Friday, September 16, 2016

Carbon Monoxide

Carbon monoxide (hereafter referred by its chemical symbol CO)
This post could save your life. How many of you own a Carbon Monoxide alarm? If you do, good for you. Make sure that it is in good working order. The units do not last  forever. Batteries need to be changed annually (at least) and some units suggest that you vacuum the cover monthly to remove accumulated dust. If you are one of the many who do not yet own one, please remedy that immediately. As of January, 2013, with few exceptions, it is the law.

Homes with a  fireplace, attached, garage, any gas appliances are at higher risk but there are many different factors that can cause an elevated level. A friend of mine is a lawyer who was involved in a heartbreaking case where a guest at a Bay Area hotel sustained long term health impairment from an exposure. The victim’s room was above the hotel pool and a faulty boiler used to heat the pool vented carbon monoxide into his room. When he didn't show up for dinner, his friends found him unresponsive. It was a very alert physician in the emergency room who figured out the cause. It was only at that point that the hotel was evacuated. This is not an isolated incident.
As a result, my lawyer friend takes a portable detector along with him on all of his travels!

Because heaters and fireplaces are often involved, exposure is usually higher during the winter months.

Carbon monoxide is a colorless, odorless and tasteless poison gas that can be fatal when inhaled. CO binds to hemoglobin with much greater affinity than oxygen, forming carboxyhemoglobin (COHb). It is hundreds of times more efficient than oxygen at attaching to the cells, so even small amounts can deprive our bodies of vital oxygen. In severe cases, for folks who survive an exposure, it can cause irreversible brain damage by starving the brain of oxygen.

Normally if someone is deprived of oxygen they may look pale or cyanotic (bluish); in the case of CO poisoning, the color will remain nice and pink. A standard pulse oximeter may not be an accurate indicator of where or not there is a problem. If carbon monoxide exposure is suspected a blood test can be done to check the carboxyhemoglobin level.
One of our local ER docs who allowed me to pick his brain added that one of the tricky things about CO poisoning is that the symptoms are very vague and nonspecific. A faster than normal heart rate (tachycardia) is the only really reliable physical exam finding.

Mild exposure  might cause slight headache, nausea, vomiting and fatigue. This can easily be mistaken for flu or viral syndrome. Medium exposure  symptoms would be a throbbing headache, drowsiness, confusion and a rapid heart rate. Extreme exposure will lead to unconsciousness, seizures, and cardio-respiratory failure that usually is fatal.
The effects of exposure can vary greatly from person to person depending on age, overall health, and the concentration and length of exposure. Young children and pets are thought to be especially vulnerable. Pregnant women should also be especially careful because the fetus can be seriously  impacted.

A carbon monoxide alarm is similar to a smoke detector because it monitors the air in your home and sounds a loud alarm to alert you of trouble. However, the way you respond to a CO alarm is very different than a smoke detector. When a smoke detector goes off, it is pretty easy to to judge the level of danger. You can see or smell the smoke.
On the other hand, because CO is completely undetectable to your senses, you are dependent on the alarm to let you know there is a problem. If the alarm sounds:

  • Operate the test/reset button
  • Call 911
  • Immediately move to fresh air. (make sure that everyone in the household is     accounted for)
  • Do not go back in until  you have the all clear from the emergency responders.

Concentrations of CO between 1 and 30 ppm can often occur in normal, everyday conditions. See the chart below for CO levels and corresponding symptoms.

If your unit is coming to the end of it’s life it may give off multiple chirps to notify you that you need to replace the device or change the batteries. Newer alarms might be good for as long as 10 years.  Ours has a digital display that will signal when it is time to replace it.

Just last month my daughter Alana had her CO alarm go off in her apartment in Michigan. She knew enough to get outside and call 911 immediately. After the fact she recounted her conversation with the fireman who had responded:

“I am worried about my cats, can you help get them out?”
“What do they look like?
“They are CATS, they are furry, have 4 feet and tails!”

Happily the kitties were all safety brought out of the apartment.

The best guess for what set off the alarm was something faulty with the air conditioning system. You may not think that your home is at risk, but there is NO downside for investing in an alarm (plus you are complying with the law.) They are inexpensive. If you are renting and there is not a unit in your apartment, call your landlord immediately and get that remedied.

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