MEDICAL MINUTE: COLD, SILENT KILLERS
As I am sure you have noticed, winter is upon us. As a fellow southerner, I love the cold weather, but don’t necessarily tolerate it well. As soon as the thermometer drops below 60 degrees or so, I will be turning on my fireplace and getting the electric blanket out. Unfortunately, this time of year and the drop in temperature leads to an open invitation for a cold, silent killer to come into our homes. This killer is Carbon Monoxide, or CO, poisoning and causes countless injuries and deaths each winter. CO is produced when there is incomplete combustion of a gas, or it is not burned cleanly. We invite it into our homes due to the way that we choose to heat our residences or through a neglect of maintenance on the appliances that use gas.
First, let’s look at how CO causes such death. Inside our blood, we have special cells that carry oxygen from our lungs to the cells for use. This is absolutely critical for survival. The oxygen molecules ride on top of red blood cells that look like a round cough-drop that circulates through our arteries. The oxygen is attracted to a specific protein called hemoglobin. Incidentally, hemoglobin is composed of iron that rusts when it comes into contact with liquid; this rust is what gives our blood its red coloring. Whenever CO enters the lungs, it becomes bound to the hemoglobin that is supposed to be carrying oxygen. The problem is that CO forms a bond that is 100 times stronger than that of oxygen. Also, the cells can’t take the CO from the red blood cell as it would oxygen. The result is that more and more of the red blood cells get stuck with CO and aren’t able to get oxygen to the cells. The end game is death or serious injury from oxygen starvation at the cellular level. If caught in time, rescuers can apply oxygen to the patient in order to super oxygenate the cells that are not bound to CO. However, the best result is to place the patient in a hyperbaric chamber in which the atmospheric pressure is gradually reduced to a level that “squeezes” off the CO from the red blood cell.
Carbon monoxide is colorless and odorless, making it impossible to sense with just the nose or eyes. Appliances that are fueled with gas, oil, kerosene, or wood may produce CO. When appliances are kept in good working order, they produce very little CO. However, if they are improperly operating or not well vented, the CO concentrations in your home can rise to dangerous levels. Likewise, using kerosene heaters, gas stoves, or grills indoors can cause a rapid rise in the poisonous gas levels inside your home. Modern built homes do not allow for much ventilation as most are airtight in their construction. The signs of poisoning include dizziness, fatigue, headache, and nausea. However, you may experience none of these if you are sleeping, which is a typical time to use heaters.
To avoid CO poisoning, make sure that all appliances, including water heaters, that use a burning fuel source are installed correctly and vented properly. Make sure that your appliances are serviced by a technician and preventive maintenance is performed. Never use outdoor grills or small propane heaters indoors. If you have a wood-burning chimney, make sure that it has been recently cleaned of soot and other items such as bird nests that can block the exit of smoke and fumes. It is a great idea to invest in an inexpensive CO alarm. These alarms sound an alert when dangerous levels of the gas are detected in the air. Install the alarm as you would a smoke detector: on every floor of the home and near sleeping areas.
CO poisoning is a real threat this time of year. So many of our friends and neighbors are living on fixed incomes and are unable to provide better ways to heat their homes. One of the easiest solutions is to have proper maintenance performed on older appliances and limit their use. You can also take small steps to keep the heat confined to one area of the house by closing doors to unused rooms. No matter what your situation, we are all subject to the same perils of CO. This winter, take the proper steps and do not let this cold, silent killer into your house. Stay safe out there.
M. Eric Williams, MS, NR-P is a Mississippi native and the Assistant Director of Emergency Medical Technology Education at Jones County Junior College. He is a current Doctoral researcher at Delta State University and has 15 years’ experience in healthcare. If you have questions or comments, you may contact him at eric.williams@jcjc.edu
