Why carbon monoxide is poisonous to humans. Carbon monoxide poisoning: what you need to know

One of the strongest poisons that people encounter at home or at work is carbon monoxide (CO). This gaseous substance is heavier than air, transparent, colorless, odorless, formed during almost all types of combustion and is therefore called carbon monoxide. Its insidiousness also lies in the fact that it easily penetrates filter materials and other obstacles: walls, windows, soil, and such protective equipment as filtering respirators do not protect against damage.

The presence of CO in the air can only be determined using special instruments. It is also felt if people begin to rapidly develop characteristic symptoms of intoxication.

Carbon monoxide poisoning is an acute pathological condition, which occurs due to CO entering the human body in a certain concentration. In common parlance it can be called carbon monoxide, and carbon monoxide itself can be called lighting. Its toxic effect on the body is so dangerous that without qualified assistance, serious consequences can occur, including death.

CO poisoning is the most common type of intoxication obtained by inhalation. At the same time, the number of cases that ended in death is quite high - 18%. They rank second after deaths caused by alcohol overdose.

Main sources of CO emissions

Carbon monoxide or lamp monoxide poisoning with significant health effects can occur near the following sources:

• stove heating, fireplaces or sauna stoves in case of their improper use;
• a garage with poor ventilation when there is a car parked in it with the engine running;
• high concentration of exhaust gases in city air;
• malfunction of household equipment running on propane;
• filling breathing apparatus with low-quality breathing mixture;
• prolonged burning of kerosene in a small, poorly ventilated room;
• fires;
• gasified premises operating gas equipment;
• possible accidents at metallurgical and chemical industry enterprises or large-scale explosions at military ammunition depots.

Why and how carbon monoxide is dangerous

The strength of carbon monoxide on the human body and the severity of poisoning will depend on several reasons:

1. Real concentration of carbon monoxide.
2. Duration of damaging effect.
3. Ambient temperature.
4. State of health and immune system, including the presence of anemia, chronic or acute pathologies of the pulmonary and/or cardiovascular system.
5. The level of physical exhaustion of the body immediately at the moment of CO action - the greater the physical activity before the “contact”, the more severe the consequences will be.

Men are less resistant to the effects of CO than women. In addition, the category of particularly sensitive to the effects of carbon monoxide includes:

1. Heavy smokers and alcoholics - compared to others, they have a hard time withstanding even mild poisoning.
2. Pregnant and lactating women.
3. Children and teenagers.

Intoxication and its consequences for the unborn newborn are especially severe. The fetus suffers from tissue hypoxia more severely and for a longer period of time than the expectant mother herself.

The accumulation of carbon monoxide in a home, in the air of a work area or during a fire, equal to 14.08 mg/l, causes vomiting, loss of consciousness and death in just 1-3 minutes.

The lowest concentration of carbon dioxide at which the first disturbances occur in the body (light and color sensitivity of the eyes begins to fall) is 0.006 mg/l with an exposure time of 25 minutes.

Maximum permissible concentration (MAC) or maximum permissible level CO is 7.04 mg/l. Within 1-2 minutes, a dull headache and severe dizziness will occur, and within 10-15 minutes, loss of consciousness will occur. However, if the necessary assistance is provided with such a PDC, the consequences and outcome can still be quite favorable.

Effect of CO on the human body

CO can enter the body only through inhalation - by inhalation. The overwhelming majority of carbon monoxide is also excreted through the lungs, and very small amounts leave the body with sweat, feces and urine. This cleansing occurs within 12 hours. Only a negligible amount that does not have any impact harmful effects On health, the amount of CO can remain dissolved in the blood plasma.

Carbon monoxide poisoning occurs due to the fact that it has a direct toxic effect on the body's cells:

• the combination of hemoglobin with carbon monoxide leads to the formation of carboxyhemoglobin, which cannot carry oxygen, and as a result, acute transport hypoxia develops, quickly leading to oxygen starvation of the body as a whole;
• the interaction of CO (up to 50%) with other hemoproteins leads to a blockade in the respiratory chains of mitochondria, which disrupts the utilization of O2 by the cell and causes acute tissue hypoxia;
• carbon monoxide disrupts the functioning of skeletal muscles and cardiac muscle by blocking myoglobin and the formation of carboxymyoglobin;
• due to reactively developing general hypoxia, multiple microhemorrhages and disturbances in the gray and white tissues quickly occur medulla, embryonic tissues are affected;
• oversaturation of the blood with free O2 leads to the development of oxidative stress;
• CO directly acts on cell membranes, which negatively affects the exchange of amino acids and catecholamines, thereby accelerating the rate of natural cell death.

Attention. Carbon monoxide intoxication, which causes disruption of the blood supply to the white matter of the brain, can cause delayed progressive demyelinating neuropathy.

Poison Clinic

Clear signs of poisoning begin to appear when CO molecules have captured about 20% of the hemoglobin found in red blood cells. In this case, the symptoms continue to depend on the degree of carbon monoxide poisoning. Moderate severity occurs when the level of carboxyhemoglobin reaches 50%, severe - at 60-70%.

The most unfavorable prognostic sign is a coma that lasts more than 48 hours.

The question of the effect of alcohol on the severity of poisoning has not been fully studied. On the one hand, lethal CO concentrations increase if ethanol is present in the blood—thus, drinking alcohol before poisoning occurs may be a protective factor. On the other hand, chronic alcoholics are more susceptible to the effects of carbon monoxide.

There is evidence of an increase in the toxic effect of CO on the body, which contains barbiturates or narcotic substances.

Pathologies that can aggravate the classic clinical picture of poisoning:

1. The brain is the first to respond to reactive oxygen starvation and oxidative stress - epileptic seizures, inadequate mental reactions, the whole range of hallucinations, aggression, “nakedness of desires” are possible.
2. Oversaturation with carboxymyoglobin - hypertension and tachycardia, which, against the background of oxygen hypoxia, can cause cardiac asthma, myocarditis, myocardial infarction.
3. Damage to the pulmonary system – secondary pneumonia.
4. Damage to the nervous system is quite persistent inflammation such as cervicobrachial plexitis, affecting the radial, ulnar or median nerve, as well as long-term polyneuritis of the auditory, optic, sciatic or femoral nerve.

Complications after CO poisoning

The consequences of carbon monoxide intoxication can be:

• memory lapses – lack of memories of the circumstances under which the poisoning occurred;
• obsessive headaches, attacks of nausea and dizziness;
• a series of fainting states;
• symptoms of extrapyramidal insufficiency - changes in muscle tone: twitching, immobilization of some muscle areas (or a combination thereof);
• in young people – twitching involuntary movements that occur suddenly;
• in the elderly – dementia and deep depression;
• manifestations mental illness, which occurred in a latent form.

Providing first aid for carbon monoxide poisoning

In case of carbon monoxide poisoning, first of all, it is necessary to leave the place where it occurred as quickly as possible. In the event of an accident or fire in which large areas are contaminated, PMK gas masks and respirators equipped with filters of efficiency classes 2 and 3 (hopcalite cartridges) are recommended to assist those who have been poisoned and remove them from the affected area. Only if they are used is the maximum possible protection achieved.

In any case, it is important to think about your own safety and be sure to make sure that the ambulance team is called, and if not, then call it yourself. The clinical picture of carbon monoxide poisoning is not always true, and additional risks of developing long-term consequences require calling a specialist for examination, consultation, and, if necessary, hospitalization of the victim.

Emergency first aid for carbon monoxide poisoning is performed in the following order:

1. If a poisoned person is taken out of the affected area unconscious, place him on his side and check that the airway is clear. Unfasten the tight collar, loosen the tightening belt or other items of clothing.
2. Next, smell ammonia and rub it, which will help stimulate blood circulation. If there is no heartbeat, it is necessary to carry out artificial respiration and chest compressions – 2:36.
3. If the poisoned person is conscious, you need to put cold compresses (or, conversely, mustard plasters) on the chest and provide the patient with plenty of hot and sweet drinks - for example, tea or coffee.
4. Ensure complete physical and emotional peace. Do not leave the poisoned person alone, have calm conversations with him.

If carbon monoxide poisoning occurs, then first aid, including first aid health care(PMP), which will really help the body is the introduction of a special antidote called acyzol. It is the speed of its administration from the moment of poisoning that will influence the development of further symptoms.

Treatment for carbon monoxide poisoning

Carbon monoxide poisoning, symptoms and treatment will depend, since the nature of the symptoms will make the initial diagnosis. The main diagnostic procedure for determining the severity of the lesion is taking blood from a vein for its biochemical analysis.

Under hospital treatment conditions, the medical care algorithm provides for the following procedures:

• hyperbaric oxygenation in a pressure chamber;
• artificial ventilation of the lungs to accelerate the removal of CO;
• transfusion of red blood cells or whole blood;
• droppers with hypertonic or cardiotonic solutions.

Preventive measures

In factories where there is a high probability of an emergency CO leak, they not only necessarily sign safety instructions, but also regularly conduct practical training so that every person working at the plant knows what to do in case of carbon monoxide poisoning.

Prevention consists of the following measures:

1. If you work at an enterprise using CO, strictly adhere to established safety standards and rules of conduct in emergency situations.
2. Monitor the serviceability of heating equipment. If a malfunction is detected, do not continue to use it under any circumstances.
3. Clean stove chimneys annually.
4. Ensure there is sufficient air ventilation in rooms where open flame burning devices are operated.
5. Do not turn on for a long time car engine in the garage.
6. Avoid spending a lot of time near roads with heavy traffic.

The last point should be noted Special attention for those who live in large cities. Sticking to healthy image In life, many people jog daily along paths along highways or located next to them and below, but at this time irreparable harm is caused to the body. You should engage in recreational jogging in specially equipped places or park areas.

Carbon monoxide poisoning is one of the most common poisonings. It occurs due to inhalation of air filled with smoke or. The toxic effect on the human body of this colorless, odorless gas is undeniable, but the exact mechanism of its action has not yet been proven.

It is important to know that intoxication resulting from poisoning occurs with complications and negatively affects functionality internal organs and systems in both children and adults.

How does carbon monoxide poisoning occur?

The saturation of air with toxic vapors, due to their lack of organoleptic properties, is difficult to determine without special instruments. Therefore, poisoning often occurs both at home and at work.

If you use heating columns at home with poor ventilation, faulty furnace installations, then saturation of the air with a toxic substance cannot be avoided. Intoxication of the body with toxic gas is also often observed as a result of prolonged stay in closed parking lots and garages with a large concentration of cars. Saturation of space in such places is as fast as possible. Sometimes symptoms of intoxication are observed in active smokers and hookah lovers.

For poisoning, it is enough to inhale air containing 0.1% CO. The severity of intoxication is also influenced by the time factor of CO exposure to the body. There is also a certain risk group of people in whom the process of acute intoxication occurs an order of magnitude faster.

The risk group includes:

• women during pregnancy;
• children;
• old men;
• young people with weakened immune systems after illness.

By international classification diseases ICD-10, poisoning of this type is assigned code T58.

Symptoms of carbon monoxide poisoning

Carbon monoxide binds red blood cells and prevents them from transporting oxygen to human organs and tissues. Thus, it inhibits mitochondrial respiration and the process of saturating the body with oxygen. The nervous system and respiratory organs suffer from a lack of oxygen, the functioning of the heart is disrupted and vascular tissue is deformed. Carbon monoxide poisoning is divided by doctors into three stages of severity. (stages below)

The first mild stage, with timely assistance, passes quickly and the symptoms subside without complications. The moderate and severe stages of intoxication provoke the development of serious complications in the victim. Prolonged inhalation of air saturated with carbon monoxide can even lead to death.

Symptoms of the mild stage:

• pulsation in the temporal region, pressing headache;
• foggy consciousness;
• noise or ringing in the ears;
• fainting state;
• mild nausea;
• decreased vision, tearfulness;
• discomfort in the larynx, causing coughing attacks;
• hard breathing.

With prolonged exposure to carbon monoxide, symptoms rapidly worsen. At the initial stage of poisoning, the concentration of carboxyhemoglobin in the body reaches 30%, then at the middle stage this figure reaches 40%.

Moderate symptoms:

1. temporary unconsciousness;
2. feeling of stupor and disturbance of general coordination in space;
3. severe shortness of breath;
4. cramps in the limbs;
5. insufficient oxygen supply to brain cells leads to hallucinations;
6. pressure in the chest area;
7. difference in the size of the pupils of the eyes;
8. temporary or permanent loss of hearing and vision.

If carbon monoxide poisoning continues, a severe form of poisoning is diagnosed. It can be complicated by a rapid course, when a person dies in a few minutes.

Main symptoms:

1. falling into a coma, which can last several days;
2. severe convulsions leading to paralysis;
3. weak pulse and dilated pupils;
4. intermittent shallow breathing;
5. blue discoloration of the skin and mucous membranes;
6. spontaneous excretion of urine and feces.

The above symptoms are characteristic of the three standard forms of carbon monoxide poisoning. Some victims exhibit atypical symptoms that were not described above.

Non-standard symptoms:

• a sharp decrease in pressure to 70-50 mmHg, which leads to fainting;
• excited state (euphoria) with hallucinations;
• coma with fatal outcome (rapid course).

First aid for gas intoxication

Only medical workers can objectively assess the situation and its severity, so you must immediately call an ambulance. Before her arrival, it is advisable to provide the victim first aid which will reduce the risk of complications.

Before the doctors arrive you need to:

• neutralize the source that produces carbon monoxide;
• provide the victim with a flow of fresh air (help him go outside or open the windows);
• free the person from tight clothing, unfasten the top buttons and loosen the belt to ensure better passage of clean air into the lungs;
• do not let the victim fall asleep, try to keep him conscious until the doctors arrive, using ammonia.
• when the victim regains consciousness, it is necessary to give him sorbent drugs, for example, Polysorb. It actively cleanses the body of toxic substances.

This should be first aid for carbon monoxide poisoning until doctors arrive. Next, the doctors themselves will conduct a diagnosis, administer an antidote and decide on the need for hospitalization. The actions of doctors in case of carbon monoxide poisoning must be clear and fast.

They include the following manipulations:

1. using an oxygen mask to restore breathing;
2. the use of the drug Acizol, which is an antidote because it destroys carboxyhemoglobin molecules;
3. subcutaneous injections of caffeine to normalize heart rate;
4. intravenous injections of the enzyme Carboxylase, which also destroys carboxyhemoglobin;
5. hospitalization of the victim for a full examination and symptomatic therapy. The antidote is administered daily, 1 ml for a week.

Treatment at home is only possible if an overdose of poisonous gas does not lead to serious consequences. The first degree of poisoning (mild) in adults is removed quickly and does not have any serious consequences in the future. A certain category of victims needs additional health examination in a hospital setting after carbon monoxide poisoning.

This list includes:

• pregnant women;
• victims with concomitant heart and vascular diseases;
• adults with neurotic disorders;
• victims with low body temperature.

When is medical attention required?

All cases of acute poisoning with corresponding symptoms require emergency medical care. Depending on the general condition of the patient, he is admitted to the intensive care unit or intensive care unit. When first medical aid is provided, the victim may need to continue treatment aimed at restoring the functioning of all organs and systems.

Consequences and prevention

Carbon monoxide poisoning causes many unpleasant complications in people associated with deteriorating health. Doctors divide them into two groups. Early complications appear immediately after poisoning, and late complications appear weeks or even months later.

Early complications:

1. regular headaches and dizziness;
2. slowness of movement and low sensitivity of fingers and toes;
3. disruption of the functioning of the intestines and urinary tract;
4. deterioration of vision and hearing;
5. unbalanced mental state;
6. swelling of the brain and lungs;
7. impaired blood flow and heart rhythm disturbances;
8. death due to cardiac arrest.

Irritation, a feeling of sand in the eyes, redness are just minor inconveniences with impaired vision. Scientists have proven that decreased vision in 92% of cases ends in blindness.

Crystal Eyes is the best remedy for restoring vision at any age.

Late complications may appear after 30-40 days. The long time it takes for pathologies to manifest is due to the fact that they develop as the functioning of internal organs and systems deteriorates. Most often, pathologies are determined in the functioning of the heart, blood vessels, respiratory organs and nervous system.

These include:

• decreased activity of the limbs leading to paralysis;
• development of amnesia;
• heart attack (can cause cardiac arrest);
• ischemic disease of the heart muscle;
• cardiac asthma.

All of these diseases develop as a result of acute carbon monoxide poisoning and delayed provision of assistance.

What to do to protect yourself and your loved ones from poisoning? Number one on the list of preventive measures is strict adherence to the rules fire safety. People often neglect these rules, causing accidents.

To eliminate the possibility of carbon monoxide poisoning at work and at home, it is recommended to avoid using broken gas and electrical equipment. You should not stay in a closed room for a long time where cars are operating. All production garages and basements must be equipped with a powerful ventilation system.

Video with Elena Malysheva about carbon monoxide

Carbon monoxide poisoning- an acute pathological condition that develops as a result of carbon monoxide entering the human body is dangerous to life and health, and without qualified medical care can lead to death.

Carbon monoxide enters the atmospheric air during any type of combustion. In cities, mainly as part of exhaust gases from internal combustion engines. Carbon monoxide actively binds to hemoglobin, forming carboxyhemoglobin, and blocks the transfer of oxygen to tissue cells, which leads to hemic hypoxia. Carbon monoxide is also included in oxidative reactions, disturbing the biochemical balance in tissues.

Poisoning is possible:

in case of fires;

in production where carbon monoxide is used to synthesize a number of organic matter(acetone, methyl alcohol, phenol, etc.);

in garages with poor ventilation, in other unventilated or poorly ventilated rooms, tunnels, since the car exhaust contains up to 1-3% CO according to standards and over 10% if the carburetor engine is poorly adjusted;

when spending a long time on or near a busy road. On major highways, the average CO concentration exceeds the toxicity threshold;

at home when there is a leak of lighting gas and when the stove dampers are untimely closed in rooms with stove heating (houses, baths);

when using low-quality air in breathing apparatus.

General information

Carbon monoxide poisoning ranks fourth in the list of the most frequently observed poisonings (after alcohol poisoning, drug and drug poisoning). Carbon monoxide, or carbon monoxide (CO), occurs wherever conditions exist for incomplete combustion of carbon-containing substances. CO is a colorless, tasteless gas; its odor is very weak, almost imperceptible. Burns with a bluish flame. A mixture of 2 volumes of CO and 1 volume of O2 explodes when ignited. CO does not react with water, acids and alkalis. Carbon monoxide is colorless and odorless, so carbon monoxide poisoning most often occurs unnoticed. The mechanism of the effect of carbon monoxide on humans is that, when it enters the blood, it binds hemoglobin cells. Then hemoglobin loses its ability to carry oxygen. And what longer person breathes carbon monoxide, the less workable hemoglobin remains in his blood, and the less oxygen the body receives. A person begins to choke, a headache appears, and consciousness becomes confused. And if you don’t go out into the fresh air in time (or don’t take someone who has already lost consciousness out into the fresh air), then a fatal outcome is possible. In case of carbon monoxide poisoning, sufficient for a long time so that hemoglobin cells can completely clear carbon monoxide. The higher the concentration of carbon monoxide in the air, the faster the life-threatening concentration of carboxyhemoglobin in the blood is created. For example, if the concentration of carbon monoxide in the air is 0.02-0.03%, then in 5-6 hours of inhaling such air a carboxyhemoglobin concentration of 25-30% will be created, if the concentration of CO in the air is 0.3-0.5% , then the lethal content of carboxyhemoglobin at the level of 65-75% will be achieved after 20-30 minutes of a person’s stay in such an environment. Carbon monoxide poisoning can occur suddenly or slowly, depending on the concentration. At very high concentrations, poisoning occurs quickly, characterized by rapid loss of consciousness, convulsions and respiratory arrest. In blood taken from the region of the left ventricle of the heart or from the aorta, a high concentration of carboxyhemoglobin is detected - up to 80%. With a low concentration of carbon monoxide, symptoms develop gradually: muscle weakness appears; dizziness; noise in ears; nausea; vomit; drowsiness; sometimes, on the contrary, short-term increased mobility; then movement coordination disorder; rave; hallucinations; loss of consciousness; convulsions; coma and death from paralysis of the respiratory center. The heart may continue to contract for some time after breathing has stopped. There have been cases of death from the consequences of poisoning even 2-3 weeks after the poisoning event.

Acute effects of carbon monoxide poisoning relative to ambient concentrations in parts per million (concentration, ppm): 35 ppm (0.0035%) - headache and dizziness during six to eight hours of continuous exposure 100 ppm (0.01%) - minor headache after two to three hours of exposure 200 ppm (0.02%) - minor headache after two to three hours of exposure, loss of criticism 400 ppm (0.04%) - frontal headache after one to two hours of exposure 800 ppm (0.08%) - dizziness, nausea and convulsions after 45 minutes of exposure; loss of senses after 2 hours 1600 ppm (0.16%) - headache, tachycardia, dizziness, nausea after 20 minutes of exposure; death in less than 2 hours 3200 ppm (0.32%) - headache, dizziness, nausea after 5-10 minutes of exposure; death after 30 minutes 6400 ppm (0.64%) - headache, dizziness after 1-2 minutes of exposure; convulsions, respiratory arrest and death after 20 minutes 12800 ppm (1.28%) - unconscious after 2-3 breaths, death in less than three minutes

Concentration 0.1 ppm - natural atmospheric level (MOPITT) 0.5 - 5 ppm - average level in houses 5 - 15 ppm - next to a properly adjusted gas stove in a house 100 - 200 ppm - from exhaust gases from cars in the central square of Mexico City 5000 ppm - in smoke from a wood stove 7000 ppm - in warm exhaust gases from cars without a catalyst

The diagnosis of poisoning is confirmed by measuring the level of carbon monoxide in the blood. This can be determined by measuring the amount of carboxyhemoglobin compared to the amount of hemoglobin in the blood. The carboxyhemoglobin ratio in the hemoglobin molecule can average up to 5%; in smokers who smoke two packs a day, levels up to 9% are possible. Intoxication appears when the ratio of carboxyhemoglobin to hemoglobin is above 25%, and the risk of mortality is at a level of more than 70%.

Deep coma with decreased or absent reflexes, thready pulse, arrhythmia, death.

Loss of consciousness (after 2-3 breaths), vomiting, convulsions, death.

In our article we will examine the question of what to do in case of carbon monoxide poisoning? Not only his future health, but also whether he will remain alive often depends on how correctly and quickly first aid is provided to the victim. What is carbon monoxide? literally in a few minutes. Chemical formula of this gaseous compound is CO (one carbon atom and one oxygen atom). Another name for carbon monoxide is carbon monoxide. This air mixture has neither color nor odor.

CO is formed from any type of combustion: from burning fuel at thermal and power plants, from burning a fire or gas stove, from the operation of an internal combustion engine, from a smoldering cigarette fire, etc.

The toxic properties of carbon monoxide have been known to mankind since ancient times. Our distant ancestors were well aware of how dangerous it is to turn off the stove draft when the wood is not completely burned out. Wanting to retain more heat, the unreasonable owner was in a hurry to close the damper, the whole family went to bed, and did not wake up the next morning.

With the development of civilization, the danger associated with carbon monoxide has not decreased. After all, now instead of stoves in homes modern people are actively working gas boilers and stoves, cars puff out toxic fumes on the streets and in garages, and reports periodically appear in the news about tragic accidents associated with CO poisoning.

How does carbon monoxide affect the human body?

Carbon monoxide has the ability to bind hemoglobin molecules, thereby preventing the blood from carrying oxygen. The longer a person breathes toxic air that contains carbon monoxide, the faster the pathological process develops. The substance carboxyhemoglobin is formed in the blood. The cells of the body do not receive life-giving oxygen, a headache appears, the person begins to experience suffocation, and the consciousness is confused. The victim does not realize what is happening to him, in this case, self-providing first aid for carbon monoxide poisoning becomes impossible. Help must come from other people.

It takes quite a long time for hemoglobin to be completely cleared of carbon monoxide. The danger to life is directly related to the increase in CO concentration in the air and the concentration of carboxyhemoglobin in the blood. If carbon monoxide builds up in air environment is only 0.02-0.03%, then after 5-6 hours the content of carboxyhemoglobin in human blood will be 25-30%.

Rescue actions in case of carbon monoxide poisoning must be very fast, because if the CO concentration reaches only 0.5%, carboxyhemoglobin will increase to lethal values ​​within 20-30 minutes.

What are the symptoms of carbon monoxide poisoning?

The toxic effects of CO on the body can be manifested by the following symptoms:

1. When a person is mildly poisoned by carbon monoxide, he may feel weakness, tinnitus, headache, nausea, and the urge to vomit. These signals are evidence oxygen starvation which the brain experiences.
2. In case of moderate poisoning, the symptoms of intoxication increase. Tremors in the muscles, short-term memory loss, and loss of coordination of movements appear. A person may cease to distinguish colors, objects begin to appear in two in the eyes. Later, respiratory function and the functioning of the circulatory system are disrupted. The victim develops tachycardia and cardiac arrhythmia. If a person does not receive at this stage quick help, then loss of consciousness and subsequent death occurs.
3. Severe CO poisoning is accompanied by irreversible damage to brain cells. The victim may fall into a comatose state and remain there for a week or more. At this time, the patient experiences severe convulsive seizures, uncontrolled urination and defecation. Breathing is usually shallow and intermittent, body temperature rises to 38-39 degrees. Respiratory paralysis and death may occur. The survival prognosis depends on the depth and duration of the coma.

When can CO poisoning occur?

With normal ventilation and a well-functioning exhaust hood, carbon monoxide is quickly removed from the room without causing any harm to the people there. However, according to statistics, more than one and a half million people die from carbon monoxide poisoning in the world every year. In some cases, this happens for reasons beyond a person’s control, for example, during a fire. Usually, people caught in a fire lose consciousness, inhaling the deadly gas, and cannot get out of the fire trap themselves.

CO poisoning is also possible when following cases and circumstances:

• In rooms with stove or fireplace heating (residential buildings, bathhouses, etc.) in case of untimely closing of the exhaust dampers or poor exhaust.
• In areas where they work gas appliances(water flow heaters, stoves, gas boilers, heat generators with an open combustion chamber); if there is insufficient air flow necessary for gas combustion, as well as if the draft in the chimney is impaired.
• In production workshops where CO is used as a working substance for the synthesis of certain organic substances (phenol, methyl alcohol, acetone, etc.).
• If you spend a long time next to a busy highway or directly on it (on most large highways, CO levels in the air can exceed the permissible standards several times).
• In garages, with the car engine running and no ventilation.

Carbon monoxide poisoning - first aid

It is important to act very quickly, remembering that the countdown is not just minutes, but even seconds. What should you do first in case of carbon monoxide poisoning? The sequence of actions should be as follows:

1. Quickly open all windows and doors and carry the person out of the room.
2. Call a specialized ambulance team. When making a call, you need to describe the problem as clearly as possible to the operator receiving the call, so that doctors with the necessary equipment are sent to the victim.
3. If a person loses consciousness due to carbon monoxide poisoning, it is necessary to lay him on his side. Next, bring a cotton wool soaked in ammonia to his nose (at a distance of 2 cm from the nostrils) and gently wave it. Remember that if you bring ammonia too close, the powerful effects of ammonia can lead to paralysis of the respiratory center.
4. If a person is not breathing, then artificial respiration must be started immediately. If the victim has not only lost consciousness, but also has no signs of cardiac activity, then artificial respiration should be supplemented with chest compressions. Such first aid for carbon monoxide poisoning should be done until the arrival of a medical team or until the person begins to actively show signs of life.
5. If the poisoned person is conscious, he must be laid down and try to ensure the maximum flow of fresh air. For this purpose, you can fan it with newspaper, turn on the air conditioner and fan. You should put a warm heating pad or mustard plasters at your feet. Alkaline drinking (for 1 liter of warm water - 1 tablespoon of soda) can bring considerable benefit to the victim.

We found out what to do in case of carbon monoxide poisoning and how to provide first aid. Now let's talk about another very important point: it is important for people involved in providing assistance to protect themselves. When removing a person from a poisoned room, you need to cover your airways with gauze or a handkerchief.

What treatment is provided in the hospital?

Victims who have received moderate or severe poisoning are subject to mandatory hospitalization. The main antidote is 100% oxygen. Its uninterrupted intake into the body is 9-16 l/min. occurs through a special mask placed on the patient’s face.

In severe cases, the victim undergoes tracheal intubation and is connected to the device artificial ventilation lungs. In a hospital setting, infusion therapy is also carried out using a course of drips with sodium bicarbonate - this helps to correct hemodynamic disorders. Solutions "Chlosol" and "Quartasol" are also used for intravenous infusion.

Another drug used by doctors to help victims of carbon monoxide poisoning is Acizol. This drug is administered intramuscularly into the body. Its action is based on accelerating the breakdown of carboxyhemoglobin while simultaneously saturating the blood with oxygen. "Acyzol" reduces the toxic effect of CO on muscle tissue and nerve cells.

Providing assistance for carbon monoxide poisoning using folk remedies

Recipes below traditional medicine can be used at home for mild carbon monoxide poisoning. Here are some easy-to-make home remedies that have very effective antitoxic properties:

1. Dandelion tincture (only roots are used). To prepare the infusion, pour 10 g of finely ground dry raw materials into a glass of boiling water. Boil for about 20 minutes. and then leave for 40 minutes. Then strain and dilute with warm water (100 ml). Take the product 3 or 4 times a day, one tablespoon at a time.
2. Lingonberry-cranberry tincture. What to do after carbon monoxide poisoning with its help? First, for cooking you will need 200 g of lingonberries and 150 g of rose hips. The ingredients are ground as thoroughly as possible and 350 ml of boiling water is poured. Infuse the berries for 3 hours, then strain the product and consume 2 tbsp orally 5 to 6 times a day. spoons.
3. Tincture of knotweed herb. 3 tbsp. spoons of crushed dry knotweed are poured into 0.5 liters of boiling water. Leave for at least 3 hours, then strain and drink a glass 3 times a day.
4. Rhodiola rosea tincture with alcohol. You do not need to prepare this drug yourself; it is sold at any pharmacy. The method of administration is as follows: 7-12 drops are added to a glass of water. Drink half a glass twice a day.

Preventive measures to prevent CO poisoning

As already mentioned, carbon monoxide is often responsible for the death of people. To protect yourself and your loved ones, you need not only to know what to do in case of carbon monoxide poisoning, but also try to follow preventive measures, which include the following:

• It is necessary to regularly check the condition of chimneys and ventilation shafts. It is especially important to pay attention to this before the start of the heating season.
• Before using flammable fuel appliances, you should always check that they are in good working order. If a fault is identified in a timely manner, many problems can be avoided.
• If the room has poor ventilation, additional measures must be taken to ventilate it regularly.
• Do not start your car in a closed, unventilated garage and do not sleep in a car with the engine running.
• Purchase a special sensor that responds to CO leaks and install it in your house or apartment.
• Try to avoid being near busy highways, especially during their busiest hours.

Carbon monoxide sensor

As already mentioned, the presence of carbon monoxide in the air cannot be detected using one’s own senses. To protect yourself and your loved ones from harm, you can purchase a carbon monoxide detector. This small device will continuously monitor the composition of the air in the room. After all, first aid in case of carbon monoxide poisoning should be almost instantaneous, otherwise you may not have time.

In the event that CO levels exceed the required norm, the sensor will notify the owners with sound and light signals. Similar devices can be used for household and industrial purposes. The latter have a more complex structure and are designed for large areas.

Risk group

To some extent, we are all at risk and, under certain circumstances, can suffer from CO. Therefore, each of us should know well what to do in case of carbon monoxide poisoning. However, there are a number of professions whose representatives are at greatest risk. These include:

• welders;
• taxi drivers;
• auto repair shop workers;
• diesel engine operators;
• firefighters;
• workers of breweries, boiler houses;
• personnel of steel foundries, oil refining, pulp and paper production, etc.

Conclusion

It is very important to know what to do if you have carbon monoxide poisoning. In difficult situations, people with necessary knowledge and skills can bring the greatest help to victims. The main thing is not to panic, but to act as quickly, clearly and consistently as possible.

Carbon monoxide, or carbon monoxide (CO), occurs wherever conditions exist for incomplete combustion of carbon-containing substances.

CO is a colorless, tasteless gas; its odor is very weak, almost imperceptible. Burns with a bluish flame. A mixture of 2 volumes of CO and 1 volume of O2 explodes when ignited. CO does not react with water, acids and alkalis.

CO poisoning often occurs in everyday life due to improper use of heating stoves and gas water heaters, when, due to poorly functioning draft, an oxygen deficiency is formed and conditions are created for incomplete combustion of fuel. In recent years, due to the increase in the number of cars for personal use, every year during the cold season, drivers are poisoned in closed garages where cars are located with their engines running.
Acute CO poisoning can also occur in production, especially in the chemical industry, during coal coking, in coal mines, foundries, when the production process produces a large number of carbon monoxide. So, for example, coal illuminating gas contains 4-11% CO, coke gas - 70%, shale gas - 17%, generator gas from coal and coke - 27%, blast furnace gas - up to 30%. Car exhaust gases contain an average of 6.3%, and sometimes up to 13.5% CO. In car cabins, the concentration of CO can reach 0.05 mg per 1 liter of air or more, on city streets, depending on the traffic load, from 0.004 to 0.21 mg/l, and near cars - 1.5-7.1 mg /l. The danger of CO poisoning in garages is great if precautions (ventilation) are not followed. So, the engine is 20 hp. With. can release up to 28 liters of CO per minute, creating a lethal concentration of gas in the air after 5 minutes.

Clinic

The first symptoms of poisoning can develop after 2 - 6 hours of exposure to an atmosphere containing 0.22-0.23 mg of CO per 1 liter of air; severe poisoning with loss of consciousness and death can develop after 20-30 minutes at a CO concentration of 3.4-5.7 mg/l and after 1-3 minutes at a poison concentration of 14 mg/l.
CO easily penetrates the blood through the lungs and interacts with hemoglobin. The process of CO entry into the blood is significantly influenced by the oxygen concentration in the inhaled air, an increase in which clearly inhibits the intensity of CO absorption. Each gram of hemoglobin is capable of binding 1.33-1.34 ml of oxygen or CO, but the affinity of hemoglobin for CO is many times greater than for oxygen. By interacting with ferrous iron of oxyhemoglobin (a compound of hemoglobin with oxygen that delivers the latter from the lungs to the tissues), CO converts it into carboxyhemoglobin (HbCO). A sharp decrease in the amount of oxyhemoglobin leads to a deterioration in the oxygen supply to tissues and the development of oxygen deficiency (hypoxia). In the presence of HbCO, the removal of oxygen from oxyhemoglobin is significantly slowed down, which aggravates hypoxia.
With the toxic effects of CO, the nervous system suffers the most as it is the most sensitive to hypoxia. In severe poisoning, diffuse brain damage, edema, and demyelination of the white matter are noted. In some cases, damage to the nervous system can be reversible, but much more often they persist for a long time as long-term consequences of former intoxication. The most common developments are amnestic disorders, pseudohysteroid conditions, epilepsy, cerebellar and extrapyramidal disorders, and asthenia. Clinical observations of CO poisoning indicate the presence of serious respiratory disorders. In case of intoxication of moderate severity, focal pneumonia can be found in a number of victims; severe poisoning is usually complicated by lobar pneumonia.
Already in the first hours after acute poisoning, damage to the heart muscle occurs, characterized by diffuse disturbances in myocardial nutrition (up to necrosis), changes in the vessels of the heart (degeneration of the endothelium, swelling of the vascular wall). Initially, the changes are reversible; with severe intoxication, organic changes in the myocardium may occur, such as toxic dystrophy, infarction, which is recorded on the ECG.
The leading clinical symptom of acute CO poisoning is impaired consciousness. Depending on the depth of the disorder of consciousness, there are 3 degrees of CO poisoning. In mild cases, poisoning occurs without loss of consciousness; only a short-term fainting state is possible. As a rule, patients experience tinnitus, pulsation of the temporal arteries, headaches in the frontal and temporal regions, a feeling of thirst, burning of the face, general anxiety, and fear. Characterized by an increase in blood pressure up to 150/90 mm Hg. Art., moderate tachycardia. The HbCO content in the blood is 15-20%.
In case of poisoning of moderate severity, the loss of consciousness is more or less prolonged and recovery occurs independently immediately after the victim is removed to fresh air or inhaled oxygen. The HbCO content in these cases is 20-40%. Psychomotor agitation, inappropriate behavior, facial flushing, increased body temperature to 38-40°C are clinically noted. arterial pressure increased to 150/90 mm Hg. Art., moderate tachycardia.
In severe and extremely severe poisoning, the HbCO content in the blood is 60-80%. In this case, a long-term (over several hours or even days) loss of consciousness is observed. As a rule, coma occurs against the background of breathing disorders, most often of the obstructive-aspiration type (with retraction of the tongue, accumulation of secretions in the oral cavity, trachea, trismus of the masticatory muscles). Less commonly observed is the central form of respiratory distress - rare, shallow breathing is replaced by a stop due to paralysis of the respiratory center. In this case, arterial hypotension up to collapse, pallor, cyanosis of the skin, signs of cerebral edema (stiff neck, anisocoria, etc.) are noted. Coming out of a coma takes a long time (up to several days). Characteristic are memory impairment (patients forget their name, words, do not recognize relatives, cannot read), dementia, epileptiform seizures, asthenia. As a rule, severe poisoning is complicated by pneumonia and trophic disorders (bedsores).

Treatment

In case of CO poisoning, prompt removal of the poison from the body and specific therapy are necessary. The victim is taken out into the fresh air, and upon arrival medical workers inhalation of humidified oxygen is carried out (in emergency conditions using KI-Z-M, AN-8 devices). In the first hours, pure oxygen is used for inhalation, then they switch to inhalation of a mixture of air and 40-50% oxygen. In specialized hospitals, oxygen inhalation is used under a pressure of 1-2 atm in a pressure chamber (hyperbaric oxygenation).
In case of breathing disorders, before oxygen inhalation, it is necessary to restore the patency of the airways (oral toilet, insertion of an air duct), perform artificial respiration up to tracheal intubation and artificial ventilation of the lungs.
In case of hemodynamic disturbances (hypotension, collapse), most often resulting from damage to the central nervous system, in addition to the intravenous administration (boost) of analeptics (2 ml of cordiamine, 2 ml of 5% ephedrine solution), rheopolyglucin (400 ml) should be administered intravenously drip in combination with prednisolone (60-90 mg) or hydrocortisone (125-250 mg).
In case of CO poisoning, great attention must be paid to the prevention and treatment of cerebral edema, since the severity of the patient’s condition, especially with prolonged disturbance of consciousness, is determined by cerebral edema that develops as a result of hypoxia. At the prehospital stage, patients are administered intravenously 20-30 ml of a 40% glucose solution with 5 ml of a 5% ascorbic acid solution, 10 ml of a 2.4% solution of aminophylline, 40 mg of Lasix (furosemide), intramuscularly - 10 ml of a 25% solution of magnesium sulfate. It is very important to eliminate acidosis, for which, in addition to measures to restore and maintain adequate breathing, it is necessary to administer a 4% sodium bicarbonate solution (at least 600 ml) intravenously. In a hospital setting, with severe symptoms of cerebral edema (stiff neck, convulsions, hyperthermia), a specialist neurologist performs repeated lumbar punctures; craniocerebral hypothermia is required; in the absence of a special apparatus, ice on the head. In order to improve metabolic processes in the central nervous system patients, especially those with severe poisoning, are prescribed vitamins, especially ascorbic acid (5-10 ml of a 5% solution intravenously 2-3 times a day), vitamins B 1, (3-5 ml of a 6% solution intravenously), B 6 ( 3-5 ml of 5% solution 2-3 times a day intravenously). To prevent and treat pneumonia, antibiotics and sulfonamides should be administered. Severely ill patients with CO poisoning require careful care; it is necessary to wash the skin of the body, especially the back and sacrum, change the position of the body (turning on the side), heavy percussion of the chest (effleurage with the side surface of the palm), vibration massage, ultraviolet irradiation of the chest with erythemal doses (by segments).

In some cases, CO poisoning can be combined with other serious conditions that significantly complicate the course of intoxication and often have a decisive influence on the outcome of the disease. Most often this respiratory tract burn, which occurs when inhaling hot air or smoke during a fire. As a rule, in these cases, the severity of the patient’s condition is due not so much to CO poisoning (which can be mild or moderate), but rather to a burn to the respiratory tract. The latter is dangerous because in the acute period acute respiratory failure may develop due to prolonged, intractable laryngobronchospasm, and in the next day severe pneumonia develops. The patient is bothered by a dry cough, sore throat, and suffocation. Objectively, shortness of breath is noted (as during an attack bronchial asthma), dry wheezing in the lungs, cyanosis of the lips, face, anxiety. When toxic pulmonary edema or pneumonia occurs, the patient's condition worsens even more, shortness of breath increases, breathing is frequent, up to 40-50 per minute, and there is an abundance of dry and moist wheezing of various sizes in the lungs. Mortality in this group of patients is high.

Treatment mainly symptomatic: intravenous administration of bronchodilators (10 ml of 2.4% aminophylline solution with 10 ml of physiological solution, 1 ml of 5% ephedrine solution, 60-90 mg of prednisolone 3-4 times or 250 mg of hydrocortisone 1 time per day, 1 ml of 5% ascorbic acid solution 3 times a day).
Great importance has local therapy in the form of oil inhalations (olive, apricot oil), antibiotic inhalations (penicillin 500 thousand units in 10 ml of saline), vitamins (1-2 ml of 5% ascorbic acid solution with 10 ml of saline); for severe laryngobronchospasm - 10 ml of 2.4% aminophylline solution, 1 ml of 5% ephedrine solution, 125 mg of hydrocortisone in 10 ml of physiological solution. For a severe cough, use codeine with soda (1 tablet 3 times a day), drink warm milk with soda or Borjomi.

The second severe complication of CO intoxication is positional injury (compartment syndrome), developing in cases where the victim lies unconscious (or sits) in one position long time, touching parts of the body (most often with limbs) to a hard surface (corner of a bed, floor) or pressing a limb with the weight of one’s own body. In areas subject to compression, unfavorable conditions for blood and lymph circulation are created. In this case, the nutrition of muscle and nervous tissue and skin is sharply disrupted, which leads to their death. The victim develops areas of reddening of the skin, sometimes with the formation of blisters filled with liquid (like burns), hardening of soft tissues, which are further intensified due to developing edema. The affected areas become sharply painful, increased in volume, dense (up to stone density). As a result of the breakdown of muscle tissue, myoglobin (a protein that is part of muscle tissue) enters the blood; if the injury area is large, a large amount of myoglobin affects the kidneys: myoglobinuric nephrosis develops. Thus, the patient develops the so-called myorenal syndrome, characterized by a combination of positional trauma and renal failure. Clinically, in addition to the muscle lesions described above, renal dysfunction is added: first, the patient produces a small amount of dark brown urine, and then anuria sets in, followed by azotemia, hyperhydration, etc. Treatment of patients with myorenal syndrome is long and is carried out in specialized hospitals, so as it requires the use of various special methods(hemodialysis, lymphatic drainage, etc.). If there is severe pain, you can administer painkillers - 1 ml of a 2% solution of promedol and 2 ml of a 50% solution of analgin subcutaneously or intravenously.

Prevention

In the vast majority of cases, poisoning occurs due to the fault of the victims themselves: improper operation heating stoves, geysers, smoking in bed (especially when drunk), leading to a fire; storing matches in places accessible to children; a long stay in a closed garage, where there is a car with a running engine, a long rest (sleep) in a car with the heater and engine on, even if the car is parked outdoors. It is especially important to conduct conversations and lectures with the population on the prevention of CO poisoning in the autumn-winter season.