EMERGENCY TREATMENT OF CARBON MONOXIDE POISONING OF WORKERS IN OIL INDUSTRY

  • Sonja Peričević Medić Zavod za zdravstvenu zaštitu radnika Novi Sad, Novi Sad
  • Jovana Ljujic EMS Subotica, Serbia
  • Ivan Mikov Faculty of Medical Sciences, University of Novi Sad, Novi Sad, Serbia
  • Milorad Spanovic Faculty of Medical Sciences, University of Novi Sad, Novi Sad, Serbia
  • Sladjana Sakac Clinical center of Vojvodina, Novi Sad, Serbia
DOI: https://doi.org/10.5937/halo26-28886
Keywords: carbon monoxide, poisoning, oil industry, workplace

Abstract


Introduction: The aim of this study was to analyze the case of acute CO poisoning in five workers of the oil industry, in a collective accommodation with a presentation of diagnostic, therapeutic and preventive measures.

Case report: Due to health problems caused by CO inhalation because of faulty gas installations, the workers were treated during the night by the emergency medical team and on the emergency department. Venous blood samples were taken to measure carboxyhemoglobin (COHb) and gas analysis at admission and after 120 minutes. Parenteral and oxygen therapy through a mask were performed. After the therapy the workers fully recovered.

Conclusion: Prompt recognition of poisoning symptoms and initiation of adequate emergency therapy are crucial for a succsesful treatment outcome. The preventive measures in terms of educating workers and implementing of health and safety measures at workplace and in the working environment are extremly important for preventing of these accidents.

References

1. Mikov M, Mikov I. Profesionalno trovanje ugljen monoksidom. U: Mikov M, Mikov I (ur.). Medicina rada: udžbenik za studente, VI izdanje. Novi Sad: Ortomedics, Novi Sad; 2007:p.206-9.
2. Thomassen O, Bratteb G, Rostrup M. Carbon monoxide poisoning while using a small cooking stove in a tent. Am J Emerg Med. 2004;22(3):204. DOI: 10.1016/j.ajem.2004.02.011.
3. Kao LW, Nańagas KA. Carbon monoxide poisoning. Med Clin N Am. 2005;89:1161–94. DOI: 10.1016/j.mcna.2005.06.007
4. Iqbal S, Clower JH, Hernandez SA, Damon SA, Yip FY. A review of disaster-related carbon monoxide poisoning: surveillance, epidemiology, and opportunities for prevention. Am J Public Health. 2012;102:1957–63. DOI: 10.2105/AJPH.2012.300674
5. Мikov I, Draskovic D, Savic M, Arsic M, Todorovski Z, Glavaski M. Occupational Intoxication with Carbon Monoxide. Arch Environ Health. 2000;55(6):455-6. DOI: 10.1080/00039890009604046.
6. Petrović S, Anđelić S, Kojić G, Tomić B. Trovanje ugljen monoksidom-prikaz slučaja. ABC-čaopis urgentne medicine. 2006;6(2-3):141-5.
7. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186:1095–101. DOI: 10.1164/rccm.201207-1284CI.
8. Smithline HA, Ward KR, Chiulli DA, Blake HC, Rivers EP. Whole body oxygen consumption and critical oxygen delivery in response to prolonged and severe carbon monoxide poisoning. Resuscitation. 2003;56:97–104. DOI: 10.1016/s0300-9572(02)00272-1.
9. Hauck H, Neuberger M. Carbon monoxide uptake and the resulting carboxyhemoglobin in man. Eur J Appl Physiol Occup Physiol. 1984;53:186–90. DOI: 10.1007/BF00422585.
10. Gorman D, Drewry A, Huang YL, Sames C. The clinical toxicology of carbon monoxide.Toxicology. 2003;187:25–38. DOI: 10.1016/s0300-483x(03)00005-2.
11. Iheagwara KN, Thom SR, Deutschman CS, Levy RJ. Myocardial cytochrome oxidase activity is decreased following carbon monoxide exposure. Biochim Biophys Acta. 2007;1772:1112–6. DOI: 10.1016/j.bbadis.2007.06.002
12. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186:1095–101. DOI: 10.1164/rccm.201207-1284CI.
13. Winter PM, Miller JN. Carbon monoxide poisoning. JAMA. 1976; 236:1502. DOI:10.1001/jama.1976.03270140054029
14. Simonsen C, Thorsteinsson K, Mortensen RN, Torp-Pedersen C, Kjćrgaard B, Andreasen JJ. Carbon monoxide poisoning in Denmark with focus on mortality and factors contributing to mortality. PLoS ONE. 2019; 14(1): e0210767. DOI:org/10.1371/journal.pone.0210767
15. Rose JJ, Wang L, Xu Q, McTiernan CF, Shiva S, Tejero J et al. Carbon monoxide poisoning: pathogenesis, management and future directions of therapy. Am J Respir Crit Care Med. 2017;195:596–606. DOI:org/10.1164/rccm.201606-1275CI
16. Pan KT, Leonardi GS,Croxford B.Factors Contributing to CO uptake and eliminationin the body: a critical review. Int J Environ Res Public Health. 2020;17(528):2-14. DOI:10.3390/ijerph17020528
17. Eichhorn L, Thudium M, Jüttner B. The diagnosis and treatment of carbon monoxide poisoning. Dtsch Arztebl Int. 2018;115:863–70. DOI:10.3238/arztebl.2018.0863
18. Huang CC, Ho CH, Chen YC, Hsu CC, Wang YF, Lin HJ et al. Impact of hyperbaric oxygen therapy on subsequent neurological sequelae following carbon monoxide poisoning. J Clin Med. 2018;7:349. DOI:org/10.3390/jcm7100349
19. Lee FY, Chen WK, Lin CL, Kao CH. Carbon monoxide poisoning and subsequent cardiovascular disease risk: a nationwide population-based cohort study. Medicine. 2015;94:e624.DOI:org/10.1097/MD.0000000000000624
20. Spina V, Tomaiuolo F, Celli L, Bonfiglio L,Cecchetti L, Carboncini MC. A case of carbon monoxide-induced delayed neurological sequelae successfully treated with hyperbaric oxygen therapy, n-acetylcysteine and glucocorticoids: clinical and neuroimaging follow-up. Neurol Med. 2019; 1-8. DOI:org/10.1155/2019/9360542
21. Kim DM, Lee IH, Park JY, Hwang SB, Yoo DS, Song CJ: Acute carbon monoxide poisoning: MR imaging findings with clinical correlation. Diagn Interv Imaging. 2017;98:299–306. DOI: 10.1016/j.diii.2016.10.004.
22. Kumarihamy P, Kularatne SAM, Pathirage M, Gunaratne W, Waduge R. A case of delayed neurological manifestation following carbon monoxide poisoning in Sri Lanka: epidemiology of exposure and literature review. BMC Pharmacol Toxicol. 2019;20(17):3-8. DOI:org/10.1186/s40360-019-0295-9
23. Rose JJ, Nouraie M, Gauthier MC, Pizon AF, Saul MI, Donahoe MP et al. Clinical outcomes and mortality impact of hyperbaric oxygen therapy in patients with carbon monoxide poisoning. Crit Care Med. 2018;46e:649–55. DOI:org/10.1097/CCM.0000000000003135
24. Huang CC, Ho CH, Chen YC, Lin HJ, Hsu CC, Wang JJ et al. Hyperbaric oxygen therapy is associated with lower short- and long-term mortality in patients with carbon monoxide poisoning. Chest. 2017; 152:943–53. DOI:org/10.1016/j.chest.2017.03.049
25. US Environmental Protection Agency. [Accessed September 13, 2020] Carbon monoxide. 2016.[Online]. Available at:http://www.epa.gov/airquality/carbonmonoxide/
26. Hawley B, Cox-Ganser JM, Cummings KJ. Carbon Monoxide Exposure in Workplaces, Including Coffee Processing Facilities. Am J Respir Crit Care Med. 2017;196(8):1080-1. DOI: org/10.1164/rccm.201703-0513LE
Published
2020/12/22
Issue
Vol. 26 No. 3 (2020): Scientific journal off emergency medicine Halo194
Section
Case report
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