![]() Attempts have also been made in the literature to divide carbon monoxide poisoning into mild, moderate, and severe based on carboxyhaemoglobin percentage levels and clinical symptoms, but there is no clear clinical consensus or agreement on this issue. Earlier studies attempted to differentiate between smokers and non-smokers. Attempts have been made in the literature to equate symptoms and signs to different carboxyhaemoglobin levels, but it is accepted that carboxyhaemoglobin levels in an acutely poisoned person only roughly correlate with clinical signs and symptoms, especially those relating to neurological function. Additionally, people with co-morbidities that make them more sensitive to the hypoxia associated with carbon monoxide can present with symptoms of poisoning at carboxyhaemoglobin levels that are either low or within the normal range. The use of carboxyhaemoglobin percentage as a measure of severity of carbon monoxide poisoning, or to predict treatment options, is limited because carboxyhaemoglobin levels are affected by removal from the source of carbon monoxide and any oxygen treatment given before measurement of percentage carboxyhaemoglobin. Smokers are exposed to increased levels of carbon monoxide in cigarettes, and otherwise healthy heavy smokers can tolerate levels of carboxyhaemoglobin of up to 15%. Interpretation of carboxyhaemoglobin levels: Non-smokers living away from urban areas have carboxyhaemoglobin levels of 0.4–1.0%, reflecting endogenous carbon monoxide production, whereas levels of up to 5% may be considered normal in a busy urban or industrial setting. The classical signs of carbon monoxide poisoning - described as cherry-red lips, peripheral cyanosis, and retinal haemorrhages - are rarely seen. ![]() In people suffering from co-morbidities, symptoms such as shortness of breath or chest pain may be more evident. The symptoms of carbon monoxide poisoning are non-specific and varied, and include headache, fatigue, malaise, “trouble thinking”, confusion, nausea, dizziness, visual disturbances, chest pain, shortness of breath, loss of consciousness, and seizures. The signs and symptoms of carbon monoxide poisoning are mainly associated with the brain and heart, which are most sensitive to hypoxia. Although the diagnosis of carbon monoxide poisoning can be confirmed by detecting elevated levels of carboxyhaemoglobin in the blood, the presence of clinical signs and symptoms after known exposure to carbon monoxide should not be ignored. Carboxyhaemoglobin percentage is the most frequently used biomarker of carbon monoxide exposure. Diagnosis of carbon monoxide poisoning: Exposure to carbon monoxide is measured either directly from blood samples and expressed as a percentage of carboxyhaemoglobin, or indirectly using the carbon monoxide in expired breath. These can, unfortunately, include damage to either the heart or the brain.Carbon monoxide is an odourless, colourless gas, and poisoning causes hypoxia, cell damage, and death. Sadly, the statistics show that somewhere between 10% and 15% of people who have suffered from very severe CO poisoning, do go on to develop complications in the long term. Because this is such concentrated oxygen, your body will be able to replace the carboxyhaemoglobin quite quickly. This will be delivered in a hospital, and the person will need to wear a tight fitting mask and will breathing air which contains approximately 21% oxygen. When you or another person has been exposed to an especially high level of CO, it will be necessary to get oxygen therapy treatment. This appliance should be checked straight away by the correctly qualified person. Obviously you need to stop using whatever appliance you believe may have been the cause of the poisoning. Additionally the persons recovery will depend on the combination of these factors. Of course like any other health issue, the reaction of the person in question, be it yourself or another person, will also depend on their general state of health. When your doctor tests for poisoning, there will be two factors that will influence the amount of CO in your bloodstream. ![]() Then go straight to the doctor and ask your doctor to test for carbon poisoning. Stop using all appliances until the culprit has been discovered. Move immediately away from the suspected source of the gas. Open all windows in your house or workplace. If you, or anyone you live with or work with, shows symptoms that having outlined in this article, make sure the person gets fresh air straight away.
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