneys every year to remove the possible build-up of carbon monoxide in them. 
• Do not patch up your vent pipe with tape or gum as it can increase the risk of gas leakage. 
• Generators should be kept in the basement or garage. They should be kept at a distance of 20 feet from any window, door, or vent.

Since the symptoms of poisoning are quite similar to that of the flu, the doctor would have to do blood tests to diagnose the levels of carbon monoxide in the blood. The doctor may also perform an electrocardiogram (ECG) to test the condition of the heart. In people with neurological symptoms, the doctor may recommend a magnetic resonance imaging scan (MRI scan) or computed tomography scan (CT scan) of the brain.

As soon as the patient arrives at the hospital, the doctor would diagnose their poisoning by the symptoms and by testing the carbon monoxide levels in their blood.

If the levels of carboxyhaemoglobin reach 30%, it indicates severe exposure. People who have mild carbon monoxide poisoning, do not require medical treatment, but they should not return to their homes until the safety is checked. 

The treatment of moderate and severe carbon monoxide poisoning involves:

• The primary treatment of carbon monoxide poisoning includes standard oxygen therapy. In this therapy, the person is given 100% oxygen through a tight-fitting mask (the normal air we breathe in contains around 21% oxygen). Breathing such high concentrations of oxygen would help in reducing the levels of carbon monoxide by 10%. 
• The doctors can also use hyperbaric oxygen therapy to overcome the oxygen shortage caused by severe carbon monoxide poisoning. Hyperbaric oxygen therapy is given inside an oxygen chamber which has twice the air pressure of normal air, which helps in increasing oxygen levels in the blood.
• Other treatments involve treatment of the symptoms associated with poisoning. The time of recovery depends on how much carbon monoxide the patient was exposed to and for how long.

Once a person is exposed to carbon monoxide, they must be provided with treatment immediately as it can lead to severe brain damage, heart problems and even death.

A person with severe carbon monoxide poisoning would present with severe breathlessness, chest pains, seizures and loss of consciousness.

Prolonged exposure to carbon monoxide can lead to the following complications:

• Moderate or severe carbon monoxide exposure can cause difficulty in remembering things.
• Severe carbon monoxide exposure can result in vision loss and hearing loss.
• Severe carbon monoxide poisoning can lead to Parkinsonism, a condition in which the person suffers from continuous shivering, stiffness in the body and slow movement. 
• Severe carbon monoxide poisoning can also lead to coronary heart disease, where the heart's blood supply is blocked due to a build-up of plaque.
• In case of blocked blood supply, the person may suffer from angina (chest pain) and even heart attack. 
• Long-term exposure to carbon monoxide in pregnant women can increase the risk of low birth weight, stillbirth and even death.