“This case report presents a 67-year-old man with CO poisoning who developed delayed neurologic sequelae (DNS) due to delayed diagnosis and missed therapeutic window for HBOT. Investigation of CO poisoning requires taking a detailed history to avoid delays in diagnosis and treatment.”
“To the best of our knowledge, this is the first report of combined ischemia of the colon, brain, and heart as complications after CO poisoning. Physicians should be alert for the rare and potentially deadly complication of ischemic colitis when managing patients with severe CO poisoning.”
“Accidental carbon monoxide poisoning deaths increased from 2015-2021 for the first time in four decades.”
Carbon monoxide poisoning mortality in the United States from 2015-2021 – PubMed (nih.gov)
ABSTRACT
Hampson NB, Holm JR.
Comparison of four low-level carbon monoxide alarms suitable for home use
or when traveling. Undersea Hyperb Med. 2022 Third Quarter; 49(3):307-313.
Introduction/Background: Interest in carbon monoxide (CO) alarms that are more sensitive than is
required for standard residential CO alarms is growing, as reflected by increased marketing of “low-level” alarms capable of measuring CO levels as low as 10 PPM. At the same time, publicity surrounding
CO poisoning events among travelers in lodging facilities has stimulated interest in travel CO alarms.
We sought to evaluate four low-level alarms that could be used in the home and especially when
traveling.
Materials/Methods: Two each of four brands of low-level alarms (CO Experts, Forensics, Kidde, and
Sensorcon) were acquired by retail purchase and tested. The eight alarms were simultaneously
exposed in an environment with a slowly increasing level of CO from indoor burning of charcoal
briquets. CO levels displayed on the alarms were recorded once per minute. Activation of preset alerts
on the alarms were noted. Finally, alarms were compared for ease of use and features available.
Results: All brands of alarms measured CO similarly over the range from 10-120 PPM. All alarms
performed as claimed by their manufacturers, both regarding range of CO reported and preset alert
activation. Each alerted at CO levels below that required by the Underwriters Laboratories 2034
Standard.
Summary/Conclusions: Since all low-level CO alarms tested measured CO similarly, consumers seeking
a low-level CO alarm for use while traveling should base their decision on features desired and price.
There are definite differences between the alarms tested, in terms of features, expected durability,
ease of operation and price.
Full article available here:
“More studies are needed to determine the best practice guidelines for CO poisoning. However, the best evidence supports the use of HBO2 in acute CO poisoning, particularly Weaver’s well done 2002 study….It is better to err on the side of treating with HBO2 because the benefits of treating outweigh the risks.”
Hyperbaric Treatment of Carbon Monoxide Toxicity – StatPearls – NCBI Bookshelf (nih.gov)
“Aphasia was the presenting symptom of CO poisoning in this case, thus making it unique. Despite having a relatively high COHb saturation, the patient showed no classic symptoms such as headache, nausea, vomiting, or drowsiness.”
Cureus | Atypical Presentation of Carbon Monoxide Poisoning With Aphasia | Article
“A team of researchers led by Professor Hiroaki Kitagishi from Doshisha University in Japan has developed a synthetic heme-model compound called “hemoCD-Twins” that acts as an antidote for CO and HCN poisoning. The researchers detail the development of this novel antidote in a recent research article published in the Proceedings of the National Academy of Sciences.”
“The findings of this research suggest that exposure to a relatively low amount of CO (raising exhaled CO levels by only 3ppm) was sufficient to cause not only changes in brain activation, but also in cognitive task performance…This does pose the question of how ambient CO pollution may be affecting our neurovascular health…”
Jenkins Foundation hotel incident data is included in this new NFPA Fire Protection Research Foundation report which gives a comprehensive look at CO data collection in the U.S., with a focus on commercial building exposure incidents.
Carbon Monoxide Incidents: A Review of the Data Landscape (nfpa.org)
Taiwan:
Background: Carbon monoxide (CO) is a colourless, odourless toxic gas produced during incomplete combustion of carbon-based fuels. Most CO incidents reported to the UK Health Protection Agency (HPA) are due to faulty gas appliances, and legislation exists to ensure gas appliances are properly installed.
Methods: We present three CO poisoning incidents of unusual origin reported to the HPA. In each, residents living above restaurants were poisoned after workers left charcoal smouldering overnight in specialist or traditional ovens whilst ventilation systems were turned off. This led to production of CO, which travelled through floorboards and built up to dangerous concentrations in the flats.
Results: Working with local authorities, these incidents were investigated and resolved, and work was conducted to prevent further occurrences.
Conclusions: The novel nature of these CO incidents led to delays in recognition and subsequent remedial action. Although previously undescribed, it is likely that due to the number of residences built above restaurants and the rising popularity of traditional cooking methods, similar incidents may be occurring and could increase in frequency. Multi-agency response and reporting mechanisms could be strengthened. Awareness raising in professional groups and the public on the importance of correct ventilation of such appliances is vital.
“The largest occurrence of carbon monoxide poisoning in Britain demonstrates the potential for mass accidental poisoning. It emphasises the need for strict public health controls and the importance of good liaison between emergency services to ensure that such events are quickly recognised and that the necessary resources are organised.”
Mass carbon monoxide poisoning – PMC (nih.gov)
“An epidemiologic and clinical investigation of 184 persons exposed to toxic levels of carbon monoxide (CO) in a public high school has been carried out. Exposure to 500 ppm of CO for periods up to 150 minutes resulted in carboxyhemoglobin (COHb) levels as high as 30% and symptomatic illness in 87% of persons exposed before the possibility of mass CO poisoning was recognized.”
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