Domestic gas poisoning ICD 10. Toxic effects of gases, fumes and vapors (adults and children)

Symptoms of carbon monoxide poisoning are pain in the eyes, drowsiness, yawning, weakness. It is important to detect intoxication in time and provide first aid to avoid dangerous complications.

When most materials burn, they release two toxic substances: hydrogen cyanide and carbon monoxide.

Carbon monoxide: prevents the body from saturating oxygen - oxidizes hemoglobin to methemoglobin, which is incapable of carrying oxygen.
Cyanide: disrupts tissue respiration.

Large amounts of these toxic substances end up in the air in the fall and spring, periods when fallen leaves are being burned everywhere.

Poisoning by other combustion products is possible. Various materials, when in contact with fire, emit vapors of alcohol, acetone, nitric and sulfuric acids, and ammonia. Since there are always many different materials in the areas where fires occur, the smoke is a cocktail of gases and acids.

Nitric acid: spreading along the respiratory tract with smoke, aggravates suffocation.
Sulfuric acid: acid vapors, during heavy smoke, enter the mucous membranes of the eyes and the epithelium of the respiratory tract. Inflammation develops and shortness of breath is possible.
Ammonia: With prolonged exposure to the lungs, the gas causes suffocation, causing coughing and watery eyes. Ammonia vapor poisoning leads to toxic edema.

The danger is posed by phosgene, which is formed upon contact of fire-fighting chemicals and artificial materials (plastic, rubber, plastic). Inhalation of its vapors can lead to pulmonary edema, which can be fatal.

In addition to intoxication by chemicals, soot fractions, especially abundant when burning plastic and rubber, cause serious harm. Fired wiring insulation is accompanied by thick, acrid smoke. It clogs the bronchi, causing serious respiratory complications that delay recovery.

Prolonged exposure to fumes from arc welding can cause asthma. Welding smoke contains a lot of slag and metal compounds that settle in the lungs.

If you don't extinguish the item well enough, it will start to smolder, causing more smoke. In some situations, it is worth leaving things to burn and leaving the dangerous place before it starts smoking.

According to the International Classification of Diseases (ICD-10), poisoning by combustion products has code T59 and is divided into 9 subsections. For simplicity, the symptoms of poisoning can be divided into three degrees.

Mild degree is characterized by symptoms:

attacks of nausea, vomiting;
general weakness;
acute headache, throbbing in the temples, spasms;
blurred vision, hearing, lacrimation;
difficulty breathing, dry cough;
irritation of mucous membranes, redness;
pressure fluctuations.

Average degree of poisoning:

skin rash;
increased drowsiness, heaviness in the body;
local paralysis of muscles and limbs;
auditory and visual hallucinations, noise, color blindness.

Severe degree:

elevated temperature;
relaxation of all muscles, inability to control stool and urination;
convulsions;
cyanosis of mucous membranes and skin;
abnormal heart rhythm;
no reaction of pupils to light;
loss of consciousness, coma;
difficulty breathing, until it stops completely.

Carbon monoxide poisoning requires special consideration. The proliferation of household gas appliances and poor home ventilation increase the chance of this event. The ability to identify poisoning is vital. Three forms of intoxication have been identified.

Typical shape:

Mild degree: the victim controls himself, but is bothered by headaches, noises, and nausea. Immediately remove the victim to fresh air.
Moderate: the victim has difficulty concentrating; in addition to mild symptoms, breathing and heart problems are added. Difficulties in coordination and muscle weakness create problems with independent movement.
Severe: There is a risk of loss of consciousness. Comatose depression of consciousness, pressure surges, convulsions, fever. The victim may end up in a coma. If it lasts more than a day, positive forecasts about his future are unlikely.

Euphoric form:

The defining feature of this form is the excited state of the victim. A short period of euphoria is replaced by depression, which occurs against the background of a severe degree of the typical form.

Syncopal form (state of syncope)/apoplectic (paralysis) form:

Syncopal: collapse of the circulatory system causes a sharp decrease in pressure, fainting.
Apoplectic: occurs when carbon monoxide enters the body in a huge concentration. Poisoning occurs faster than usual and develops more actively.

A woman's body is extremely sensitive during pregnancy. Prolonged exposure to smoke from a regular fire can lead to mild poisoning.

First aid rules

Providing first aid to victims of smoke or carbon monoxide in a fire should be an emergency. The duration of exposure to smoke is directly proportional to the severity of the poisoning.

Action plan:

Stop further poisoning from dangerous carbon smoke. Take the victim to fresh air, ensure free access of oxygen to the body. Free the victim's chest from tight clothing.
To slow down the spread of harmful substances through the blood, you can try cooling your chest and head. Apply ice or a cold compress.
To neutralize alkaline compounds that have entered the body, you need to drink diluted table vinegar.
It is necessary to increase the tone of the body, for this you drink strong tea or coffee.
If there is a risk of loss of consciousness/fainting, bring ammonia to the victim’s nose.
If the victim does not come out of the unconscious state, lay him on his side. This measure will prevent choking on vomit.
In case of cardiac arrest - urgent cardiac massage and artificial respiration.
When first aid for poisoning by combustion products has been provided, call the hospital.

In order to carry out emergency measures, first medical aid is provided. Having improved the condition of the poisoned person, you can call an ambulance.

Smoke poisoning from a fire is treated with measures aimed at removing poisons and toxins from the body. When intoxication is stopped, its consequences are eliminated through general therapy.

First, oxygen is supplied, displacing harmful substances from the lungs and blood. If the victim’s condition is serious, he is placed in a medical pressure chamber.
Serious poisoning from combustion products can be neutralized with an antidote.
In the euphoric form of carbon dioxide poisoning, the victim needs to take sedatives.
Obstruction of the respiratory tract is eliminated with Eufillin.
To prevent pneumonia, the victim is given antibiotics.
Muscle cramps stop after taking Barbamil and an injection of Phenazepam.
Cordiamine does not treat heart failure, but excites the neurons of the respiratory center.
In case of severe pain, the doctor will prescribe a mixture of Aminazine, Promedol, Diphenhydramine.

After the first measures, when the patient’s condition is stabilized, he is recommended to take frequent walks in the fresh air. The doctor prepares a complex of vitamins designed to speed up the recovery of the body.

Medical supervision is assigned to the patient until complete recovery.

Possible complications

Exposure to kitchen fumes and acrid smoke from burning plastic is dangerous for pregnant women. They can become poisoned even from a small volume of combustion products. This may affect the development of the fetus.
Oxygen starvation of the brain can negatively affect the central nervous system.
Pressure surges and lungs clogged with fumes threaten the development of bronchial asthma.
Cerebral and pulmonary edema are deadly conditions that require intensive care.

Carbon monoxide has no odor and is not visible to the eye. It is produced when carbon-containing substances burn. Carbon monoxide poisoning is often fatal. There are known cases of mass deaths that occur during explosions. Carbon monoxide impairs the flow of oxygen to tissues and organs. If the concentration of a dangerous substance increases, irreversible changes and death occur.

ICD 10 code

According to the International Classification of Diseases (ICD 10), when carbon monoxide accumulates in the body, code T58 is assigned.

Causes

Carbon monoxide is more easily incorporated into the respiratory protein, displacing oxygen. It is not immediately possible to detect the effects of carbon monoxide on the body. Intoxication develops when the concentration of toxic carboxyhemoglobin is more than 10%. The time spent in gas-contaminated conditions is of great importance. When a person breathes smoke for a long time, brain tissue begins to starve.

The pathogenesis of the disease considers not only the manifestations of the influence of carbon monoxide, but also the causes of poisoning. Thus, a large proportion of people are poisoned in the garage when the car is running, incorrect operation of the stove, breakdown of heating and exhaust systems, geysers, etc.

You can get poisoned in a car if carbon monoxide accumulates in the body. The danger of intoxication lies in the fact that the injured person does not immediately realize that he has been exposed to toxic effects. The mechanism of intoxication involves the development of tissue hypoxia. The pathological condition in which shortness of breath and migraine pain appear is called second-degree poisoning. Interruptions in the functioning of the brain and cardiovascular system accompany chronic carbon monoxide poisoning. In severe cases of poisoning, when the CO content reaches 0.3% or higher, the person loses consciousness and dies.

The toxic component provokes conditions that occur with other forms of intoxication: weakness, apathy. If victims inhaled carbon monoxide in a sauna, steam room or bathhouse, they may confuse such manifestations with the relaxing effects of heat. The likelihood of CO intoxication is higher at high air temperatures; people with heart disease, who are more susceptible to poisoning, are also at risk.

Often, poisoning occurs in an apartment due to a fire that ignites. The fire spreads rapidly, the amount of carbon monoxide increases sharply. In this case, a significant number of people are exposed to poisoning: apartment residents, neighbors.

Symptoms

In case of prolonged exposure to gas, nerve structures are destroyed, tissue hypoxia, convulsions, and confusion may develop. Symptoms of carbon monoxide poisoning are determined by the amount of carbon monoxide in the air. So, early signs of carbon monoxide poisoning are:

decreased concentration;

dizziness, disorientation, tinnitus or nausea;

irritability and anxiety;

heaviness in the chest;

pulse more than 90 beats per minute;

paroxysmal headache, pounding in the temples;

decreased visual acuity, blurred vision.

First aid

How to efficiently provide first aid for carbon monoxide poisoning? The burnt person is taken out of the room into the air. In case of a quick response, it will be possible to bring the poisoned person to his senses at the scene of the incident and avoid possible complications of intoxication. It is impossible to evacuate victims without a protective suit; in extreme cases, they hold their breath and carry people out. Call an ambulance immediately.

In case of mild carbon monoxide poisoning, the victim's collar and cuffs are unbuttoned and air flow to the tissues is ensured. In case of carbon monoxide poisoning, it is necessary, first of all, to get away from the source of intoxication. The further procedure includes:

bring the burnt person to consciousness with the help of ammonia;
give caffeine-containing drinks: tea, coffee;
rub your limbs to stimulate blood circulation;
give an alkaline drink to neutralize CO;
apply a heating pad to your limbs.

First aid for carbon monoxide poisoning in case of suffocation requires mouth-to-mouth breathing. First of all, the head is slightly thrown back, the jaw is extended, and the nose is pinched with the hand. Two artificial entries are made without violent action, but with sufficient intensity. In the absence of cardiac activity, first aid involves chest compressions and artificial respiration. If the above measures do not produce results, cardiopulmonary resuscitation must be repeated. If the poisoned person is unconscious, he should be placed on his side.

Providing first aid for clinical carbon monoxide poisoning requires a lot of effort. It is difficult for a beginner to master the PMP algorithm without training, so emergency care for carbon monoxide poisoning is trusted to professionals, especially during pregnancy and childhood. First aid rules require the participation of a physician in resuscitation efforts.

What to do with someone who is burned after carbon monoxide poisoning? At home, the following can be done to help the victim: give more fluids, take 1 tsp. activated carbon every hour, diluting the tablets in oatmeal broth.

Treatment

To make a diagnosis, a comprehensive examination is necessary. The gas composition of the mixture and acid-base balance are determined, and the hemoglobin level is assessed. Treatment and rehabilitation after carbon monoxide poisoning are determined by the intensity of the toxic effect.

Often, in case of severe carbon monoxide poisoning, an antidote is used - pure oxygen. It can hardly be called an antidote, but it is the only substance that the body needs in case of acute carbon monoxide poisoning. After resuscitation measures, an oxygen mask is connected. In the hospital, complex treatment is carried out to eliminate the consequences of hypoxia.

Based on the degree of poisoning, carbon monoxide detoxification is chosen. Intensive therapy for carbon monoxide poisoning involves the administration of the drug Azizol and a glucose solution, and the intake of absorbent tablets. In case of acute poisoning, oxygen inhalation is prescribed, the mucous membranes are moistened, and in case of hypotension, an ephedrine solution is administered.

Ascorbic acid is especially useful for patients. During the recovery phase, a healthy diet with a high content of antioxidants is prescribed. Vitamins B1 and B6 are prescribed intravenously. For painful attacks that occur due to burns, analgin is administered subcutaneously or intravenously. Treatment methods such as hemodialysis and lymphatic drainage are designed to revive oppressed cells.

Complications and consequences

The inevitable outcome of poisoning in the absence of medical care is respiratory arrest and death. If help for poisoning was provided late, coma develops. Complicating factors also lead to death: the presence of heart and vascular diseases, previous heart attacks, strokes, and brain pathologies. Intoxication caused by the huge release of carbon monoxide into the air during explosions and fires is fatal.

Negative consequences of long-term carbon monoxide poisoning include interruptions in the functioning of the central and peripheral nervous system, headaches, and ophthalmological disorders. Hypoxia has a detrimental effect on brain activity and causes complications such as amnesia, neuritis, and cognitive decline. Long-term consequences of long-term carbon monoxide poisoning include pneumonia and myocarditis.

Prevention

To prevent poisoning, do not forget about prevention. Mandatory precautions include checking gas equipment and ventilation systems in the building. Car enthusiasts should remember that after entering the garage, the engine is turned off. Repair work is not carried out with the engine running.

Dear readers of the 1MedHelp website, if you still have questions on this topic, we will be happy to answer them. Leave your reviews, comments, share stories of how you survived such poisoning and successfully dealt with the consequences! Your life experience may be useful to other readers.

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Carbon monoxide poisoning is... What is Carbon Monoxide Poisoning?

Carbon monoxide poisoning is an acute pathological condition that develops as a result of carbon monoxide entering the human body, is dangerous to life and health, and without adequate medical care can be fatal.

Carbon monoxide enters the atmospheric air during any type of combustion. In cities, mainly as part of exhaust gases from internal combustion engines. Carbon monoxide actively binds to hemoglobin, forming carboxyhemoglobin, and blocks the transfer of oxygen to tissue cells, which leads to hemic hypoxia. Carbon monoxide is also included in oxidative reactions, disturbing the biochemical balance in tissues.

At-risk groups

Poisoning is possible:

in case of fires;
in production, where carbon monoxide is used for the synthesis of a number of organic substances (acetone, methyl alcohol, phenol, etc.);
in garages with poor ventilation, in other unventilated or poorly ventilated rooms, tunnels, since the car exhaust contains up to 1-3% CO according to standards and over 10% if the carburetor engine is poorly adjusted;
when spending a long time on or near a busy road. On major highways, the average CO concentration exceeds the toxicity threshold;
at home when there is a leak of lighting gas and when the stove dampers are untimely closed in rooms with stove heating (houses, baths);
when using low-quality air in breathing apparatus.

Signs and symptoms

Concentration of CO in the air, carboxyhemoglobin HbCO in the blood and symptoms of poisoning. CO,

% about. (20°C)

Time

impact, h

in blood, %

Main signs and symptoms of acute poisoning

≤0.009	≤100	3.5-5	2.5-10	A decrease in the speed of psychomotor reactions, sometimes a compensatory increase in blood flow to vital organs. In persons with severe cardiovascular insufficiency - chest pain during exercise, shortness of breath
0.019	220	6	10-20	Slight headache, decreased mental and physical performance, shortness of breath with moderate physical activity. Visual perception disorders. May be fatal to fetuses and persons with severe heart failure
≤0.052	≤600	1
≤0.052	≤600	2	20-30	Throbbing headache, dizziness, irritability, emotional instability, memory loss, nausea, poor coordination of fine hand movements
0.069	800	1
≤0.052	≤600	4	30-40	Severe headache, weakness, runny nose, nausea, vomiting, blurred vision, confusion
0.069	800	2
0.069	800	2	40-50	Hallucinations, severe ataxia, tachypnea
0.1	1250	2	50-60	Fainting or coma, convulsions, tachycardia, weak pulse, Cheyne-Stokes breathing
0.17	2000	0.5
0.15	1800	1.5	60-70	Coma, convulsions, respiratory and cardiac depression. Possible death
0.2	2300	0.5
0.49	5700	2-5 min	70-80	Deep coma with decreased or absent reflexes, thready pulse, arrhythmia, death.
1.2	14000	1-3 min	Loss of consciousness (after 2-3 breaths), vomiting, convulsions, death.

Symptoms:

For mild poisoning:
- headache appears
- knocking in the temples,
- dizziness,
- chest pain,
- dry cough,
- lacrimation,
- nausea,
- vomit,
- visual and auditory hallucinations are possible,
- redness of the skin, carmine red coloring of the mucous membranes,
- tachycardia,
- increased blood pressure.
in case of moderate poisoning:
- drowsiness,
- possible motor paralysis with preserved consciousness
in case of severe poisoning:
- loss of consciousness, coma
- convulsions,
- involuntary passage of urine and feces,
- breathing disorder that becomes continuous, sometimes Cheyne-Stokes type,
- dilated pupils with weakened reaction to light,
- sharp cyanosis (blue discoloration) of the mucous membranes and facial skin. Death usually occurs at the scene as a result of respiratory arrest and a drop in cardiac activity.

When emerging from a comatose state, a sharp motor excitation is characteristic. Coma may develop again.

Severe complications are often observed:

cerebrovascular accident,
subarachnoid hemorrhages,
polyneuritis,
phenomena of cerebral edema,
visual impairment,
hearing impairment,
Possible development of myocardial infarction,
Skin trophic disorders (blisters, local edema with swelling and subsequent necrosis), myoglobinuric nephrosis,
With a long coma, severe pneumonia is constantly observed.

First aid

Remove the victim from the room with high carbon monoxide content. If poisoning occurs while using a breathing apparatus, it should be replaced.
If shallow breathing is weak or stops, begin artificial respiration.
Help eliminate the consequences of poisoning: rubbing the body, applying a heating pad to the legs, short-term inhalation of ammonia (the swab with alcohol should be no closer than 1 cm, the swab should be waved in front of the nose, which is very important, since when the swab touches the nose, due to the powerful exposure of ammonia to the respiratory center can cause paralysis). Patients with severe poisoning are subject to hospitalization, as complications from the lungs and nervous system are possible at a later date.

Treatment

It is necessary to immediately eliminate the source of polluted air and provide breathing with pure oxygen under an increased partial pressure of 1.5-2 atm or, preferably, carbogen.

In the first minutes, administer the Acizol antidote solution intramuscularly to the victim. Further treatment in hospital.
To relieve seizures and psychomotor agitation, you can use neuroleptics, for example, aminazine (1-3 ml of a 2.5% solution intramuscularly, previously diluted in 5 ml of a 0.5% sterile solution of novocaine) or chloral hydrate in an enema. Contraindicated: bemegride, corazol, analeptic mixture, camphor, caffeine.
If breathing is impaired - 10 ml of 2.4% aminophylline solution into a vein again.
In case of severe cyanosis (blue discoloration), intravenous administration of a 5% solution of ascorbic acid (20-30 ml) with glucose is indicated in the 1st hour after poisoning. Intravenous infusion of 5% glucose solution (500 ml) with 2% novocaine solution (50 ml), 40% glucose solution into a vein drip (200 ml) with 10 units of insulin under the skin.

Prevention

Carry out work in well-ventilated areas
Check the opening of dampers when using stoves and fireplaces in homes
Take the antidote "Acyzol" 1 capsule 30-40 minutes before contact with carbon monoxide.

Notes

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Carbon monoxide poisoning: symptoms, treatment, first aid

Carbon monoxide is dangerous because it is almost invisible when inhaled and does not have a pronounced unpleasant odor or color. In order to help a person with carbon monoxide poisoning, you need to know the symptoms, first aid and treatment methods. After all, intoxication occurs quickly and has serious consequences: all human organs are affected, often ending in his death.

It is very important to immediately provide pre-medical care to someone who has been poisoned. During a fire, you can often get carbon monoxide poisoning, and people die not from fire, but from smoke containing combustion products, including CO2.

First aid for carbon monoxide poisoning of people who happen to be nearby can restore the life of someone in trouble and save them from serious consequences. Such intoxication is classified by ICD-10 code T58 and requires the administration of an antidote.

Carbon monoxide is a product of combustion of various substances; it is very toxic and poisonous. When inhaled, it spreads quickly and enters the bloodstream. If a little more than 1% of this gas accumulates in the air, a person will not live even 5 minutes. It happens that people “burn out” due to improper use of stove heating.

The disease with ICD-10 code T58 poses a mortal danger for the following reasons:

Its presence in the room is imperceptible; when inhaled, it is not felt.
Able to seep through thick layers of any substance - through the ground, wooden partitions and doors.
Not retained by porous gas mask filters.

The main reason for the rapid death of a victim from CO2 occurs because the gas completely blocks the supply of O2 to the cells of vital organs. In this case, red blood cells (erythrocytes) die. Hypoxia of the body occurs.

The cells of the brain and nervous system are the first to experience a lack of air. Severe headache, vomiting, loss of balance appears. The toxic gas penetrates the protein of skeletal muscles and heart muscle. The rhythm of contractions is lost, the blood flows unevenly, and the person begins to choke. The heart beats very weakly and quickly. Movements are constrained.

The first signs of intoxication appear the sooner the higher the concentration of CO2 in the atmosphere and the longer a person inhales poisoned air. Based on these conditions, the degree of intoxication is determined.

At 1.2 degrees of poisoning, the following symptoms appear:

the whole head hurts, with foci of unbearable pain in the temples and frontal part;
noise in ears;
loss of coordination and balance;
vomit;
blurred vision, blurred vision;
lethargy;
temporary weakening of hearing and vision;
short fainting.

Severe carbon monoxide poisoning will be accompanied by obvious painful symptoms:

the person is unconscious;
convulsions;
coma;
uncontrolled urination.

With mild poisoning, heart rhythms become more frequent, and aching pain appears in the heart area. In the third degree of damage, the pulse reaches 140 beats per minute, but is very weak. Often followed by a real threat of myocardial infarction.

In the process of carbon monoxide poisoning, the respiratory organs are affected first. If the dose of intoxication is insignificant, shortness of breath and rapid shallow breathing are observed. In severe cases, the respiratory function is severely impaired, the person inhales air intermittently and in small portions.

Changes in the skin and mucous membranes during CO2 intoxication are not noticeable. Sometimes the face and upper body become red. With significant poisoning, the skin turns pale and the mucous membranes lose their normal appearance. The blood supply to the epidermis, like the whole body, is disrupted.

In medical practice, there are cases of atypical manifestations of CO2 poisoning:

a sharp decrease in blood pressure, anemia of the upper layers of the skin, fainting;
state of euphoria - the patient behaves animatedly, excitedly, and reacts inadequately to real events. Then the activity abruptly comes to naught, loss of consciousness occurs, which leads to cardiac arrest and cessation of breathing.

The consequences can appear immediately or after a long period of time.

Early complications occur in the first two to three days. These are problems arising from the nervous system - dizziness, severe long-term pain, lethargy and physical weakness, partial numbness of the limbs. In this condition, chronic cardiovascular and neurological diseases worsen.

Inevitable brain changes may occur. Due to damage by toxins, pulmonary edema is observed, arrhythmia occurs, the heart beats weakly and frequently. Lack of oxygen, disruption of blood supply to the brain and organs can suddenly stop the heart. This entails death.

Late-period complications appear within a month after poisoning:

Temporary and fairly long-lasting amnesia.
Excited nervous state.
Weakening of mental activity.
Decrease in intelligence level.

The person’s behavior is inhibited, there is a state of indifference to what is happening, and vision decreases. The limbs may be in a state of tremor, and excretory functions are not controlled. In severe cases, paralysis occurs.

Problems with the functioning of the heart occur with any degree of damage. Angina pectoris, cardiac asthma develop, and myocardial infarction may occur.

Damage to the respiratory system results in pneumonia and burns of the bronchi.

To avoid serious consequences, and often simply save a person’s life, you need to know what measures need to be taken in the first minutes after discovering the victim. An antidote must be administered as soon as possible.

What to do if you have carbon monoxide poisoning? Algorithm of actions:

In case of carbon monoxide poisoning, the victim first of all needs to call emergency help, no matter what condition the person is in. Symptoms of carbon monoxide poisoning may not appear immediately, and lost time will have a serious impact on the patient’s condition. Only a medical professional can reliably assess his state of health. No one can say how deeply the poisons penetrated into the blood. Providing first aid for carbon monoxide poisoning and the correct actions of others will reduce the possibility of severe consequences. There is no time to waste.
Helping a patient before doctors arrive involves isolating him from a burning building with a high concentration of CO2. You must immediately close the source of the poisonous gas, open the windows and doors, and transport the person outside the room with the fumes. If possible, we should try to increase the flow of oxygen into the patient’s lungs. You can use an oxygen bag, an oxygen concentrator, or a special gas mask.
These actions are possible if devices are available nearby. Usually, they don't happen. You need to know how to provide first aid for carbon monoxide poisoning. The victim should be placed on his side horizontally, with his head slightly raised. Then you need to relax the outer clothing that restricts breathing, the buttons on the collar and chest, and remove heavy, dense items.
It is necessary to bring the patient to his senses as soon as possible. Then the blood intensely rushes to the brain. For this procedure, you need to use ammonia, which should be in any car first aid kit. A cotton wool soaked in it should be brought to the nostrils. To improve blood flow, mustard plasters can be placed on the chest area and back. This cannot be done on the projection of the heart. If the person regains consciousness, he should be given hot sweet tea or coffee to increase blood pressure.
If the heart stops before the doctor arrives, you can try to “start the engine” with a manual massage. They do it like this - place the palms on the heart area and make quick, strong pressure on the sternum (30 times). Before and after this, mouth-to-mouth artificial respiration is performed 2 times. If a person is conscious, he is breathing on his own, he should be covered with a warm blanket and ensure peace. Body temperature should be monitored. In this position, the victim must wait for the doctor to arrive. He makes a diagnosis using ICD-10 code T58.

Video: the effect of carbon monoxide.

The doctor, providing medical care on the spot, must immediately administer an antidote to the patient. If a person feels normal, then hospitalization is not necessary. The victim is advised to see a doctor the next day to rule out the possibility of complications.

The following categories of people with CO2 poisoning should definitely go to a hospital for treatment after a PMP:

Women are in an “interesting” position.
People who are registered with a cardiologist or who have experienced loss of consciousness.
Victims with noticeable symptoms - hallucinations, delusions, loss of orientation.
If your body temperature is below normal.

Poisoning often ends in the death of the victim. But people nearby can help avoid this.

To undergo complete rehabilitation, the victim must be under the supervision of a doctor for some time on sick leave according to ICD-10 code T58.

To avoid carbon monoxide poisoning when helping in a fire, you need to protect your respiratory tract with a mask made of wet fabric, and not stay in the smoke for a long time.

Treatment after carbon monoxide poisoning according to ICD-10 code T58 consists of removing the effects of poisonous toxins. This is the cleansing of organs and restoration of their functions.

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Signs of household gas poisoning and first aid algorithm

Gas poisoning can occur when gas equipment malfunctions, leaks from cylinders, depressurized hoses, or damaged pipes. There are frequent cases of deliberate organization of leakage and poisoning for the purpose of suicide.

Signs and symptoms of poisoning

More than 90% of natural gas is methane. The composition may include: propane, ethane, butane, carbon dioxide, helium, water vapor, hydrogen sulfide. Natural is colorless and odorless, and is dangerous because it is difficult to detect its leakage. To protect the population from poisoning, gas with impurities is supplied to residential buildings, apartments, industrial enterprises and boiler houses to give it a specific odor.

The danger of leakage of a gaseous substance is the possibility of developing irreversible processes in the body and the danger of explosion. If methane makes up 5-15% of the total volume of air, there is a high probability of an explosion when a flame or spark appears.

Intoxication in humans occurs when the air contains more than 20% methane. The negative impact of household gas on the body is expressed in damage to the central nervous system and respiratory organs, provoking acute hypoxia.

Toxicologists distinguish 4 degrees of poisoning. Depending on the severity of the lesion and symptoms, appropriate therapy is prescribed.

Forms of poisoning	Signs of household gas poisoning
Lightweight	The victim experiences rapid breathing, suffocation, headache, dizziness, pain in the eyes, nausea, general weakness, pain in the heart, and drowsiness.
Average	Impaired brain function, vomiting, increased heart rate, impaired fine motor skills and coordination, hallucinations, changes in skin color to a red or bluish tint, signs of cardiovascular failure appear, and the threat of death develops.
Heavy	Brain dysfunction, convulsions, pulmonary edema, heartbeat disturbances with myocardial damage, lack of response to any irritants, bluish skin, unconsciousness. Death may occur due to the development of acute heart failure.
Instant	Severe intoxication and loss of consciousness occur. In the absence of emergency assistance, death occurs within 3-5 minutes.

Methane poisoning can be combined with carbon monoxide intoxication, which is formed during any type of combustion (gas stove burners, heat generators, water heaters, internal combustion engines).

Carbon monoxide has an insidious effect on humans. With insufficient air exchange in a closed room, the percentage of CO increases, penetrates through the respiratory tract into the blood, binds to hemoglobin, forms a carboxyhemoglobin compound that is unable to carry oxygen, which leads to hypoxia of tissues and organs.

If the air contains only 0.08% CO, a person begins to show symptoms of poisoning (pain in the head, chest, impaired consciousness, coordination, speech), and with 0.32% carbon dioxide, paralysis and loss of consciousness occurs after half an hour - death. With 1.2% CO in the air, two breaths are enough to die within 3 minutes.

ICD 10 code – X47 (intoxication by gas or vaporous substance), T58 (toxic effects of carbon monoxide in carbon monoxide poisoning).

Detoxification methods for poisoning by natural gas toxins

Domestic gas used at home for heating and cooking, consisting of 75-98% methane, is not toxic. Its negative effect on the human body is expressed in the displacement of oxygen, which causes hypoxia with subsequent disorders of the central nervous and cardiovascular systems. And a person can die not due to severe intoxication, but due to an acute lack of oxygen in the air - suffocation.

Methane is characterized as a physiologically harmless gaseous substance; natural gas poisoning does not involve detoxification of the body, but therapeutic methods are used to treat symptoms and consequences after severe oxygen deprivation.

When methane is incompletely burned due to lack of oxygen, deadly poisonous carbon monoxide is formed.

To cleanse the blood of toxins during carbon monoxide intoxication, efferent therapy is used. It provides for the release of biological fluid from toxins, foreign proteins, and in case of poisoning by vapors of chemicals and gases.

The victim may be prescribed plasmapheresis and hemosorption. Extracorporeal detoxification methods are carried out in a hospital setting and involve cleansing the blood of harmful substances outside the patient’s body. Blood is passed through the system through a special apparatus containing filters and returned to the human vascular system in a purified state.

The drug Acizol is an antidote (antidote) for carbon monoxide and can be used to prevent poisoning. Half an hour before entering a gas contaminated area during accidents, fires, rescue operations, 1 ml of the medicine is administered intramuscularly and is effective for 2 hours. Victims are advised to administer a dose of Acizol. After which the formation of carboxyhemoglobin, the product of the binding of carbon monoxide with hemoglobin, stops, and the process of removing the toxin from the body is established. The sooner the antidote is administered to the victim, the lower the risk of complications. The mechanism of action of the drug and dosage of use are described in the instructions.

Sorbents are used that absorb toxins from the blood and remove them naturally. A popular method of removing toxins from CO poisoning is the use of charcoal with a decoction of oats. The product should be taken 1 teaspoon every hour for several days.

The use of drugs has little effect on the gas-poisoned body. Treatment in a medical institution is aimed at saturating the blood, organs and tissues with oxygen.

Oxygen therapy is carried out in the following order:

Artificial hyperventilation of the lungs to quickly remove gas from the respiratory tract.
Hyperbaric oxygenation in a pressure chamber (the patient is placed in a chamber where oxygen is supplied under pressure for 40 minutes. The course of treatment is up to 10 days).
Blood transfusion or red blood cell replacement.

First aid algorithm

Having discovered signs of intoxication, it is necessary to act quickly and competently. It is necessary to call an ambulance team. And before the arrival of qualified specialists, it is necessary to provide first aid to victims of a gas leak.

Algorithm of actions when providing first aid:

Take or carry the victim out of the house and onto the street. If this is not possible, you need to quickly turn off the gas, open the windows wide and create a draft. To avoid poisoning yourself, you need to cover your nose and mouth with clothes, a scarf, and a towel.
Lay the patient face up, unbutton clothes, place any object under his feet so that the lower limbs are higher than the head.
Apply cold to your head (wet towel, ice from the refrigerator, frozen foods).
Give the victim plenty of water or any other non-alcoholic drink to drink.
If there is a urge to vomit, it is necessary to turn the victim's head to the side to avoid vomit from entering the respiratory tract.
If a person begins to lose consciousness, you need to put a cotton swab soaked in ammonia under your nose. Give it a sniff from time to time to avoid falling asleep or blacking out.
If there is no breathing, artificial respiration is performed through moistened gauze or a handkerchief.
If the victim is unconscious, you should feel the pulse; if it is absent, begin chest compressions. For an adult, the massage is done with two hands, for a teenager - with one hand using little force, for children and newborns - with two fingers. The chest is compressed by 3-5 cm with a compression frequency of 100 times in 60 seconds. The helper should be on his knees in a strictly vertical position in relation to the victim’s chest.

Correctly and quickly provided first aid for gas poisoning can prevent the development of complications and save a person’s life.

Emergency care in a medical facility for carbon monoxide poisoning includes endotracheal intubation for artificial ventilation, the use of drugs to improve heart function, medications for the respiratory system, analgesics to eliminate headaches and uncomfortable pain in the chest.

As an additional therapy, you can treat household gas poisoning using breathing exercises. It will help to gradually restore respiratory functions and avoid negative consequences.

Possible complications of intoxication

Gas poisoning can cause diseases of the cardiovascular, nervous, respiratory and visual systems. The development of disorders in the form of memory lapses, speech inhibition, and deterioration of attention may be observed. It is difficult for a person to concentrate, process and analyze information, formulate and reproduce thoughts.

Gas intoxication is especially dangerous during pregnancy. In case of severe poisoning, the fetus may suffer. Blocking hemoglobin leads to oxygen starvation of the baby. Exposure of a pregnant woman to carbon monoxide can result in intrauterine fetal death.

It is important to notice the characteristic symptoms of intoxication in time. Proper first aid will prevent dangerous complications from occurring.

The risk of poisoning due to inhalation of various combustion products awaits a person not only during fires. Intoxication is also possible in other cases. Burning grass or spending long periods of time near a fire can also lead to big problems and sometimes even quick death.

Combustion products are gaseous, solid or liquid toxic substances formed as a result of combustion. Their composition depends on what exactly was burning and the conditions under which this process took place.

When burned, inorganic and organic substances form CO, SO 2, CO 2, P 2 O 5 and so on.

During incomplete combustion, alcohols, acetones, sulfur gas, carbon monoxide, etc. are released into the air. As a result, the air is filled with caustic, poisonous smoke, consisting of tiny solid particles of the combustible substance.

According to ICD 10 (international classification of diseases), such poisonings correspond to code T 59.

Causes of intoxication

You can be poisoned by smoke and the combustion products it contains if they enter the respiratory tract during breathing.

The most dangerous are hydrogen cyanide and carbon monoxide, released during combustion. Carbon monoxide stops the production of hemoglobin and the transport of oxygen to the organs stops. As a result, death occurs from hypoxia (oxygen deficiency).

Read also: Carbon monoxide poisoning in humans

Hydrogen cyanide leads to poisoning, disrupting tissue metabolism and the flow of oxygen into the blood.

You can inhale and become poisoned by substances formed during combustion in the following cases:

in case of fire;
while burning last year's leaves;
due to smoldering of wiring, fabric, furniture, etc. (when complete combustion is prevented by insufficiently high temperature or lack of oxygen in the air);
while in the garage with the doors closed and the engine running;
due to malfunction of stoves or when they are fired with an insufficiently open damper;
problems with gas stoves or heating appliances.

The combustion of any materials leads to the release of harmful gases into the air, inhaling which can cause poisoning. But even when extinguishing a fire, the danger of poisoning from combustion products is no less:

When interacting with water, many gases react with it and form caustic acids (sulphurous, nitric) and ammonia. These combustion products damage the bronchi, quickly accumulate in the lungs and severely burn the mucous membranes of the respiratory tract.
When a fire is put out with a fire extinguisher, highly toxic phosgene is produced. Having been poisoned by this gas, a person can die from rapidly developing pulmonary edema, especially since there is no antidote to phosgene.

When rubber, plastic, paint and varnish materials, as well as foam rubber and plywood burn, toxic products of their combustion are formed - phosgene, cyanide, dioxin, etc. And if a person managed to get help in time for poisoning with these products, there is no guarantee that he will not subsequently develop cancer or severe allergies.

Symptoms

To understand that the deterioration of the condition began precisely because of combustion products, characteristic signs will help:

lacrimation;
“heaviness” in the head;
pain in the temples and frontal area of the head;
sudden facial hyperemia;
increasing weakness;
noise in ears;
increased heart rate;
lack of air, shortness of breath;
muscle pain both under tension and at rest (myalgia);
vomiting as a symptom of almost all poisonings;
chest pain;
burning in the throat;
intractable severe cough;
loss of consciousness;
overexcitation or drowsiness (if the poisoned person falls asleep in a smoky room, without emergency assistance, death will occur in his sleep).

The dangerous thing is that signs of poisoning can sometimes appear only after a few hours. But even symptoms that appear immediately sometimes suddenly decline and even disappear completely after a day. However, this does not mean that the poisoning went away on its own. Miracles do not happen in such cases, and a deceptive feeling of relief may actually hide the onset of pulmonary edema.

If first aid for poisoning is not provided for some reason, the patient’s condition worsens:

breathing becomes painful and uneven;
redness of the face is replaced by cyanosis;
If help is not provided, the person dies.

With a severe degree of poisoning, in addition to the listed signs, the following sharply appear:

rapid breathing;
convulsions;
hallucinations (as a result of the long-term toxic effect of moderately concentrated gases);
rave;
rapid development of cardiac and pulmonary failure (it happens that after breathing has stopped, the heart continues to beat for some time);
coma.

Sometimes there is simply no time to provide first aid, even if you start acting immediately. For example, after just a few breaths of carbon monoxide at a concentration of 1.2%, fatal poisoning occurs instantly: a person loses consciousness and dies within 3 minutes, and the survival rate in such cases is zero.

How to help

You need to start providing emergency first aid by calling an ambulance. It is important to do this in any case, even with a mild form of poisoning. Then immediately, without delay, take action:

remove (or remove) the victim to fresh air from the room where the poisoning occurred;
unbutton, tear or cut restrictive clothing (especially on the chest - collar, scarf, tie, etc.) to provide the poisoned person with the opportunity to breathe more freely;
give sorbents (Polysorb, activated carbon, Atoxyl) diluted in a small amount of water;
drink strong sweet tea;
give ascorbic acid (at least 2 pieces);
wipe your face and chest with a cloth soaked in cool water, apply a cold compress to your forehead;
if the poisoned person has a fever, apply moderately hot heating pads;
if you lose consciousness, bring a cotton swab dipped in ammonia or wipe your temples with it;
in case of severe weakness and on the verge of loss of consciousness, lay the victim on his side, clean the mouth and nose of vomit with a handkerchief (if there was vomiting);
control pulse;
If breathing or heartbeat stops, immediately proceed to resuscitation measures (indirect cardiac massage, artificial respiration).

All first aid measures for poisoning due to inhalation of combustion products should be provided quickly, and only in fresh air. Otherwise, the degree of poisoning will increase, and the person providing assistance will become intoxicated from inhaling gases generated during combustion.

Treatment

Whether the poisoned person needs to be hospitalized and how to treat him will be determined by doctors, depending on the results of the examination of the victim, when the symptoms and treatment are compared from a professional point of view. And if the decision is made in favor of the hospital, then the patient will undergo the appropriate procedures there:

pure oxygen in the first hours after poisoning to displace gases and their compounds with hemoglobin;
then - an air mixture with 40-50% oxygen;
in case of severe poisoning - a pressure chamber;
for acute CO poisoning - antidote Acizol intramuscularly to improve oxygen transport;
sedation for overexcitation;
the drug Eufillin for obvious obstruction of the respiratory tract;
antibiotics to prevent pneumonia;
for convulsions - Barbamil (intravenously, slowly), Phenazepam intramuscularly, magnesium sulfate 25%;
for heart failure, intramuscular Cordiamin, glucose solution with Strophanthin intravenously and slowly, caffeine solution subcutaneously;
if there are signs of cerebral edema or suspicion of it - a “cocktail” of Promedol, Aminazine and Diphenhydramine or Pipolfen intramuscularly;
in case of coma and for the prevention of cerebral edema - a number of drugs (ascorbic acid with glucose, Prednisolone, Insulin, Calcium gluconate (chloride), Furosemide, etc.);
prevention of toxic pulmonary edema;
hormonal drugs (corticosteroids, etc.);
vitamin therapy.

Read also: Poisoning in humans with hydrogen sulfide

The patient is prescribed complete rest, including from negative emotions.

The treatment is complex, multicomponent and quite difficult. Therefore, if you are severely poisoned by combustion products, you cannot count on a speedy recovery.

Consequences

Complications after intoxication with combustion products are almost inevitable, even if the poisoning was not severe.

After a mild form of poisoning, the following consequences are possible:

miscarriage or developmental defects of the unborn child (in case of poisoning in pregnant women);
hypertension;
bronchial asthma;
long-term disturbances in the functioning of the nervous system.

In other cases, the consequences can appear almost immediately after poisoning and treatment, or after some time.

Early complications after poisoning:

neuritis;
hearing and vision impairment;
heart rhythm disturbances;
swelling of the brain or lungs.

Later consequences:

serious pathologies of the nervous system up to loss of mental abilities for life;
psychoses;
memory impairment;
oncological diseases;
movement disorders (paralysis, etc.);
pneumonia;
acute heart failure or heart attack.

The consequences can also be fatal, and death sometimes occurs 2 weeks after poisoning. This is possible when a person, having been poisoned by combustion products, for some reason did not complete treatment (insisted on premature discharge or neglected doctor’s prescriptions). Or the victim mistakenly determined that he had recovered during a false improvement, which often occurs a day after poisoning, and did not consult a doctor.

Have you ever been poisoned by waste products?

Poisoning by combustion products often causes death. As a rule, intoxication occurs as a result of forest fires, insufficiently safe stove heating in wooden houses, and welding. Sometimes the burning of autumn leaves becomes a provocateur; the fire sometimes literally “eats” peat deposits. Materials subject to prolonged smoldering are especially dangerous for the human body.

ICD code 10-T59.

Why are they poisoned by smoke?

Combustion products are gaseous, solid or liquid chemicals released during the process. The composition depends entirely on the item being burned. The most frequently formed harmful compounds are CO, SO2, CO2, P2O5. The atmosphere is literally saturated with vapors of acetone, alcohol, and carbon monoxide.

The most toxic are carbon monoxide and cyanide:

The first interferes with the production of hemoglobin and the transport of O2.
The second disrupts metabolism and does not allow oxygen to penetrate the tissues.

Poisoning is possible when exposed to any substances released during combustion. However, extinguishing a fire is sometimes no less dangerous.

Common causes of intoxication:

Some gases react with water, releasing toxic substances, such as nitric or sulfuric acid, ammonia. As a result, the mucous membranes of the lungs and bronchial tree are burned.
Few people know, but sometimes extinguishing a fire with professional means provokes poisoning. Using a fire extinguisher when there is a fire in plastic, plastic, or rubber can lead to the formation of phosgene, which causes swelling of the respiratory system.
It is easy to get poisoned by carbon monoxide when visiting a bathhouse, or from household poisoning when the stove pipeline is worn out.
Damage is possible when the vehicle warms up. Oil distillation products, gasoline and diesel fuel, quickly saturate the air in a closed garage. In this case, the person falls asleep and cannot resist intoxication.
The hidden threat is tobacco smoke. It doesn’t matter whether you develop an addiction to cigarettes or aesthetic hookah smoking, the lungs are equally affected.

Often the cause of intoxication with combustion products is going out into nature.

Fire smoke poisoning

What is the threat:

Cooking over an open fire releases toxins equal to those produced by smoking 40 cigarettes.
Women during pregnancy, as well as children suffering from respiratory diseases, are especially susceptible to smoke poisoning. Carbon monoxide also negatively affects the development of the fetus.
If you relax outdoors in humid weather, smoke particles easily combine with water, which increases the risk of injury.

Starting a fire can lead to massive burning of dried leaves, bushes, and trees. In this case, you will have to not only treat the consequences of poisoning, but also be legally responsible for the forest fire. The threat of being burned alive cannot be ruled out either.

Signs of intoxication

Unfortunately, symptoms do not always appear immediately. Sometimes a long-term effect is characteristic, sometimes the clinical picture disappears after a day, and then appears with renewed vigor.

Main signs of poisoning:

Rapid increase in weakness.
There is a feeling of heaviness in the occipital region.
Pain in the temples, joints, muscle tissues.
The skin of the face and neck takes on a reddish tint.
Breathing is difficult.
The pulse quickens.
There is noise in the ear canals.
The person is prone to drowsiness.
Attacks of nausea and vomiting appear.
Irritation of the mucous membranes of the larynx and bronchi provokes a hacking cough.
The influence of acrid smoke leads to fainting.

In the absence of PMF, combustion products settle in the lungs and cause tissue swelling. Severe poisoning causes seizures and cardiovascular failure.

Death is declared as a result of cardiac arrest or paralysis of the respiratory center.

First aid

Not only the health, but often the life of the victim depends on the actions of others:

It is necessary to call a medical team.
The person is taken out into fresh air, away from the possible influence of combustion products.
Unbutton tight clothes - nothing should interfere with breathing.
If he is conscious, give him sweet and strong tea to drink.
Activated carbon or other sorbents are used to remove toxins.
Wipe the temporal areas with a swab dipped in a solution of ammonia - this measure will prevent fainting or bring you back from it.
Sometimes there is chills. A heating pad applied to your legs will help get rid of it.
If the victim does not respond to first aid, lay him on his side, which will prevent choking on vomit.
Monitor pulse and breathing. If this is not the case, artificial ventilation and chest compressions are used.

This pre-medical treatment at home will help reduce the symptoms of smoke poisoning. Emergency workers who arrive on the call will assess the situation and, if necessary, transport you to the hospital.

Treatment methods

What medical procedures are indicated:

Oxygen is introduced, which displaces toxic gases.
In severe cases, they are placed in a pressure chamber.
If acute CO2 damage is diagnosed, Acizol is used intramuscularly as an antidote.
In cases of agitation, sedatives are recommended.
When airway obstruction is detected, Eufillin is used.
To prevent pneumonia, antibiotics, to eliminate seizures, barbamil intravenously, Phenazepam intravenously or 25% magnesium sulfate.
Heart failure is treated with Cordiamine, a glucose solution with the addition of Strophanthin.
If swelling of the brain is suspected, a mixture of Promedol, Diphenhydramine, and Aminazine is administered.

Assistance is also aimed at preventing coma or recovery from this state. Corticosteroids, hormones, ascorbic acid, and vitamin complexes are used.

The therapy is long-term and complete rest must be maintained.

Possible consequences

Poisoning by carbon dioxide and other products often causes complications:

Even with mild exposure, a pregnant woman can lose her baby.
There are high risks of developing hypertension, bronchial asthma, and central nervous system disorders.
People exposed to chemical compounds are susceptible to neuritis, hearing and vision problems.
Serious consequences also include swelling of the brain and lung tissue.

Sometimes combustion products provoke oncology, loss of mental abilities, paralysis, and heart attacks. Death is also possible some time after poisoning.

Prevention

You can avoid the problem by following simple recommendations:

Quit smoking.
In case of fire, immediately leave the premises and use protective equipment - respirators.
Exercise caution when starting a fire.
Replace gas stove pipelines in a timely manner.
Do not forget to open the view when heating with a stove, or when visiting a bathhouse.
Do not allow children to play with matches and lighters.

Clinical picture of acute poisoning. The clinical picture of acute CO poisoning is characterized, first of all, by symptoms of central nervous system damage. General cerebral disorders are manifested by headaches localized in the temporal and frontal regions, often of a girdling nature (hula hoop symptom), dizziness, and nausea. Vomiting occurs, sometimes repeated, loss of consciousness develops up to deep coma in severe lesions.

Stem-cerebellar disorders are characterized by miosis, mydriasis, anisocoria, but in most cases the pupils are of normal size, with a lively reaction to light. Unsteadiness of gait, loss of coordination of movements, tonic convulsions, and spontaneous myofibrillations are noted.

The development of pyramidal disorders is evidenced by an increase in muscle tone of the limbs, an increase and expansion of tendon reflex zones, and the appearance of Babinski and Oppenheimer symptoms.

Particular attention should be paid to the occurrence of hyperthermia, which is of central origin and is considered one of the early signs of toxic cerebral edema, which is the most severe complication of acute carbon monoxide poisoning.

Disorders of mental activity may manifest themselves as agitation or stupor. An excited state, manifested by symptoms of acute psychosis (disorientation, visual and auditory hallucinations, persecution mania), is typical for situations associated with emotional impact (fires, bomb explosions, shells, etc.). In case of household poisoning and poisoning from car exhaust gases, the typical state is stupor, stupor or coma.

In some cases, in addition to hemic and tissue hypoxia, hypoxic hypoxia also develops, caused by inspiratory shortness of breath of central origin and impaired patency of the upper respiratory tract as a result of bronchorrhea and hypersalivation. Violation of the function of external respiration, tissue and hemic hypoxia, is accompanied by a violation of the acid-base state with the development of first respiratory and then metabolic acidosis.

If carbon monoxide is inhaled in high concentrations, sudden death will occur at the scene due to respiratory arrest and primary toxic collapse caused by paralysis of the respiratory and vasomotor centers. In some cases of severe poisoning, a picture of exotoxic shock develops. With less severe lesions, hypertensive syndrome with severe tachycardia is observed.

ECG changes are nonspecific; signs of myocardial hypoxia and coronary circulatory disorders are usually detected: the R wave decreases in all leads, especially in the chest leads, the S-T interval shifts below the isoelectric line, the T wave becomes biphasic or negative. In severe cases, the ECG shows signs of impaired coronary circulation, reminiscent of myocardial infarction. These changes usually quickly disappear as the general condition of the patients improves, however, in severe poisoning, coronary abnormalities on the ECG can persist for up to 7-15 days or more.

CO intoxication is often accompanied by the occurrence of trophic disorders, especially in cases where victims, due to a rapid loss of consciousness, are in an uncomfortable position for a long time, with their limbs tucked and compressed (positional trauma). In the early stages of trophic skin disorders, bullous dermatitis with hyperemia of skin areas and swelling of subcutaneous tissues is observed. Sometimes trophic disorders take the form of ischemic polyneuritis, expressed in atrophy of individual muscle groups, impaired sensitivity and limited function of the limbs.

In more severe cases, necrotizing dermatomyositis develops, when compactions and infiltrates are noted in areas of hyperemic skin with further tissue necrosis and the formation of deep ulcers. In particularly severe cases of dermatomyositis, the development of myorenal syndrome and acute renal failure due to myoglobinuric nephrosis of varying severity is possible.

If poisoning has occurred recently, then the skin and visible mucous membranes are scarlet (the scarlet color is due to carboxyhemoglobin). The skin of patients in a state of severe hypoxia is usually cyanotic.

The severity of carbon monoxide toxicity is determined by the concentration and exposure of the poison. Currently, toxicologists distinguish two variants of the course of acute CO intoxication: slow - with typical and euphoric forms of the clinical course and fulminant - with apoplectic and syncope forms.

In a typical form of mild poisoning (HbCO level 10-30%), headache appears mainly in the frontal and temporal regions, dizziness, tinnitus, shortness of breath, general weakness, nausea, sometimes vomiting and fainting. A slight blush is visible on the cheeks, cyanosis of the mucous membranes, consciousness is usually preserved, reflexes are increased, tremor of outstretched arms, a slight increase in respiration, pulse and a moderate increase in blood pressure are noted. These symptoms disappear a few hours after the cessation of CO action, with the exception of headache, which can persist for up to a day or more.

In case of poisoning of moderate severity (HbCO level 30-40%), these symptoms are more pronounced. Muscle weakness and adynamia are noted; sometimes they are so pronounced that despite the life-threatening danger, patients are not able to overcome even a short distance; coordination of movements is impaired. Shortness of breath intensifies, the pulse becomes more frequent, blood pressure decreases, and scarlet spots often appear on the face. Patients lose orientation in time and space, consciousness is confused, there may be loss of consciousness or memory loss.

Severe poisoning (HbCO level 50-70%) is accompanied by complete loss of consciousness and coma, the duration of which can be up to 10 hours or more. The skin and mucous membranes are initially bright scarlet, then acquire a cyanotic tint. The pupils are maximally dilated. The pulse is frequent, blood pressure is sharply reduced. Breathing is impaired, may be intermittent Cheyne-Stokes type. Body temperature rises to 38-40° C. The muscles are tense, and attacks of tonic or clonic-tonic convulsions are possible. Subsequently, a coma develops, staying in it for more than a day is an unfavorable prognostic sign.

Severe cases of CO poisoning on the 2-3rd day can be complicated by trophic disorders, the appearance of erythematous spots, subcutaneous hemorrhages, and vascular thrombosis.

The euphoric form is a type of severe CO poisoning and is characterized by a relatively slow increase in hypoxia and the development of speech and motor excitation, followed by loss of consciousness, impaired respiratory and cardiac activity.

The clinical forms of the fulminant variant of poisoning are apoplexy and syncope.

The apoplectic form develops with short-term inhalation of carbon monoxide in very high concentrations (more than 10 g/m3). The affected person quickly loses consciousness and 3-5 minutes later, after a short-term attack of convulsions, dies from paralysis of the respiratory center.

The syncopal form is characterized by predominant inhibition of the vasomotor center and is manifested by a sharp decrease in blood pressure, cerebral ischemia, pallor of the skin, rapid loss of consciousness, and emptying of peripheral vessels. The skin acquires a pale, waxy color. The patient also dies within a few minutes.

First aid and treatment. Since the leading link in the pathogenesis of carbon monoxide intoxication is hypoxia, combating it is the main direction of providing medical care to victims. Poisoned people should be evacuated from the polluted atmosphere as quickly as possible and taken to fresh air.

First aid for acute respiratory failure is provided, as a rule, in the form of self- and mutual assistance and consists of ensuring airway patency, performing artificial ventilation of the lungs using mouth-to-nose, mouth-to-mouth methods, and chest compressions.

Pre-medical care includes, in addition to the measures taken, the administration of bronchodilators, oxygen inhalation, artificial respiration using air ducts, and chest compressions in terminal conditions.

To treat those affected by carbon monoxide, oxygen therapy is used, which can be classified as pathogenetic therapy for this type of intoxication. The most commonly used is isobaric oxygen therapy, which is technically easy to implement with the appropriate equipment (DP-2, DP-9, GS-8, KI-3). In the first hours after poisoning, it is recommended to use pure oxygen, and later - a 40-50% oxygen-air mixture. The most effective method of treating CO poisoning, especially moderate and severe cases, is oxygen barotherapy (OBT), when oxygen is supplied under high pressure.

In case of moderate and severe acute poisoning with carbon monoxide, the earliest possible introduction of the CO antidote - acizole, which has the ability to improve the oxygen transport functions of the blood in conditions of acute CO intoxication. Acizol is administered intramuscularly in 1.0 ml of 6.0% solution (1 person dose). It is possible to re-administer the antidote after 1.5-2 hours.

The rest of the drug therapy for CO poisoning is symptomatic. In case of excitement, the administration of sedatives is indicated, and in case of convulsive syndrome, the administration of barbamyl 50-100 ml of a 1% solution intravenously slowly, intramuscularly - 1 ml of a 1% solution of phenazepam, 10 ml of a 25% solution of magnesium sulfate. In case of severe agitation and symptoms of cerebral edema, use a lytic cocktail: aminazine (2 ml of a 2.5% solution), promedol (1 ml of a 2% solution), diphenhydramine or pipolfen (2 ml of a 2.5% solution) intramuscularly. The administration of morphine is strictly prohibited.

Breathing disorders and airway obstruction due to bronchospasm are indications for intravenous administration of 10 ml of 2.4% aminophylline solution. For heart failure - subcutaneously 1-2 ml of a 20% solution of caffeine, intramuscularly 2 ml of cordiamine, slowly intravenously 0.5-1.0 ml of a 0.05% solution of strophanthin in 10-20 ml of a 40% glucose solution.

In case of severe intoxication and the development of coma, for the prevention and treatment of cerebral edema - an ice pack on the head or craniocerebral hypothermia, intravenous 40 ml of a 40% glucose solution with 4-6 ml of a 5% ascorbic acid solution and 8 units of insulin, 50-100 mg of prednisolone, 40-80 mg of furosemide, 10 ml of 10% calcium chloride (gluconate) solution. An important place in the treatment of intoxications is occupied by the fight against metabolic acidosis - 250-400 ml of 2-6% sodium bicarbonate solution is prescribed intravenously. 2-4 ml of a 6% solution of thiamine bromide and 2-4 ml of a 5% solution of pyridoxine hydrochloride are administered intravenously or intramuscularly (do not administer in one syringe) to correct tissue metabolic disorders. Measures are taken to prevent and treat toxic pulmonary edema; antibiotics are prescribed in normal dosages to prevent pneumonia.