Sarah J Jones consultant in environmental health protection, Amber Horton environmental public health programme support officer, Huw Brunt lead consultant in environmental health protection, Giri Shankar professional lead consultant in health protection
Jones S J, Horton A, Brunt H, Shankar G.
Preventing carbon monoxide poisoning
BMJ 2019; 366 :l4613
doi:10.1136/bmj.l4613
Carbon monoxide poisoning can be prevented
Carbon monoxide is found in gases produced by boilers, vehicles, portable generators, stoves, flashlights, gas stoves, or burning coal or wood. Carbon monoxide from these sources can accumulate in closed or semi-enclosed spaces. People and animals that are in these spaces can get intoxicated and die by inhaling CO.
Carbon monoxide poisoning is known as a simulatory disease, since the doctor can confuse the condition with other conditions, by sharing signs and symptoms with food gastroenteritis, with ischemic heart disease and with different neurological conditions.
When power outages occur during emergencies, such as hurricanes or severe storms, the use of alternative sources of electricity to heat or cool the environment, or to cook, can cause carbon monoxide to build up in homes, garages or mobile homes, and intoxicate people and animals inside.
Carbon monoxide poisoning is a frequent problem, often undiagnosed, or suspected during urgent care. The knowledge of the clinical manifestations induced by the inhalation of this dangerous gas and the possibility of determining the presence of carboxyhemoglobin (COHb) in blood, together with other complementary studies, are essential elements for its correct diagnosis and treatment.
More than 400 people die each year in the United States from involuntary carbon monoxide poisonings that are not related to fires.
There are measures that must be followed to prevent carbon monoxide poisoning:
• Have a qualified technician maintain your heating system, water heater and any other device that runs on gas, oil or coal every year.
• Install a carbon monoxide detector that works with batteries or has backup batteries in your home, and check or replace the batteries when the time changes in spring and autumn.
• Leave your home immediately if the carbon monoxide detector alarm sounds and call the emergency service. Seek immediate medical attention if you think you have been poisoned with carbon monoxide and feel dizzy, lightheaded or nauseous.
• Do not leave your car or truck with the engine running inside your home garage, even if the door is open.
• Do not burn anything in a stove or in a fireplace that does not have an outside exhaust pipe.
• Do not use gas ovens to heat your home.
• Do not use generators, charcoal grills, camp stoves or other appliances that run on gasoline or coal inside the house, in the basement, in the garage or outside the house within 20 feet of windows, doors or exits of air.
Carbon monoxide poisoning is totally preventable.
References
1. Salas Pardo E. El empleo del oxígeno hiperbárico en Medicina Intensiva y Urgencias. Intoxicación por monóxido de carbono tratamiento con OHB. En: Sociedad Andaluza de Medicina Intensiva, Urgencias y Coronarias. Principios de Urgencias, Emergencias y Cuidados Críticos [en línea]. Andalucía: SAMIUC, 2008. Disponible en: http://tratado.uninet.edu [consulta: 24 jul. 2019].
2. Kales AN, Christiani DC. Acute chemical emergencies. N Engl J Med 2004; 350 (8): 800-8.
3. Pose D, Negrin A, Laborde A. Intoxicaciones por monóxido de carbono. En: Bello O, Sehabiague G, Prego J, de Leonardis D. Pediatría. Urgencias y Emergencias. Montevideo: Bibliomédica, 2009: 1081-8.
4. Gasman JD, Varon J, Garder JP. Revenge of the barbecue grill: carbon monoxide poisoning. West J Med 1990; 153: 656-7.
5. Pastorini J. Intoxicación por monóxido de carbono y oxigenoterapia hiperbárica [historia clínica posgrado]. Montevideo: Facultad de Medicina. Cátedra de Pediatría Intensiva, 2003.
6. Dueñas Laite A, Hernández Gajate M, García Calvo C, Cerda Gómez R, Martín Escudero JC, Pérez Castrillón JL. Guía de actuación ante la intoxicación aguda por monóxido de carbono (CO). Emergencia 1997: 9 (4): 242-4.
7. Lindell K. Carbon monoxide poisoning. Crit Care Clin 1999; 15 (2): 297.
8. Ernst A, Zibrak JD. Carbon monoxide poisoning. N Engl J Med 1998; 339 (22): 1063-8.
9. Pose D, Fernández S, Tortorella MN, De Ben S, Burger M. Intoxicaciones más frecuentes en Pediatría. En: Bello O, Sehabiague G, Prego J, de Leonardis D. Pediatría. Urgencias y Emergencias. Montevideo: Bibliomédica, 2009: 1063-80.
10. De Latorre M, Molina JC. Intoxicaciones por monóxido de carbono. En: Mintegui S. Manual de intoxicaciones en Pediatría. Madrid: Ergon, 2003: 181-9.
11. Loiselle JM. Quemaduras e inhalación de humo. En: Selbest SM, Cronan K. Secretos de las urgencias en pediatría. México: McGraw Hill, 2001: 316-7.
Competing interests: No competing interests