home Diseases Carbon monoxide is the first to strike. Why is carbon monoxide dangerous? There are two of them - fainting and euphoric

Carbon monoxide is the first to strike. Why is carbon monoxide dangerous? There are two of them - fainting and euphoric

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Carbon monoxide poisoning (carbon dioxide poisoning) is acute pathology, which develops when toxic carbon monoxide enters the body. Without providing fast, qualified first aid and high-quality medical treatment carbon monoxide poisoning in the presence of primary symptoms, this problem often leads to death.

How exactly does carbon monoxide affect the body? What are the first symptoms of poisoning? What first aid can be provided to the victim? You will read about this and much more in our article.

How does carbon monoxide affect the body?

Carbon monoxide is a special form of carbon monoxide and is most often formed during the incomplete combustion of various substances containing classical carbon. In modern conditions, the overwhelming majority of it is formed from the exhaust gases of cars with an internal combustion engine, but there are also household and natural sources of CO production.

Carbon monoxide itself, being odorless and colorless, has good penetrating ability, easily seeps through soil, partitions and even thin walls, while it is not absorbed by most simple porous materials, which makes the use of standard gas masks based on an atmospheric air filtration system ineffective (the exception is complexes with the ability to install a hopcalite cartridge).

The main danger of CO for the body lies in the triple pathological effect of carbon monoxide on a number of systemically important processes:

Blocking the delivery of oxygen to tissues and organs. CO actively interacts with hemoglobin in the blood, forming carboxyhemoglobin compounds, as a result of which the erythrocyte masses partially or completely cease to transfer oxygen to organs and tissues, which provokes almost immediate hypoxia;
Disruption of the heart muscle. CO binds to myoglobin, which leads to a deterioration in heart function with characteristic manifestations - weakening of the pulse, the appearance of shortness of breath and arrhythmia;
Formation of muscle weakness. Carbon monoxide pathologically affects the protein structures of smooth muscles, which leads to their weakness, sometimes partial or even complete paralysis of skeletal muscles.

The first signs of carbon monoxide poisoning

As modern medical statistics show, a person usually gets CO poisoning from prolonged inhalation of exhaust gases. road transport, especially in enclosed spaces, as well as in everyday life against the background of improper operation of heating devices operating on combustion principles, due to leakage of household gas, and so on.

A significant proportion of cases are associated with fires in enclosed spaces, transport cars, airplanes, and so on, when a person dies not from thermal effects as such, but because of the very rapid poisoning Symptoms with loss of consciousness and inability to independently evacuate.

The primary symptoms of carbon monoxide poisoning directly depend on its concentration in the air, as well as the duration of exposure to CO on the body.

As the concentration of carbon monoxide in the blood increases, the following manifestations are noted:

Decreased speed of psychomotor reactions;
Deterioration in performance– both physical and mental;
Dyspnea;
Headache, increasing in intensity depending on the concentration of CO in the blood;
Nausea, weakness, vomiting;
Confusion and impaired coordination of small movements;
Formation of hallucinations, fainting or unconsciousness, weakening of the pulse.

The above primary symptoms characteristic of mild and moderate degrees of poisoning. In severe forms of pathology, the indicated symptoms can be combined and change almost at lightning speed.

Main symptoms of poisoning

Basic symptom complex Carbon monoxide intoxication includes many different negative manifestations.

Mild to moderate degree of intoxication

Mild and moderate forms of pathology (with carboxyhemoglobin content in the blood from 20 to 50 percent) depending on the location of the lesion. Symptoms of mild to moderate carbon monoxide poisoning:

From the central nervous system. Headache of a girdling nature, mild at first, and later of moderate strength and intensity. Tinnitus, decreased quality of vision and hearing, nausea with vomiting, impaired coordination of movement, fogged consciousness and short-term loss of consciousness may also occur. The above manifestations are almost always primary, since it is the central nervous system that first suffers from intoxication;
. Increased heart rate, up to 90 beats per minute. Pain and pressure in the heart area, arrhythmia. These symptoms are formed due to feedback from the intense work of the heart, trying to clear the bloodstream of carboxyhemoglobin and improve the delivery of oxygen to all systems of the body;
. Mostly shortness of breath and rapid breathing. With mild and moderate degrees of poisoning, compensation mechanisms still operate as the body’s reverse response to a progressive lack of oxygen. This is the main symptom of such poisoning;
From the skin and mucous membranes. Their redness is observed, which is the result of increased blood flow speed.

Severe degree of intoxication

As a rule, the lack of prompt and correct treatment for severe forms of carbon monoxide poisoning leads to death.

Symptoms of severe carbon monoxide poisoning:

From the central nervous system. Prolonged loss of consciousness, convulsions, uncontrolled bowel movements and urination, coma. Formed with deep lesions of nerve structures;
From the cardiovascular system. Increased heart rate, up to 130 beats per minute, while it is faintly palpable. Severe arrhythmia against the background of a significant increase in the risk of myocardial infarction (with a complete stop in the delivery of oxygen to the heart muscle);
From the respiratory system. Intermittent and shallow breathing caused by systemic damage to the center of regulation of this function in the brain against the background of the development of generalized decompensation processes;
From the skin and mucous membranes. Pallor of these structures due to profound disruption of oxygen supply to peripheral systems.

Symptoms for atypical forms of poisoning

In some cases of carbon monoxide poisoning, atypical symptoms with a special mechanism of development are diagnosed:

Complications and consequences

In addition to the pathological symptoms directly during the poisoning process, the victim may develop various complications in the post-reactive period, even with timely and complete provision of both first pre-medical and subsequent inpatient and resuscitation care.

Short term

Most of the consequences described below occur 1-2 days after carbon dioxide poisoning:

CNS. Lesions of the nervous periphery with limitation motor activity and sensitivity, constant pain in the head, swelling of the brain, disruptions in the gastrointestinal tract and urinary system, development of new and progression of chronic mental illness, visual and hearing impairment;
Respiratory system. Pulmonary edema;
The cardiovascular system. Violation of coronary circulation and heart rhythm;

Medium term

Most of the consequences described below occur 2-30 days after carbon monoxide poisoning:

CNS, paralysis, various chorea. Systemic psychoses with memory loss, alternating with attacks of apathy, are also diagnosed. Less commonly – blindness and parkinsonism;
Respiratory system. Secondary bacterial pneumonia, obstructive bronchitis;
The cardiovascular system. Myocarditis, angina pectoris, myocardial infarction, cardiac asthma.

First aid

Timely and qualified provision of first aid in the vast majority of cases of carbon monoxide poisoning saves the life of the victim and significantly reduces the risks of developing numerous complications in the post-reactive period of the pathology.

Basic algorithm of first aid actions:

Carbon monoxide is a product released when carbon burns; therefore, anyone can be poisoned by it. A particular danger is that for lethal escape a tiny amount of gas is needed, which has neither color nor odor. The second aspect is the speed of action of the poison; often doctors simply do not have time to provide assistance.

Carbon monoxide (CO) is carbon monoxide that is released along with carbon dioxide (CO2) when burned. True, unlike carbon dioxide, the CO content in the room is required to be much less to cause fatal poisoning. Poisoning with the toxin in question is one of the most common household intoxications, which is why it is so important to know its symptoms in order to prevent disastrous consequences.

CO poisoning ranks first in Russia in terms of mortality among household intoxications. Every year in our country people die, at least, 100 people from . The death of those who are poisoned occurs at the scene of poisoning; doctors simply do not have time to provide assistance to the victims. Therefore, it is so important to start taking rescue measures as early as possible.

The physicochemical properties of CO are such that it is a gas that has neither color nor odor. It is released during the partial combustion of substances containing carbon. To answer the question about carbon monoxide, whether it is heavier or lighter than air, you need to remember your school chemistry course or turn to Wikipedia. With any of the options, we learn that it is lighter than air, and, therefore, during a fire, we need to move, bending as low as possible to the ground.

It easily penetrates thin walls and layers of loose soil. It is not absorbed by materials with a porous structure, which makes filter-type gas masks useless. Carbon monoxide has a rapid, general toxic effect. Thus, when its concentration in the air is over 1.3%, death occurs within 3-4 minutes.

CO is ubiquitous. Consequently, poisoning occurs quite often. You can be poisoned by this gas:

in case of domestic fires;
in industries where CO is used as a reagent (chemical industry, heavy metallurgy);
with insufficient ventilation in rooms with gas equipment, with leaks in gas cylinders (has a characteristic odor due to odorous substances specially added to it, pure CO has no odor);
with prolonged burning of kerosene and gasoline lamps;
In places where car exhaust gases accumulate (major highways, garages), you can also get carbon monoxide poisoning.

Effect on the human body

Carbon monoxide, causing acute poisoning, is a dangerous chemical compound for a living organism.

The following groups of people are especially susceptible to its damaging effects:

people with bad habits(alcoholics, drug addicts and smokers);
teenagers;
women during pregnancy;
children and adolescents under 16 years of age;
people with exhaustion of the body;
people diagnosed with anemia;
people suffering from chronic respiratory diseases, such as bronchial asthma and COPD.

So, the harmful effect on the human body is based on the transformation of the blood composition and damage to the respiratory system.

The main damaging factors of carbon monoxide include:

Blocking transport processes

CO is a blood poison that primarily affects red blood cells (erythrocytes). With the help of hemoglobin protein, which contains iron, cells transport oxygen. When carbon monoxide enters the body, hemoglobin binds more quickly to CO, forming a compound called carboxyhemoglobin. Red blood cells containing such a modified protein lose their ability to deliver oxygen to the organs and tissues of the body, as a result of which they begin to experience oxygen starvation. That is, hypoxia develops.

Nerve cells are the most sensitive to oxygen deficiency. Therefore, the initial signs of CO intoxication will be associated with disorders of the nervous system.

Disorders of skeletal and cardiac muscles

In addition to hemoglobin, which is found in the blood, CO can also bind to myoglobin, which is found in muscle tissue. This also results in the formation of a compound that loses its ability to perform its original function of providing oxygen to the muscle fibers. Thus, symptoms appear in the muscular and cardiovascular systems. These include: shortness of breath, increased heart rate, thready pulse, general muscle weakness.

Carbon monoxide enters into other biochemical reactions of the body, disrupting the metabolic balance in tissues and organs.

Symptoms of carbon monoxide poisoning

For people in classes at risk of fatal CO poisoning, the manifestations and severity of intoxication are directly dependent on the concentration of the toxic gas in the air and the time spent in the poisoned air environment. They range from benign to lethal.

CO concentration, %	Time of onset of symptoms, h	Signs and symptoms that appear
< 0,008	3−5	Slowing of psychomotor reactions, compensatory increase in blood circulation in organs and tissues, chest pain and shortness of breath (with heart failure).
< 0,02	6	Performance deteriorates, headache, dyspnea on exertion, impaired perception and vision, death in persons with heart failure and in the fetus.
0,02−0,055	2	Throbbing headache, confusion, impaired fine motor skills, inability to concentrate.
<0,07	2	Severe headache, vision, runny nose, vomiting.
0,07−0,095	2	Hallucinations, ataxia, shallow rapid breathing.
0,1	2	Fainting, weakening pulse, convulsions and seizures, tachycardia, rare shallow breathing, coma.
0,15	1,5
0,18	0,5	The same as at a concentration of 0.1%
0,2−0,3	0,5	Convulsions, cardiac and respiratory failure, coma, possible death.
0,5−1	0,08−0,1	Suppression of all reflexes, arrhythmia, thread-like pulse wave, deep coma, death
>1,3	0,01−0,07	Convulsions, loss of consciousness, vomiting, coma and death.

Early and late consequences of poisoning

Carbon monoxide is insidious, and the symptoms that appear after poisoning will bother the victim for a long time. First of all, as we found out, the nervous and cardiovascular systems suffer. So, from the nervous system in the first days after poisoning the following will appear:

headache and dizziness;
decreased sensitivity in the extremities (associated with damage to peripheral nerve fibers);
disorders of the visual and auditory analyzers;
exacerbation of existing mental illnesses.

Late complications that appear a week or even a month after intoxication include:

The occurrence of both early and late complications is caused by a single mechanism. The cells of the nervous system are most susceptible to a lack of oxygen supply to them. Thus, with hypoxia, damage occurs to the white and gray matter of the brain and spinal cord. There is also a direct poisoning effect. Disturbances in the peripheral nervous system are caused by the binding of CO to proteins that form the myelin sheath of the nerve fiber, which leads to disruption of the conduction of nerve impulses.

Consequences from the heart and blood vessels are also divided into early and late.

Early	Late
Sudden death, violation heart rate and blood circulation in the coronary vessels	Myocardial infarction, myocarditis, cardiac asthma, angina pectoris.

The mechanism of occurrence is both in hypoxia of cardiac muscle tissue when carbon monoxide binds to muscle protein - myoglobin, and in the direct toxic effect of carbon monoxide on cardiac tissue.

On the part of the respiratory system, toxic pulmonary edema may occur, and in the long term, a person’s susceptibility to pneumonia of various origins will increase. This is caused by the weakening of the body's natural barriers due to the toxic effects of CO.

Help with poisoning

The outcome of intoxication depends on many factors, but correct and timely measures can save a person’s life. The first thing to do when you see a victim is to call an ambulance. This must be done because, firstly, only a specialist is able to assess the severity of poisoning, and secondly, external signs may mislead you into thinking that the victim has light form intoxication; thirdly, timely initiation of drug therapy can save a person’s life and prevent his or her disability.

Need hospitalization:

people with moderate and severe degrees of poisoning;
pregnant women (due to the risk of fetal death);
victims with a history of cardiovascular diseases;
victims with body temperature below normal;
poisoned with loss of consciousness and other disorders of the nervous system.

After calling an ambulance, it is necessary to ensure a flow of fresh air to the victim. To do this, you need to get rid of the source of CO or leave the dangerous place yourself. The poisoned person can also put on an oxygen mask (if available) or a gas mask (NOT a filter type). This will ensure that the toxin does not enter the body.

Then you need to ensure free circulation of air in the upper respiratory tract. To do this, all windows in the room are opened, the patient is freed from restrictive clothing and placed on his side. On fresh air the concentration of carboxyhemoglobin in the blood decreases, and the position of the body on the side will prevent the tongue from retracting in case of loss of consciousness.

In case of loss of consciousness, it is necessary to give the patient a sniff of ammonia, which stimulates the respiratory centers in the brain. You can rub the victim’s chest and back and apply mustard plasters. These measures will increase blood circulation in the thoracic and cerebral arteries. After the person has been brought to consciousness, he can be offered tonic drinks (tea, coffee) that contain substances that stimulate the central nervous system.

If necessary, carry out resuscitation measures - artificial respiration and chest compressions with a cycle of 2 breaths and 30 chest compressions in the heart area in one approach. This will help maintain basic body functions until doctors arrive.

If the poisoned person is in a stable condition, it is necessary to protect him from unnecessary energy expenditure. To do this, he needs to be provided with peace, wrapped in blankets, and laid on his side on the bed.

The arriving doctors will begin treatment measures:

Oxygen therapy. 12−15 liters per minute for 6−7 hours. The procedure is carried out using an oxygen mask, oxygen tent or ventilator. Oxygen seems to compete with the poisonous gas for space on hemoglobin. Therefore, the more oxygen molecules in the inhaled air, the large quantity red blood cells will connect with it.
Administration of the antidote. The antidote in this case is acyzol (6% ampoules, 1 ml or 120 mg capsules). 1 ml is administered intramuscularly as early as possible. Repeated administration - after 60 minutes. The drug is also used for prevention. It is taken 20-30 minutes before entering a potentially dangerous area.

Acizol is a remedy against CO poisoning. The drug accelerates the breakdown of carboxyhemoglobin, helping to remove it from the body, increases the affinity of hemoglobin for oxygen, and reduces the toxic effect of the gas on the tissues and organs of the body.

Carbon monoxide poisoning is one of the most common poisonings. It occurs due to inhalation of air filled with smoke or carbon monoxide. The toxic effect on the human body of this colorless, odorless gas is undeniable, but the exact mechanism of its action has not yet been proven.

It is important to know that intoxication resulting from poisoning occurs with complications and negatively affects functionality internal organs and systems in both children and adults.

How does carbon monoxide poisoning occur?

The saturation of air with toxic vapors, due to their lack of organoleptic properties, should be determined without special devices hard. Therefore, poisoning often occurs both at home and at work.

If you use heating columns at home with poor ventilation or faulty stove installations, then saturation of the air with a toxic substance cannot be avoided. Intoxication of the body with toxic gas is also often observed as a result of prolonged stay in closed parking lots and garages with a large concentration of cars. Saturation of space in such places is as fast as possible. Sometimes symptoms of intoxication are observed in active smokers and hookah lovers.

For poisoning, it is enough to inhale air containing 0.1% CO. The severity of intoxication is also influenced by the time factor of CO exposure to the body. There is also a certain risk group of people who have the process acute intoxication comes an order of magnitude faster.

The risk group includes:

women during pregnancy;
children;
old men;
young people with weakened immune systems after illness.

According to the international classification of diseases ICD-10, poisoning of this type is assigned code T58.

Symptoms of carbon monoxide poisoning

Carbon monoxide binds red blood cells and prevents them from transporting oxygen to human organs and tissues. Thus, it inhibits mitochondrial respiration and the process of saturating the body with oxygen. The nervous system and respiratory organs suffer from a lack of oxygen, the functioning of the heart is disrupted and vascular tissue is deformed. Carbon monoxide poisoning is divided by doctors into three stages of severity. (stages below)

First easy stage With timely assistance, it passes quickly and the symptoms subside without complications. The moderate and severe stages of intoxication provoke the development of serious complications in the victim. Prolonged inhalation of air saturated with carbon monoxide can even lead to death.

Symptoms of the mild stage:

pulsation in the temporal region, pressing headache;
foggy consciousness;
noise or ringing in the ears;
fainting state;
mild nausea;
decreased vision, tearfulness;
discomfort in the larynx, causing coughing attacks;
hard breathing.

With prolonged exposure to carbon monoxide, symptoms rapidly worsen. At the initial stage of poisoning, the concentration of carboxyhemoglobin in the body reaches 30%, then at the middle stage this figure reaches 40%.

Moderate symptoms:

temporary unconsciousness;
feeling of stupor and disturbance of general coordination in space;
severe shortness of breath;
cramps in the limbs;
insufficient oxygen supply to brain cells leads to hallucinations;
pressure in the chest area;
difference in the size of the pupils of the eyes;
temporary or permanent loss of hearing and vision.

If carbon monoxide poisoning continues, a severe form of poisoning is diagnosed. It can be complicated by a rapid course, when a person dies in a few minutes.

Main symptoms:

falling into a coma, which can last several days;
severe convulsions leading to paralysis;
weak pulse and dilated pupils;
intermittent shallow breathing;
blue discoloration of the skin and mucous membranes;
spontaneous excretion of urine and feces.

The above symptoms are characteristic of the three standard forms of carbon monoxide poisoning. Some victims exhibit atypical symptoms that were not described above.

Non-standard symptoms:

a sharp decrease in pressure to 70-50 mmHg, which leads to fainting;
excited state (euphoria) with hallucinations;
state of coma with fatal outcome (rapid course).

First aid for gas intoxication

Only medical workers can objectively assess the situation and its severity, so it is necessary to immediately call ambulance. Before her arrival, it is advisable to provide the victim with pre-medical care, which will reduce the risk of complications.

Before the doctors arrive you need to:

neutralize the source that produces carbon monoxide;
provide the victim with a flow of fresh air (help him go outside or open the windows);
free the person from tight clothing, unfasten the top buttons and loosen the belt to ensure better passage of clean air into the lungs;
do not let the victim fall asleep, try to keep him conscious until the doctors arrive, using ammonia.
when the victim regains consciousness, it is necessary to give him sorbent drugs, for example, Polysorb. It actively cleanses the body of toxic substances.

This should be first aid for carbon monoxide poisoning until doctors arrive. Next, the doctors themselves will conduct a diagnosis, administer an antidote and decide on the need for hospitalization. The actions of doctors in case of carbon monoxide poisoning must be clear and quick.

They include the following manipulations:

using an oxygen mask to restore breathing;
the use of the drug Acizol, which is an antidote because it destroys carboxyhemoglobin molecules;
subcutaneous injections of caffeine to normalize heart rate;
intravenous injections of the enzyme Carboxylase, which also destroys carboxyhemoglobin;
hospitalization of the victim for a full examination and symptomatic therapy. The antidote is administered daily, 1 ml for a week.

Treatment at home is only possible if an overdose of poisonous gas does not lead to serious consequences. The first degree of poisoning (mild) in adults is removed quickly and does not have any serious consequences in the future. A certain category of victims needs additional health examination in a hospital setting after carbon monoxide poisoning.

This list includes:

pregnant women;
victims with concomitant diseases heart and blood vessels;
adults with neurotic disorders;
victims with low temperature bodies.

When is medical attention required?

All cases of acute poisoning with corresponding symptoms require emergency medical care. Depending on the general condition the patient is admitted to the department intensive care or to intensive care. When first medical aid is provided, the victim may need to continue treatment aimed at restoring the functioning of all organs and systems.

Consequences and prevention

Carbon monoxide poisoning causes many unpleasant complications in people associated with deteriorating health. Doctors divide them into two groups. Early complications appear immediately after poisoning, and late complications appear weeks or even months later.

Early complications:

regular headaches and dizziness;
retardation of movements and low sensitivity fingers and toes;
disruption of the functioning of the intestines and urinary tract;
deterioration of vision and hearing;
unbalanced mental state;
swelling of the brain and lungs;
impaired blood flow and heart rhythm disturbances;
death due to cardiac arrest.

Late complications may appear after 30-40 days. The long time it takes for pathologies to manifest is due to the fact that they develop as the functioning of internal organs and systems deteriorates. Most often, pathologies are determined in the functioning of the heart, blood vessels, respiratory organs and nervous system.

These include:

decreased activity of the limbs leading to paralysis;
development of amnesia;
heart attack (can cause cardiac arrest);
ischemic disease of the heart muscle;
cardiac asthma.

All of these diseases develop as a result of acute carbon monoxide poisoning and delayed provision of assistance.

What to do to protect yourself and your loved ones from poisoning? Number one on the list preventive measures – strict adherence fire safety rules. People often neglect these rules, causing accidents.

To eliminate the possibility of carbon monoxide poisoning at work and at home, it is recommended to avoid using broken gas and electrical equipment. You should not stay in a closed room for a long time where cars are operating. All production garages and basements must be equipped with a powerful ventilation system.

Video with Elena Malysheva about carbon monoxide

Carbon monoxide, or carbon monoxide (CO), occurs wherever conditions exist for incomplete combustion of carbon-containing substances.

CO is a colorless, tasteless gas; its odor is very weak, almost imperceptible. Burns with a bluish flame. A mixture of 2 volumes of CO and 1 volume of O2 explodes when ignited. CO does not react with water, acids and alkalis.

CO poisoning often occurs in everyday life due to improper use of heating stoves and gas water heaters, when, due to poorly functioning draft, an oxygen deficiency is formed and conditions are created for incomplete combustion of fuel. In recent years, due to the increase in the number of cars for personal use, every year during the cold season, drivers are poisoned in closed garages where cars are located with their engines running.
Acute CO poisoning can also occur in production, especially in the chemical industry, during coal coking, in coal mining, and foundries, when large amounts of carbon monoxide are formed during the production process. So, for example, coal illuminating gas contains 4-11% CO, coke gas - 70%, shale gas - 17%, generator gas from coal and coke - 27%, blast furnace gas - up to 30%. Car exhaust gases contain an average of 6.3%, and sometimes up to 13.5% CO. In car cabins, the concentration of CO can reach 0.05 mg per 1 liter of air or more, on city streets, depending on the traffic load, from 0.004 to 0.21 mg/l, and near cars - 1.5-7.1 mg /l. The danger of CO poisoning in garages is great if precautions (ventilation) are not followed. So, the engine is 20 hp. With. can release up to 28 liters of CO per minute, creating a lethal concentration of gas in the air after 5 minutes.

Clinic

The first symptoms of poisoning can develop after 2 - 6 hours of exposure to an atmosphere containing 0.22-0.23 mg of CO per 1 liter of air; severe poisoning with loss of consciousness and death can develop after 20-30 minutes at a CO concentration of 3.4-5.7 mg/l and after 1-3 minutes at a poison concentration of 14 mg/l.
CO easily penetrates the blood through the lungs and interacts with hemoglobin. The process of CO entry into the blood is significantly influenced by the oxygen concentration in the inhaled air, an increase in which clearly inhibits the intensity of CO absorption. Each gram of hemoglobin is capable of binding 1.33-1.34 ml of oxygen or CO, but the affinity of hemoglobin for CO is many times greater than for oxygen. By interacting with ferrous iron of oxyhemoglobin (a compound of hemoglobin with oxygen that delivers the latter from the lungs to the tissues), CO converts it into carboxyhemoglobin (HbCO). A sharp decrease in the amount of oxyhemoglobin leads to a deterioration in the oxygen supply to tissues and the development of oxygen deficiency (hypoxia). In the presence of HbCO, the removal of oxygen from oxyhemoglobin is significantly slowed down, which aggravates hypoxia.
With the toxic effects of CO, the nervous system suffers the most as it is the most sensitive to hypoxia. In severe poisoning, diffuse brain damage, edema, and demyelination are observed. white matter. In some cases, damage to the nervous system can be reversible, but much more often they persist for a long time as long-term consequences former intoxication. The most common developments are amnestic disorders, pseudohysteroid conditions, epilepsy, cerebellar and extrapyramidal disorders, and asthenia. Clinical observations in case of CO poisoning, they indicate the presence of serious respiratory disorders. In case of intoxication of moderate severity, focal pneumonia can be found in a number of victims; severe poisoning is usually complicated by lobar pneumonia.
Already in the first hours after acute poisoning, damage to the heart muscle occurs, characterized by diffuse disruption of myocardial nutrition (up to necrosis), changes in the vessels of the heart (degeneration of the endothelium, swelling vascular wall). Initially, the changes are reversible; with severe intoxication, organic changes in the myocardium may occur, such as toxic dystrophy, infarction, which is recorded on the ECG.
The leading clinical symptom of acute CO poisoning is impaired consciousness. Depending on the depth of the disorder of consciousness, there are 3 degrees of CO poisoning. In mild cases, poisoning occurs without loss of consciousness; only a short-term fainting state is possible. As a rule, patients experience tinnitus, pulsation of the temporal arteries, headaches in the frontal and temporal regions, a feeling of thirst, burning of the face, general anxiety, and fear. Characterized by an increase in blood pressure up to 150/90 mm Hg. Art., moderate tachycardia. The HbCO content in the blood is 15-20%.
In case of poisoning of moderate severity, the loss of consciousness is more or less prolonged and recovery occurs independently immediately after the victim is removed to fresh air or inhaled oxygen. The HbCO content in these cases is 20-40%. Clinically, psychomotor agitation, inappropriate behavior, facial hyperemia, increased body temperature to 38-40 ° C, and blood pressure increased to 150/90 mm Hg are noted. Art., moderate tachycardia.
In severe and extremely severe poisoning, the HbCO content in the blood is 60-80%. In this case, a long-term (over several hours or even days) loss of consciousness is observed. As a rule, coma occurs against the background of breathing disorders, most often of the obstructive-aspiration type (with retraction of the tongue, accumulation of secretions in the oral cavity, trachea, trismus of the masticatory muscles). Less commonly observed central shape breathing disorders - rare, shallow breathing is replaced by a stop due to paralysis of the respiratory center. In this case, arterial hypotension up to collapse, pallor, cyanosis of the skin, signs of cerebral edema (stiff neck, anisocoria, etc.) are noted. Coming out of a coma takes a long time (up to several days). Characteristic are memory impairment (patients forget their name, words, do not recognize relatives, cannot read), dementia, epileptiform seizures, asthenia. As a rule, severe poisoning is complicated by pneumonia and trophic disorders (bedsores).

Treatment

In case of CO poisoning, it is necessary to quickly remove the poison from the body and specific therapy. The victim is taken out into the fresh air, and upon arrival medical workers inhalation of humidified oxygen is carried out (in emergency conditions using KI-Z-M, AN-8 devices). In the first hours, pure oxygen is used for inhalation, then they switch to inhalation of a mixture of air and 40-50% oxygen. IN specialized hospitals oxygen inhalation is used under a pressure of 1-2 atm in a pressure chamber ( hyperbaric oxygen therapy).
In case of breathing disorders, before oxygen inhalation, it is necessary to restore the patency of the airways (oral toilet, insertion of an air duct), perform artificial respiration up to tracheal intubation and artificial ventilation of the lungs.
In case of hemodynamic disorders (hypotension, collapse), most often resulting from damage to the central nervous system, in addition to the intravenous administration (boost) of analeptics (2 ml of cordiamine, 2 ml of 5% ephedrine solution), rheopolyglucin (400 ml) should be administered intravenously drip in combination with prednisolone (60-90 mg) or hydrocortisone (125-250 mg).
Much attention in case of CO poisoning, it is necessary to pay attention to the prevention and treatment of cerebral edema, since the severity of the patients’ condition, especially with long-term disorder consciousness is determined by cerebral edema that develops as a result of hypoxia. On prehospital stage patients are administered intravenously 20-30 ml of 40% glucose solution with 5 ml of 5% solution ascorbic acid, 10 ml of a 2.4% solution of aminophylline, 40 mg of Lasix (furosemide), intramuscularly - 10 ml of a 25% solution of magnesium sulfate. It is very important to eliminate acidosis, for which, in addition to measures to restore and maintain adequate breathing, it is necessary to administer a 4% sodium bicarbonate solution intravenously (at least 600 ml). In a hospital setting, with severe symptoms of cerebral edema (stiff neck, convulsions, hyperthermia), a specialist neurologist performs repeated lumbar punctures; craniocerebral hypothermia is required; in the absence of a special apparatus, ice on the head. In order to improve metabolic processes in the central nervous system, patients, especially those with severe poisoning, are prescribed vitamins, especially ascorbic acid (5-10 ml of a 5% solution intravenously 2-3 times a day), vitamins B1, (3-5 ml 6% solution intravenously), B 6 (3-5 ml of 5% solution 2-3 times a day intravenously). To prevent and treat pneumonia, antibiotics and sulfonamides should be administered. Severely ill patients with CO poisoning require careful care; it is necessary to wash the skin of the body, especially the back and sacrum, change the position of the body (turning on the side), heavy percussion of the chest (effleurage with the side surface of the palm), vibration massage, ultraviolet irradiation of the chest with erythemal doses (by segments).

In some cases, CO poisoning can be combined with other serious conditions that significantly complicate the course of intoxication and often have a decisive influence on the outcome of the disease. Most often this respiratory tract burn, which occurs when inhaling hot air or smoke during a fire. As a rule, in these cases, the severity of the patient’s condition is due not so much to CO poisoning (which can be mild or moderate), but rather to a burn to the respiratory tract. The latter is dangerous because in the acute period acute respiratory failure may develop due to prolonged, intractable laryngobronchospasm, and in the next day severe pneumonia develops. The patient is bothered by a dry cough, sore throat, and suffocation. Objectively, shortness of breath (as during an attack of bronchial asthma), dry wheezing in the lungs, cyanosis of the lips, face, and anxiety are noted. When toxic pulmonary edema or pneumonia occurs, the patient's condition worsens even more, shortness of breath increases, breathing is frequent, up to 40-50 per minute, and there is an abundance of dry and moist wheezing of various sizes in the lungs. Mortality in this group of patients is high.

Treatment mostly symptomatic: intravenous administration bronchodilators (10 ml of 2.4% aminophylline solution with 10 ml of saline, 1 ml of 5% ephedrine solution, 60-90 mg of prednisolone 3-4 times or 250 mg of hydrocortisone 1 time per day, 1 ml of 5% solution ascorbic acid 3 times a day).
Local therapy in the form of oil inhalations (olive, apricot oil), antibiotic inhalations (penicillin 500 thousand units in 10 ml of saline solution), vitamins (1-2 ml of 5% ascorbic acid solution with 10 ml of saline solution) is of great importance; for severe laryngobronchospasm - 10 ml of 2.4% aminophylline solution, 1 ml of 5% ephedrine solution, 125 mg of hydrocortisone in 10 ml of physiological solution. For a severe cough, use codeine with soda (1 tablet 3 times a day), drink warm milk with soda or Borjomi.

The second severe complication of CO intoxication is positional injury (compartment syndrome), developing in cases where the victim lies unconscious (or sits) in one position long time, touching parts of the body (most often with limbs) to a hard surface (corner of a bed, floor) or pressing a limb with the weight of one’s own body. In areas subject to compression, unfavorable conditions for blood and lymph circulation are created. In this case, the nutrition of muscle and nervous tissue and skin is sharply disrupted, which leads to their death. The victim develops areas of reddening of the skin, sometimes with the formation of blisters filled with liquid (like burns), hardening of soft tissues, which are further intensified by developing edema. The affected areas become sharply painful, increased in volume, dense (up to stone density). As a result of the breakdown of muscle tissue, myoglobin (a protein that is part of muscle tissue) enters the blood; if the injury area is large, a large amount of myoglobin affects the kidneys: myoglobinuric nephrosis develops. Thus, the patient develops the so-called myorenal syndrome, characterized by a combination of positional trauma and renal failure. Clinically to those described above muscle lesions impaired renal function is added: first, the patient produces a small amount of dark brown urine, and then anuria sets in, followed by azotemia, overhydration, etc. Treatment of patients with myorenal syndrome is long-term and is carried out in specialized hospitals, as it requires the use of various special methods (hemodialysis, lymphatic drainage, etc.). If there is severe pain, you can administer painkillers - 1 ml of a 2% solution of promedol and 2 ml of a 50% solution of analgin subcutaneously or intravenously.

Prevention

In the vast majority of cases, poisoning occurs due to the fault of the victims themselves: improper operation of heating stoves, gas water heaters, smoking in bed (especially when drunk), leading to a fire; storing matches in places accessible to children; a long stay in a closed garage, where there is a car with a running engine, a long rest (sleep) in a car with the heater and engine on, even if the car is in the open air. It is especially important to conduct conversations and lectures with the population on the prevention of CO poisoning in the autumn-winter season.

Carbon monoxide is a strong toxic substance that, when entering the body, leads to disruption of the functioning of its organs and systems.

Carbon monoxide poisoning can occur in a variety of places. This substance is odorless, which undoubtedly increases its danger, since people are not aware of its presence in the air.

The entire body is forced to work under conditions of severe oxygen deficiency. It leads to serious consequences: damage to the heart, brain, lungs, skeletal muscles.

The effect of carbon monoxide on the human body

First of all, it is necessary to consider its effect on the composition and functioning of the blood. This dangerous substance enters the human body through the respiratory tract into the lungs, which are well supplied with blood. It is here that the poison is quickly absorbed into the blood.

In the bloodstream, carbon monoxide seeks out red blood cells and binds to them. These blood cells, in turn, perform an important function - respiratory. That is, they bind oxygen and transfer it to all organs and tissues.

In case of poisoning, carboxyhemoglobin is formed in the blood, which is no longer able to perform this function. That is, red blood cells lose their ability to capture oxygen. In this case, a severe pathological condition develops - hypoxia, that is, oxygen starvation.

Carbon monoxide poisoning can occur under the following conditions:

Household. Fires release large amounts of this dangerous gas. This occurs when the interior burns, the decoration of which contains plastic, wiring and household appliances. When staying for a long time in a closed garage where the car is running. In a traffic jam in calm weather. In the event of a domestic gas leak, as well as improper operation of furnace equipment;
Production. Poisoning can occur in the gas and automobile industries. Where carbon monoxide is used for the synthesis of organic compounds.

It should be noted that children, pregnant women, elderly and weakened people are most sensitive to carbon monoxide. Let's take a closer look at the consequences of individual body systems.

Effect on heart function

Under conditions of hypoxia, the heart activates compensatory devices. That is, under any conditions it tries to fulfill its main function– supply the body with oxygen-enriched blood.

When carbon monoxide enters the blood, the oxygen concentration in it decreases significantly. In this case, the heart begins to pump blood through the systemic and pulmonary circulation at a higher speed. This leads to tachycardia - an increase in the number of heartbeats per minute.

At first the tachycardia is moderate, but with severe poisoning or prolonged exposure to gas on the body, the pulse becomes frequent, but weakly filled. The heart rate reaches 130 – 140 beats per minute.

Against the background of severe tachycardia and hypoxia, there is a high probability of developing myocardial infarction.

Consequences for the central nervous system

With the bloodstream, the toxin enters the brain, where it has a negative effect on its various parts. First, a person feels a severe headache, and “cerebral vomiting” may occur, which occurs when the center of the brain responsible for digestion is irritated.

Carbon monoxide leads to disruption of nervous regulation, which is manifested by dysfunction various organs feelings:

Hearing impairment (noise, ringing), decreased hearing acuity;
Violation visual function. There may be fog, spots in front of the eyes, blurry pictures, decreased visual acuity (may be significant).

When the cerebellum is damaged, the victim exhibits pathological signs such as unsteady gait and incoordination.

IN severe cases a large volume of the brain is affected, which manifests itself in such consequences as convulsive syndrome and coma.

Carbon monoxide and respiratory organs

Hypoxia provokes disruption of the respiratory system. There is hyperventilation of the lungs, that is, shortness of breath, which progresses over time. This is a compensatory mechanism. Thus, the lungs try to eliminate the oxygen deficiency in the body.

If a person with carbon monoxide poisoning is not immediately given help, then his breathing becomes shallow, that is, unproductive. In this case, respiratory arrest and death of the victim may occur.

Effect of gas on skeletal muscles

Muscles need a constant supply of oxygen. If it is deficient, they cease to function fully. A person experiences severe weakness. He cannot stand on his feet; they give way.

Symptoms of poisoning

Clinical picture poisoning in this case depends on the severity pathological process(the amount of carbon monoxide affecting the body and the time a person spends in unfavorable conditions).

There are 3 degrees of severity of carbon monoxide poisoning:

First or mild degree manifested by headache, pressure in the temples and forehead, nausea, and single vomiting. There is dizziness and slight weakness in the body. Man complains about rapid heartbeat and chest tightness. IN in rare cases are registered auditory hallucinations;
Second or average degree severity is characterized by neurological symptoms. The patient experiences complete or partial paresis and paralysis. The victim is drowsy and has reduced hearing;
Third or severe degree. The patient is in critical condition and requires immediate medical attention. Convulsions and loss of consciousness are observed. Uncontrolled bowel movements may occur Bladder and intestines. Breathing is shallow, pupils almost do not react to light. High probability fatal outcome before arriving at the hospital.

First aid and subsequent recovery

A person suffering from carbon monoxide poisoning should receive first aid as soon as possible. The outcome of the poisoning depends on this.

Algorithm for providing first emergency aid to a victim:

Stop the flow of carbon monoxide into the body. To do this, the person must be removed or removed from the gas-contaminated area;
Provide oxygen access. You should loosen tight clothing, remove your belt, tie, scarf, handkerchief, and so on. If a person is indoors, then you need to open the windows;
Call an ambulance. Before the arrival of medical workers, provide assistance independently;
If the person is conscious, then you should give him hot and strong coffee or tea;
If consciousness is absent, check for pulse and breathing. If these indicators are not determined, then you should immediately begin to implement cardiopulmonary resuscitation(indirect cardiac massage and artificial respiration);
To improve blood circulation, you need to rub the patient’s limbs, cheeks and chest;
If a person is unconscious, pulse and breathing are detected, then it is necessary to give him a stable lateral position. That is, lay it on its side. This prevents the tongue from retracting and aspiration of the respiratory tract with vomit (in the presence of vomiting);
If ammonia is available, they need to lubricate the temples and let the victim smell cotton wool soaked in ammonia.

The ambulance team continues to provide assistance to the victim:

Oxygen is supplied through an oxygen mask;
It is necessary to introduce an antidote - Acizol. The solution is administered intramuscularly in a volume of 1 milliliter. This drug eliminates negative impact carbon monoxide. It is capable of destroying carboxyhemoglobin formed in the blood;
To restore the functions of the cardiovascular and respiratory systems, subcutaneous administration of caffeine is indicated;
Carboxylase is administered intravenously. This drug is an enzyme that destroys carboxyhemoglobin;
Hospitalization of the victim in a hospital.

Symptomatic therapy is carried out in the hospital, and treatment with Acizol is also continued. The course of treatment with this drug is at least 7 days.

Please remember that carbon monoxide is a potent toxic substance. Therefore, the consequences of poisoning are very diverse.

Doctors distinguish 2 types of consequences that arise due to the toxic effects of this substance:

Early occurs in the first few days after poisoning;
Late - develops after several weeks or months.

Early complications include:

Prolonged headaches and loss of coordination;
Impaired functioning of the sense organs. There is a sharp decrease or short-term absence of vision and hearing;
ONMK ( acute disorder cerebral circulation). This pathology develops due to ischemia meninges(oxygen starvation) or hemorrhages when the integrity of the blood vessel is violated. There may be a stroke varying degrees gravity. In severe cases, coma and death of the patient occur;
Cerebral edema is a pathological condition that involves the impregnation of brain tissue with fluid from blood vessels. This condition is very dangerous for human life. The consequences of carbon monoxide poisoning for the brain are extremely severe: disruption of the central nervous system, damage to brain tissue and death;
Pulmonary edema is an emergency condition that requires immediate resuscitation. A characteristic sign is a severe cough with pink foam coming from the mouth, the patient begins to choke;
Heart rhythm disturbances;
Sudden cardiac arrest and, as a result, death of the victim.

Late consequences are due to the fact that many organs and systems were damaged under the influence of carbon monoxide.

Late Negative consequences most often observed from the nervous, cardiovascular and respiratory systems:

Memory impairment. Amnesia develops, that is, memory loss;
Decrease in a person’s intellectual abilities;
Impaired motor function of the upper and lower limbs up to paralysis;
Blindness;
Disorders of the bladder and intestines. Urinary incontinence and involuntary bowel movements are observed;
Myocardial infarction is characterized by an area of necrosis in the heart muscle. This is an emergency condition that can be fatal (especially with a large heart attack);
Angina pectoris is ischemic heart disease;
Cardiac asthma. In this case, the patient is worried about shortness of breath, a feeling of tightness in the chest, an obsessive cough, and suffocation. The attack occurs during physical exertion and horizontal position person;
Pneumonia. They occur frequently and have a long course with complications.

1travmpunkt.com

First aid for carbon monoxide poisoning: symptoms and treatment, consequences

Carbon monoxide poisoning refers to acute pathological conditions that develop as a result of a certain concentration of carbon monoxide entering the human body. This condition is life-threatening even without qualified assistance doctors can be fatal.

Carbon monoxide (CO, carbon monoxide) is a combustion product and enters the atmosphere in any form. Having no smell or taste, the substance does not demonstrate its presence in the air in any way and easily penetrates walls, soil and filter materials.

Therefore, excess CO concentrations can be detected only with the help of special devices, and in the worst case, in a rapidly developing clinic. In urban air, the main contribution to the concentration of this dangerous substance comes from exhaust gases from automobile internal combustion engines.

Effect on the body

CO enters the bloodstream 200 times faster than O2 and enters into active contact with hemoglobin in the blood. As a result, carboxyhemoglobin is formed - a substance that has a stronger bond with hemoglobin than oxyhemoglobin (oxygen combined with hemoglobin). This substance blocks the process of oxygen transfer to tissue cells, causing hemic hypoxia.
CO binds to myoglobin (a protein in skeletal and cardiac muscle), reducing the pumping function of the heart and causing muscle weakness.
In addition, carbon monoxide enters into oxidative reactions and disrupts the biochemical balance in tissues.

Where are cases of CO poisoning possible?

On fires.
In production where CO is used in reactions for the synthesis of substances (phenol, acetone).
In gasified premises operating gas equipment (gas stoves, water heaters, heat generators) with insufficient ventilation or insufficient amount of supply air necessary for gas combustion.
Garages, tunnels and other areas with insufficient ventilation where vehicle exhaust fumes may accumulate.
When staying near busy highways for a long time.
At the time of a lighting gas leak at home.
When the stove doors of a home stove, a stove in a bathhouse, or a fireplace are closed untimely (early).
Prolonged use of a kerosene lamp in an unventilated area.
Use of poor quality air in breathing apparatus.

Risk groups (with increased sensitivity to CO)

Signs of poisoning depending on CO concentration

CO concentration, %	Coming time clinical manifestations	Signs
Up to 0.009	3-5 hours	Decreased speed of psychomotor reactions Compensatory increase in blood circulation in vital organs Chest pain and shortness of breath in people with severe heart failure
Up to 0.019	6 hours	Decreased performance Mild headache Shortness of breath during moderate physical activity Visual impairment (perception) May cause death in persons with severe heart failure and in the fetus
0,019-0,052	2 hours	Severe throbbing headache Dizziness Emotional instability, irritability Attention and memory impairment Nausea Fine motor impairment
Up to 0.069	2 hours	Strong headache Visual impairment Confusion General weakness Runny nose Nausea and vomiting
0,069-0,094	2 hours	Hallucinations Severe motor disorder (ataxia) Shallow rapid breathing
0,1	2 hours	Fainting Weak pulse Convulsions Tachycardia Rare shallow breathing
0,15	1.5 h
0,17	0.5 h
0,2-0,29	0.5 h	Convulsions Depression of cardiac and respiratory activity Possible death
0,49-0,99	2-5 min	Lack of reflexes Arrhythmia Thready pulse Deep coma Death
1,2	0.5-3 min	Convulsions Loss of consciousness Vomit Death


headache and dizziness; knocking in the temporal region; chest pain, dry cough; lacrimation; nausea and vomiting; redness of the scalp, face and mucous membranes; hallucinations (visual and auditory); tachycardia; hypertension.	weakness and drowsiness; muscle paralysis with preserved consciousness.	loss of consciousness; convulsions; breathing problems; coma; uncontrolled urination and bowel movements; dilated pupils with a weak reaction to a light stimulus; significant bluish discoloration of mucous membranes and skin.

The brain and nerve cells are most sensitive to hypoxia, so headache, nausea, dizziness, etc. are a signal that nerve cells are suffering from oxygen starvation.
More severe neurological symptoms (convulsions, loss of consciousness) occur against the background of deep damage to the nervous structures, even irreversible.

The lack of oxygen begins to be compensated by more intense cardiac activity (tachycardia), but the occurrence of pain in the heart indicates that the heart muscle is also experiencing hypoxia. Acute pain indicates a complete cessation of oxygen supply to the myocardium.

Respiratory symptoms

Increased breathing also refers to compensatory mechanisms, but damage to the respiratory center in severe poisoning leads to superficial, ineffective respiratory movements.

Skin symptoms

The red-blue tint of the scalp and mucous membranes indicates increased, compensatory blood flow to the head.

Consequences of carbon monoxide poisoning

In mild to moderate poisoning, the patient may experience headaches, dizziness, decreased memory and intelligence, and emotional instability for a long time, which is associated with damage to the gray and white matter of the brain.

Severe complications are most often irreversible and often lead to death:

trophic skin disorders (edema followed by tissue necrosis);
subarachnoid hemorrhages;
disturbance of cerebral hemodynamics;
cerebral edema;
polyneuritis;
visual and hearing impairment total loss;
myocardial infarction;
severe pneumonia complicating coma.

First aid for carbon monoxide poisoning

First aid c implies stopping the victim’s contact with the poisonous gas and restoring vital functions. Providing first aid for carbon monoxide poisoning should prevent poisoning of the person who is trying to provide this very assistance. Ideally, you should put on a gas mask and only then enter the room where the victim is located.

Remove or remove the injured person from the room where there is an increased concentration of CO. This is the activity that must be performed first, since with each breath the pathological changes in organism.
Call an ambulance for any condition of the patient, even if he is joking and laughing. Perhaps this is a consequence of the effect of CO on vital centers of the central nervous system, and not a sign of health.
In case of mild poisoning, give the person strong, sweet tea, warm him up and provide him with peace.
In the absence or confusion of consciousness - lay on a flat surface on the side, unfasten the collar, belt, provide a flow of fresh air. Let the cotton wool with ammonia be sniffed at a distance of 1 cm.
If there is no cardiac or respiratory activity, perform artificial respiration and massage the sternum in the projection of the heart.

What to do if you are poisoned in a fire?

If it so happens that there are people left in the burning building, you cannot try to save them yourself - this will lead to an increase in the number of victims of the emergency and nothing more! You should immediately call the Ministry of Emergency Situations.

Even 2-3 breaths of CO poisoned air can be fatal, so no amount of wet rags or filter masks will protect the person who comes to help. Only a gas mask can protect against deadly dangerous action SO!

Therefore, rescuing people in such a situation should be trusted to professionals - the Emergencies Ministry team.

Treatment

If a person is in critical condition, the ambulance team carries out a set of resuscitation measures. In the first minutes, the antidote Acizol 6% is administered by intramuscular injection in a volume of 1 ml. The patient is taken to the hospital (intensive care unit).

In a hospital setting, the patient is provided with complete peace. Organize breathing pure oxygen with a partial pressure of 1.5-2 atm or carbogen (95% oxygen and 5% carbon dioxide) within 3-6 hours.

Further therapy is aimed at restoring the functioning of the central nervous system and other organs and depends on the severity of the condition and the reversibility of the pathological reactions that have occurred.

Prevention of CO poisoning

All work associated with the risk of CO poisoning should be carried out only in well-ventilated areas.
Check stove and fireplace dampers. Never close them if the firewood is not completely burned.
Install autonomous gas detectors in rooms with a potential risk of CO poisoning.
In case of possible contact with CO, take 1 capsule of Acizol half an hour before possible contact with the gas. The protection lasts 2-2.5 hours after taking the capsule.

Acizol is a domestic drug, a fast and effective antidote against acute carbon monoxide poisoning in lethal doses. Prevents the formation of carboxyhemoglobin and accelerates the removal of CO from the body. As early as possible, intramuscular administration of Acizol to victims significantly increases their chances of survival and increases the effectiveness of subsequent resuscitation and medical measures.

zdravotvet.ru

Carbon monoxide poisoning. First aid for poisoning.

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician. Carbon monoxide poisoning is a common and severe form of intoxication that can cause serious damage to human organs and systems, including death. The consequences of poisoning often lead to loss of ability to work and disability of the victims. In Russia, carbon monoxide poisoning ranks first among the causes of death from acute poisoning. Fatalities occur predominantly at the scene of the incident. Timely assistance to the victim, carried out at the scene of the incident, during transportation and in a hospital setting, can significantly reduce the risk of severe complications and the number of deaths. Carbon monoxide, also known as carbon monoxide or carbon monoxide (CO), is formed during incomplete combustion of substances containing carbon. It has neither color nor smell. It is able to penetrate through partitions, walls, and layers of soil. It is not absorbed by porous materials; therefore, filter gas masks will not protect against carbon monoxide poisoning. Carbon monoxide is a poison with a rapid, general toxic effect; when its concentration in the air is 1.28% or more, death occurs in less than 3 minutes. Carbon monoxide is considered a blood poison, as it primarily affects blood cells (red blood cells). Normally, red blood cells carry oxygen to organs and tissues using a special protein - hemoglobin. Once in the blood, carbon monoxide binds tightly to hemoglobin, forming a destructive compound - carboxyhemoglobin. In this case, red blood cells lose their ability to carry oxygen and deliver it to vital important bodies. The entire body begins to experience oxygen starvation (hypoxia). Nerve cells are most sensitive to lack of oxygen. And therefore, the first symptoms of carbon monoxide poisoning are associated with disruption of the nervous system (headache, dizziness, nausea, lack of coordination, etc.). Carbon monoxide binds to skeletal muscle and heart muscle protein (myoglobin), which results in general muscle weakness and a decrease in the pumping function of the heart (shortness of breath, rapid heartbeat, weak pulse).

1. Inhalation of vehicle exhaust gases, long stay in closed garages in a car with the engine running;

2. Carbon monoxide poisoning in the home: malfunction of heating appliances (fireplaces, stoves, etc.), leakage of household propane gas (propane contains 4-11% CO), prolonged burning of kerosene lamps, etc.

3. Poisoning due to fires (buildings, transport cars, elevators, airplanes, etc.)

The manifestation of symptoms of carbon monoxide poisoning directly depends on its concentration in the inhaled air and on the duration of its effect on the human body. So, when the concentration of carbon monoxide in the atmosphere is 0.02-0.03% and the exposure time on the body is 4-6 hours, the following symptoms will appear: headache, dizziness, nausea, impaired coordination of movements. And at a concentration of 0.1-0.2% and a duration of exposure of 1-2 hours, coma occurs, respiratory arrest occurs and death is possible.

What is affected?	Light and medium degree	Severe degree	Mechanism of occurrence
CNS (central nervous system)	Headache in the temples and forehead, of a girdling nature Dizziness Noise in ears Flickering before the eyes Nausea, vomiting Brain fog Impaired movement coordination Decreased visual acuity and hearing Brief loss of consciousness	Loss of consciousness Possible seizures Possible involuntary urination or bowel movements	The most sensitive organ to a lack of oxygen is the brain and all the nerve structures adjacent to it. Thus, all primary symptoms such as headache, dizziness, tinnitus, nausea are the result of nerve cells suffering from oxygen starvation. All subsequent symptoms such as loss of coordination, loss of consciousness, convulsions are the consequences of deeper damage to the nervous structures from lack of oxygen.
The cardiovascular system	Heartbeat Rapid pulse (more than 90 beats per minute), Possible pressing pain in the heart area.	The pulse is rapid (130 beats per minute or more), but weakly palpable, High risk of developing myocardial infarction	The body tries to compensate for the lack of oxygen with more intense work of the heart, pumping as much blood as possible (palpitations, rapid pulse). Pain is a signal of lack of nutrition to the heart muscle. Complete violation delivery of oxygen to the heart muscle leads to a heart attack.
Respiratory system	Rapid breathing Lack of air (shortness of breath),	Breathing is shallow, intermittent	Rapid breathing is a compensatory mechanism in response to lack of oxygen. In the severe stage, the respiratory control center is damaged, which is accompanied by shallow and irregular breathing movements.
Skin and mucous membranes	Facial skin and mucous membranes are bright red or Pink colour	The skin and mucous membranes are pale, with a slightly pinkish tint	The result of increased blood flow to the head area. In the severe stage, the body becomes exhausted and loses its ability to pump blood effectively. In areas of insufficient blood circulation, the skin turns pale.
Carboxyhemoglobin content in blood

Form	Symptoms	Mechanism of occurrence
Fainting form	Paleness of the skin and mucous membranes Marked decrease in blood pressure (70/50 mmHg or less) Loss of consciousness	The exact mechanism is unknown. It is assumed that under the influence of a lack of oxygen and the toxic effect of CO, the center for regulating vascular tone is affected. This leads to a sharp drop in pressure and loss of consciousness.
Euphoric form	Physical and mental arousal Mental disorders: delusions, hallucinations, unmotivated actions, etc. Loss of consciousness Respiratory and cardiac dysfunction	Toxic effect of carbon monoxide on the centers of higher nervous activity.
A fulminant form of carbon monoxide poisoning occurs when the concentration of carbon monoxide in the air exceeds 1.2% per 1 m³. In a matter of minutes, the concentration of carboxyhemoglobin in the victim’s blood reaches 75% or more. Which in turn is accompanied by loss of consciousness, convulsions, respiratory paralysis and death in less than 3 minutes.

Carbon monoxide poisoning entails a number of complications from the organs and systems of the body. There are early and late complications.

Consequences of carbon monoxide poisoning
What is affected?	Early complications of acute poisoning (first 2 days after poisoning)	Late complications of acute poisoning (2-40 days)	Mechanism of occurrence
Nervous system	Prolonged headaches and dizziness Defeat peripheral nerves, which is accompanied by impaired motor activity and loss of sensitivity in the limb Bowel and bladder dysfunctions Hearing and vision disorders Swelling of the brain, first symptoms of increased body temperature Exacerbation and development of mental illness	Memory loss Decrease in intelligence Psychoses Apathy Parkinsonism Movement disorders (choreas) Paralysis Blindness Functional impairment pelvic organs	Damage to the white and gray matter of the brain under conditions of oxygen starvation Direct toxic effect of carbon monoxide on nerve cells. CO binds to the protein of nerve cell membranes (myelin), disrupting the conduction of impulses along nerve endings.
The cardiovascular system	Sudden death Rhythm disturbance Coronary circulation disorder	Myocardial infarction Angina pectoris Myocarditis Cardiac asthma	Lack of oxygen Direct damaging effect of CO on heart cells Binding of CO to cardiac muscle cell protein (myoglobin)
Respiratory system			Toxic effect of CO on lung tissue Weakening of the lungs' defense mechanisms Accession of infection

From the concentration of carbon monoxide in the inhaled air
The duration of exposure to carbon monoxide on the human body
From degree physical activity the victim at the time of the action of the poison (the higher the load, the more severe the consequences of poisoning)
Women are more resistant to carbon monoxide than men
Poisoning is difficult to tolerate: exhausted people suffering from anemia, bronchitis, bronchial asthma, alcoholics, heavy smokers.
Children, adolescents and pregnant women are especially sensitive to the effects of the poison.

Not really

Why?

Yes need!

And this must be done as soon as they see the victim.

Only a doctor is able to objectively assess the condition of the victim.

Symptoms and signs of poisoning do not always indicate the true severity of the poisoning. Long-term complications may develop, after 2 days or several weeks.

Timely medical treatment can reduce the rate of mortality and disability resulting from carbon monoxide poisoning.

Indications for hospitalization for carbon monoxide poisoning:

All patients with moderate and severe poisoning (with a carboxyhemoglobin concentration in the blood of more than 25%)
Pregnant women (with a carboxyhemoglobin concentration in the blood of more than 10%)
Victims with cardiovascular diseases (with a carboxyhemoglobin concentration in the blood of more than 15%)
Victims who have lost consciousness, as well as those with neurological disorders (impaired coordination, delirium, hallucinations, etc.)
Victims with low body temperature (below 36.6 °C)

Help steps	How?	For what?
Stop exposure to CO		Remove to fresh air, or Shut off the CO source, or Wear an oxygen mask or gas mask (with hopcalite cartridge)	With every minute the body is exposed to carbon monoxide, the possibility of survival decreases.
Ensure airway patency and adequate oxygen delivery		Take the victim out into the open air, or put on an oxygen mask (if available), or open windows and doors indoors. Inspect and clear the airways Free yourself from restrictive clothing, tie, shirt Lay the victim on his side	In half an hour in the fresh air, the content of carboxyhemoglobin in the blood decreases by 50% Lying on your side prevents your tongue from sticking out
Stimulate breathing and ensure blood flow to the head, bring consciousness		Give ammonia to smell (no closer than 1 cm from the nose) Rub your chest, put mustard plasters on your chest and back (if you have them) Give hot tea, coffee	Ammonia stimulates the respiratory center and removes you from unconsciousness. Rubbing the chest and mustard plasters improve blood circulation in the upper sections body, which enhances cerebral circulation. Tea and coffee contain caffeine, which has a tonic effect on the nervous system, and also stimulates breathing.
If necessary, perform indirect cardiac massage and artificial respiration		One cycle: 2 breaths and 30 chest compressions. See chest compressions and artificial respiration.	Provides blood circulation and oxygen delivery to organs and tissues. Supports vital important functions body until medical help arrives.
Ensure peace, protect from unnecessary waste of energy		Lay on your side Warm, protect from hypothermia, wrap. But do not overheat the victim.	Lay down to reduce oxygen consumption. When hypothermia or overheating occurs, the body spends a lot of energy to maintain the necessary balance.
		Oxygen 12-15 liters per minute, for 6 hours (supplied using: oxygen mask, oxygen tent, or artificial ventilation). Acizol, ampoules 6% -1.0 ml, Capsules 120 mg. Treatment: 1 ml intramuscularly, as soon as possible after poisoning. Repeated administration after 1 hour. For prevention: 1 ml intramuscularly, 20-30 minutes before entering the danger zone.	Oxygen competes with CO for a place “on hemoglobin”, so the more oxygen there is, the more chances it has to displace CO and take its natural place. Acizol is an antidote to carbon monoxide, accelerates the breakdown of the pathological compound - carboxyhemoglobin and promotes the addition of oxygen to hemoglobin. Reduces the toxic effect of CO on cells. It is also used as a prophylactic agent, it reduces several times harmful effects carbon monoxide on the body.

www.polismed.com

Carbon monoxide poisoning - symptoms, first aid, treatment, consequences

Carbon monoxide, or carbon monoxide ( chemical formula CO) is an extremely poisonous, colorless gas. It is an obligatory product of incomplete combustion of carbon-containing substances: it is detected in automobile exhaust gases, cigarette smoke, smoke from fires, etc. Carbon monoxide has no odor, so it is impossible to detect its presence and assess the concentration in the inhaled air without instruments.