Treatment after carbon monoxide poisoning?

Update:12-10-2019
Summary:

  1. Mild poisoning pp patients may have headache, […]

 

1. Mild poisoning pp patients may have headache, dizziness, insomnia, blurred vision, tinnitus, nausea, vomiting, general malaise, tachycardia, brief fainting. The blood carboxyhemoglobin content is 10%-20%.

2. Moderate poisoning pp In addition to the above symptoms, lips, nails, skin and mucous membranes appear cherry red, sweating, blood pressure first increased and then decreased, heart rate accelerated, arrhythmia, irritability, temporary sensation and movement separation (ie there are still Thinking, but not acting). Symptoms continue to worsen, and can cause drowsiness and coma. The blood carboxyhemoglobin is about 30%-40%. After timely rescue, it can be awake quickly, generally without complications and sequelae.

3. Severe poisoning patients quickly enter a coma. In the early stage, the muscle tension of the limbs increased, or paroxysmal tonic spasm; the late muscle tension was significantly reduced, the patient's face pale or bruising, blood pressure decreased, the pupil dilated, and finally died of respiratory paralysis. Survivors who survive the rescue may have severe comorbidities and sequelae.

4. sequelae pp, severe poisoning patients have neurasthenia, tremor paralysis, hemiplegia, hemianopia, aphasia, dysphagia, mental retardation, toxic psychosis or degenerative brain. Some patients may develop secondary encephalopathy.

Rescue step

1. Improve tissue hypoxia and protect vital organs

(1) Immediately move the patient to a ventilated, fresh air, untie the collar, clear the secretions of the respiratory tract, and keep the airway open. If necessary, perform mouth-to-mouth resuscitation or endotracheal intubation, or perform tracheal incision. Keep warm in winter.

(2) Oxygen absorption: to accelerate the dissociation of carboxyhemoglobin. Conditional hyperbaric oxygen therapy is the best. The oxygen flow rate of the oxygen inhalation of the nasal cannula is 8-10 L/min.

(3) Protect important organs such as heart and brain: intravenous infusion of cytochrome C30mg (before skin test), or 20mg of adenosine triphosphate, coenzyme I (coenzyme A) 50U, ordinary insulin 4U added to 25% glucose solution 250ml Intravenous infusion.

(4) Those with cerebral vasospasm and tremor palsy can be injected intravenously with atropine or 654-2.

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