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Spotting a silent killer

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Spotting a silent killer

The symptoms of carbon monoxide poisoning can appear similar to those of many common health problems, but would you be able to tell the difference and save a life?

Carbon monoxide is sometimes called the ‘silent killer’, with more than 50 people dying from accidental poisoning every year in the UK and 200 left seriously ill, according to figures from the NHS.

As a poisonous gas with no smell or taste, carbon monoxide is not detectable by those breathing it in, and because the symptoms of poisoning mimic those of other common illnesses, it is often hard for healthcare professionals to spot. However there are things to look out for which will help you identify if your customer is suffering from carbon monoxide inhalation – and quick action on your part could save their life.

How does CO poisoning happen?

Carbon monoxide is produced when fuels such as gas, oil, coal or wood do not burn fully, which can happen in an enclosed space.

Poorly maintained or faulty household appliances, such as gas boilers and cookers, are also common sources of carbon monoxide emissions, while blocked chimneys and ventilation systems can prevent carbon monoxide from escaping.

Carbon monoxide that is inhaled then enters the bloodstream and mixes with haemoglobin to form carboxyhaemoglobin. When this happens, the blood is no longer able to carry oxygen, and it is this lack of oxygen that causes the body’s cells and tissues to die and can result in serious illness and death.

Signs and symptoms

The commonest symptoms of carbon monoxide poisoning include:

  • Headache
  • Dizziness
  • Nausea and vomiting
  • Tiredness and confusion
  • Stomach pain
  • Shortness of breath and difficulty breathing.

At first glance symptoms are similar to those of flu or food poisoning, but the big giveaway is that, unlike flu, carbon monoxide poisoning does not cause a fever.

Acute exposure to high levels of carbon monoxide brings even more severe symptoms, that can include:

  • Impaired mental state
  • Personality changes
  • Vertigo
  • Ataxia
  • Breathlessness and tachycardia
  • Chest pain caused by angina or a heart attack
  • Seizures
  • Loss of consciousness, often followed by death within minutes in cases of high-level exposure.

Questions that might clarify whether carbon monoxide poisoning is the cause of a customer’s ill health include:

  • Do others in the household or workplace have similar symptoms?
  • Do their symptoms disappear when they go away (e.g. on holiday) and return when they come back?
  • Are their symptoms seasonal? (e.g. do they get more headaches in winter when the central heating is on?)

‘At risk’ groups

Carbon monoxide is dangerous to everyone, but certain groups are more vulnerable to its effects, including:

  • Babies and young children
  • Pregnant women
  • People with chronic heart disease
  • People with respiratory problems.

Household pets can be the first to show signs of carbon monoxide poisoning because they are smaller creatures and therefore more vulnerable to the effects of the gas.

Asking your customer if they have had a pet that has died unexpectedly or become suddenly ill, is another way of determining if they could be living with a carbon monoxide leak.

What to do if you suspect a leak

If you think your customer is being or has been affected by a carbon monoxide leak, you should recommend that they go to A&E for immediate treatment, even if they seem to be walking and talking without any problems, and they should ensure that everyone else who shares their home or work space does the same. At the location of the leak:

  • All cooking and heating appliances that use fuel other than electricity should be turned off
  • All windows in the building should be opened
  • Neighbours should be informed, particularly those in flats above or below the affected space
  • The gas supplier to the property should be called out to inspect all appliances, as well as the chimneys.

More advice is available from the Health and Safety Executive (HSE) gas safety advice line on freephone 0800 300 363.

Treatment and recovery

Anyone exposed to carbon monoxide gas will need oxygen therapy treatment in hospital – which involves breathing in 100 per cent oxygen through a tight-fitting mask in order to quickly replace the carboxyhaemoglobin – or, in extreme cases, treatment in a hyper- baric chamber.

Recovery time depends on the length of exposure to the carbon monoxide and how high the levels were. While there are no long-term studies showing the ongoing effects and real-life impact of carbon monoxide poisoning, the NHS estimates that between 10-15 per cent of people who survive severe poisoning develop long- term complications such as damage to the brain or heart, which is why early intervention and treatment is all the more vital.

AVOIDING CAMPING CATASTROPHES

There have been numerous cases of fatal carbon monoxide poisoning caused by campers leaving a smouldering barbecue inside their tent to help them stay warm. “In small enclosed spaces such as tents and caravans, levels of carbon monoxide produced by barbecues can build up very quickly to levels which can kill,” says Professor Virginia Murray from the Health Protection Agency’s centre for radiation, chemical and environmental hazards. “Disposable barbecues should never be used or left inside tents or awnings once they have been lit or after they have been used.”

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