Carbon Monoxide, A Very Silent Killer
By: Anthony Tannous, MD – Eastern Maine Medical Center
Carbon monoxide (CO) is a deadly poison that cannot be seen, smelled, or heard and it claims the lives of about 400 people across the US every year, according to the CDC. It makes thousand others ill and it is a common occurrence in emergency rooms during the winter season. Many household items including gas and oil-burning furnaces, portable generators, central heating systems, water heaters, and charcoal grills produce this gas which is usually the product of incomplete combustion of fuel. Usually this occurs when the appliances are not well serviced. Leaving a car running in a closed garage and blocked chimneys are additional causes of CO build up. Carbon Monoxide binds to hemoglobin, the molecule in our red blood cells responsible for carrying oxygen and prevents it from performing that role. Very frequently the person exposed to carbon monoxide will feel something is wrong but will not know why they are feeling sick. Within the first few hours of exposure, the person may experience a loss of balance, vision problems, memory problems, and eventually loss of consciousness. A good clue that carbon monoxide may be the culprit is several people in the same space suffering from the same symptoms. If the symptoms are mild, there is a good chance for full recovery once the exposure is interrupted. However, people with underlying breathing or heart problems may have more severe symptoms. Pregnant women, babies, and the elderly are also more susceptible. So are pets, by the way, who may get suddenly ill or unexpectedly die. If you present to the emergency department with the above symptoms, a provider may request a blood test to measure the level of CO bound to hemoglobin and run some tests on your heart to examine its function. Mild symptoms are readily reversible but severe symptoms will require admission to the hospital. Treatment usually includes 100 percent oxygen or even hyperbaric oxygen therapy to compensate for the lack of oxygen. Patients in a coma may need very aggressive breathing and cardiac support. Unfortunately, some of the complications of CO poisoning may be long lasting such as brain damage, progressive worsening of memory, and cognitive function, heart damage including coronary artery disease and urinary incontinence.
The best treatment remains prevention. To avoid running the risk of CO poisoning for you and your loved ones, make sure to keep appliances in good working order and use them safely. Have them serviced regularly by qualified professionals, and make sure all rooms are well ventilated and have chimneys be regularly swept. Do not leave gasoline powered engine running in the garage, service the exhaust pipe every year, and do not use charcoal on an indoor barbecue. In addition, for better protection, the CDC advises every household to install a CO alarm. Some are digital (above 70 ppm is when symptoms start to appear) and some emit high pitched sounds above a critical value. This alarm can be placed in every sleeping area in the house and should be checked regularly. Stay warm and safe this winter