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Carbon monoxide can injure, kill as people turn to faulty heat systems

Dr. Ziad Mirza, a physician with the Wound Care and Hyperbaric Medicine Center at Greater Baltimore Medical Center
Dr. Ziad Mirza, a physician with the Wound Care and Hyperbaric Medicine Center at Greater Baltimore Medical Center (Photo courtesy of GBMC)

As the temperatures drop in winter and people turn to alternative heating systems, the chances of carbon monoxide poisoning increase. Faulty space heaters and gas-burning electric generators, along with furnaces and water heaters that aren't functioning properly, can lead to injury and death by poisoning. Carbon monoxide is odorless, so people need to check that their heating systems are operating properly and are well ventilated, and they need to be on the lookout for symptoms, said Dr. Ziad Mirza, a physician with the Wound Care and Hyperbaric Medicine Center at Greater Baltimore Medical Center.

What is carbon monoxide?

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Carbon monoxide is an odorless gas that is mainly produced by burning fossil fuel. Potential sources include gas engines, furnaces, stoves, lanterns, grills, fireplaces and gas ranges.

How common is carbon monoxide poisoning, and when do you begin seeing more victims each year?

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According to the Centers for Disease Control and Prevention, carbon monoxide poisoning accounts for more than 20,000 visits to the emergency room, leading to 4,000 hospitalizations and 400 deaths per year. There is an increase in carbon monoxide cases during the cold weather due to furnaces and during power outages when electric generators as well as other fuel-based equipment are in use in a sub-optimal ventilated environment. It is easy to overlook the symptoms of carbon monoxide poisoning, and prolonged exposure can be fatal. Know the symptoms of carbon monoxide poisoning and never ignore them, especially if others are experiencing them, too. The consequence for not acting can be severe neurological damage or death.

What does carbon monoxide do to people?

When carbon monoxide is present in the air we breathe, it gets in our lungs and adheres to hemoglobin with a higher affinity than oxygen, thus disturbing normal cellular function. This causes a number of symptoms such as headache, dizziness, weakness, upset stomach, vomiting, chest pain and confusion. Carbon monoxide symptoms are often described as flu-like and can be confused with flu during the winter season.

How can people recognize they are affected, and what should they do?

Flu-like symptoms are very common and can lead to the wrong initial diagnosis. People should look for a source of combustion as it relates to everyday living. These could include a poorly maintained oil furnace, a chimney that has not been cleaned for some time, an indoor heater and an old car with rust. People with chronic heart disease, anemia or breathing problems are more likely to get sick.

What are the normal treatments, and how effective are they?

The treatment consists of removing the source of carbon monoxide and delivering 100 percent oxygen by face mask over several hours in order to raise the availability of oxygen into the blood stream. The process is slow and takes several hours to resolve the toxic effect of carbon monoxide. People with cardiac or neurological symptoms might need to be hospitalized and monitored closely. Hyperbaric oxygen therapy is recommended in such cases and when no improvement is noted with 100 percent oxygen therapy delivered by face mask.

What is hyperbaric oxygen therapy and when is it used?

Hyperbaric oxygen therapy is a modality of breathing 100 percent oxygen under two to three atmospheric pressures. This is the equivalent to diving between 33 to 66 feet in sea water with oxygen tanks instead of air tanks. Under such conditions, oxygen becomes soluble in blood bypassing the red cell carrying capacity, thus oxygenating tissues. It also displaces the carbon monoxide from the red cells, allowing them to go back to their normal physiological function. Some patients require several hyperbaric oxygen sessions for complete resolution of symptoms. Without hyperbaric oxygen therapy, it takes about seven hours for toxic levels of carbon monoxide in a patient's bloodstream to decrease by half; however, hyperbaric oxygen therapy reduces [that time] to just 23 minutes. Clinical studies have shown that hyperbaric oxygen therapy is an effective treatment for other health conditions besides carbon monoxide poisoning, such as chronic bone infection, diabetic wounds of the lower extremities, delayed radiation injury, compromised flaps and grafts, and necrotizing infections.

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