Carbon Monoxide Poisoning

First Things First (assess & treat for the following)

• Carbon monoxide
  • Immediate removal from contaminated area
  • ABCs (airway, breathing, circulation)
  • Assess fire victims for airway obstruction, thermal injury, cyanide intoxication, myocardial ischemia, conduction defects.
  • Administer 100% oxygen immediately for management; for some, hyperbaric O2 may be indicated if available.
• Tissue hypoxia is the primary problem.
• Mechanisms:
  • Carbon monoxide (CO) binds to hemoglobin with an affinity 250 times that of oxygen, resulting in reduced oxyhemoglobin saturation and decreased blood oxygen-carrying capacity.
  • Also, the oxyhemoglobin dissociation curve is displaced to the left, impairing oxygen delivery at the tissues.
  • CO may also directly inhibit cytochrome oxidase, further disrupting cellular function.
  • CO is known to bind to myoglobin, possibly contributing to impaired myocardial contractility.