Degrees of carbon monoxide poisoning. One step away from death: about my acquaintance with carbon monoxide

Carbon monoxide is a product released during the combustion of carbon, so anyone can be poisoned by it. Of particular danger is the fact that for deadly care, an insignificant amount of gas is needed, which has neither color nor smell. The second aspect is the speed of the poison, often doctors simply do not have time to provide assistance.

Carbon monoxide (CO) is carbon monoxide that is released together with carbon dioxide (CO2) when burned. True, in contrast to carbon dioxide, the CO content in the room is required much less in order 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 dire consequences.

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

The physical and chemical properties of CO are such that it is a colorless and odorless gas. It is released during the partial combustion of substances that have carbon in their composition. To answer the question about carbon monoxide, is it heavier or lighter than air, you need to remember a school chemistry course or turn to Wikipedia. With any of the options, we learn that it is lighter than air, and, therefore, in case of a fire, you need to move around, 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 fast total toxic effect. So, with its concentration in the air over 1.3%, death occurs in 3-4 minutes.

CO is ubiquitous. Therefore, poisoning occurs quite often. It is possible to be poisoned by this gas:

• in domestic fires;
• in industries where CO is used as a reagent (chemical industry, heavy metallurgy);
• in case of insufficient ventilation in rooms with gas equipment, in case of leakage in gas cylinders (has a characteristic smell due to specially added odorous substances, pure CO has no smell);
• at long burning kerosene and petrol lamps;
• in places of accumulation of exhaust gases of cars (large highways, garages), you can also get poisoned with carbon monoxide.

Impact 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;
• people with exhaustion of the body;
• people diagnosed with anemia;
• people suffering chronic diseases respiratory system, such as asthma and COPD.

So, the detrimental effect on the human body is based on the transformation of the composition of the blood and the defeat of 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 a protein called hemoglobin, which contains iron, cells carry oxygen. When carbon monoxide enters the body, hemoglobin binds to CO more quickly, forming a compound called carboxyhemoglobin. Erythrocytes 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 lack of oxygen. Therefore, the initial signs of CO intoxication will be associated with disorders from the side nervous system.

Violation of the skeletal and cardiac muscles

In addition to hemoglobin, which is found in the blood, CO is also able to bind to myoglobin, which is found in muscle tissues. As a result of this, a compound is also formed that loses its ability to perform its original function of providing oxygen to muscle fibers. So, there are symptoms from 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

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

CO concentration, %	Time of onset of symptoms, h	Manifesting signs and symptoms
< 0,008	3−5	Slowdown 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, shortness of breath physical activity, disturbance of 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 breathing.
0,1	2	Fainting, weakening of the pulse, convulsions and convulsions, tachycardia, rare shallow breathing, coma.
0,15	1,5
0,18	0,5	Same as at 0.1% concentration
0,2−0,3	0,5	Convulsions, heart and respiratory failure, coma, possibly fatal.
0,5−1	0,08−0,1	Inhibition of all reflexes, arrhythmia, filiform pulse wave, deep coma, death
>1,3	0,01−0,07	Convulsions, loss of consciousness, vomiting, coma and death.

Early and late effects of poisoning

Carbon monoxide is insidious, and the symptoms that will show themselves after poisoning are still for a long time will disturb the victim. First of all, as we found out, the nervous and the cardiovascular system. So, from the side of the nervous system in the first days after poisoning, there will be:

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

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

The occurrence of both early and late complications are due to a single mechanism. The cells of the nervous system are most susceptible to a lack of oxygen supply to them. So, during hypoxia, damage to the white and gray matter of the brain and spinal cord occurs. There is also a direct toxic effect. Violation of the peripheral nervous system due to the binding of CO to the proteins that form the myelin sheath of the nerve fiber, which leads to a violation of the conduction of the nerve impulse.

The consequences of the heart and blood vessels are also divided into early and late.

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

The mechanism of occurrence lies both in the hypoxia of the cardiac muscle tissue when carbon monoxide binds to the muscle protein - myoglobin, and in the direct poisoning effect of carbon monoxide on the heart 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 poisoning effects of CO.

Help with poisoning

The outcome of intoxication depends on many factors, however, the correct and timely measures taken can save a person's life. The first thing to do when you see an injured person is to call an ambulance. This must be done, because, firstly, only a specialist is able to assess the severity of poisoning, secondly, external signs can mislead you that the victim has a mild form of intoxication, and thirdly, drug therapy started on time can save a life person and prevent his disability.

In need of hospitalization:

• people with moderate and severe severity, poisoning;
• pregnant women (because of the risk of fetal death);
• victims with a history of cardiovascular disease;
• 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 the flow fresh air to the victim. To do this, you need to get rid of the source of CO or leave the dangerous place yourself. Also, the poisoned person can wear 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 the free circulation of air in the upper respiratory tract. To do this, open all the windows in the room, the patient is freed from restrictive clothing and laid on his side. In the fresh air, there is a decrease in the concentration of carboxyhemoglobin in the blood, and the position of the body on the side will prevent the tongue from sinking 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 chest and back of the victim, put mustard plasters. These measures will increase blood circulation in the thoracic and cerebral arteries. After a person has been brought to consciousness, he can be offered tonic drinks (tea, coffee), which contain substances that stimulate the central nervous system.

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

If the poisoned person is in a stable condition, it is necessary to protect him from extra costs energy. To do this, he needs to ensure peace, wrap him in blankets, lay him on his side on the bed.

Arriving doctors will begin treatment activities:

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

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

Carbon monoxide poisoning is one of the most common poisoning in everyday life, it is very dangerous and often leads to serious consequences and even death.

CO (carbon monoxide) is a product of incomplete combustion organic matter. It is a colorless, tasteless and odorless gas, does not irritate the skin and mucous membranes, therefore it is not organoleptically determined in the air. The source of this poison can be any flame, running internal combustion engines, unregulated stove heating, damage to gas pipelines in apartments and other premises.

More often acute carbon monoxide poisoning is obtained in garages, apartments, fires, industrial accidents. In such cases, the concentration of CO can reach significant levels. So, in the exhaust gases of cars, it can exceed 3-6%.

Carbon monoxide has a high toxicity, which is determined by its concentration in the air. So, when a person is in a room where its concentration reaches 0.1% for 1 hour, he develops acute poisoning of moderate severity; severe - at a concentration of 0.3% for 30 minutes, and fatal - when a person inhales air with 0.4% CO for 30 minutes or 0.5% for only 1 minute.

Formation of carboxyhemoglobin

The danger to humans and animals arises from the inhalation penetration of carbon monoxide into the body and is determined to a large extent by the affinity of CO with iron-containing compounds: hemoglobin, myoglobin, cytochrome enzymes that form reverse complexes. In particular, CO, interacting with hemoglobin, converts it into a state of carboxyhemoglobin (sleep). It is able to carry oxygen from the lungs to the tissues. Moreover, in the presence of dormouse, the dissociation of oxyhemoglobin into O2 and hemoglobin decreases. This makes it difficult to transport oxygen to tissues and negatively affects the activity of organs and systems of the body, primarily the brain and heart.

In persons who breathe air containing 0.1% CO, the level of sleepiness in the blood can reach 50%. Such a high level of this compound is facilitated by a significant affinity (affinity) of CO with hemoglobin, which is 220 times higher than the affinity of O2. The dissociation of carboxyhemoglobin is 3600 times slower than that of oxyhemoglobin. Its stability in the body creates the basis for the development of hemic and tissue hypoxia.

The antagonist of carbon monoxide in the body is oxygen. At an air pressure of 1 atm., TCO from the body is about 320 minutes, with inhalation of 100% oxygen - 80 minutes, and in a pressure chamber (2-3 atm.) - decreases to 20 minutes.

Signs of carbon monoxide poisoning

Carbon monoxide poisoning is very dangerous because carbon monoxide is odorless and colorless. A person does not even understand that he is in mortal danger.
Signs of carbon monoxide poisoning are:

• drowsiness,
• vision and hearing problems
• headache,
• dizziness,
• dyspnea,
• noise in ears,
• nausea,
• indifference to danger
• loss of consciousness,
• convulsions.

Symptoms of poisoning

Manifestations of carbon monoxide intoxication are determined not only by its content in the air, but also by the duration of action and the intensity of breathing. Inhalation of CO at a concentration of 0.05% for 60 minutes leads to a mild headache. At the same time, the concentration of sleepyheads in the blood does not exceed 20%. Longer exposure or more intense inhalation can increase dormice levels by up to 40-50%. Clinically, this is manifested by significant headache, confusion, bright red coloration of the skin and mucous membranes. At a concentration of CO in the air of 0.1%, loss of consciousness occurs, breathing is weakened. Death is possible if the duration of action of the gas exceeds 1 hour. At the same time, the level of sleepiness can reach 60-90%. At a sleepiness level of less than 15%, there are no signs of acute poisoning.
The severity of acute carbon monoxide poisoning increases with overwork, blood loss, hypovitaminosis, if the victims have concomitant diseases, especially the cardiovascular and respiratory systems, high temperature air, reducing the content of O2 and increasing CO2 in it.

The leading clinical signs of acute carbon monoxide poisoning are hypoxia and the appearance of symptoms in the following sequence:

• a) psychomotor disorders;
• b) headache and feeling of pressure in the temporal region;
• c) confusion and decreased visual acuity;
• d) tachycardia, tachypnea, loss of consciousness, coma;
• e) deep coma, convulsions, shock and respiratory arrest.

Degrees of acute intoxication

There are 4 degrees of severity of acute carbon monoxide poisoning CO: mild, moderate, severe and fulminant.

mild poisoning

Mild CO poisoning occurs when the level of dormice in plasma reaches 20-30%. There is a headache, dizziness, a feeling of heaviness and squeezing in the head, pulsation in the temples, tinnitus, drowsiness and lethargy. Possible euphoria with visual and auditory hallucinations, nausea, and sometimes vomiting. Often develops tachycardia, moderate hypertension, shortness of breath. Moderately dilated pupils react to light.

Moderate poisoning

Manifestations of acute poisoning of moderate severity occur when the level of sleepiness increases to 50%. Clinically, this is manifested by drowsiness, severe dizziness and headache, increasing weakness, impaired coordination of movements, and vomiting. Characteristic short-term loss of consciousness and memory, the appearance of convulsions, tonic contraction of the masticatory muscles (trismus). As with mild poisoning, the skin and mucous membranes remain bright red, the heartbeat and shortness of breath increase, and sometimes a coma develops.

severe poisoning

When the content of dormice in the blood exceeds 50%, the condition of the victims deteriorates sharply (severe degree of intoxication). In patients, consciousness may not be restored. There are such manifestations of CNS damage as hallucinations, delirium, clonic-tonic convulsions, paresis and paralysis, decerebral rigidity, hyperthermia, meningitis symptoms, and from the circulatory system - severe tachycardia, arrhythmias, angina pectoris, tachypnea. Breathing becomes pathological, like Cheyne-Stokes.
Urination and defecation are involuntary.

Depending on the circumstances, the clinical picture of acute intoxication may be supplemented by other manifestations. So, fires can develop a burn of the upper respiratory tract, acute respiratory failure of the aspiration-obstructive type, sudden death(lightning degree of poisoning). Victims instantly lose consciousness. Their breathing stops, and after 3-5 minutes their heart stops.

In addition, acute carbon monoxide poisoning in the toxicogenic phase can be complicated by pulmonary edema, myocardial infarction, and in the somatogenic phase - polyneuritis, pneumonia, impaired skin trophism, and acute kidney failure.

At the pre-medical stage, the diagnosis of acute CO intoxication is based on the results of clinical manifestations, anamnesis data, and an analysis of the circumstances at the scene. 5 ml of blood (with 1-2 drops of heparin) is transferred to the laboratory for analysis. Patients are evacuated to a hospital, preferably with a pressure chamber.

What to do about carbon monoxide poisoning

When we see a person in an unconscious state, first of all we need to assess what happened to him. In order to understand, one should study the environment of the victim.

If an unconscious person assumes that he has been poisoned by carbon monoxide, it is possible if:
1. The victim is in the garage with the car engine running.
2. The victim is at the stove.

A person poisoned by carbon monoxide will have difficulty breathing as long as he is conscious.

What to do?
First of all, don't panic.
When moving the victim, you must always remember about your own safety. Therefore, try not to breathe the air exhaled by the victim and the air in the room where there is a gas leak.
First step: fresh air
If a person has lost consciousness, he must be taken out to fresh air. If this is not possible, provide fresh air on site (switch off car, open garage door, window).

Second step: assessment of the victim's respiratory function
In case of unconsciousness, after providing fresh air, he should be given artificial respiration. In the event of an anomaly, immediately call ambulance, and then proceed to massage the chest (30 compressions and 2 breaths).

Third step: waiting for help
If it was possible to recover correct breathing, put the victim in a safe position and look forward to the arrival of medical help. While waiting, you can not leave the patient, you need to constantly check his condition. In addition, the patient should be covered - protected from hypothermia.

Emergency aid for intoxication

Emergency care consists in the immediate cessation of further penetration of carbon monoxide into the body of the victim and providing him with calmness, warmth and high level ventilation. To do this, you should immediately take it out of the contaminated room, provide access to clean air or oxygen. Bring a cotton swab moistened to the nose ammonia, rub the chest, put heating pads on the legs, mustard plasters on the chest and back, give the victim hot tea or coffee to drink.

When breathing stops, it is necessary to resort to artificial ventilation of the lungs in the hyperventilation mode, the introduction of respiratory stimulants (lobelin hydrochloride 1 ml of 1% solution, cytiton 1 ml). The use of carbogen and methylene blue is contraindicated. It is also necessary to stop convulsions with anticonvulsants.

Pharmacological correction of cardiac disorders and prevention of threatening disorders of heart rhythm and conduction in acute carbon monoxide poisoning is carried out using unithiol 5-10 ml 5% solution, sodium thiosulfate 30-60 ml 30% solution, cytochrome C 25-50 mg vitamin E 1 ml 30% oil solution subcutaneously. It is advisable to infuse 5-10% glucose with insulin, B vitamins, ascorbic acid, glucocorticoids, for example, intravenously 90-120 mg of prednisolone hemisuccinate.

In the presence of hyperthermia, intravenous analgin injections of 2 ml of a 50% solution and craniocerebral hypothermia are indicated. With the appearance of an injection of mezaton 0.5-1 ml of a 1% solution, ephedrine hydrochloride 1 ml of a 5% solution. The stages of providing medical care to a victim of carbon monoxide are presented in the table.

Stages of medical care for victims of carbon monoxide poisoning(according to P. Kondratenko, 2001)

Therapeutic measures	Actions of the medical staff	Medications and manipulation
1	2	3
First aid and first aid	Remove victim to fresh air	In case of cardiac arrest - indirect heart massage and mechanical ventilation: mouth-to-nose or mouth-to-mouth breathing
First aid	Delivery of the victim to the intensive care unit	Cordiamin or caffeine, or mezaton (1 ml of a 1% solution intramuscularly). Ascorbic acid - 20-30 mg in 20-50 ml of 40% glucose solution intravenously; 500 ml of 5% glucose with 50 ml of 2% novocaine and 20-30 ml of 5% ascorbic acid intravenously. Analgin or Reopirin - intramuscularly, as well as glucocorticoids. In case of cardiac arrest - chest compressions and mechanical ventilation: mouth-to-nose or mouth-to-mouth breathing
Qualified medical care		Ventilation with machines in hyperventilation mode, using 100% oxygen supply. Cytochrome C - 15-60 mg / day. Antihypoxants (sodium hydroxybutyrate), tranquilizers or antipsychotics, antihistamines intravenously. Symptomatic therapy. Glucocorticoids.

Most effective method The treatment of acute intoxication with carbon monoxide is oxybarotherapy (at a pressure of 2.5 atmospheres for 30-90 minutes), since inhalation of O2 under pressure sharply accelerates the release of CO from the serum, contributes to the disappearance of hemocirculatory disorders, improves respiration and heart activity.

Chronic carbon monoxide toxicity

With chronic exposure to CO, poisoning is most common in the professional environment.

Main clinical manifestations

• cerebrasthenia,
• diencephaly,
• polyneuritis,
• angina attacks,
• thyrotoxicosis,
• impotence,
• pernicious anemia,
• polycythemia,
• splenomegaly and others. After severe poisoning, there are consequences - deterioration of memory and intelligence.

Treatment

Collecting the history that caused acute poisoning, stopping contact with CO, symptomatic treatment, cerebroprotective treatment with glucose-insulin infusions, B vitamins, enzyme preparations, physiotherapy, rehabilitation - physical and mental.

Carbon monoxide: symptoms, first aid

Carbon monoxide poisoning kills hundreds of people every year. According to statistics from the Ministry of Emergency Situations, the number of victims in winter period much higher than at other times of the year.

The reason for this can be many different factors, but in order to protect yourself and your loved ones as much as possible, you first need to know signs of carbon monoxide poisoning, as well as possible consequences. In this article, you can find useful information regarding the interaction of the body with this gas, its further effects and recommended precautions.

The danger of carbon monoxide

Places where there is an increased risk of CO poisoning

The main danger of carbon monoxide lies in the fact that it is able, even in small doses, to quickly act on human body.

Carbon monoxide is also colorless, odorless, and tasteless, making it very difficult to detect with the naked eye. Because of this, many people often write off the first signs of gas poisoning on other factors, without thinking about the danger. You can encounter it absolutely anywhere, both at home and at work. And given that carbon monoxide, aka CO (carbon monoxide), is formed by cars, and even hookah apparatus with poor oxygen access, then we come into contact with it almost daily.

The effect of carbon monoxide on the body

The effect of CO on humans

As soon as CO enters the human body, it immediately begins to affect the circulatory system. And if the dose exceeds allowable rate, then carbon monoxide actively combines with hemoglobin cells, turning into carboxyhemoglobin, which prevents oxygen from reaching tissue cells. As a result, this effect leads to hypoxia and disruption of the biochemical balance.
Also suffer from this muscle tissues and the heart itself. Due to the lack of oxygen, human muscles begin to weaken, and the heart, unable to cope with the load, loses its working rhythm. In an attempt to deliver the oxygen necessary for the tissues, the heart increases the rate, exhausting the poisoned body. The result of this action is quite simple - increased heart rate and general weakness. And the more carbon monoxide affects a person, the faster his body is engaged in self-destruction.

The main causes of carbon monoxide poisoning

The first and most numerous cause of CO poisoning occurs in a fire. Experienced firefighters know that carbon monoxide is in some cases much more dangerous than the destructive power of a fire. The second cause, according to death statistics, is a gas leak in enclosed spaces. The most common victim of this case are novice motorists who like to close the door in the garage and at the same time forget to turn off the car engine or leave it for the heater to work.
Also, owners of gas-using equipment equipped with poor ventilation often encounter carbon monoxide. This is mainly due to a violation of safety regulations or a violation of the conditions of construction. ventilation ducts and chimneys. Larger gas equipment it is used in production, where leakage can also occur, and as a result, poisoning of the operating personnel. And now you already know How does carbon monoxide poisoning happen?.

The main symptoms and signs of manifestation

Signs of carbon monoxide poisoning

The symptoms of CO ingestion can vary greatly depending on the amount of gas that has entered the body. Some of them may coincide with other diseases, and even pass for a common ailment. But the boundary between a moderate state and a mortal danger is very thin, since this gas is too active, and it is very easy to get poisoned by it.
To make a more convenient classification, experts divided the symptoms of carbon monoxide poisoning into three categories that can form: mild, moderate and severe.

Light degree of influence:

• high blood pressure;
• headache;
• knocking in the temples;
• vomiting and nausea;
• dizziness and weakness;
• chest pain and dry cough;
• increased heart rate;
• tearfulness and possible auditory hallucinations.

Average degree of influence:

• partial or complete paralysis;
• increased noise in the ears;
• drowsiness;

Severe degree of influence:

• muscle cramps;
• loss of consciousness;
• pupillary enlargement with minimal light reaction;
• uncontrolled emptying of the bowels or bladder;
• labored breathing;
• bluing of the facial skin.

All of these factors are the result of a dangerous carbon monoxide leak. And if you feel any of these symptoms, and there is a gasified source nearby, we strongly recommend that you leave the premises.

Atypical forms of poisoning

Unlike common forms of carbon monoxide poisoning, atypical forms depend on several factors. Often this can be either too large and rapid gas release or a combination of a small concentration with internal state person.

Euphoric degree

It is characterized by a relatively small concentration of CO, which flows next to a person suffering from nervous overwork. As a result, the victim may feel a state of euphoria, but in the future simply lose consciousness.

chronic degree

This category most often includes people who are exposed to carbon monoxide in a work environment. It can be like employees of boiler houses, factories, workshops, and so on. All this is accompanied by characteristic headaches, increased heart rate, rapid pulse, wear and tear of the heart and the body as a whole, not only during the entire period of work, but also after it.

Powder degree

The rarest category, since in this case poisoning occurs with the help of explosive gases formed from combustible gunpowder. In this case, irritation of the mucous membranes, pain in the nasopharynx and respiratory system, lacrimation and coughing may occur.
As you can see for yourself, these symptoms of these forms are somewhat different from the main classification of poisoning, but they are no less deadly.

Further complications of poisoning

Complications of CO poisoning

Even if you were able to quickly identify poisoning and seek help, carbon monoxide is not so easy to completely eliminate from the body. Consequences of carbon monoxide poisoning can be very different - it all depends on physical condition organism, individual for each person, as well as the duration of exposure and, of course, the provision of PMP.
Basically, a person will be accompanied by prolonged weakness and frequent headaches. In some cases, there is a short-term cramp or slight tinnitus. If the impact of carbon monoxide on the human body was very large, then the treatment may be accompanied by the occurrence of pneumonia and necrosis of internal tissues. The effects of small doses are not so critical and are usually accompanied by headaches or high blood pressure within a few days.

First aid for poisoning

What to do in case of carbon monoxide poisoning

Now it's time to answer the question: what to do about carbon monoxide poisoning? If the victim is in the affected area, then it must be immediately removed from there. As soon as you move to a safe distance, the victim is unfastened all clothing that can make breathing difficult. If the victim is unconscious, then he must perform artificial respiration, as well as call an ambulance.
It should be called for any symptoms of moderate and severe poisoning, since in such cases the poisoned person needs an oxygen mask, and he also needs carbon monoxide antidote- Amizol. Without the help of these funds, the moderate and severe form can cause death in a short time.

End result of poisoning

The outcome of carbon monoxide poisoning depends on several factors:

• duration of exposure;
• the concentration of gas around the victim;
• leak detection rate;
• over what period of time was provided urgent care in carbon monoxide poisoning.

It also affects individual parameters person and his state of health. The victim can get off with both mild symptoms and symptoms of moderate severity, with further complications and a long rehabilitation period. Otherwise, inaction can lead to death.

Prevention of CO poisoning

In any plant, the resulting poison gas must have access to ventilation system Therefore, all work must be carried out in well-ventilated rooms.

If your home has a fireplace or stove, then you need to check the dampers on a regular basis.

Also, before any contact with carbon dioxide, medical personnel strongly recommend taking the antidote "Amizol" 30-40 minutes before exposure to CO. As you can see for yourself, the consequences of carbon dioxide poisoning can be very serious.
This can be caused by many different factors. Compliance with safety regulations and prompt medical attention will help keep you and your loved ones healthy.

Video

How to independently determine the stage of carbon monoxide poisoning? What kind of help should be given to the victim? These and other questions can be answered in these videos.

Carbon monoxide, or carbon monoxide, has chemical formula CO. It has no color, taste, smell. The characteristic smell attributed to it by non-specialists is actually the smell of impurities, which, like CO, are released during the combustion of organic matter.

Carbon monoxide is formed during the combustion of substances and materials containing carbon. In addition to wood and coal, these include oil and its products, including gasoline and diesel fuel. Accordingly, the cause of poisoning can be staying in the immediate vicinity of the place of combustion of carbonaceous substances, including close to running car engines.

The maximum allowable concentration of carbon monoxide in the atmospheric air for a person is 33 mg/m³. By hygiene standards concentration should not exceed 20 mg/m³. Death is caused by inhalation of air, 0.1% of which is carbon monoxide, within an hour. For comparison, the exhaust of an automobile internal combustion engine contains 1.5–3% of this toxic substance, therefore, CO belongs to the 2.3 hazard class according to the international classification.

Causes of carbon monoxide poisoning

Most common causes carbon monoxide poisoning:

• long (over 5 hours) being in close proximity to highways with busy traffic;
• being in an unventilated room in which there is a source of combustion, devoid of the removal of combustion products. It can be a fire, a running car, a stove with a closed chimney, etc.;
• neglect of safety rules and instructions for the devices used when using household and homemade devices that provide for combustion (burners, stoves, potbelly stoves and other heating devices).

Cigarette smoke also contains CO, but its concentration is too low to cause serious poisoning.

Carbon monoxide is also formed during gas welding, which uses carbon dioxide. The latter, which is carbon dioxide (CO2), loses an oxygen atom when heated and turns into CO. But when burning natural gas in serviceable stoves and appliances, CO is not formed. If they are faulty, then carbon monoxide is released in concentrations dangerous to health.

Signs of carbon monoxide poisoning

At concentrations of carbon monoxide less than 0.009%, poisoning occurs only in cases of being in a gassed place for more than 3.5 hours. Intoxication proceeds in a mild form and often goes unnoticed, since its symptoms are mild: psychomotor reactions slow down, blood rush to the organs is possible. In people suffering from cardiovascular diseases may experience shortness of breath and chest pain.

With an increase in the concentration of CO in the air to 0.052%, an hour of continuous exposure is required for the development of symptoms of intoxication. As a result, headache and visual disturbances are added to the above symptoms.

When the concentration rises to 0.069%, an hour is enough for the headache to become throbbing, dizziness, nausea, incoordination, irritability, short-term memory lapses and visual hallucinations appear.

A concentration of CO equal to 0.094% within two hours leads to hallucinations, severe ataxia and tachypnea.

Higher levels of CO2 in the air lead to rapid loss of consciousness, coma and death. These symptoms of carbon monoxide poisoning at its concentration in the inhaled air of 1.2% occur within a few minutes.

First aid for carbon monoxide poisoning

Carbon monoxide is a volatile compound that quickly dissipates in the atmosphere. The victim must immediately leave the epicenter with the highest concentration of gas. Most often, for this it is enough to leave the room in which the source is located, if the victim cannot do this, he should be taken out (carried out).

It is impossible for a non-specialist to independently assess the severity of the victim's condition, this can only be done based on the results of a blood test. Therefore, even with minor signs of poisoning, it is necessary to seek medical help. In a state of moderate severity, even if the victim is able to move independently, you need to call an ambulance. When calling, the dispatcher must be informed of the exact symptoms, the source of poisoning and the duration of being near it.

While waiting for the arrival of doctors, the victim should be kept calm. Lay down, turning your head to one side, get rid of clothes that interfere with breathing (unbutton your collar, belt, bra), ensure a constant supply of oxygen.

In this condition, hypothermia of the body is dangerous, and it should be prevented by applying heating pads or mustard plasters to the legs.

In case of loss of consciousness, it is necessary to carefully turn the victim on his side. This posture will keep the airways open and eliminate the possibility of choking on saliva, phlegm, or the tongue sunk into the throat.

Treatment for carbon monoxide poisoning

The general principle of medical care in case of poisoning with this product is to saturate the body of the victim with oxygen. For mild poisoning, oxygen masks are used, in most cases this is sufficient.

In more severe cases apply:

• forced ventilation of the lungs (IVL);
• subcutaneous administration of caffeine or lobelin;
• the introduction of cocarboxylase intravenously;
• administration of Acizol intramuscularly.

In severe poisoning, the patient can be placed in a hyperbaric pressure chamber.

Carbon monoxide poisoning in children

Most childhood carbon monoxide poisoning results from playing with fire. In second place is staying in rooms with faulty stoves.

At the first sign of carbon monoxide poisoning, it is necessary to take the child to fresh air and call an ambulance. The use of oxygen bags in this case is not recommended. Hospitalization is necessary in all cases, even if the degree of poisoning is insignificant. Children are at high risk of serious complications, in particular pneumonia.

Carbon monoxide poisoning in pregnant women

Pregnant women are much more sensitive to elevated concentrations of carbon monoxide in the air than others. Studies conducted in 1993 by foreign scientists showed that symptoms of poisoning can be observed at the maximum allowable concentration or even less. Therefore, expectant mothers should avoid the places of potential risk listed above.

In addition to the usual complications, carbon monoxide poisoning during pregnancy carries with it another danger.

Even small doses of CO that enter the bloodstream can lead to fetal death.

Complications and consequences

When breathing, carbon dioxide passes from the lungs into the blood in the same way as oxygen does, and enters into chemical reaction with hemoglobin. As a result, instead of normal oxyhemoglobin, carboxyhemoglobin is formed in next proportion- with a ratio of CO and air of 1/1500, half of the hemoglobin will turn into carboxyhemoglobin. This compound is not only unable to carry oxygen, but also prevents the release of the latter from oxyhemoglobin. As a result, oxygen starvation of the hemic type occurs.

The processes described above cause hypoxia, which negatively affects the work of all internal organs. Asphyxia is especially dangerous for the brain. It can cause both minor impairments to memory and thinking, and serious neurological or even psychiatric diseases.

Recently, British scientists from the University of Leeds, together with French colleagues, found that even minor carbon dioxide poisoning disrupts the heart rhythm, which can lead to serious consequences, including death.

Prevention of carbon monoxide poisoning

The density of atmospheric air at altitudes characteristic of most of the territory of Russia is such that it is heavier than carbon monoxide. It follows from this fact that the latter will always accumulate in the upper part of the room, and outside them rise to the upper layers of the atmosphere. Therefore, once in smoky rooms, you should leave them, keeping your head as low as possible.

You can protect your home from unintended CO2 emissions using a sensor that automatically detects the concentration of this substance in the air and gives an alarm when it is exceeded.

Garages, houses with furnace heating and enclosed spaces, where there are devices and devices that can serve as a source of carbon monoxide, it is necessary to check at least once a year for compliance with safety regulations. So, in garages, the ventilation system should be checked regularly, and in houses with stove heating, the health of the heating system, especially the chimney and exhaust pipe.

When working with devices that imply combustion (for example, with gas burner or an electric welding machine), use ventilation in rooms without ventilation.

Spend as little time as possible near busy freeways.

When spending the night in a garage or a freestanding car, make sure that the engine is turned off.

Video from YouTube on the topic of the article:

Update: October 2018

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

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

Therefore, excess CO concentrations can only be detected 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 hazardous substance is made by exhaust gases from automobile internal combustion engines.

Action on the body

• CO enters the bloodstream 200 times faster than O 2 and enters into an active bond with blood hemoglobin. As a result, carboxyhemoglobin is formed - a substance that has a stronger bond with hemoglobin than oxyhemoglobin (oxygen in combination with hemoglobin). This substance blocks the process of oxygen transfer to tissue cells, causing hemic type 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 the reactions of synthesis of substances (phenol, acetone).
• In gasified premises operating gas equipment ( gas stoves, water heaters, heat generators) in case of insufficient ventilation or not enough supply air needed to burn the gas.
• Garages, tunnels and other poorly ventilated areas where vehicle exhaust fumes can accumulate.
• When you stay near busy highways for a long time.
• At the time of leakage of lighting gas at home.
• When untimely (early) closed stove barriers of the home stove, stove in the bath, fireplace.
• Prolonged use of a kerosene lamp in an unventilated area.
• The use of low-quality air in breathing apparatus.

Risk groups (with hypersensitivity to CO)

Signs of poisoning depending on the concentration of CO

CO concentration, %	Time of onset of clinical manifestations	signs
Up to 0.009	3-5 h	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 h	Decreased performance Minor headache Shortness of breath during moderate exercise Impaired vision (perception) May cause death in individuals with severe heart failure and in the fetus
0,019-0,052	2 h	Severe throbbing headache Dizziness Emotional instability, irritability Violation of attention and memory Nausea Fine motor disorder
Up to 0.069	2 h	Strong headache visual impairment Confused mind General weakness Runny nose Nausea and vomiting
0,069-0,094	2 h	hallucinations Severe motor disorder (ataxia) Shallow rapid breathing
0,1	2 h	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 Inhibition 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 Vomit Death

Symptoms of carbon monoxide poisoning

Light poisoning:	Moderate poisoning:	Severe poisoning:
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; paralysis of muscles against the background of preserved consciousness.	loss of consciousness; convulsions; respiratory failure; coma; uncontrolled urination and defecation; dilated pupils with a weak reaction to a light stimulus; significant bluing of the mucous membranes and skin.

The mechanism of occurrence of symptoms

Neurological symptoms

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

Cardiovascular symptoms

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

Respiratory symptoms

Increased respiration 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 shade of the scalp and mucous membranes indicates an increased, compensatory blood flow to the head.

Consequences of carbon monoxide poisoning

With mild and moderate degrees of severity of poisoning, the patient may be disturbed for a long time by headaches, dizziness, decreased memory and intelligence, emotional instability, 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:

• skin-trophic disorders (edema followed by tissue necrosis);
• subarachnoid hemorrhages;
• violation of cerebral hemodynamics;
• swelling of the brain;
• polyneuritis;
• impaired vision and hearing to complete loss;
• myocardial infarction;
• severe pneumonia complicating coma.

First aid for carbon monoxide poisoning

Pre-hospital care involves stopping the contact of the victim with poison gas and restoring vital functions. First aid for carbon monoxide poisoning should exclude the poisoning of someone who is trying to provide this very help. Ideally, you should put on a gas mask and only then go into 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 measure that must be performed first of all, since pathological changes in the body intensify with each breath.
• Call an ambulance for any condition of the patient, even if he jokes and laughs. Perhaps this is a consequence of the action of CO on the vital centers of the central nervous system, and not a sign of health.
• With a mild degree of poisoning, give a person a strong sweet tea to drink, warm and ensure peace.
• In the absence or confusion of consciousness - lay on a flat surface on its side, unfasten the collar, belt, provide fresh air. Give a sniff of cotton wool with ammonia at a distance of 1 cm.
• In the absence of cardiac or respiratory activity, perform artificial respiration and massage the sternum in the projection of the heart.
  

What to do in case of fire poisoning?

If it so happened that people were left in the burning room, you should not try to save them on your own - 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 lethal, so no wet rags or filter masks can protect a person who comes to the rescue. Only a gas mask can protect against the deadly action of CO!

Therefore, the rescue of people in such a situation should be trusted to professionals - the EMERCOM team.

Treatment

If a person is in a 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, the patient is provided with complete rest. They organize breathing with pure oxygen with a partial pressure of 1.5-2 atm or carbogen (95% oxygen and 5% carbon dioxide) for 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 dampers for stoves and fireplaces. Never close them when 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 the likely contact with gas. Protection lasts 2-2.5 hours after taking the capsule.

Azizol is a domestic drug, a quick and effective antidote against acute carbon monoxide poisoning in lethal doses. It prevents the formation of carboxyhemoglobin substance and accelerates the excretion 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.