pulse classroom carbon monoxide: the odorless killer
TRANSCRIPT
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Carbon Monoxide:
The Odorless Killer
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Introduction
• Carbon monoxide
– Colorless, odorless, tasteless, toxic gas
– By-product of incomplete combustion
– Commonly found in all areas of home and work
– Difficult to detect, easy to misdiagnosis
– Deadly poison, immediate threat to life
– Numerous long-term health effects
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After completing this course, the participant should be able to:
• define carbon monoxide (CO) and carbon monoxide poisoning.
• identify signs and symptoms of CO poisoning.• identify current methods for diagnosing CO poisoning.• describe the risks firefighters face with CO.• describe the role of the EMS provider in treating patients
with CO poisoning.
After completing this course, the participant should be able to:
• define carbon monoxide (CO) and carbon monoxide poisoning.
• identify signs and symptoms of CO poisoning.• identify current methods for diagnosing CO poisoning.• describe the risks firefighters face with CO.• describe the role of the EMS provider in treating patients
with CO poisoning.
Objectives
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Objective 1: What Is CO?
Definitions
Carbon monoxide
Carbon monoxide poisoning
Carboxyhemoglobin
Definitions
Carbon monoxide
Carbon monoxide poisoning
Carboxyhemoglobin
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Objective 1: Why Is CO Poisoning so Deadly?
Pathophysiology
• Binds to hemoglobin occupying site intended for oxygen
• Prevents release of oxygen to cells
• Intracellular toxin
• Binds with myoglobin in cardiac and muscle cells causing significant muscle impairment
Pathophysiology
• Binds to hemoglobin occupying site intended for oxygen
• Prevents release of oxygen to cells
• Intracellular toxin
• Binds with myoglobin in cardiac and muscle cells causing significant muscle impairment
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Objective 1: How Many People Are Affected Each Year?
• Leading cause of toxic-related death in United States
• As many as 40,000 emergency department visits for carbon monoxide poisoning per year
• 1,000 to 2,000 accidental deaths per year
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Knowledge Assessment
• What are some common sources of CO?
• Why is CO sometimes difficult to diagnose?
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Objective 2: The Symptoms
• Immediate symptoms
– Headache– Dizziness and weakness– Chest pain– Nausea and vomiting– Confusion– Loss of memory, concentration, orientation– High doses: loss of consciousness and death
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Objective 2: The Symptoms
• Other symptoms• Neurological
– Long-term nervous system damage
• Cardiovascular– Hypotension– Dysrhythmias– Clotting disorders
• Respiratory– Hypoxia– Shortness of breath
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Objective 2: What Is Considered a Dangerous CO Level?
Cohb% Signs & Symptoms
5% Headache
10% Headache, shortness of breath with exertion
10-20% Moderate headache, shortness of breath with mild exertion
20-30% Worsening headache, nausea, dizziness, fatigue
30-40% Severe headache, vomiting, vertigo, altered judgment
40-50% Confusion, syncope, tachycardia
50-60% Seizures, shock, apnea, coma
> 70 ppm Headache, fatigue, nausea
> 150-200 ppm
Disorientation, unconsciousness, and death possible
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Knowledge Assessment
• What are some of the conditions that CO poisoning can mimic?
• TRUE or FALSE: CO levels at 5% is when most people start to exhibit symptoms.
• Name five common immediate symptoms of CO poisoning.
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Objective 3: Diagnosis
• Traditional methods
– Blood draw– Carboxyhemoglobin saturation – ABG– CBC
– Breath analyzers
– Brain imaging scans– MRI– PET
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Objective 3: Limitations of Traditional Diagnosis
• Clinical signs and symptoms are often misleading
• Without clear signs and symptoms, diagnosis may be missed
• Not feasible for use in the field
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Objective 3: Revolutionary Technology
Masimo Rainbow™ SET Pulse CO-Oximetry™ (Rad-57)
Portable Noninvasive Accurately measures
CO in seconds Easy to operate Allows rapid and
accurate triage
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Obj. 3:Rad-57 vs. Blood Sample
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Objective 4: Who Benefits?
• Firefighters
– High risk for exposure during:• overhaul phase of structure fires.• all wild land fires.• rescue situations.• training situations.
– Administer test to each other
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Objective 5: Who Benefits?
• Patients at the scene
– CO is the cause of most fire-related deaths – Misdiagnosis is common– Quick diagnosis leads to quick treatment
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Objective 5: Who Benefits?
• Patients in the ER
– Quickly spot CO poisoning without blood draw
– Differential diagnosis for comatose or altered patients
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Objective 5: Who Benefits?
• MCI victims – High CO levels post-incident– Limited breathing protection and
compressed air resources– Essential CO screening of rescue personnel
and patients– Hospital transport and screening not
feasible– Maximize resources and minimize errors
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Knowledge Assessment
• Name three duties in which firefighters are exposed to CO.
• What are three traditional methods for checking CO levels?
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Summary
• CO is a common poison found in combustion fumes– Difficult to diagnose in the field through
traditional means– New technology makes screening quick,
easy, and accurate– Result is better patient outcomes – www.masimo.com/CPUB/clinicals.htm