Carbon Monoxide Poisoning

Every day, thousands of calls are generated to emergency medical systems to summons help for numerous reasons. One of the most frightening calls a dispatcher can receives are those involving a patient who is not breathing or is struggling to breathe. One very common problem that goes unseen due to its colorless, odorless and tasteless properties, and is a major worldwide public health problem, is poisoning from carbon monoxide (Graber et al 2007). According to the Journal of the American Medical Association, 2000 Americans die each year from accidental exposure to carbon monoxide and another 2,300 from intentional exposure (suicide).

Carbon monoxide is naturally produced in our bodies in small amounts and released as a by-product by cell metabolism (Thompson, 1997). Also, we are exposed to relatively low concentrations of carbon monoxide through the combustion of fuel for the motor vehicles we drive everyday and portable gas heaters we may use in the winter to stay warm. Poisoning from carbon monoxide can occur anywhere there is carbon containing fuels that are being burned and the supply of oxygen is limited. This can be an acute poisoning when exposed to high levels such as a fire or low level poisoning over a longer period of time.

Inhaled through the lungs, carbon monoxide interferes with the ability of the blood to carry oxygen to the tissues. In the blood, there are millions of red blood cells that contain an intracellular protein called hemoglobin. Each hemoglobin molecule can carry four oxygen molecules. Hemoglobin is the main transported of oxygen, carrying around 98% of the oxygen in the blood, with the remainder 2% carried in the dissolved state (Porth 2011). If all four subuni...

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It is very important to understand the relationship of oxygen saturation to the partial pressure of oxygen. The total oxygen content and factors that affect the curves affinity of hemoglobin to oxygen will help give a better understanding and explanation of clinical problems when presented with the possibility of poisoning by carbon monoxide.

References:

Graber JM,Macdonald SC, Kass BE, Smith AE, Anderson HA (2007 Carbon monoxide: the case for environmental public health surveillance. Public Health Reports. 122,2,138-144.

Hardy KR, Thom SR (1994) Pathophysiology and treatment of carbon monoxide poisoning. Journal of Toxicology – Clinical Toxicology. 32, 6, 613- 629.

Porth Carol Mattson (2011) Essentials of Pathophysiology. 3rd ed. page 531.

Thompson, June, et al. Mosby’s Clinical Nursing. 4th ed. St. Louis: Mosby, 1997.