Dyshemoglobinemias

Question 1

Mild CO Acute Clinical Effects

Answer 1

HA, N/V, dizziness

Question 2

Moderate CO Acute Ciinical Effects

Answer 2

Chest Pain, Blurred Vision, Tachycardia, Tachypnea, Dyspnea upon exertion, Cognitive Deficits, Myonecrosis, Ataxia

Question 3

Severe CO Acute Clinical Effects

Answer 3

Seizures
Coma
Dysrhythmias, Hypotension
Mi/Ischemia
Skin Bullae

Question 4

CO Late/Chronic Efects

Answer 4

Cognitive Dysfunction
Dementia, Psychosis, Amnesia
Parkinsonism, Paralysis Chorea, Cortical Blindness, Apraxia, Anosias, Peripheral Neuropathy, Incontinence

Question 5

When does “late /Chronic effects” from CO poisoning occur?

Answer 5

After lucent period which lasts areound 2-40 days

Question 6

What are the two reperfusion injury theories in regards to CO Late Effects?

Answer 6

1. WBS’s are attracted and adhere to the microvasculature of the brain
2. WBC’s release proteases that convert xanthine dehydrogenase to xanthene oxidase, facilitating free radical formation and leads to delayed lipid peroxidations

Question 7

How do you evaluate for CO poisoning?

Answer 7

Check for end organ manifestations of toxicity and measure the lebel using arterial blood gas co-oximeter. Pulse oximetry and calculation form arterial blood gas will be falsely normal.

Question 8

How does ABC’s and oxygen and hyperbaric oxygen sork to trat CO toxxxicitiy?

Answer 8

ABC’s shorten CO t1/2 to 2-7 hr and HBO shortens t1/2 (4-86 mins) increased O2

Question 9

What are some indications for HBO?

Answer 9

Presentation of Syncope, Comas, Seisures (GCS 4-15)

CO level greater than 25%