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Carbon monoxide is in the news all year round, but it intensifies with the return of the winter cold. And the so-called silent killer takes lives in the first days of each year. Newspapers and television report almost daily of entire families poisoned by CO inside their homes throughout Spain, some of them with fatal results.
SPAIN, February 19, 2024.- “All cases follow the same pattern: the malfunction of a domestic appliance such as a butane, propane, or natural gas heater, or the use of braziers that generate carbon monoxide in instead of carbon dioxide. This difference, which chemically is no more than that of an oxygen atom in both molecules, at levels of toxicity for the human body is immense, since the former binds to the hemoglobin of the blood and blocks the transport of oxygen in the body and makes it difficult to release it to the tissues”, explains Jordi Desola Alá, a renowned doctor and Doctor of Medicine, in the sector of Occupational Medicine, Internal Medicine, and Sports Medicine. Jordi Desola is a great expert in the treatment of Carbon Monoxide poisoning, because in recent years, together with his team, they have treated several thousand cases, as specialists in Hyperbaric Medicine. This discipline is one of those that has studied this disorder the most and for this reason, Dr. Desola has dedicated a good part of his life to deciphering how monoxide damages the body, how to quickly diagnose this type of poisoning, and what is the best way to apply an effective treatment. Some errors are very common in the diagnosis and even in the treatment of CO poisoning. Some are historical because they are typical and repeated year after year. Dr. Desola puts the magnifying glass on seven common situations in the process of detecting CO poisoning and its treatment and formulates some keys to face them successfully:1. Diagnosis: although less and less, there are occasions in which the type of gas that causes the poisoning is confused. It is not the leaks or escapes of butane or natural gas that are responsible, but rather their poor combustion in boilers, braziers, or defective heaters.2. Clinical picture: Carbon monoxide poisoning causes redness of the skin, but it is not an essential sign. Poisoning should not be ruled out if there is no cherry red discoloration of the skin.3. Inappropriate interpretation of blood gas analysis (gasometry): Due to interactions between CO and the analysis devices, a severely intoxicated person may have apparently normal results. For this reason, conservative treatments are sometimes applied even though the patient is severely hypoxic [lack of oxygen].4. Misvaluation of Carboxyhemoglobin: this strange word is the compound that CO forms in contact with the hemoglobin of the blood, which is responsible for the transport of oxygen under normal conditions. It is detectable in blood tests and is usually very high in CO poisoning even if it is not very serious, but not always. A seriously intoxicated person may have normal values, so this test only confirms the diagnosis, but it is not constant or essential, and it does not always correlate with the severity of the poisoning.5. Overestimation of normobaric oxygen therapy: the administration of oxygen at atmospheric pressure is not sufficient to treat this serious poisoning. It is necessary to apply a high concentration system with a hyperbaric chamber.6. Forget late neurological syndrome: if the treatment has not been correct and under high pressure, despite a significant or definitive improvement, a serious relapse can occur a few days or even weeks after the apparent cure. This late effect can go unnoticed due to the delay and its consequences can be devastating.7. Delay in applying definitive treatment: sometimes treatment is delayed for technical reasons or due to difficulty in accessing the Hyperbaric Medicine center. CO poisoning is always a true emergency, although the initial symptoms may seem mild. At the beginning of the cold seasons, Dr. Jordi Desola and his team disseminate detailed action guides each year with the aim of clarifying doubts and combating the effects of this poisoning, so serious, so silent, and so widespread, which, however, has a sophisticated but very effective treatment to resolve most cases, even the most serious ones.
Contact Contact name: Jordi Desola Alá Contact description: CRIS-UTHT Contact phone: 935572662
