Carbon Monoxide: The Odorless Killer

1. Carbon Monoxide: The Odorless Killer

2. 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

3. Objectives 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.

4. Objective 1: What Is CO? • Definitions • Carbon monoxide • Carbon monoxide poisoning • Carboxyhemoglobin

5. 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

6. 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

7. Knowledge Assessment • What are some common sources of CO? • Why is CO sometimes difficult to diagnose?

8. 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 consciousnessand death

9. Objective 2: The Symptoms • Other symptoms • Neurological • Long-term nervous system damage • Cardiovascular • Hypotension • Dysrhythmias • Clotting disorders • Respiratory • Hypoxia • Shortness of breath

10. Objective 2: What Is Considered a Dangerous CO Level?

11. 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.

12. Objective 3: Diagnosis • Traditional methods • Blood draw • Carboxyhemoglobin saturation • ABG • CBC • Breath analyzers • Brain imaging scans • MRI • PET

13. 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

14. 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

15. Obj. 3:Rad-57 vs. Blood Sample

16. 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

17. 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

18. Objective 5: Who Benefits? • Patients in the ER • Quickly spot CO poisoning without blood draw • Differential diagnosis for comatose or altered patients

19. 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

20. Knowledge Assessment • Name three duties in which firefighters are exposed to CO. • What are three traditional methods for checking CO levels?

21. 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