Poisoning in humans by products of combustion. Signs of household gas poisoning and first aid algorithm Carbon monoxide poisoning, microbial code 10

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 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 insufficient heat 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 combustion products damage the bronchi, quickly accumulate in the lungs and severely burn the mucous membranes. 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 poisoned by 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, without emergency assistance death will come in a dream).

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. There are no miracles 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.

At strong degree severity of poisoning, in addition to the listed signs, 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.

Effects

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

After mild form 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?

Carbon monoxide is formed as a result of the decomposition of combustion products, it can pollute environment. When breathing, toxins enter the lungs and cause severe harm to human health. The ICD-10 code is T58.

The allowable rate of gas in the air, harmless to humans, is 0.08 mg per 1 liter, with overestimated rates, you can get poisoned. The content of CO in the environment directly affects the severity of poisoning.

At a concentration of 3-5 mg per 1 liter of air, severe intoxication occurs. If the air contains toxic substances in the proportion of 13-15 mg/l, death occurs within 1 to 3 minutes.

Death from fumes is the fourth most common cause of reported deaths. Leaks of carbon monoxide are found in everyday life, at work.

Causes of poisoning

Carbon monoxide is formed and concentrated in the air during the combustion of organic substances. Most common causes carbon monoxide poisoning in humans is a conflagration. A person cannot detect a threat due to the absence of a smell from the gas. More often than others, children, persons with cardiac pathologies, women during pregnancy are susceptible to intoxication.

The factors listed below affect the increase in the concentration of gas in the room.

life factor

News is often broadcast that in domestic conditions intoxication occurs when the rules for using stove and gas equipment are violated. A common case is the ignition of electrical wiring.

If you stay near a running car for a long time in a closed garage, a person can burn out.

Signs of intoxication may appear in hookah lovers.

production factor

Carbon monoxide, known as carbon monoxide, fills mines when blasting is carried out. Accumulations are found during maintenance of open-hearth furnaces or blast furnaces. There are frequent cases of carbon dioxide emission during the synthesis of chemical components. occurs when the norms of sanitation and hygiene, operational requirements related to the operation of devices are violated.

Pathogenesis

Being in an unfavorable environment, a person breathes poisoned air, the poison settles in the lungs. From there it spreads through the body through the blood. Carbon monoxide at the cellular level is similar to hemoglobin - it quickly penetrates into the blood structure, blocking the ability to transport oxygen. There is a hypoxic reaction. The condition of the victim worsens greatly when the violation of biochemical processes fermented by iron content begins. The accumulation of underoxidized metabolites begins, affecting the central nervous system and organs. This condition is difficult to treat.

Studies with a pathological bias reveal a crimson color of the skin, organs and mucous membranes. The brain and lungs acquire signs of edema. The plethora of stagnant nature in the internal organs is clearly traced. Areas with dead tissues appear on the brain, heart and lungs.

Classification

The course of poisoning is possible in two forms:

Acute leakage;
Chronic.

The course of intoxication depends on how strong the concentration of carbon monoxide is in the room, and how much time the person spent inside. If the dose exceeds the permissible norms and affects the body for a short time, the nature of the poisoning is acute. If the concentration is exceeded slightly, and the inhalation of poisoned air occurs constantly, a chronic process develops.

Toxicology divides carbon dioxide poisoning into three degrees:

The degree of light tolerance. The characteristic of a mild degree is manifested through the transient symptoms of pathologies that can develop. Signs of poisoning disappear as soon as the exposure stops. Some manifestations characteristic of carbon monoxide intoxication persist for a day. An analysis for pathological hemoglobin shows 30% of the total blood volume.
The average degree of tolerance. Reveal 30-40% of the content of carboxyhemoglobin. Symptoms of carbon monoxide poisoning are pronounced, but when provided health care, the process is slowed down. A few days there are phenomena of a residual nature.
The degree of severe tolerance. Carboxyhemoglobin occupies half of the total mass of blood. Organs and systems are severely affected, which often causes death. The consequences develop in the form of complications. Each symptom appears within two to three weeks.

Ordinary forms of intoxication do not always apply to carbon monoxide. Often there are atypical manifestations. They easily disguise themselves as other pathologies. Toxicology knows the forms, divided by clinical symptoms:

euphoric;
syncope;
lightning fast;
powder.

Symptoms

Symptoms of carbon monoxide poisoning are divided according to the degree of poisoning. Similarities are possible, but each phase has its own characteristics.

The symptoms that occur during carbon monoxide intoxication must be known in order to provide emergency assistance in time.

Mild poisoning occurs frequently, is characterized by manifestations:

Systematic headache, the victim knocks in the temples;
Haunted cough, dry and irritating, interfering with free breathing;

Attacks of dizziness;
Nausea, outpouring of vomit;
There is lacrimation;
Appear pain in the chest;
The emergence of visions, visual, auditory;
The epidermis of the scalp becomes purple;
Persistent increase in blood pressure;
Pulse quickened.

The average degree of intoxication is characterized by:

Great weakness and desire to sleep;
Feeling tired, there is noise in the ears;
Muscles are paralyzed.

Acute poisoning requires emergency measures:

The person loses consciousness;
There is an uncontrolled release of urine and feces;
Violations of the respiratory process are noticeable;
The victim experiences convulsions;
The epidermis and mucous membranes turn blue;
Dilated pupils do not respond to light;
The patient falls into a coma.

If, in case of severe intoxication, medical assistance is not provided on time, a lethal outcome is guaranteed. With a mild or moderate form of poisoning, the consequences of an irreversible etiology may occur:

Constant whirling and pains of the head, the latter take the form of a migraine;
Irreversible disorders of the central nervous system;
Development regression;
The victim has difficulty remembering information;

Intellectual abilities are not developed.

If intoxication is severe, the consequences are:

Poor cerebral circulation;
Multiple disorders of nerve endings;
Edema appears in the brain;
Vision and hearing deteriorate or completely disappear;
Edema appears in the lungs, flowing into inflammation of the lung tissue.

First aid and treatment of intoxication

First aid for carbon monoxide poisoning consists of a series of measures with the obligatory call of physicians. If it is suspected that a person has died, evacuation from the affected area should be immediate.

Providing assistance involves a number of actions. The patient needs to provide enough fresh air. Warming up is one of the first steps. To be able to improve the function pulmonary respiration the victim should drink tea or coffee. Avoid hypothermia.

Absent breathing or its weak manifestation leads to artificial respiration, which is done by counting pressures per minute. First aid includes actions to improve blood circulation for the brain. For this purpose, a person is rubbed on his chest and back, if possible, mustard plasters are applied. The victim lies on his side and waits for the ambulance to arrive. In a nutshell, these are first aid actions.

Upon arrival, an ambulance administers an antidote and oxygen therapy.

Doctors need to be told what circumstances caused the poisoning. If the victim cannot independently give an answer, the place of occurrence should be examined. Remember the details and point them out to the doctors. If a crime or suicide has occurred, the medical history should contain information.

If necessary, the patient is resuscitated. Hospitalization is mandatory. In the hospital, the victim is tested and prescribed treatment.

In the hospital, a person will undergo a course of detoxification and symptomatic therapy.

It is mandatory to put droppers with cardiotropic drugs, make anticonvulsant injections. Diuretics and vitamins are prescribed. Hyperbaric oxygen therapy is performed only if severe forms poisoning.

Treatment with home remedies

Carbon monoxide is a dangerous gas that causes serious consequences after poisoning. When conducting medical examination the degree of influence on the body is revealed. If the doctor allows therapy at home, then the following measures can be applied at home:

Rhodiola rosea extract helps to restore the body's activity. Tincture without a prescription is purchased at a pharmacy. Reception occurs 2 times a day according to the instructions. It is important not to use the medicine after 7 pm, but to use the drug, accompanied by a cocktail, which includes water and honey.
An antitoxic agent is a decoction based on the roots of dandelion officinalis. 10 g of dried roots are poured with a glass of boiling water and boiled over an open fire for 10-15 minutes. The broth should be infused for 30 minutes, then it is filtered and brought to the original volume with boiled water. The remedy is taken 3 times a day, 1 tablespoon.

Getting into the hospital is not unreasonable. You can not self-medicate if you can get qualified help. The result of home treatment without medical supervision can adversely affect health! Quality treatment occurs only under the supervision of a specialist.

Precautionary measures

Pathologies that occur after carbon monoxide poisoning are difficult to eliminate. Some phenomena will accompany a person all his life. In order to avoid dangerous situations, it is necessary to observe precautionary measures, constant prevention is needed:

Operation of heaters only in good condition;
If there is stove heating in the house or in the bathhouse, the ventilation is cleaned frequently, and the chimney is checked every time before the stove is ignited;
Before kindling the fireplace, check the damper;
A running car cannot be left in the garage;
Avoid staying on smoky roads.

Clinical picture 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 muscle tone extremities, increase and expansion of tendon reflex zones, the appearance of Babinski's and Oppenheimer's symptoms.

Special attention attention should be paid to the occurrence of hyperthermia, which is of central origin and is considered as one of the early signs 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 due to inspiratory dyspnea. central genesis and violation of the patency of the upper respiratory tract as a result of bronchorrhea and hypersalivation. Impaired function external respiration, tissue and hemic hypoxia, 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 they improve. general condition patients, 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 kidney failure due to myoglobinuric nephrosis of varying severity.

If the poisoning has occurred recently, then the skin and visible mucous membranes are scarlet (the scarlet color is due to carboxyhemoglobin). Skin patients in a state of severe hypoxia are 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: delayed - with typical and euphoric forms. clinical course and lightning-fast - 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 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 medium degree severity (HbCO level 30-40%), these symptoms are more pronounced. There is muscle weakness and adynamia; sometimes so pronounced that despite the danger, life threatening, 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 total loss 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 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 lightning 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, conducting 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. Most effective method treatment of 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 administration 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 drug therapy 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 indications for intravenous administration 10 ml of 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.

Carbon monoxide poisoning is one of the most common poisonings. It occurs due to the inhalation of air filled with smoke or. The toxic effect on the human body of this colorless, odorless gas is undeniable, but the exact mechanism of its action has not yet been proven.

It is important to know that intoxication resulting from poisoning occurs with complications and negatively affects the functionality internal organs and systems in both children and adults.

How does carbon monoxide poisoning happen?

The saturation of the air with toxic vapors, due to their lack of organoleptic properties, is difficult to determine without special instruments. Therefore, poisoning often occurs both at home and at work.

If you use heating columns with poor ventilation at home, faulty stove installations, then saturation of the air with a toxic substance cannot be avoided. Also, intoxication of the body with poisonous gas is often observed as a result of a long stay in closed parking lots and garages with a large concentration of cars. The saturation of space, in such places, is as fast as possible. Sometimes symptoms of intoxication are observed in active smokers and lovers of hookahs.

For poisoning, it is enough to inhale air containing 0.1% CO2. The severity of intoxication is also affected by the time factor of CO impact on the body. There is also a certain risk group of people in whom the process of acute intoxication occurs an order of magnitude faster.

The risk group includes:

women during pregnancy;
children;
old men;
young people with weakened immunity after illness.

According to the international classification of diseases ICD-10, the poisoning of this type is assigned the code T58.

Symptoms of carbon monoxide poisoning

Carbon monoxide binds red blood cells and prevents them from transporting oxygen to human organs and tissues. Thus, it inhibits mitochondrial respiration and the process of saturating the body with oxygen. Suffering from lack of oxygen nervous system, respiratory organs, the work of the heart is confused and the vascular tissue is deformed. Carbon monoxide poisoning is divided by physicians into three stages of severity. (stages below)

First easy stage with timely assistance, it passes quickly and the symptoms subside without complications. The average and severe stages of intoxication provoke the development of the victim serious complications. With prolonged inhalation of air saturated with carbon monoxide, even death is possible.

Mild stage symptoms:

pulsation in the temporal region, squeezing headache;
blurred consciousness;
noise or ringing in the ears;
pre-fainting state;
mild nausea;
decreased vision, tearfulness;
discomfort in the larynx, causing coughing fits;
hard breathing.

With more prolonged inhalation of carbon monoxide, symptoms rapidly worsen. At the initial stage of poisoning, the concentration of carboxyhemoglobin in the body reaches 30%, then at the middle stage this figure reaches 40%.

Moderate symptoms:

temporary unconsciousness;
a feeling of stupor and a violation of general coordination in space;
severe shortness of breath;
cramps in the limbs;
insufficient oxygen supply to brain cells leads to hallucinations;
pressure in the chest area;
difference in the size of the pupils of the eyes;
temporary or permanent loss of hearing and vision.

If carbon monoxide poisoning continues, severe poisoning is diagnosed. It can be complicated by a rapid course, when a person dies in a few minutes.

Main symptoms:

falling into a coma, which can last several days;
severe convulsions leading to paralysis;
weak pulse and dilated pupils;
intermittent shallow breathing;
bluish skin and mucous membranes;
spontaneous excretion of urine and feces.

The above signs are characteristic of the three standard forms of carbon monoxide poisoning. Some victims show atypical symptoms that are not described above.

Non-standard symptoms:

a sharp decrease in pressure to 70-50 mm Hg, which leads to fainting;
excited state (euphoria) with hallucinations;
a state of coma with a fatal outcome (rapid course).

First aid for gas intoxication

An objective assessment of the situation and its severity can only be medical workers, so you must immediately call ambulance. Prior to her arrival, it is advisable to provide the victim first aid which will reduce the risk of complications.

Before the arrival of the doctors you need:

neutralize the source that emits carbon monoxide;
provide the victim with an influx of fresh air (help him go outside or open windows);
release the person from tight clothing, unfasten the top buttons and loosen the belt to ensure better patency of clean air into the lungs;
do not let the victim fall asleep, try to keep him conscious until the doctors arrive, using ammonia.
when the victim regained consciousness, it is necessary to give him absorbent drugs, for example, Polysorb. It actively cleanses the body of toxic substances.

This should be first aid for carbon monoxide poisoning until the arrival of doctors. Next, the doctors themselves will diagnose, administer an antidote and decide on the need for hospitalization. The actions of physicians in case of carbon monoxide poisoning should be clear and quick.

They include the following manipulations:

using an oxygen mask to restore breathing;
the use of the drug Acizol, which is an antidote because it destroys carboxyhemoglobin molecules;
subcutaneous injections of caffeine to normalize the heart rhythm;
intravenous injections of the enzyme Carboxylase, which also destroys carboxyhemoglobin;
hospitalization of the victim complete examination and symptomatic therapy. The antidote is administered daily at 1 ml for a week.

Treatment at home is possible only in the case when an overdose of poisonous gas did not lead to serious consequences. The first degree of poisoning (lightened) in adults is removed quickly and does not have any serious consequences in the future. A certain category of victims needs an additional health examination in a hospital, after carbon monoxide poisoning.

This list includes:

pregnant women;
victims with concomitant diseases of the heart and blood vessels;
adults with neurotic disorders;
victims with low temperature body.

When is medical assistance required?

All cases of acute poisoning with corresponding symptoms suggest the provision of emergency medical care. Depending on the general condition of the patient, he is registered in the department intensive care or in intensive care. When first aid is provided, the victim may need to continue treatment aimed at restoring the work of all organs and systems.

Consequences and prevention

Carbon monoxide poisoning causes many unpleasant health complications in people. Physicians divide them into two groups. Early complications appear immediately after poisoning, and late complications appear weeks or even months later.

Early complications:

regular headaches and dizziness;
slowness of movement and low sensitivity fingers and toes;
violation of the functioning of the intestines and urea;
deterioration of vision and hearing;
unbalanced mental state;
swelling of the brain and lungs;
violation of the outflow of blood and failures in the heart rhythm;
death due to cardiac arrest.

Irritation, a feeling of sand in the eyes, redness are only minor inconveniences with impaired vision. Scientists have proven that vision loss in 92% of cases ends in blindness.

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Late complications may appear after 30-40 days. long time manifestations of pathologies due to the fact that they develop as the work of internal organs and systems worsens. Most often, pathologies are determined in the work of the heart, blood vessels, respiratory organs and the nervous system.

These include:

decreased limb activity leading to paralysis;
development of amnesia;
heart attack (may cause cardiac arrest);
ischemic disease of the heart muscle;
cardiac asthma.

All of these diseases develop as a result of acute carbon monoxide poisoning and the provision of 1 help late.

What to do to protect yourself and your loved ones from poisoning? Number one on the list preventive measures- Strict adherence to fire safety regulations. People often carelessly follow these rules, causing accidents.

To exclude the possibility of carbon monoxide poisoning at work and at home, it is recommended to stop using broken gas and electrical equipment. It is not necessary to stay in a closed room where cars work for a long time. All industrial garages and basements must be equipped with a powerful ventilation system.

Video with Elena Malysheva about carbon monoxide

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, 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 chemical substances 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 former interferes with the production of hemoglobin and 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 by professional means causes 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 warmed up vehicle. 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 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 massage hearts.

Such pre-medical therapy at home will reduce the symptoms of smoke poisoning. On-call workers emergency care 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.
Greater risk of developing hypertension bronchial asthma, CNS disorders.
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.