To the United States, CO poisoning accounts for over 3,800 accidental and suicidal deaths each year, making it the leading cause of death by poisoning in this country today. At least an additional 10,000 individuals miss one or more days of work as a result of sublethal exposure. Although the major environmental source of the gas is the internal combustion engine, fires and associated smoke inhalation are responsible for most of the accidental fatalities associated with CO. Fatalities associated with suicide are more likely to be linked to exposure to automobile exhaust; however, most cases of sublethal exposure can be traced to automobile engines, the use of solid fuels in home heating or cooking, tobacco smoke, or industrial plant exposure.
Carbon monoxide exerts its effects by combining with hemoglobin to form the stable compound, COHb, thus reducing the total oxygen-carrying capacity of the blood. Most of the signs and symptoms of CO poisoning can thus be ascribed to the resultant tissue hypoxia. Nonlethal CO exposure is frequently misdiagnosed due to the nonspecific nature of its symptoms. When poisoning is not recognized, its presentation is most commonly described as a flu-like viral illness; however, the persistence of its protean symptoms should lead to its inclusion in the differential diagnosis. The goals of therapy in acute CO poisoning are the reduction of blood COHb levels to baseline values by the administration of high concentrations of oxygen and the support of any systems affected by the hypoxia resulting from the exposure; however, these steps are of little value unless the offending source is determined and the possibility of subsequent exposure to the gas is eliminated. Viagra Super Active