Carbon Monoxide Poisoning
by Mark C Howard, MD

With cooler autumn weather on the horizon and with forecasts of an unusually brisk winter, it is once again time to plan for the heating season. The "go green" movement may be capturing the headlines of our nation as Americans contemplate global warming and spiraling energy costs, but fossil fuel as the main source of heat remains present day reality.

One of the exhaust ingredients of our gas and heating oil furnaces is the colorless, odorless and tasteless gas known as carbon monoxide (CO). Present in large concentrations it can poison people and animals, as it starves living tissue for vital oxygen. In fact, carbon monoxide is the most common cause of lethal poisoning in the United States. The Centers for Disease Control (CDC) estimates that more than 20,000 people annually seek emergency medical attention for CO inhalation. Most occurrences occur in the winter months. The most common location for exposure is, in fact, at home.

Signs and Symptoms
Symptoms of mild poisoning include headache and shortness of breath with activity. As exposure increases symptoms may progress to confusion, headache, nausea, and dizziness. Rapid heart rate and breathing as well as bleeding from the retina of the eyes may follow. With even greater exposure, chest pain may occur as a symptom of the accumulation of fluid within the lungs and diminished blood flow to the heart muscle. Seizures, fainting, and poor balance may occur. People who are sleeping or who are intoxicated may not even experience symptoms before possibly succumbing to the gas. Long term effects of severe exposure may include injury to an unborn baby (if the victim is pregnant), memory impairment and personality changes.

The Cause of the Poisoning
Carbon monoxide suffocates the tissues in people and in animals as it out competes with oxygen in attaching to hemoglobin, the red blood cell molecule that normally carries oxygen and carbon dioxide to and from the lungs. The end result can include suffocation and poisoning at the cellular level.

First Aid
The priority is to move a victim out of the area where the exposure may have occurred and into fresh air. Contact emergency medical services. Ensure that breathing is occurring, and if necessary, start CPR. Realize that other toxic or irritant gases may be present, which can increase the risks to rescuers.

Avoiding Exposure
On an annual basis have heating systems (furnaces and hot water heaters) inspected by qualified technicians. Never use flameless chemical heaters indoors. When purchasing gas equipment make sure that the gas equipment carries the seal approval of the Underwriters' Laboratories or the American Gas Association.

Install battery operated CO detectors in the home. Also beware that carbon monoxide gas accumulation can also occur in or around vehicles. Never operate a motor vehicle within a poorly ventilated area. Have vehicle exhaust systems regularly inspected, since even a small leak can cause toxic accumulation of gases.

On a final note, don't forget that portable electricity generators produce gases, including carbon monoxide. St. Louisians are no strangers to widespread power outages. Never use a generator inside.