Carbon monoxide

Colorless, odorless and tasteless gas produced by incomplete combustion in fuel burning devices which include: motor vehicles, furnaces and portable generators.

Nonirritating gas that is produced by the incomplete combustion of hydrocarbons.

Poisoning associated with nausea, dizziness, headache and confusion and can result in death.

Accounts for 15,000 emergency department visits and 500 unintentional deaths each year in the U.S.

National annual death rate approximately 1.5 per million persons.

Rates of poisoning highest among adults ages 65 years, males, whites, and African-Americans.

Deaths from poisoning highest in winter months and more common among western and midwestern states in the U.S.

Poisoning can be prevented by proper installation and maintenance of fuel burning appliances and the use of carbon monoxide detectors.

Generators, charcoal grills, camp stoves, gasoline or charcoal burning devices should not be used indoors.

Associated with fireplaces, tobacco smoke and occupational sources.

Poisoning often misdiagnosed and under detected as a result of the nonspecific nature of presentation.

Approximately 73% of cases of exposures occur in homes and 41% occur during the winter.

Carbon monoxide has a 200 times greater affinity to heme proteins than oxygen.


Carbon monoxide is naturally produced by the action of heme oxygenase 1 and 2 on the heme from hemoglobin breakdown. 


Carboxyhemoglobinemia alters the shape of the heme protein within hemoglobin and greatly decreases the ability of the three of the oxygen binding sites to release oxygen to peripheral tissues, creating a leftward shift of the oxyhemoglobin dissociation curve. 


Carboxyhemoglobinemia can create an oxygen saturation gap of greater than 5%.


Tobacco smoking raises the blood levels of COHb by a factor of several times from its normal concentrations.


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