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Carbon Monoxide Poisoning Q & A

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Duke Health News 919-660-1306

What is carbon monoxide (CO)?

Whenever anything is burned, such as charcoal, propane,
gasoline or kerosene, carbon dioxide is released as a part of
the combustion process. However, if during this burning there
is not enough ventilation or oxygen present, CO is produced
instead.

What is CO poisoning?

What makes CO poisoning such an important public health
issue is that most times people don't even realize that it is
happening. CO is colorless, tasteless, odorless and does not
cause irritations in the lungs or on the skin. When it is
inhaled, it attaches itself to the hemogloblin in red blood
cells in the same location that oxygen would, thereby depriving
the body of needed oxygen.

It is estimated that that about 40,000 Americans seek
medical attention for CO poisoning each year, and according to
the Centers for Disease Control and Protection, more than 500
will die from unintentional CO poisoning.

What are the symptoms?

Low levels of CO can cause such vague ailments as
depression, fatigue and headaches. More severe poisonings can
cause dizziness, confusion, irregular heartbeats, convulsions,
unconsciousness and even death.

How is CO poisoning treated?

For low-level exposures, patients often receive 100 percent
oxygen delivered through a tight fitting mask. Oxygen helps
separate the CO that has attached itself to the hemoglobin in
the red blood cells.

For more severe poisonings, hyperbaric treatments are often
used. For this approach, patients are placed in special
chambers and oxygen is pumped in at higher than normal
pressures. This allows the oxygen to enter the body's tissues
and "squeeze out" the CO.

Duke physicians typically treat between 20-30 patients each
year in the hyperbaric medicine facility, according to Duke
hyperbaric medicine expert Bret Stolp, M.D.

What are the most commons causes of CO
poisoning?

The two most common occasions for the occurrence of CO
poisoning in the United States is during cold weather or after
a natural disaster, such as a hurricane, when power is
lost.

Each year, as the temperatures outside drop, the number of
people seen by Duke physicians for CO poisoning rises. The
culprits in the winter are kerosene heaters and charcoal grills
used to heat an improperly ventilated house. And what makes it
so frustrating for Stolp is that simple precautions will ensure
that the carbon monoxide created by the combustion of kerosene
doesn't cause health problems.

During Hurricane Fran, the last major storm to hit central
North Carolina, many people were treated at the Duke hyperbaric
center because the gasoline generators used to keep the
household supplied with electricity were placed too close to
the house, allowing exhaust fumes to enter the house.

How can CO poisoning be prevented?

Ventilation and common sense are key.

When using kerosene heaters indoors, Stolp said "All it
takes is opening a window a crack in the room with the heater.
Especially since houses today tend to be airtight, it is very
important to allow for some ventilation."

Stolp recommends that generators be placed at least 25 feet
from the house, and not near open windows or air vents. Carbon
monoxide detectors in living areas of the house are also a good
idea, he said. Generators, just like kerosene heaters used
indoors during the winter, can emit carbon monoxide as they
burn fuel. However, since they usually burn gasoline, people
are not as likely to smell anything.

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