Texas Emergency Management ONLINE 2015 Vol. 62 No. 12

The Silent Killer: Carbon Monoxide Poisonings


Carbon monoxide (CO) is a colorless, odorless, poisonous gas that causes vague flu-like symptoms that are often misinterpreted after an exposure. Initial symptoms of carbon monoxide poisoning, such as headaches, nausea and fatigue, are often mistaken for the flu, because the deadly gas was undetected in a home. Carbon monoxide poisoning is caused by inhaling combustion fumes, and, when too much carbon monoxide is in the air you're breathing, your body replaces the oxygen in your red blood cells with carbon monoxide. This prevents oxygen from reaching your tissues and organs.

Carbon monoxide poisoning can be especially dangerous for people who are sleeping or intoxicated. People may have irreversible brain damage or even die before anyone realizes there's a problem. According to the Centers for Disease Control and Prevention (CDC), carbon monoxide causes thousands of deaths each year in the United States and is the leading cause of accidental poisoning deaths in America. Patients who survive the initial poisoning still face the prospect of delayed neurologic dysfunction, which occurs in 14 to 40 percent of serious cases.

Common symptoms of carbon monoxide poisoning:

  • Dull headache
  • Weakness
  • Dizziness
  • Nausea or vomiting
  • Shortness of breath
  • Fast heart rate
  • Chest pain
  • Blurred vision
  • Confusion and drowsiness
  • Seizures
  • Loss of consciousness

Common risk factors associated with carbon monoxide poisoning:

  • Children: Young children take breaths more frequently than adults do, which may make them more susceptible to carbon monoxide poisoning.
  • Older adults: Older people who experience carbon monoxide poisoning may be more likely to develop brain damage.
  • Depending on the degree and length of exposure, carbon monoxide poisoning can cause:
    • Permanent brain damage
    • Damage to your heart, possibly leading to life-threatening cardiac complications
    • Death

Common causes of carbon monoxide poisoning:

Carbon monoxide can come from any source that burns fuel. Common sources are cars, fireplaces, powerboats, wood stoves, kerosene space heaters, charcoal grills and gas appliances, such as water heaters, ovens and dryers. Usually these cause no problems, but trouble comes when:

  • Cars, trucks or other engines are left running in enclosed spaces, such as garages. Carbon monoxide can build up in a garage and leak back into the house. Even sitting in an idling car in an open garage or swimming behind an idling boat can be dangerous.
  • Fuel-burning appliances are not installed or used properly. Dangerous levels of carbon monoxide can build up inside houses and other buildings.
  • Fuel-burning heating systems and appliances are used during cold weather, when doors and windows are closed. Chimneys in older buildings become blocked and release fumes into the homes or offices. Newer houses that are well insulated and tightly sealed can trap carbon monoxide inside. If you have a leak in the ventilation system, carbon monoxide can spread through your home and lead to the exposure.

Simple precautions can help prevent carbon monoxide poisoning

Install carbon monoxide detectors. Put one in the hallway near each sleeping area in your house. Check the batteries every time you check your smoke detector batteries at least twice a year. If the alarm sounds, leave the house and call 911 or the fire department. Carbon monoxide detectors are also available for motor homes and boats. Understand that carbon monoxide detectors are a backup safety measure. They do not replace the need to check appliances regularly and use them safely.

Open the garage door before starting your car. Never leave your car running in your garage. Be particularly cautious if you have an attached garage. Leaving your car running in a space attached to the rest of your house is never safe, even with the garage door open.

Use gas appliances as recommended. Never use a gas stove or oven to heat your home. Use portable gas camp stoves outdoors only. Use fuel-burning space heaters only when someone is awake to monitor them and doors or windows are open to provide fresh air. Don't run a generator in an enclosed space, such as the basement or garage.

Keep your fuel-burning appliances and engines properly vented. These include:

  • Space heaters
  • Furnaces
  • Charcoal grills
  • Cooking ranges
  • Water heaters
  • Fireplaces
  • Portable generators
  • Wood-burning stoves
  • Car and truck engines

If you have a fireplace, keep it in good repair. Clean your fireplace chimney and flue every year. Keep vents and chimneys unblocked during remodeling. Check that they aren't covered by tarps or debris.

Do repairs before returning to the site of an incident. If carbon monoxide poisoning has occurred in your home, it's critical to locate and repair the source of the carbon monoxide before you stay there again. Your local fire department or utility company may be able to help. Ask your utility company about yearly checkups for all gas appliances, including your furnace.

If you suspect an environment to have high levels of carbon monoxide or have symptoms that you think could be caused by carbon monoxide poisoning, leave the area immediately, call 911 and let the fire department assess and manage the cause and ventilation of carbon monoxide gases. If you have symptoms call 911 or go to the emergency room.

Centers for Disease Control and Prevention
Texas Department of State Health Services
United States Coast Guard

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