Carbon Monoxide Poisoning

Often called "the silent killer," carbon monoxide is a colorless, odorless, tasteless gas that can be fatal when inhaled. Smoke from fires, backdrafts from blocked chimney flues, grills that use charcoal or chemical fuels, emissions from faulty gas heaters, and the exhaust of motor vehicles, boats, emergency generators and appliances are all common sources of carbon monoxide.

Accidental deaths from carbon monoxide tend to occur in the home during the winter, usually at night while people are sleeping and unaware of the danger. But you can also get CO poisoning in summer if you use a fuel-burning heater or lamp inside a tent or run a gas-burning heater, lantern, or stove in a boat.

What to watch for

Symptoms of carbon monoxide poisoning include:

• Headache
• Dizziness
• Nausea
• A flushed, blotchy, red face
• Weakness and light-headedness
• Confusion
• Inability to move or concentrate
• Chest pain
• Rapid, distressed breathing
• Unconsciousness
• Coma
• Vomiting
• Sleepiness
• Seizures
• Fatigue
• High levels of carbon monoxide can cause also cause the skin to turn gray-blue with a faint red tinge.

What to do

If you suspect someone is suffering carbon monoxide poisoning:

• Call 911 immediately and ask for both the fire and ambulance services.
• Before you attempt a rescue by entering any garage, hall, or room that you suspect may contain carbon monoxide, open the doors or windows wide to let the gas escape.
• Get the victim into fresh air immediately. Choose a place upwind of the poisonous fumes. If the victim is unconscious, open the airway. Check breathing and pulse. Perform CPR if necessary.
• Loosen tight clothing around the victims neck and waist.
• Seek medical attention even if the victim seems to recover. It is important for a doctor to assess whether any lasting damage has been done by exposure to carbon monoxide.

How to prevent carbon monoxide poisoning

• The Consumer Product Safety Commission recommends installing a CO detector in the hallway near every separate sleeping area of the home. Depending on the size of your house or apartment, one monitor may not be enough.
• Schedule annual inspections of all furnaces and gas appliances to make sure they are properly installed and operating with adequate ventilation.
• Make sure the flue is open before starting a fire in the fireplace.
• Have your chimney or flue inspected and cleaned once a year.
• Never burn charcoal inside a vehicle, tent, or inside your house, or in unventilated areas outside (such as garages). In some cases, entire families have been poisoned while using a grill indoors on a rainy day.
• Make sure CO detectors aren't covered up by furniture or curtains.
• Don't go to sleep with a gas-burning heater on.
• Never leave a car running in an attached garage, even with the garage door open. Cars running in an attached garage have been source of many fatal CO poisonings.
• Don't use gas-powered tools and engines indoors. If this is unavoidable, open all the windows and doors and make sure the room is well ventilated.
• Install CO detectors in boats and recreational vehicles.
• Don't use fuel-burning heaters or lanterns in a camper, tent, or other enclosure.
• Never operate unvented fuel-burning appliances in any room with closed doors or windows.
• Don't let children or adults swim near the exhaust from a boat engine, and don't stand directly over the boat's exhaust pipe while on deck.
• Avoid swimming near houseboats where generators are in use since carbon monoxide can build up in areas around exhaust vents.

References

American Medical Association. Carbon Monoxide Poisoning. Handbook of First Aid and Emergency Care, pp. 128-129

American College of Emergency Physicians. First Aid Manual, pp. 70-71

The American Red Cross First Aid & Safety Handbook. pp. 167-168

Consumer Product Safety Commission. Carbon Monoxide Questions and Answers. http://www.cpsc.gov/cpscpub/pubs/466.html

Consumer Product Safety Commission. CPSC Warns of Carbon Monoxide Poisoning with Camping Equipment.

Pergament, Eugene, MD, et al. Carbon Monoxide and Pregnancy. RISK Newsletter, Vol. 35.

United States Coast Guard. Boating Safety. Where CO May Accumulate. http://www.uscgboating.org/command/co.htm

National Institute for Occupational Safety and Health. Carbon Monoxide Dangers in Boating: Facts You Should Know About CO. http://origin.cdc.gov/niosh/topics/coboating/