Acute carbon monoxide poisoning tends to occur at night and early in the morning during the cold season. Carbon monoxide poisoning is prone to occur when using firewood, honeycomb coal, charcoal for heating or eating charcoal hot pot in poorly ventilated places, installing gas water heaters in closed bathrooms, sleeping in cars with closed windows and air conditioning, and fire scenes.
What to do about carbon monoxide poisoning?
When carbon monoxide poisoning is perceived, the cerebral cortex, which governs human movement, is paralyzed and the hands are no longer able to listen to calls, so people with carbon monoxide poisoning are often unable to effectively save themselves.
Emergency measures
When you find that someone around you has carbon monoxide poisoning, immediately call 120, immediately open the doors and windows, circulate the air, and immediately turn the patient away from the poisoning environment, move to a place with sufficient air, untie the patient's neckline, and keep the airway open. If the patient vomits, the dirt in the oral cavity and nasal cavity should be removed, and the patient should pay attention to keeping warm, and the patient should rest quietly to avoid increasing the burden on the heart and lungs and increasing oxygen consumption after activity.
It is necessary to check the breathing, pulse, blood pressure, etc. of the delirious patient in the shortest possible time, and decide whether to perform emergency treatment such as cardiopulmonary resuscitation. At the same time, pay attention to close the valves of piped gas, gas stoves, water heaters, etc., extinguish charcoal fires, etc., and avoid using items that are easy to produce sparks.
Grading and symptoms
Clinically, the severity of carbon monoxide poisoning is graded primarily by the patient's carboxyhemoglobin content.
Mild poisoning
The carboxyhemoglobin content is 10%-20%, which is judged to be mild poisoning. Patients may experience dizziness, headache, dizziness, and malaise. Patients with a history of coronary heart disease can have angina pectoris, and if the patient can get out of the toxic environment in time, inhale fresh air or oxygen therapy, the symptoms will generally be quickly reduced and disappeared.
Moderate poisoning
When the carboxyhemoglobin content is 20%-40%, it is judged to be moderately poisoned. On the basis of mild poisoning symptoms, patients can have dyspnea, pulse rate, excessive sweating, irritability, blurred vision, movement disorders, drowsiness, shallow coma, etc., the mucous membrane of the lips can be cherry red, pupil light reflex, corneal reflex and other symptoms, if effective measures are taken, it can be basically **, and rarely leave sequelae.
Severe poisoning
If the carboxyhemoglobin content exceeds 40%, it is judged to be severely poisoned. Patients will quickly develop coma, respiratory depression, pulmonary edema, arrhythmia, heart failure, loss of various reflexes, weak pulse, irregular breathing, decreased blood pressure, and can also have a high fever of about 40 degrees Celsius, at which time life is in danger and mortality is high. Even if they survive, they will be left with serious sequelae.
Diagnosis and treatment of carbon monoxide poisoning
On imaging, the basic cause of encephalopathy caused by hypoxia of brain tissue caused by carbon monoxide poisoning is cerebral vasospasm. Accompanied by cerebral vasospasm, extensive ischemia, hemorrhage, edema and swelling of brain tissue, and in severe cases, cerebral vasospasm can cause cerebral thrombosis, infarction of the basal ganglia area, and even cerebral cortex, and extensive demyelination of white matter. However, imaging findings are not characteristic of carbon monoxide poisoning and require a professional physician to make a determination.
* For acute carbon monoxide poisoning, the most important tool is hyperbaric oxygen, which is most effective within 6 hours of onset. Hyperbaric oxygen is to use more oxygen molecules to "snatch" the hemoglobin in the sick carboxyhemoglobin to re-form normal oxyhemoglobin and re-transport oxygen to the whole body, thereby correcting the state of cellular hypoxia.
Patients with carbon monoxide poisoning need to be treated with hyperbaric oxygen for 10-14 days**, and if the patient feels well after several times** and stops**, the delay will easily lead to the occurrence of late-onset encephalopathy. Carbon monoxide poisoning late-onset encephalopathy refers to the recurrence of a group of neuropsychiatric symptoms mainly acute dementia after a group of neuropsychiatric symptoms of carbon monoxide poisoning patients who have recovered from acute poisoning symptoms and have behaved normally or near normal for several days and weeks after recovery. Therefore, patients with carbon monoxide poisoning should follow their doctor's advice and take continuous hyperbaric oxygen (CPO)** as soon as possible to minimize the development of late-onset encephalopathy.
*: Healthy Beijing.
Editor: Xie Yongli.
Process Editor: Guo Dan.