By Col. (Dr.) Timothy Hursh and Lt. Col. (Dr) Steve Sabo
USAF School of Aerospace Medicine

Capt. Melissa Mouchette, a hyperbaric nurse, puts a hood on a patient in the hyperbaric chamber at the U.S. School of Aerospace Medicine, Brooks City-Base, Texas. (U.S. Air Force photo)

SAN ANTONIO -- The Wilford Hall Emergency Department and Brooks-City Base Hyperbaric Medicine Division recently saved the life of a civilian with severe carbon monoxide poisoning. The victim was discovered unconscious in an enclosed area. Subsequent investigation revealed a very high level of carbon monoxide gas in the area she was rescued from.

Carbon monoxide (CO) is a toxic, odorless and colorless gas that is produced by the incomplete combustion of fuels such as natural gas, coal, wood, charcoal, gasoline and oil. It can be emitted from poorly ventilated generators, furnaces, woodstoves, stoves, fireplaces, water heaters, automobile exhaust from attached garages, and tobacco smoke. Problems can arise as a result of improper installation, maintenance, or inadequate ventilation of appliances and heaters.

CO gas interferes with the delivery of oxygen in the blood to the rest of the body. Depending on the amount inhaled, this gas can cause fatigue, headache, nausea, vomiting, weakness and confusion. At very high levels it can cause unconsciousness, heart attack, permanent brain injury and death.

CO gas poisoning can be prevented by following the below rules:

• Make sure appliances are properly working and adjusted to manufacturers’ instructions.
  
  
• A qualified technician should inspect and repair heating system, chimneys and flues.
  
  
• Open flues when fireplaces are in use.
  
  
• Use only the proper fuel in kerosene space heaters.
  
  
• Do NOT use ovens and gas ranges to heat your home.
  
  
• Do NOT burn charcoal inside a home, cabin, recreational vehicle or camper.
  
  
• Never leave a car or lawn mower engine running in a shed or garage, or in any enclosed space.
  
  
• Make sure your gas stove and furnace have adequate intake of air and open vents to outside the house.
  
  

CO detectors can be used as backup safety, but not as a replacement for proper use and maintenance of your fuel-burning appliances. CO detector technology is still being developed and the detectors are not generally considered to be as reliable as smoke detectors. You should not choose a CO detector solely on the basis of cost; research the quality and different features available.

If you suspect carbon monoxide poisoning, get fresh air immediately! Open doors and windows, and turn off potential combustion appliances and leave the house or enclosed space. Call 911 or go to the emergency room. Have your local fire department check it out before anyone goes back into the enclosed space.

There is evidence that hyperbaric (pressure chamber) oxygen will reduce delayed brain injury due to moderate to severe CO poisoning.

If you have further questions concerning carbon monoxide poisoning, ask your primary care provider or call the U.S. Air Force School of Aerospace Medicine Hyperbaric Medicine Division at (210) 536-3281 (DSN 240).