Household gas poisoning microbial 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, to provide first aid in order to avoid dangerous complications.

When most materials are burned, two toxic substances are released: hydrogen cyanide and carbon monoxide.

Carbon monoxide: interferes with the saturation of the body with oxygen - oxidizes hemoglobin to methemoglobin, incapable of carrying oxygen.
Cyanide: interferes with tissue respiration.

A large amount of these toxic substances is in the air in autumn and spring - during periods when the burning of fallen leaves is everywhere.

Possible poisoning by other combustion products. Various materials in contact with fire release vapors of alcohol, acetone, nitric and sulfuric acids, ammonia. Since there are always many different materials in places where a fire occurs, smoke is a cocktail of gases and acids.

Nitric acid: along with smoke, spreading through the respiratory tract, exacerbates suffocation.
Sulfuric acid: acid vapors, during heavy smoke, enter the mucous membranes of the eyes and the epithelium of the respiratory tract. Inflammation develops, shortness of breath is possible.
Ammonia: With prolonged exposure to the lungs, the choking gas is manifested by coughing and tearing. Poisoning with ammonia vapor leads to toxic edema.

The danger is phosgene, which is formed during the contact of fire-fighting chemicals and artificial materials (plastic, rubber, plastic). Inhalation of its vapors is fraught with pulmonary edema with a fatal outcome.

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

Prolonged exposure to smoke from arc welding is fraught with the development of asthma. Welding smoke contains a lot of slag and metal compounds that settle in the lungs.

If the object is not extinguished well enough, it will begin to smolder, which will cause even more smoke. In some situations, it is worth leaving things on fire and leaving the dangerous place before it starts to smoke.

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

A mild degree is characterized by symptoms:

bouts of nausea, vomiting;
general weakness;
acute headache, throbbing in the temples, spasms;
blurred vision, hearing, lacrimation;
shortness of breath, 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, limbs;
auditory and visual hallucinations, noise, color blindness.

Severe degree:

elevated temperature;
relaxation of all muscles, inability to control feces and urination;
convulsions;
cyanosis of mucous membranes and skin;
disturbed heart rhythm;
no pupillary reaction to light;
loss of consciousness, coma;
shortness of breath, up to its complete stop.

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

Typical shape:

Mild degree: the victim is in control of himself, but he is worried about headaches, noises, nausea. Move victim to fresh air immediately.
Medium degree: the victim has difficulty concentrating, in addition to mild symptoms, breathing and heart problems are added. Difficulties in coordination and weakness in the muscles create problems with independent movement.
Severe: there is a risk of loss of consciousness. Coma depression of consciousness, pressure surges, convulsions, fever. The victim may be in a coma. If it lasts more than a day, positive forecasts about its 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 a typical form.

Syncopal form (syncope state) / apoplexy (paralysis) form:

Syncope: collapse of the circulatory system causes a sharp decrease in pressure, fainting.
Apoplexy: comes from the ingestion of carbon monoxide in a huge concentration. Poisoning occurs faster than usual and develops more actively.

The body of a woman during pregnancy is extremely sensitive. Prolonged exposure to the smoke screen from a conventional fire can lead to mild poisoning.

First aid rules

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

Action plan:

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

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

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

First, oxygen is supplied, which displaces harmful substances from the lungs and blood. In a serious condition of the victim, he is placed in a medical pressure chamber.
Serious poisoning by combustion products is neutralized by an antidote.
With the euphoric form of carbon dioxide poisoning, the victim needs to take sedatives.
Obstruction (obstruction) of the airways is eliminated by Eufillin.
To prevent pneumonia, the victim is given antibiotics.
Muscle cramps stop after taking Barbamil, an injection of Phenazepam.
Cordiamin does not cure heart failure, but excites the neurons of the respiratory center.
With severe pain syndrome, the doctor will prescribe a mixture of Aminazin, Promedol, Dimedrol.

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

Until full recovery, the patient is assigned medical supervision.

Possible Complications

Exposure to kitchen waste and acrid smoke from burning plastic is dangerous for pregnant women. They are able to poison themselves even from a small volume of combustion products. This may affect the development of the fetus.
Oxygen starvation of the brain can adversely affect the central nervous system.
Pressure surges and clogged lungs threaten the development of bronchial asthma.
Cerebral and pulmonary edema are deadly conditions that require resuscitation.

Carbon monoxide does not smell and is not visible to the eye. It is produced when carbonaceous substances are burned. Carbon monoxide poisoning is often fatal. There are cases of mass deaths of people, which happens during explosions. Carbon monoxide impairs the flow of oxygen to tissues and organs. If the concentration of a hazardous substance increases, irreversible changes and death occur.

ICD code 10

According to the international classification of diseases (ICD 10), with the accumulation of carbon monoxide in the body, the code T58 is assigned.

Causes

Carbon monoxide is more easily integrated 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%. Of great importance is the time spent in gas conditions. 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 with the car running, erroneous operation of the stove, breakdown of heating and exhaust systems, gas water heaters, etc.

You can get poisoned in the car if carbon monoxide accumulates in the back. The danger of intoxication lies in the fact that the ugly person does not immediately understand that he has been exposed to toxic effects. The mechanism of intoxication implies 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 work of the brain and CCC accompany chronic carbon monoxide poisoning. In a severe form of poisoning, when the CO content reaches 0.3% or more, the person loses consciousness and dies.

The toxic component provokes conditions that occur with other forms of intoxication: weakness, apathy. If the victims inhaled carbon monoxide in a sauna, steam room or bath, they may confuse such manifestations with the relaxing effects of heat. The likelihood of CO intoxication is higher at high air temperatures, and 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 has ignited during a fire. The fire spreads rapidly, the amount of carbon monoxide increases dramatically. In this case, a significant number of people are exposed to poisoning: apartment residents, neighbors.

Symptoms

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

decrease in 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, blurry vision.

First aid

How to effectively provide first aid for carbon monoxide poisoning? The victim is taken out of the room into the air. In the 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 the victims without a protective suit, in extreme cases, they hold their breath and carry people out. Immediately call an ambulance.

In case of mild carbon monoxide poisoning, the victim is unbuttoned the collar, cuffs, and provides air flow to the tissues. In case of carbon monoxide poisoning, it is necessary, first of all, to get away from the source of intoxication. The next course of action is:

bring the victim to consciousness with the help of ammonia;
drink caffeinated drinks: tea, coffee;
rub the limbs to stimulate blood circulation;
give alkaline drink to neutralize CO;
apply a heating pad to the extremities.

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 pushed forward, the nose is pinched by hand. Make two artificial entrances without violent action, but with sufficient intensity. In the absence of cardiac activity, first aid involves an indirect heart massage and artificial respiration. If these measures fail, repeat cardiopulmonary resuscitation. In the unconscious state of the poisoned person, it is necessary to lay it on its 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 preparation, therefore, emergency care for carbon monoxide poisoning is trusted by professionals, especially during pregnancy and in childhood. First aid rules require the participation of a physician in resuscitation.

What to do with a burnt out after carbon monoxide poisoning? At home, as an aid to the victim, the following can be done: give more to drink, take 1 tsp. activated charcoal every hour, diluting the tablets in oatmeal broth.

Treatment

A comprehensive examination is necessary to make a diagnosis. Determine the gas composition of blood and acid-base balance, evaluate the level of hemoglobin. Treatment and rehabilitation after carbon monoxide poisoning are determined by the intensity of toxic effects.

Often, in 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, an oxygen mask is connected. In the hospital, complex treatment is carried out, eliminating the consequences of hypoxia.

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

Ascorbic acid is especially useful for patients. At the recovery stage, a healthy diet with a high content of antioxidants is prescribed. Vitamins B1 and B6 are prescribed intravenously. For pain attacks that occur due to burns, analgin is administered subcutaneously or intravenously. Such methods of treatment as hemodialysis, lymphatic drainage are called upon to reanimate 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, a coma develops. Complicating factors also lead to death: the presence of heart and vascular diseases, previous heart attacks, strokes, brain pathologies. A lethal outcome turns into intoxication caused by a huge release of carbon monoxide into the air during explosions and fires.

The negative consequences of long-term carbon monoxide poisoning include interruptions in the functioning of the central and peripheral nervous system, headaches, and ophthalmic disorders. Hypoxia has a detrimental effect on brain activity and gives complications such as amnesia, neuritis, cognitive decline. Delayed effects of prolonged carbon monoxide poisoning are pneumonia, myocarditis.

Prevention

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

Dear readers of the 1MedHelp website, if you have any questions on this topic, we will be happy to answer them. Leave your feedback, comments, share stories of how you survived such a poisoning and successfully coped 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 atmosphere during any type of combustion. In cities, mainly in the composition 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 type hypoxia. Carbon monoxide is also involved in oxidative reactions, disrupting the biochemical balance in tissues.

At-risk groups

Poisoning is possible:

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

Signs and symptoms

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

% about. (20°C)

Time

impact, h

in blood, %

The main signs and symptoms of acute poisoning

≤0.009	≤100	3.5-5	2.5-10	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	Minor headache, decreased mental and physical performance, shortness of breath with moderate physical exertion. Visual disturbances. May be fatal to the fetus, those with severe heart failure
≤0.052	≤600	1
≤0.052	≤600	2	20-30	Throbbing headache, dizziness, irritability, emotional instability, memory disorder, nausea, incoordination of small 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 lethal outcome
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,
- possible visual and auditory hallucinations,
- redness of the skin, carmine-red color of the mucous membranes,
- tachycardia,
- increase in blood pressure.
for moderate poisoning:
- drowsiness,
- possible motor paralysis with preserved consciousness
for severe poisoning:
- loss of consciousness, coma
- convulsions,
- involuntary discharge of urine and feces,
- respiratory failure that becomes continuous, sometimes of the Cheyne-Stokes type,
- dilated pupils with a weakened reaction to light,
- sharp cyanosis (blue) of the mucous membranes and skin of the face. Death usually occurs at the scene as a result of respiratory arrest and a drop in cardiac activity.

When leaving a coma, the appearance of a sharp motor excitation is characteristic. Possible re-development of coma.

Severe complications are often noted:

cerebrovascular accident,
subarachnoid hemorrhage,
polyneuritis,
phenomena of cerebral edema,
visual impairment,
hearing loss,
Possible myocardial infarction
Often there are skin-trophic disorders (bubbles, local edema with swelling and subsequent necrosis), myoglobinuric nephrosis,
With prolonged coma, severe pneumonia is constantly noted.

First aid

Remove the victim from a room with a high carbon monoxide content. If poisoning occurs while using a breathing apparatus, it should be replaced.
With weak shallow breathing or its stop, begin artificial respiration.
Contribute to the elimination of the consequences of poisoning: rubbing the body, applying a heating pad to the legs, short-term inhalation of ammonia (a 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 is touched to the nose due to the powerful effects of ammonia on the respiratory center may cause its 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 at an increased partial pressure of 1.5-2 atm or, preferably, carbogen.

In the first minutes, the victim should be injected intramuscularly with a solution of the antidote "Acyzol". Further treatment in the hospital.
To stop seizures and psychomotor agitation, antipsychotics can be used, such as chlorpromazine (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: bemegrid, corazole, analeptic mixture, camphor, caffeine.
In case of respiratory failure - 10 ml of a 2.4% solution of aminophylline in a vein again.
With a sharp cyanosis (blue), in the 1st hour after poisoning, intravenous administration of a 5% solution of ascorbic acid (20-30 ml) with glucose is indicated. 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
Taking 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 imperceptible when inhaled, does not have a pronounced unpleasant odor, color. In order to help a person with carbon monoxide poisoning, you need to know the symptoms, methods of first aid and treatment. After all, intoxication occurs quickly and has serious consequences: all organs of a person are affected, often this ends with his death.

It is very important to immediately give home care to the poisoned person. In a fire, you can often get poisoned by carbon monoxide, and people die not from fire, but from smoke containing combustion products, including CO2.

First aid for carbon monoxide poisoning of people who accidentally happened to be nearby will be able to restore life to those in trouble, and save them from serious consequences. Such intoxication is classified by ICD-10 code T58 and requires the introduction of an antidote.

Carbon monoxide is a product of combustion of various substances, it is very toxic and poisonous. When inhaled, it spreads rapidly 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 under the ICD-10 code T58 is a mortal danger for the following reasons:

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

The main reason for the rapid death of the victim from CO2 is due to the fact that the gas completely blocks the flow of O2 to the cells of vital organs. At the same time, red blood cells (erythrocytes) die. Hypoxia sets in.

The first lack of air experience the cells of the brain and nervous system. There is a severe headache, vomiting, loss of balance. Toxic gas penetrates the protein of skeletal muscles and heart muscle. The rhythm of contractions gets off, the blood flows unevenly, the person begins to suffocate. The heart beats very weakly and often. Movements are hindered.

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 pockets of unbearable pain in the temples and frontal part;
noise in ears;
loss of coordination and balance;
vomit;
blurred vision, blurred vision;
lethargy of consciousness;
temporary weakening of hearing and vision;
short faint.

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

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

Heart rhythms with mild poisoning become more frequent, aching pains appear in the region of the heart. With the third degree of damage, the pulse reaches 140 beats per minute, but very weak. Often, a real threat of myocardial infarction follows later.

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

Changes in the skin and mucous membranes with CO2 intoxication are not noticeable. Sometimes the face and upper body turns red. With significant poisoning, the skin turns pale, the mucous membranes lose their normal appearance. The blood supply of the epidermis, as well as the whole body, is disturbed.

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

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

Consequences can appear immediately and 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 prolonged pain, lethargy and physical weakness, partial numbness of the limbs. In this state, chronic diseases of the cardiovascular and neurological are exacerbated.

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

Complications of the late period appear within a month after poisoning:

Temporary and rather prolonged amnesia.
Excited nervous state.
Weakening of mental activity.
Lowering the level of intelligence.

Human behavior is inhibited, there is a state of indifference to what is happening, vision is falling. Limbs may be in a state of tremor, excretory functions are not controlled. In severe cases, paralysis occurs.

Problems with the work of the heart occur with any degree of damage. Angina pectoris, cardiac asthma develops, myocardial infarction can occur.

The defeat of the respiratory system turns into pneumonia, burns of the bronchi.

In order to avoid serious consequences, and often just save a person's life, you need to know what measures should be taken in the first minutes after the discovery of the victim. Antidote should be administered as soon as possible.

What to do in case of carbon monoxide poisoning? Action algorithm:

In case of carbon monoxide poisoning, the victim must first of all call for emergency assistance, no matter what state the person is in. Symptoms of carbon monoxide poisoning may not appear immediately, and the lost time will seriously affect the patient's condition. Only a medical professional can reliably assess his state of health. How deeply the poisons have penetrated into the blood, no one can say. Providing first aid for carbon monoxide poisoning and the correct actions of others will reduce the possibility of serious consequences. Time cannot be missed.
Helping the patient before the arrival of doctors is to isolate him from a burning building with a high concentration of CO2. Immediately it is necessary to close the source of distribution of poisonous gas, open windows, doors, transport a person outside the room with fumes. If possible, try to increase the supply of oxygen to the patient's lungs. You can use an oxygen bag, an oxygen concentrator, a special gas mask.
These actions are possible if the devices are nearby. Usually, they don't exist. You need to know how to provide first aid for carbon monoxide poisoning. The victim should be laid on his side horizontally, slightly raising his head. Then it is necessary to relax the upper clothing that restricts the breath, the buttons on the collar and chest, remove heavy, dense things from it.
It is necessary to bring the patient to his senses as soon as possible. Then the blood rushes intensely to the brain. For this procedure, you need to use ammonia, which should be in any car first-aid kit. Cotton wool soaked in it should be brought to the nostrils. To improve blood flow, mustard plasters can be placed on the chest and back. This cannot be done on the projection of the heart. If the person has regained consciousness, he should be given hot sweet tea or coffee to increase blood pressure.
In case of cardiac arrest, before the doctor arrives, you can try to “start the engine” with a manual massage. They do it like this - put the palms on the heart area and make quick strong pressure on the sternum (30 times). Before and after 2 times artificial respiration is done mouth - to - mouth. If a person is conscious, he breathes on his own, he must be covered with a warm blanket and ensure peace. Body temperature should be controlled. In this position, the victim must wait for the arrival of the doctor. He diagnoses according to the ICD-10 code T58.

Video: the effect of carbon monoxide.

The doctor, providing medical assistance on the spot, must immediately introduce 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.

Definitely, the following categories of those poisoned with CO2 should go to the hospital for treatment after PMP:

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

Often poisoning ends in the death of the victim. But people nearby can help to avoid this.

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

In order not to be poisoned by carbon monoxide, helping in case of fire, it is necessary to protect the respiratory tract with a mask made of wet fabric, and not to be in the smoke for a long time.

Treatment after carbon monoxide poisoning according to the ICD-10 T58 code is to remove the effects of damage by toxic toxins. This is the cleansing of organs and the 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, damaged pipes. Cases of deliberate organization of leakage and poisoning with the aim of suicide are not uncommon.

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 devoid of color and smell, dangerous because it is difficult to detect its leakage. In order to protect the population from poisoning, gas with impurities is supplied to residential buildings, apartments, industrial enterprises and boiler rooms to acquire a specific smell.

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

Intoxication in humans is manifested when the content in the air is more than 20% of methane. The negative impact of domestic gas on the body is expressed in the defeat of 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
Light	The victim has rapid breathing, suffocation, headache, dizziness, pain in the eyes, nausea, general weakness, pain in the heart, drowsiness.
Medium	Dysfunction of the brain, vomiting, acceleration of the heartbeat, impaired fine motor skills and coordination, hallucinations, discoloration of the skin to a red or bluish tint, signs of cardiovascular insufficiency appear, and a threat of death develops.
heavy	Brain dysfunction, convulsions, pulmonary edema, palpitations with myocardial damage, lack of response to any stimuli, blue skin, unconsciousness. Death may occur due to the development of acute heart failure.
Instant	There is a strong intoxication, loss of consciousness. 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 is an insidious imperceptible effect on a person. 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 not able 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 at 0.32% carbon monoxide, paralysis occurs, loss of consciousness, after half an hour - death. With 1.2% CO2 in the air, two breaths are enough to die within 3 minutes.

ICD code 10 - X47 (intoxication with a gas or vaporous substance), T58 (toxic effects of carbon monoxide during carbon monoxide poisoning).

Detoxification methods for poisoning with natural gas toxins

Household gas used at home for heating and cooking, consisting of 75-98% methane, is non-toxic. Its negative effect on the human body is expressed in the displacement of oxygen, due to which hypoxia occurs 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 starvation.

With incomplete combustion of methane due to lack of oxygen, carbon monoxide is formed, a deadly poisonous gas.

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, in case of poisoning with vapors of chemicals and gases.

The victim can be assigned plasmapheresis, hemosorption. Extracorporeal detoxification methods are carried out in a hospital and are the purification of blood from harmful substances outside the patient's body. The 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) of carbon monoxide and can be used to prevent poisoning. Half an hour before entering the gas contamination zone in case of accidents, fires, rescue operations, 1 ml of the drug is injected intramuscularly and acts for 2 hours. Victims are shown the introduction of a dose of Acizol. After that, the formation of carboxyhemoglobin, the product of binding carbon monoxide to 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 the dose of application are described in the instructions.

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

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

Oxygen therapy is carried out in this 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 found signs of intoxication, it is necessary to act quickly and competently. You need to call an ambulance. And before the arrival of qualified specialists, it is necessary to provide first aid to victims of a gas leak.

Algorithm of actions in the provision of first aid:

Remove or take the victim out of the house to the street. If this is not possible, you need to quickly turn off the gas, open the windows wide open and organize a draft. In order not to poison yourself, you need to cover your nose and mouth with clothes, a scarf, a towel.
Lay the patient face up, unfasten the clothes, put any object under the legs so that the lower limbs are higher than the head.
Apply cold to the head (wet towel, ice from the refrigerator, frozen foods).
Have the victim drink plenty of water or any non-alcoholic drink.
If there is an urge to vomit, it is necessary to turn the head of the victim to one side, in order to avoid getting vomit into the respiratory tract.
If a person begins to lose consciousness, you need to bring a cotton swab dipped in ammonia under the nose. Periodically give it to smell in order to avoid falling asleep or blackout.
In the absence of 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, start an indirect heart massage. For an adult, 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 chest of the victim.

Properly and quickly provided first aid in case of gas poisoning can save the development of complications, save a person's life.

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

As an additional therapy, household gas poisoning can be treated with the help of breathing exercises. It will help to gradually restore respiratory functions and avoid negative consequences.

Possible complications of intoxication

In case of gas poisoning, diseases of the cardiovascular, nervous, respiratory systems and organs of vision can develop. There may be development of disorders in the form of memory lapses, inhibition of speech, deterioration of attention. It is difficult for a person to concentrate, process and analyze information, formulate and reproduce thoughts.

Especially dangerous is gas intoxication during pregnancy. In case of severe poisoning, the fetus may suffer. Blocking hemoglobin leads to oxygen starvation of the baby. The result of exposure to carbon monoxide in a pregnant woman may be intrauterine fetal death.

It is important to notice the characteristic symptoms of intoxication in time. Proper first aid will relieve the manifestation of dangerous complications.

The risk of getting poisoned due to inhalation of various combustion products lies in wait for a person not only at the time of fires. Intoxication is possible in other cases. Burning grass or spending a lot of time around a fire can also lead to big problems, and sometimes to a quick death.

Combustion products are gaseous, solid or liquid toxic substances resulting from combustion. Their composition depends on what specifically burned, and the conditions in which this process took place.

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

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

According to ICD 10 (International Classification of Diseases), such poisoning corresponds to code T 59.

Causes of intoxication

You can be poisoned by smoke and the products of combustion contained in it 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 the metabolism in tissues and the flow of oxygen into the blood.

You can inhale and get poisoned by substances formed during combustion in such cases:

in case of fire;
during the burning of last year's foliage;
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 a malfunction of the furnaces 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 be poisonous. But even when extinguishing a fire, the danger of poisoning by combustion products is no less:

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

When burning rubber, plastic, paints and varnishes, as well as foam rubber and plywood, poisonous products of their combustion are formed - phosgene, cyanide, dioxin, etc. And if a person managed to be helped in time when poisoning with these products, there is no guarantee that he will not subsequently develop cancer or severe allergies.

Symptoms

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

lacrimation;
"heaviness" in the head;
pain in the temples and frontal region of the head;
sudden hyperemia of the face;
growing weakness;
noise in ears;
acceleration of the heartbeat;
shortness of breath, shortness of breath;
muscle pain both in tension and at rest (myalgia);
vomiting as a symptom of almost all poisonings;
chest pain;
burning in throat;
irresistible severe cough;
loss of consciousness;
overexcitation or drowsiness (if the poisoned person falls asleep in a smoky room, death will occur in a dream without emergency assistance).

The danger is that signs of poisoning can sometimes appear only after a few hours. But even the symptoms that appear immediately sometimes suddenly subside and even completely disappear 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 sense of relief can actually hide the onset of pulmonary edema.

If first aid in case of poisoning for some reason is not received, the patient's condition worsens:

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

With a strong degree of severity of poisoning, in addition to the listed signs, the following are sharply manifested:

frequent breathing;
convulsions;
hallucinations (as a result of long-term toxic effects of medium-concentrated gases);
rave;
the rapid development of heart and lung failure (it happens that after stopping breathing, the heart still continues to beat for some time);
coma.

Sometimes there is simply no time for first aid, even if you start acting right away. 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 after 3 minutes, and the survival rate in such cases is zero.

How to help

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

remove (or take out) the victim to fresh air from the room where the poisoning occurred;
unfasten, tear or cut tight clothing (especially on the chest - a collar, scarf, tie, etc.) to allow the poisoned person to breathe more freely;
give sorbents (Polysorb, activated carbon, Atoxil) diluted in a small amount of water;
drink strong sweet tea;
give ascorbic acid (at least 2 pieces);
wipe the face and chest with a cloth dipped in cool water, a cold compress on the forehead;
if the poisoned person has a fever, apply moderately hot heating pads;
in case of loss of consciousness, bring a cotton swab dipped in ammonia, or wipe the temples with it;
in case of severe weakness and a state on the verge of losing consciousness, lay the victim on his side, clean his mouth and nose from vomit with a handkerchief (if there was vomiting);
control the pulse;
when breathing or palpitations stop, urgently proceed to resuscitation measures (indirect heart massage, artificial respiration).

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

Treatment

Whether it is necessary to hospitalize the poisoned person and how to treat him - the doctors will determine, 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;
in acute CO poisoning - antidote Acizol intramuscularly to improve oxygen transport;
sedation when overexcited;
the drug Eufillin with obvious obstruction of the respiratory tract;
antibiotics to prevent pneumonia;
with convulsions - Barbamil (intravenously, slowly), Phenazepam intramuscularly, magnesium sulfate 25%;
in heart failure intramuscularly Cordiamin, glucose solution with Strofantin intravenously and slowly, caffeine solution subcutaneously;
if there are signs of cerebral edema or suspicion of it - a "cocktail" of Promedol, Aminazin 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: Hydrogen sulfide poisoning in humans

At the same time, the patient is prescribed complete rest, including from negative emotions.

The treatment is complex, multicomponent and rather heavy. Therefore, having been severely poisoned by combustion products, you can not 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 malformations of the unborn child (in case of poisoning in pregnant women);
hypertension;
bronchial asthma;
long-term disturbances in the work of the nervous system.

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

Early complications after poisoning:

neuritis;
hearing and vision impairments;
heart rhythm failures;
swelling of the brain or lungs.

Later consequences:

serious pathologies of the nervous system up to the 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, with death sometimes occurring 2 weeks after poisoning. This is possible when a person, having been poisoned by combustion products, for some reason did not recover (he insisted on a premature discharge or neglected the doctor's prescriptions). Or the victim mistakenly identified his recovery during a false improvement, often occurring a day after the poisoning, and did not consult a doctor.

Have you ever had poisoning with orenium 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 foliage becomes provocateurs, the fire sometimes literally "eats" peat deposits. Particularly dangerous for the human body are materials that are subject to prolonged smoldering.

ICD code 10-T59.

Why are they poisoned by smoke?

Combustion products are called gaseous, solid or liquid chemicals released in the process. The composition depends entirely on the object being burned. Most often, such harmful compounds as CO, SO2, CO2, P2O5 are formed. The atmosphere is literally saturated with vapors of acetone, alcohol, 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 likely 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 on plastic, plastic, rubber fires 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 bath, household when the furnace pipeline is worn out.
Damage is possible when the vehicle warms up. Oil distillation products, gasoline and diesel fuel, quickly saturate the air of a closed garage. At the same time, the person falls asleep and cannot resist intoxication.
The hidden threat is tobacco smoke. It doesn't matter whether one develops 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 delivers toxins comparable to smoking 40 cigarettes.
Smoke poisoning is especially susceptible to women during pregnancy, as well as a child suffering from respiratory diseases. Carbon monoxide negatively affects the development of the fetus.
If you rest in nature in wet weather, smoke particles easily combine with water, which increases the risk of injury.

Breeding a fire can lead to massive burning of dried leaves, shrubs, trees. In this case, it will be necessary not only to treat the consequences of poisoning, but also to be legally responsible for the forest fire. There is also the possibility of being burned alive.

Signs of intoxication

Unfortunately, symptoms do not always appear immediately. Sometimes a distant effect is characteristic, sometimes the clinical picture disappears in a day, and then arises with renewed vigor.

The main signs of poisoning:

Rapid increase in weakness.
Feeling of heaviness in occipital region.
Pain in the temples, joints, muscle tissues.
The skin of the face and neck acquire a reddish tint.
Breathing is difficult.
The pulse quickens.
There is noise in the ear canals.
The person is sleepy.
There are bouts of nausea and vomiting.
Irritation of the mucous membranes of the larynx and bronchi provokes a hacking cough.
Exposure to acrid smoke leads to fainting.

In the absence of PMF, combustion products settle in the lungs, causing swelling of the tissues. Severe poisoning is the cause of convulsions, cardiovascular failure.

Ascertain death as a result of cardiac arrest or paralysis of the respiratory center.

First aid

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

You need to call the medical team.
The person is taken out to fresh air, away from the possible influence of combustion products.
Unfasten tight clothing - nothing should interfere with breathing.
If he is conscious, give him sweet and strong tea to drink.
Activated charcoal or other sorbents are used to remove toxins.
They wipe the temporal zones with a swab dipped in a solution of ammonia - this measure will prevent fainting or return from it.
Sometimes there is chills. A heating pad applied to the legs will help get rid of it.
If the victim does not respond to first aid, lay on one side, which will prevent choking with vomit.
Monitor pulse and respiration. In the absence of resort to artificial ventilation and indirect heart massage.

Such pre-medical therapy at home will reduce the symptoms of smoke poisoning. Arriving emergency workers will assess the situation and, if necessary, transport to the hospital.

Treatment Methods

What medical procedures are shown:

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

Assistance is also aimed at preventing coma or withdrawal from this state. Apply corticosteroids, hormones, ascorbic acid, vitamin complexes.

Therapy is long-term, while complete rest must be observed.

Possible consequences

Poisoning with carbon monoxide and other products often causes complications:

Even with mild exposure, a pregnant woman can lose her baby.
The risks of developing hypertension, bronchial asthma, and CNS disorders are high.
People who have undergone exposure to chemical compounds are prone to neuritis, problems with hearing and vision.
Serious consequences are also swelling of the brain, lung tissue.

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

Prevention

You can avoid the problem by following simple recommendations:

Quit smoking.
In case of fire, immediately leave the room, and also use protective equipment - respirators.
Exercise caution when lighting a fire.
Timely change the pipelines of gas stoves.
Do not forget to open the view during stove heating, when visiting a bath.
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 CNS damage. Cerebral disorders are manifested by headache with localization in the temporal and frontal regions, often of a girdle character (symptom of a hoop), dizziness, and nausea. Vomiting occurs, sometimes repeated, loss of consciousness develops up to a 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 live reaction to light. Unsteadiness of gait, impaired coordination of movements, tonic convulsions, spontaneous myofibrillations are noted.

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

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

Disorders of mental activity can be manifested by excitement or stunning. An excited state, manifested by symptoms of acute psychosis (disorientation, visual-auditory hallucinations, persecution mania), is typical for situations associated with emotional impact (fires, explosions of bombs, shells, etc.). In case of household poisoning and poisoning from car exhaust gases, a state of stupor, stupor or coma is typical.

In some cases, in addition to hemic and tissue hypoxia, hypoxic hypoxia also develops, caused by inspiratory dyspnea 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 respiratory and then metabolic acidosis.

When carbon monoxide is inhaled at a high concentration, 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 circulation disorders are usually detected: the R wave decreases in all leads, especially in the chest, 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, resembling a myocardial infarction. These changes usually disappear quickly as the general condition of patients improves, however, in severe poisoning, coronary ECG disturbances 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 the victims, due to rapid loss of consciousness, are in an uncomfortable position for a long time, with twisted and squeezed limbs (positional injury). In the early stages of skin-trophic disorders, bullous dermatitis is observed with hyperemia of skin areas and swelling of subcutaneous tissues. Sometimes trophic disorders take the form of ischemic polyneuritis, which is expressed in the atrophy of certain muscle groups, impaired sensitivity and limited function of the limbs.

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

If the 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 intoxication 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 apoplexy and syncopal forms.

In a typical form of mild poisoning (HbCO level 10-30%), a 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, there is a slight increase in respiration, pulse and a moderate increase in blood pressure. These symptoms disappear a few hours after the cessation of CO, with the exception of headache, which may persist for up to a day or more.

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

Severe poisoning (HbCO level 50-70%) is accompanied by a complete loss of consciousness and a 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 hue. The pupils are maximally dilated. The pulse is frequent, blood pressure is sharply reduced. Breathing is disturbed, may be intermittent such as Cheyne-Stokes. Body temperature rises to 38-40 ° C. Muscles are tense, attacks of tonic or clonic-tonic convulsions are possible. In the future, a coma develops, staying in which for more than a day is an unfavorable prognostic sign.

Severe cases of CO poisoning on the 2-3rd day may 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.

Clinical forms of the fulminant variant of poisoning are apoplexy and syncopal forms.

The apoplexy 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 after 3-5 minutes, after a short 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 desolation 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, the fight against it is the main direction in providing medical care to victims. The poisoned should be evacuated from the polluted atmosphere as soon as possible, taken to fresh air.

First aid for ARF is usually provided in the form of self-help and mutual assistance and consists in ensuring the patency of the respiratory tract, artificial ventilation of the lungs using the mouth-to-nose, mouth-to-mouth methods, chest compressions.

First aid includes, in addition to the measures taken, the introduction of bronchodilators, the implementation of oxygen inhalation, artificial respiration using air ducts, indirect heart massage in a terminal state.

For the treatment of those affected by carbon monoxide, oxygen therapy is used, which can be attributed to 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 - 40-50% oxygen-air mixture. The most effective treatment for poisoned CO, especially moderate and severe, is oxygen barotherapy (OBT), when oxygen is supplied under high pressure.

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

The rest of the drug therapy for CO poisoning is symptomatic. When excited, the introduction of sedatives is indicated, and with a convulsive syndrome, the introduction 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. With a sharp excitation and phenomena of cerebral edema - a lytic cocktail: chlorpromazine (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 introduction of morphine is strictly prohibited.

Respiratory failure and airway obstruction due to bronchospasm are an indication for intravenous administration of 10 ml of a 2.4% solution of aminophylline. In heart failure - subcutaneously 1-2 ml of a 20% caffeine solution, 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 severe intoxication and the development of coma for the prevention and treatment of cerebral edema - an ice pack on the head or craniocerebral hypothermia, intravenously 40 ml of 40% glucose solution with 4-6 ml of 5% ascorbic acid solution and 8 IU 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 intoxication is occupied by the fight against metabolic acidosis - 250-400 ml of a 2-6% solution of sodium bicarbonate is prescribed intravenously. Intravenously or intramuscularly, 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 inject in one syringe) in order to correct tissue metabolism disorders. Measures are being taken to prevent and treat toxic pulmonary edema, antibiotics are prescribed in usual dosages to prevent pneumonia.