Substance
carbon
monoxide
Common name or Trade name
一氧化碳
Involving system
CO produces
toxicity by binding to hemoglobin, thereby reducing oxygen-carrying capacity,
and by binding to myoglobin, which may impair cardiac output and result in
cerebral ischemia [1].
Presentation
Asymptomatic HbCO 0—10%
Mild headache, respiratory distress HbCO 10—20%
Headache,
nausea. Lethargy, weakness HbCO 20—30%
Nausea, vomiting, syncope, weakness HbCO 30—40%
Unconsciousness
seizure, arrhythmia. HbCO 50%
Deep coma HbCO 60%
Fatal 70% [2]
Fetus HbCO level higher than maternal HbCO
15%[2]
Antidote and Treatment
ACLS if hemodynamic unstable.
NRM or mask 100%
HBO (hyperbaric oxygenation) when coma.
AMS. ABG pH<7.1, Cardiac ischemia. HbCO> 25%; pregnant female HbCO>
20% [2]
Disposition
Admission if complication with
rhabdomyolysis, aspiration pneumonia, AMS, etc.
References
[1]. Olson KR.
Carbon monoxide poisoning: mechanisms, presentation, and controversies in
management. J Emerg Med. 1984;1(3):233–243. doi:10.1016/0736-4679(84)90078-7
[2].急性中毒救命術, 第三版. P.309—17.
~~ April, 26th, 2020. Yu-Jang Su
