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Carbon monoxide poisoning typically occurs from inhaling carbon monoxide (CO) gas at high levels. This gas can be caused by vehicle exhaust or gas leaks in a home or worksite. Large exposures can result in loss of consciousness, arrhythmias, seizures, or death.
Your doctor may ask these questions to check for this disease:
Immediate treatment in a hospital is necessary. Treatment involves breathing pure oxygen by mask or, in some more severe cases, a hyperbaric chamber in which the air pressure and oxygen content is about two to three times higher than normal.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Poisoned by Hemlock? Why It’s Lethal & Medically Approved Next Steps
A.
Hemlock poisoning is a true medical emergency because coniine toxins rapidly block nerve to muscle signals, causing escalating weakness, paralysis, and life threatening respiratory failure; there is no antidote, but urgent hospital care with breathing support can be lifesaving. There are several factors to consider for safe next steps, including correct plant identification, exposure amount and timing, and immediate actions like calling emergency services and not inducing vomiting; see below for complete, medically approved next steps and guidance that could change what you should do right now.
References:
* Karimov, Z., & Yelland, S. (2023). Conium maculatum Poisoning: A Systematic Review. Toxicology Reports, 11, 237–243.
* Schep, L. J., Dinnett, N., & Eardley, R. J. (2018). Poison hemlock (Conium maculatum) poisoning: A case report and review of the literature. Clinical Toxicology (Philadelphia, Pa.), 56(12), 1228–1232.
* Tuncok, H. A., Uzun, A., Durukan, P., & Soysal, T. (2016). Management of hemlock poisoning: a case series. The American Journal of Emergency Medicine, 34(6), 1184.e5-1184.e6.
* Narayanan, S., Khosa, A., & Gupta, A. (2017). Accidental ingestion of poison hemlock (Conium maculatum): a case report. Journal of Medical Case Reports, 11(1), 164.
* Frank, A. A., & Reed, W. M. (2012). Conium maculatum alkaloids: analysis and toxicity. Journal of Natural Toxins, 21(1), 1–11.
Q.
Poisoned? Why Your Body Is Reacting and Critical Medical Next Steps
A.
Poison exposure can cause sudden headache, dizziness, confusion, vomiting, breathing trouble, chest pain, or collapse as toxins disrupt nerves, lungs, gut, skin, and vital organs; if symptoms are severe or worsening, call emergency services, get to fresh air, rinse skin and remove contaminated clothing, and do not induce vomiting. There are several factors to consider, including the silent danger of carbon monoxide and delayed injuries from substances like acetaminophen or toxic mushrooms, as well as who is at higher risk and what tests and antidotes may be needed; see the complete guidance below for critical red flags and step by step actions that could change your next steps.
References:
* Isbister GK, DD M. Acute poisoning: general management principles. Postgrad Med J. 2004 May;80(943):273-9. doi: 10.1136/pmj.2003.016912. PMID: 15138318; PMCID: PMC1743048.
* Guengerich FP. Molecular and Cellular Toxicology: The Central Role of Metabolism. Mol Pharmacol. 2021 Dec;100(6):531-542. doi: 10.1124/molpharm.121.000392. Epub 2021 Nov 22. PMID: 34810246; PMCID: PMC8619379.
* Olson KR. Emergency toxicology: diagnosis and management of the poisoned patient. Med Clin North Am. 2005 Mar;89(2):227-42, vii. doi: 10.1016/j.mcna.2004.10.009. PMID: 15723908.
* St-Onge M, Anseeuw K, Cantrell FL, Juurlink DN, Tenenbein M, Gosselin S. Management of acute drug and poison ingestions in the emergency department. Crit Care. 2014 Aug 29;18(5):471. doi: 10.1186/s13054-014-0471-x. PMID: 25256247; PMCID: PMC4192667.
* Brent J. Principles of clinical toxicology. Crit Care Clin. 2005 Oct;21(4):661-78, v. doi: 10.1016/j.ccc.2005.04.004. PMID: 16182141.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Rose JJ, Wang L, Xu Q, McTiernan CF, Shiva S, Tejero J, Gladwin MT. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. Am J Respir Crit Care Med. 2017 Mar 1;195(5):596-606. doi: 10.1164/rccm.201606-1275CI. Erratum in: Am J Respir Crit Care Med. 2017 Aug 1;196 (3):398-399. PMID: 27753502; PMCID: PMC5363978.
https://www.atsjournals.org/doi/10.1164/rccm.201606-1275CIChenoweth JA, Albertson TE, Greer MR. Carbon Monoxide Poisoning. Crit Care Clin. 2021 Jul;37(3):657-672. doi: 10.1016/j.ccc.2021.03.010. PMID: 34053712.
https://www.criticalcare.theclinics.com/article/S0749-0704(21)00021-X/fulltextWu PE, Juurlink DN. Carbon monoxide poisoning. CMAJ. 2014 May 13;186(8):611. doi: 10.1503/cmaj.130972. Epub 2014 Jan 6. PMID: 24396094; PMCID: PMC4016057.
https://www.cmaj.ca/content/186/8/611Macnow TE, Waltzman ML. Carbon Monoxide Poisoning In Children: Diagnosis And Management In The Emergency Department. Pediatr Emerg Med Pract. 2016 Sep;13(9):1-24. Epub 2016 Sep 2. PMID: 27547917.
https://www.ebmedicine.net/topics/toxicology-environmental/pediatric-carbon-monoxideWeaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med. 2009 Mar 19;360(12):1217-25. doi: 10.1056/NEJMcp0808891. PMID: 19297574.
https://www.nejm.org/doi/full/10.1056/NEJMcp0808891