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Carbon Monoxide is Not Well Understood

Misconceptions

Properties, Presence & Detection:

* CO is easy to detect.
* CO is lighter than air and therefore rises (to the ceiling) and stays there.
* CO is not combustible.
* CO and natural gas are the same thing.
* You can always tell if CO is present because of a peculiar odor that will be present.
* A brand new, well designed, perfectly “tuned” heating/cooking device cannot produce toxic/lethal amounts of CO.
* Diesel engine exhaust never contains adequate CO to cause harm.
* HVAC and gas company personnel always check for CO when performing maintenance/service on home heating systems.
* CO will be detected immediately by service personnel if it is present in a home heating system.
* When your home CO detector shows low levels of CO, it is probably just an instrument malfunction.
* Cracks in heat exchangers are responsible for production of CO.
* Home CO detectors/sensors are the best devices to ferret out CO because they react to very low levels of the gas.

Physiology

* CO binding to hemoglobin is irreversible.
* CO (caused) hypoxia is no more serious than any other type of hypoxia.
* CO poisoning is no more serious than an anemia in which there is a comparable amount of hemoglobin able to carry oxygen.
* Small animals (birds, mice, etc.) die more quickly because their hemoglobin binds CO more avidly than that of humans, thus they were used as alarms for CO in mines.
* The fetus is protected from CO by the maternal body.
* Good COHb measurements can be obtained one day to a week after a person leaves the site of the CO poisoning.
* Breathing “clean” air for 2-3 hours will eliminate all CO from the body.
* Breathing 100% oxygen for 20-30 minutes will eliminate all CO from the body.
* Breathing (filter) masks protect the wearer from inhalation of CO.

Symptoms

* The skin, nail beds, etc. of people with CO poisoning are invariably red or pink in color.
* Fever is a symptom of CO poisoning.
* Nasal congestion, cough and hoarseness are symptoms of CO.
* The lungs are inflammed by low to moderate levels of CO and will show pathology on X-rays.
* Symptom clusters involving prolonged headache, dizziness, nausea, and fatigue of the whole family should be blamed on viruses, bad food, or group craziness.
* Everyone responds to CO in the same way, ie. show the same symptoms.

Treatment, Outcome

* Inhalation of 100% oxygen from a rebreathing mask or from nasal prongs are recommended best immediate means of removing CO from the body.
* Victims of CO poisoning should be released from medical care immediately following 1-2 hours of oxygen treatment, whether or not their symptoms have disappeared.
* There is no need for repeat COHb measurements, psychometric tests, or other clinical tests following medical treatment for CO poisoning.
* People who recover from CO poisoning are always completely normal.
* Depression and personality change never result from CO poisoning.
* CO exposure never produces brain damage unless there is a period of unconsciousness.
* Low / moderate CO exposure cannot produce brain damage or significant changes in functional performance.
* In environments containing CO, the levels of CO2, oxygen and other gases are unimportant in the degree of poisoning.

Miscellaneous

* Physicians receive adequate training in the diagnosis and treatment of CO poisoning in medical school.
* Physicians obtain adequate experience with CO poisoning in treating their patients.
* Psychiatrists and neurologists are the best medical professionals of choice to determine the extent of CNS damage caused by CO.
* High-tech imaging devices (CT, MR, SPECT) always shows areas of brain damage from CO poisoning, if it exists