Carbon monoxide poisoning

Question 1

Sources of carbon monoxide:

Answer 1

1) Gasoline
2) Exhaust fumes
3) Diesel
4) Propane powered engines
5) Charcoal fire smoke
6) Methylene chloride
7) Tobacco smoke

Question 2

When is the peak time for carbon monoxide poisoning?

Answer 2

6-10pm

Question 3

What are the peak months for carbon monoxide poisoning?

Answer 3

December and January (non-fire)

Question 4

Most common setting for carbon monoxide poisoning?

Answer 4

At home

Question 5

How does carbon monoxide work?

Answer 5

Reversibly binds hemoglobin = functional anemia

Question 6

Small concentrations of carbon monoxide can result in significant ___.

Answer 6

Carboxyhemoglobin (HbCO)

Question 7

Carbon monoxide shifts the oxygen-hemoglobin dissociation curve to the __.

Answer 7

Left

Question 8

What is the Bohr effect?

Answer 8

Oxygen and carbon monoxide binding is inversely proportional

Question 9

What are the body systems most affected by carbon monoxide poisoning?

Answer 9

1) CVS
2) CNS

Question 10

What are the signs and symptoms of carbon monoxide poisoning? (HbCO: 5-20%)

Answer 10

Mild severity:
1) Asymptomatic
2) Headache
3) Shortness of breath
4) Nausea and vomiting
5) Dizziness
6) Blurred vision

Question 11

What are the signs and symptoms of carbon monoxide poisoning? (HbCO: 21-40%)

Answer 11

Moderate severity:
1) Worsening headache
2) Confusion
3) Syncope
4) Chest pain
5) Dyspnea
6) Tachycardia
7) Tachypnea
8) Weakness

Question 12

What are the signs and symptoms of carbon monoxide poisoning? (HbCO: 41-60%)

Answer 12

Severe:
1) Dysrhythmias
2) Palpitations
3) Cardiac ischemia
4) Confusion
5) Respiratory arrest
6) Pulmonary edema
7) Seizures
8) Coma
9) Cardiac arrest

Question 13

What are the long term cardiovascular effects of carbon monoxide poisoning?

Answer 13

1) Myocardial injury from hypoxia and cellular damage
2) Premature death

Question 14

What are the factors increasing myocardial injury risk in carbon dioxide poisoning?

Answer 14

1) Male
2) History of hypertension
3) GCS < 14 when the patient was first found

Question 15

What are the long term neurological effects of carbon monoxide poisoning?

Answer 15

Delayed onset neurobehavioral dysfunction (CO-induced delayed neuropsychiatric syndrome)

Question 16

What is delayed onset neurobehavioral dysfunction (CO-induced delayed neuropsychiatric syndrome) characterized by?

Answer 16

1) Impaired cognitive function
2) Dementia

Question 17

What factors increase the risk of delayed onset neurobehavioral dysfunction (CO-induced delayed neuropsychiatric syndrome)?

Answer 17

1) Heart disease
2) COPD
3) Anemia
4) Infants

Question 18

What is the treatment of carbon monoxide poisoning?

Answer 18

1) Remove from contaminated area into fresh air
2) Give CPR
3) 100% oxygen
4) Keep resting

Question 19

How do you avoid carbon monoxide poisoning?

Answer 19

1) Avoid open flames without proper ventilation

2) Avoid sleeping in/near vehicles with the engine running

3) Never operate engines in a closed garage without exhaust ventilation

4) Avoid using unvented heaters and charcoal grills or any open flame in closed areas

5) Make sure heaters are set at the proper combustion ratio and heating system is leak-free

6) Install a carbon monoxide detector