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.

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Last updated: April 12, 2010