CO poisoning Flashcards

1
Q

Describe CO.

A

odorless, tasteless, colorless, nonirritating gas formed by hydrocarbon combustion

atmospheric CO is < 0.001%

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2
Q

What is the physiology with CO inhalation?

A

CO binds to Hb with much greater affinity than O2, forming carboxyhemoglobin (COHb) –> impaired oxygen transport and utilization

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3
Q

What are the sources of CO poisoning?

A
  • Smoke from fires
  • Faulty heating system
  • Poor ventilation for heating devices
  • Cars operating in poorly ventilated areas
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4
Q

How does the oxygenation curve shift with CO poisoning?

A

Left - diminished ability of the other 3 oxygen sites in Hb to offload oxygen to tissues

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5
Q

What are the clinical features of CO poisoning?

A
  • Headache
  • Dizziness
  • Malaise
  • Nausea
  • Confusion
  • SOB
  • Visual changes
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6
Q

How do you diagnose CO poisoning?

A
  • May be informed of high CO levels by fire department at site of fire
    OR
  • COHb blood levels (venous) - >3% in non-smokers, >10% in smokers
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7
Q

What other investigations should be done in CO poisoning?

A
  • ECG
  • Troponin/BNP
  • ABG/VBG
  • FBS
  • Urinalysis
  • CXR
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8
Q

What is the management of CO poisoning?

A
  • ABCDE approach
  • High flow oxygen via nonrebreathing mask
  • +/- hydroxycobalamin - to treat co-existent cyanide poisoning
  • +/- hyperbaric oxygen therapy - if very high COHb or LOC, severe metabolic acidosis
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9
Q

What are the long term complications of CO poisoning?

A
  • neurocognitive impairment from hypoxic-ischaemic brain injury
  • myocardial injury may predispose to CVD mortality
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