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.
- 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.
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