How To Prevent Carbon Monoxide Poisoning

Carbon monoxide (CO) is a deadly, colorless, odorless, poisonous gas. Consumers should follow the manufacturer's instructions. Using a test button tests whether the circuitry is operating CPSC helps promote carbon monoxide safety by raising awareness of CO hazards and the need for correct...Which of the following is an appropriate response to carbon monoxide (CO) poisoning? slow breathing into a paper bag hyperventilation to exhale CO from the body immediate application of bicarbonate ions to facilitate removal of CO from Hb hyperbaric oxygen chamber to increase PO2 and...PDF | This article describes carbon monoxide poisoning. Using a case study approach, the article logical sequelae after CO exposure. Carbon monoxide is an. inflammatory mediator leading to have psychological or psychiatric evaluation, as well as. appropriate follow-up and involvement of family...Carbon monoxide poisoning is a serious threat. People need to be informed about. By educating ourselves on the dangers of CO we can significantly reduce the health risk as well as save lives. The following are more susceptible to carbon monoxide poisoning.Carbon monoxide (CO) is a colorless, odorless, poisonous gas. The initial symptoms of CO poisoning are similar to the flu (but without the fever). They include Consumers should follow the manufacturer's instructions. Using a test button, some detectors/alarms test whether the circuitry as...

Ch. 22 respiratory system Flashcards | Quizlet

Carbon monoxide is a poisonous gas that has no smell or taste. Breathing it in can make you unwell, and it can kill if you're exposed to high levels. Every year there are around 60 deaths from accidental carbon monoxide poisoning in England and Wales. After carbon monoxide is breathed in, it enters...I have heard that carbon monoxide is extremely poisonous. Every poison has a particular trait that causes it to be poisonous. Once carbon monoxide attaches, it is very difficult to release. So if you breath in carbon monoxide, it sticks to your hemoglobin and takes up all of the oxygen binding sites.CO poisoning is entirely preventable. Protect yourself and your family by learning the symptoms of CO poisoning and how to prevent it. When winter temperatures plummet and home heating systems run for hours the risk of carbon monoxide (CO) poisoning increases.Carbon monoxide (CO) poisoning remains an important cause of illness and death. Carbon monoxide is an odorless, nonirritating gas that readily binds to hemoglobin, reducing the ability of the Based on the most recent study, Weaver recommends HBO be considered if the following are...

(PDF) Carbon Monoxide Poisoning: Case Studies and Review

Carbon monoxide (CO) poisoning happens when you breathe in fumes that contain CO. You can get very sick or even die if you breathe high levels of CO for even a few minutes. Carbon monoxide (CO) is a gas produced when gasoline and other fuels burn. It is invisible and colorless."Carbon monoxide (CO) is found in fumes produced any time you burn fuel in cars or trucks, small engines, stoves, lanterns, grills, fireplaces, gas Even using devices outside of the home comes with a caution that you stay more than 20 feet from a window, door, or vent, to prevent carbon monoxide...Carbon Monoxide Poisoning Prevention and Alarm Responses. Carbon Monoxide (CO), an odorless, colorless, and tasteless deadly gas Since CO may not be readily detected, it is important to be aware of the symptoms of CO poisoning. These symptoms are similar to the flu, and may include...I call it the winter ninja: Carbon Monoxide (CO) is a colorless, odorless, lethal gas formed in the break down of carbon. So lethal in fact that it is currently the worldwide leader in deaths due to a toxin. Far more deaths occur in winter months as CO is emitted by home heating units, but vehicles that have...Yes, the carbon monoxide in the exhaust can build up and poison anyone in a closed garage where the car is Carbon monoxide, an odorless, invisible deadly gas is a byproduct of generators and will build up in Carbon dioxideThat is as carbon source. Carbon from CO2 is used to build up glucose.

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Carbon monoxide poisoningOther namesCarbon monoxide intoxication, carbon monoxide toxicity, carbon monoxide overdoseCarbon monoxideSpecialtyToxicology, emergency drugsSymptomsHeadache, dizziness, weak point, vomiting, chest pain, confusion[1]HeadachesLoss of consciousness, arrhythmias, seizures[1][2]CausesBreathing in carbon monoxide[3]Diagnostic methodCarboxyl-hemoglobin level:3% (nonsmokers)10% (smokers)[2]Differential analysisCyanide toxicity, alcoholic ketoacidosis, aspirin poisoning, higher respiration tract an infection[2][4]PreventionCarbon monoxide detectors, venting of gasoline appliances, repairs of exhaust methods[1]TreatmentSupportive care, 100% oxygen, hyperbaric oxygen treatment[2]DiagnosisRisk of dying 1–31%.[2]Frequency>20,000 emergency visits for non-fire comparable cases consistent with year (US)[1]Deaths>Four hundred non-fire similar a 12 months (US)[1]

Carbon monoxide poisoning most often happens from inhaling carbon monoxide (CO) at over the top ranges.[3] Symptoms are ceaselessly described as "flu-like" and frequently include headache, dizziness, weak point, vomiting, chest pain, and confusion.[1] Large exposures may end up in loss of consciousness, arrhythmias, seizures, or demise.[1][2] The classically described "cherry red skin" hardly happens.[2] Long-term headaches might include feeling tired, bother with memory, and movement issues.[5] In the ones uncovered to smoke, cyanide toxicity must even be thought to be.[2]

Carbon monoxide poisoning can happen as an attempt to end one's personal life, or as an strive to end any other's existence.[6][7] CO is a drab and odorless gas which is to begin with non-irritating.[5] It is produced all over incomplete burning of organic subject.[5] This can occur from motor cars, warmers, or cooking apparatus that run on carbon-based fuels.[1] It can also happen from publicity to methylene chloride.[8] Carbon monoxide essentially causes adversarial effects by way of combining with hemoglobin to form carboxyhemoglobin (HbCO) fighting the blood from carrying oxygen.[5] Additionally, myoglobin and mitochondrial cytochrome oxidase are affected.[2] Diagnosis is in response to a HbCO level of more than 3% among nonsmokers and more than 10% among people who smoke.[2]

Efforts to save you poisoning include carbon monoxide detectors, correct venting of fuel appliances, preserving chimneys clean, and preserving exhaust techniques of cars in excellent repair.[1] Treatment of poisoning normally is composed of giving 100% oxygen together with supportive care.[2][5] This must usually be carried out until signs are now not present and the HbCO point is lower than 10%.[2] While hyperbaric oxygen remedy is used for serious poisonings, the get advantages over same old oxygen delivery is unclear.[2][6] The risk of loss of life among the ones affected is between 1 and 30%.[2]

Carbon monoxide poisoning is rather not unusual, leading to more than 20,000 emergency room visits a 12 months in the United States.[1][9] It is the maximum commonplace sort of fatal poisoning in many nations.[10] In the United States, non-fire similar instances lead to greater than Four hundred deaths a 12 months.[1] Poisonings happen extra incessantly in the wintry weather, specifically from the use of portable turbines all through energy outages.[2][8] The poisonous effects of CO were recognized since historical history.[11] The discovery that hemoglobin is suffering from CO was once made in 1857.[11]

Signs and symptoms

Carbon monoxide is not poisonous to all forms of life. Its destructive results are due to binding with hemoglobin so its threat to organisms that don't use this compound is in doubt. It thus has no impact on photosynthesising crops.[12] It is easily absorbed via the lungs.[13] Inhaling the fuel can lead to hypoxic harm, fearful system damage, or even dying. Different people and populations will have other carbon monoxide tolerance ranges.[14] On reasonable, exposures at 100 ppm or better is dangerous to human health.[15] In the United States, the OSHA limits long-term office exposure ranges to less than 50 ppm averaged over an 8-hour duration;[16][17] as well as, workers are to be removed from any confined house if an higher prohibit ("ceiling") of 100 ppm is reached.[18] Carbon monoxide publicity would possibly lead to a significantly shorter lifestyles span due to heart harm.[19] The carbon monoxide tolerance level for someone is altered via several components, including job level, rate of air flow, a pre-existing cerebral or cardiovascular disease, cardiac output, anemia, sickle mobile illness and other hematological disorders, barometric strain, and metabolic price.[20][21][22]

Effects of carbon monoxide in relation to the concentration in portions per million in the air:[23][24] Concentration Symptoms 35 ppm (0.0035%), (0.035‰) Headache and dizziness inside six to 8 hours of constant exposure A hundred ppm (0.01%), (0.1‰) Slight headache in two to three hours two hundred ppm (0.02%), (0.2‰) Slight headache within two to 3 hours; loss of judgment 400 ppm (0.04%), (0.4‰) Frontal headache within one to two hours 800 ppm (0.08%), (0.8‰) Dizziness, nausea, and convulsions inside Forty five min; insensible inside 2 hours 1,Six hundred ppm (0.16%), (1.6‰) Headache, greater middle price, dizziness, and nausea inside of 20 min; loss of life in not up to 2 hours 3,2 hundred ppm (0.32%), (3.2‰) Headache, dizziness and nausea in five to ten mins. Death inside half-hour. 6,400 ppm (0.64%), (6.4‰) Headache and dizziness in a single to two minutes. Convulsions, respiratory arrest, and death in less than 20 minutes. 12,800 ppm (1.28%), (12.8‰) Unconsciousness after 2–3 breaths. Death in lower than 3 mins. Acute poisoning CO toxicity signs

The main manifestations of carbon monoxide poisoning increase in the organ techniques maximum depending on oxygen use, the central anxious system and the heart.[16] The preliminary signs of acute carbon monoxide poisoning come with headache, nausea, malaise, and fatigue.[25] These signs are ceaselessly fallacious for a deadly disease comparable to influenza or other sicknesses reminiscent of food poisoning or gastroenteritis.[26] Headache is the maximum not unusual symptom of acute carbon monoxide poisoning; it is steadily described as dull, frontal, and steady.[27] Increasing publicity produces cardiac abnormalities including fast heart price, low blood pressure, and cardiac arrhythmia;[28][29]central fearful system symptoms include delirium, hallucinations, dizziness, unsteady gait, confusion, seizures, central frightened machine melancholy, unconsciousness, respiratory arrest, and death.[30][31] Less common symptoms of acute carbon monoxide poisoning come with myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, high blood sugar, lactic acidosis, muscle necrosis, acute kidney failure, pores and skin lesions, and visible and auditory issues.[28][32][33][34]

One of the major issues following acute carbon monoxide poisoning is the severe behind schedule neurological manifestations that can occur. Problems might come with difficulty with higher intellectual functions, momentary reminiscence loss, dementia, amnesia, psychosis, irritability, a abnormal gait, speech disturbances, Parkinson's disease-like syndromes, cortical blindness, and a depressed temper.[26][35] Depression may happen in those who did not have pre-existing despair.[36] These delayed neurological sequelae may happen in up to 50% of poisoned other folks after 2 to Forty days.[26] It is tricky to are expecting who will broaden behind schedule sequelae; alternatively, complicated age, loss of consciousness whilst poisoned, and preliminary neurological abnormalities might building up the likelihood of creating delayed signs.[37]

One vintage sign of carbon monoxide poisoning is extra ceaselessly seen in the useless moderately than the dwelling – other people have been described as having a look red-cheeked and healthy (see underneath). However, since this "cherry-red" look is extra common in the dead, it is not regarded as an invaluable diagnostic check in medical drugs. In post-mortem examinations, the ruddy look of carbon monoxide poisoning is notable because unembalmed useless people are typically bluish and pale, while useless carbon-monoxide poisoned people might appear strangely real looking in coloration.[38][39][40] The colorant impact of carbon monoxide in such postmortem circumstances is thus analogous to its use as a pink colorant in the commercial meat-packing trade.

Chronic poisoning

Chronic publicity to fairly low ranges of carbon monoxide might reason chronic complications, lightheadedness, depression, confusion, memory loss, nausea, listening to problems and vomiting.[41][42] It is unknown whether or not low-level persistent exposure might cause everlasting neurological damage.[26] Typically, upon elimination from publicity to carbon monoxide, signs typically resolve themselves, except there was an episode of critical acute poisoning.[41] However, one case noted everlasting memory loss and finding out issues after a three-year publicity to slightly low levels of carbon monoxide from a misguided furnace.[43] Chronic exposure might worsen cardiovascular signs in some folks.[41] Chronic carbon monoxide publicity may increase the chance of developing atherosclerosis.[44][45] Long-term exposures to carbon monoxide present the biggest risk to individuals with coronary middle disease and in females who are pregnant.[46] In experimental animals, carbon monoxide seems to aggravate noise-induced listening to loss at noise exposure prerequisites that would have limited results on listening to differently.[47] In people, hearing loss has been reported following carbon monoxide poisoning.[42] Unlike the findings in animal research, noise exposure was once now not a important issue for the auditory issues to occur.

Causes

Concentration Source 0.1 ppm Natural surroundings point (MOPITT)[48]0.5 to 5 ppm Average level in properties[49]5 to 15 ppm Near correctly adjusted gas stoves in houses[49]100 to 200 ppm Exhaust from automobiles in the Mexico City central space[50]5,000 ppm Exhaust from a home wooden hearth[51]7,000 ppm Undiluted warm automotive exhaust and not using a catalytic converter[51]30,000 ppm Afterdamp following an explosion in a coal mine[52]

Carbon monoxide is a product of combustion of organic topic below prerequisites of restricted oxygen supply, which prevents entire oxidation to carbon dioxide (CO2). Sources of carbon monoxide come with cigarette smoke, space fires, faulty furnaces, warmers, wood-burning stoves,[53]internal combustion automobile exhaust, electric generators, propane-fueled equipment such as portable stoves, and gasoline-powered equipment corresponding to leaf blowers, garden mowers, high-pressure washers, concrete slicing saws, power trowels, and welders.[26][41][54][55][56][57][58] Exposure in most cases occurs when equipment is utilized in buildings or semi-enclosed areas.[26]

Riding in the again of pickup vehicles has led to poisoning in youngsters.[59] Idling vehicles with the exhaust pipe blocked via snow has led to the poisoning of car occupants.[60] Any perforation between the exhaust manifold and shroud can lead to exhaust gases attaining the cabin. Generators and propulsion engines on boats, particularly houseboats, has resulted in deadly carbon monoxide exposures.[61][62]

Poisoning may also occur following the use of a self-contained underwater breathing apparatus (SCUBA) due to erroneous diving air compressors.[63]

In caves carbon monoxide can build up in enclosed chambers due to the presence of decomposing organic topic.[64] In coal mines incomplete combustion might occur all through explosions resulting in the manufacturing of afterdamp. The gasoline is up to 3% CO and is also deadly after only a unmarried breath.[52] Following an explosion in a colliery, adjoining interconnected mines may grow to be unhealthy due to the afterdamp leaking from mine to mine. Such an incident adopted the Trimdon Grange explosion which killed men in the Kelloe mine.[65]

Another source of poisoning is publicity to the natural solvent dichloromethane, sometimes called methylene chloride, found in some paint strippers,[66] as the metabolism of dichloromethane produces carbon monoxide.[67][68][69] In November 2019, an EPA ban on dichloromethane in paint strippers for consumer use took effect in the United States.[70]

Pathophysiology

The actual mechanisms by way of which the results of carbon monoxide are precipitated upon bodily systems, are complex and now not yet fully understood.[25] Known mechanisms come with carbon monoxide binding to hemoglobin, myoglobin and mitochondrial cytochrome c oxidase and limiting oxygen supply, and carbon monoxide inflicting mind lipid peroxidation.[30][38][71]

Hemoglobin Carbon monoxide shifts the oxygen-dissociation curve to the left.

Carbon monoxide has the next diffusion coefficient in comparison to oxygen, and the simplest enzyme in the human body that produces carbon monoxide is heme oxygenase, which is located in all cells and breaks down heme. Under standard prerequisites, carbon monoxide levels in the plasma are approximately Zero mmHg because it has a higher diffusion coefficient and the body easily will get rid of any CO made.[72] When CO is not ventilated it binds to hemoglobin, which is the primary oxygen-carrying compound in blood; this produces a compound known as carboxyhemoglobin. The conventional understanding is that carbon monoxide toxicity arises from the formation of carboxyhemoglobin, which decreases the oxygen-carrying capacity of the blood and inhibits the transport, delivery, and utilization of oxygen by the body. The affinity between hemoglobin and carbon monoxide is roughly 230 occasions more potent than the affinity between hemoglobin and oxygen so hemoglobin binds to carbon monoxide in preference to oxygen.[38][73][74]

Hemoglobin is a tetramer with four oxygen binding sites. The binding of carbon monoxide at one of those sites increases the oxygen affinity of the final 3 websites, which reasons the hemoglobin molecule to retain oxygen that may in a different way be delivered to the tissue.[71] This state of affairs is described as carbon monoxide moving the oxygen dissociation curve to the left.[38] Because of the greater affinity between hemoglobin and oxygen throughout carbon monoxide poisoning, little oxygen will if truth be told be released in the tissues. This causes hypoxic tissue damage.[26] Hemoglobin acquires a shiny crimson colour when converted into carboxyhemoglobin, so poisoned cadavers or even industrial meats treated with carbon monoxide gain an unnatural reddish hue.

Myoglobin

Carbon monoxide also binds to the hemeprotein myoglobin. It has a excessive affinity for myoglobin, about 60 instances more than that of oxygen.[26] Carbon monoxide certain to myoglobin might impair its ability to utilize oxygen.[38] This reasons lowered cardiac output and hypotension, which might result in mind ischemia.[26] A delayed return of signs were reported. This effects following a recurrence of greater carboxyhemoglobin ranges; this impact may be due to a past due unencumber of carbon monoxide from myoglobin, which therefore binds to hemoglobin.[10]

Cytochrome oxidase

Another mechanism comes to effects on the mitochondrial respiratory enzyme chain that is liable for effective tissue usage of oxygen. Carbon monoxide binds to cytochrome oxidase with much less affinity than oxygen, so it is imaginable that it calls for vital intracellular hypoxia earlier than binding.[75] This binding interferes with cardio metabolism and environment friendly adenosine triphosphate synthesis. Cells reply by means of switching to anaerobic metabolism, inflicting anoxia, lactic acidosis, and eventual cellular death.[76] The rate of dissociation between carbon monoxide and cytochrome oxidase is gradual, causing a reasonably prolonged impairment of oxidative metabolism.[25]

Central nervous system results

The mechanism that is idea to have an important affect on behind schedule effects comes to formed blood cells and chemical mediators, which reason mind lipid peroxidation (degradation of unsaturated fatty acids). Carbon monoxide reasons endothelial mobile and platelet release of nitric oxide, and the formation of oxygen free radicals together with peroxynitrite.[25] In the mind this causes additional mitochondrial disorder, capillary leakage, leukocyte sequestration, and apoptosis.[77] The result of these results is lipid peroxidation, which reasons behind schedule reversible demyelination of white topic in the central frightened system known as Grinker myelinopathy, which can lead to edema and necrosis inside of the brain.[71] This brain damage occurs principally during the restoration period. This may result in cognitive defects, particularly affecting memory and finding out, and movement disorders. These disorders are in most cases similar to harm to the cerebral white subject and basal ganglia.[77][78] Hallmark pathological changes following poisoning are bilateral necrosis of the white topic, globus pallidus, cerebellum, hippocampus and the cerebral cortex.[15][26][79]

Pregnancy

Carbon monoxide poisoning in pregnant women might purpose severe hostile fetal effects. Poisoning causes fetal tissue hypoxia by means of lowering the liberate of maternal oxygen to the fetus. Carbon monoxide also crosses the placenta and combines with fetal hemoglobin, inflicting extra direct fetal tissue hypoxia. Additionally, fetal hemoglobin has a ten to 15% upper affinity for carbon monoxide than grownup hemoglobin, inflicting more serious poisoning in the fetus than in the adult.[10] Elimination of carbon monoxide is slower in the fetus, main to an accumulation of the toxic chemical.[80] The point of fetal morbidity and mortality in acute carbon monoxide poisoning is important, so in spite of mild maternal poisoning or following maternal restoration, critical fetal poisoning or loss of life may nonetheless happen.[81]

Diagnosis

Finger tip carboxyhemoglobin saturation observe (SpCO%). Note: This is now not the identical as a pulse oximeter (SpO2%), even supposing some fashions (such as this one) do measure both the oxygen and carbon monoxide saturation. Breath CO track displaying carbon monoxide concentration of an exhaled breath pattern (in ppm) with its corresponding p.c concentration of carboxyhemoglobin.

As many signs of carbon monoxide poisoning also happen with many other varieties of poisonings and infections (equivalent to the flu), the prognosis is often tough.[69][82] A historical past of attainable carbon monoxide exposure, comparable to being exposed to a residential fireplace, may counsel poisoning, but the analysis is confirmed via measuring the levels of carbon monoxide in the blood. This will also be made up our minds by means of measuring the amount of carboxyhemoglobin when put next to the quantity of hemoglobin in the blood.[26]

The ratio of carboxyhemoglobin to hemoglobin molecules in an average particular person is also up to 5%, despite the fact that cigarette smokers who smoke two packs consistent with day may have levels up to 9%.[83] In symptomatic poisoned people they're often in the 10–30% range, while persons who die may have postmortem blood levels of 30–90%.[84][85]

As people may proceed to enjoy significant signs of CO poisoning lengthy after their blood carboxyhemoglobin focus has returned to normal, presenting to exam with a normal carboxyhemoglobin point (which might happen in late states of poisoning) does not rule out poisoning.[86]

Measuring

Carbon monoxide is also quantitated in blood using spectrophotometric strategies or chromatographic ways so as to verify a diagnosis of poisoning in an individual or to lend a hand in the forensic investigation of a case of fatal exposure.

A CO-oximeter can be used to decide carboxyhemoglobin ranges.[87][88] Pulse CO-oximeters estimate carboxyhemoglobin with a non-invasive finger clip equivalent to a pulse oximeter.[89] These devices serve as by way of passing various wavelengths of gentle through the fingertip and measuring the mild absorption of the differing kinds of hemoglobin in the capillaries.[90] The use of a regular pulse oximeter is not effective in the analysis of carbon monoxide poisoning as other people with carbon monoxide poisoning can have an ordinary oxygen saturation point on a pulse oximeter.[91] This is due to the carboxyhemoglobin being misrepresented as oxyhemoglobin.[92]

Breath CO monitoring gives an alternative to pulse CO-oximetry. Carboxyhemoglobin levels have been proven to have a powerful correlation with breath CO concentration.[93][94] However, many of these gadgets require the user to inhale deeply and maintain their breath to allow the CO in the blood to break out into the lung prior to the size will also be made. As this is no longer possible in people who are unresponsive, those gadgets may not appropriate to be used in on-scene emergency care detection of CO poisoning.

Differential diagnosis

There are many conditions to be considered in the differential prognosis of carbon monoxide poisoning.[16][31] The earliest signs, especially from low level exposures, are continuously non-specific and readily at a loss for words with different illnesses, usually flu-like viral syndromes, despair, persistent fatigue syndrome, chest pain, and migraine or other complications.[95] Carbon monoxide has been called a "great mimicker" due to the presentation of poisoning being numerous and nonspecific.[16] Other prerequisites incorporated in the differential diagnosis include acute respiratory misery syndrome, altitude sickness, lactic acidosis, diabetic ketoacidosis, meningitis, methemoglobinemia, or opioid or poisonous alcohol poisoning.[31]

Prevention

Carbon monoxide detector connected to a North American energy outlet Detectors A carbon monoxide observe clipped to the uniform of a paramedic

Prevention remains an important public health issue, requiring public schooling on the safe operation of appliances, warmers, fireplaces, and internal-combustion engines, as well as increased emphasis on the installation of carbon monoxide detectors.[13] Carbon monoxide is tasteless, odourless, and colourless, and subsequently can't be detected through visible cues or smell.[96]

The United States Consumer Product Safety Commission has said, "carbon monoxide detectors are as important to home safety as smoke detectors are," and recommends each house have at least one carbon monoxide detector, and preferably one on each point of the construction.[97] These gadgets, which are moderately inexpensive[98] and widely available, are either battery- or AC-powered, with or without battery backup.[99] In buildings, carbon monoxide detectors are generally installed round heaters and different apparatus. If a relatively excessive point of carbon monoxide is detected, the tool sounds an alarm, giving other folks the likelihood to evacuate and ventilate the construction.[98][100] Unlike smoke detectors, carbon monoxide detectors shouldn't have to be placed near ceiling point.

The use of carbon monoxide detectors has been standardized in many spaces. In the US, NFPA 720-2009,[101] the carbon monoxide detector guidelines printed by means of the National Fire Protection Association, mandates the placement of carbon monoxide detectors/alarms on every level of the place of dwelling, including the basement, as well as to out of doors slumbering areas. In new houses, AC-powered detectors should have battery backup and be interconnected to be certain that early warning of occupants at all levels.[101] NFPA 720-2009 is the first nationwide carbon monoxide same old to deal with units in non-residential buildings. These guidelines, which now pertain to schools, healthcare centers, nursing houses and different non-residential buildings, come with 3 main points:[101]

1. A secondary power supply (battery backup) should perform all carbon monoxide notification appliances for a minimum of 12 hours, 2. Detectors will have to be on the ceiling in the similar room as permanently put in fuel-burning appliances, and 3. Detectors should be located on each and every liveable point and in each HVAC zone of the construction.

Gas organizations will often recommend to get gas appliances serviced once or more a year.[102]

Legal requirements

The NFPA standard is not essentially enforced via regulation. As of April 2006, the US state of Massachusetts requires detectors to be present in all residences with attainable CO resources, regardless of development age and whether they are owner-occupied or rented.[103] This is enforced by means of municipal inspectors, and was impressed via the dying of 7-year-old Nicole Garofalo in 2005 due to snow blocking a home heating vent.[104] Other jurisdictions might haven't any requirement or best mandate detectors for brand spanking new development or at time of sale.

Despite an identical deaths in vehicles with clogged exhaust pipes (for instance in the Northeastern United States snowfall of 1978 and February 2013 nor'easter) and the industrial availability of the apparatus, there is no prison requirement for car CO detectors.

World Health Organization suggestions

The following tenet values (ppm values rounded) and periods of time-weighted moderate exposures have been determined in such a approach that the carboxyhaemoglobin (COHb) point of 2.5% is no longer exceeded, even if an ordinary subject engages in mild or reasonable workout:

100 mg/m3 (87 ppm) for 15 min 60 mg/m3 (Fifty two ppm) for 30 min 30 mg/m3 (26 ppm) for 1 h 10 mg/m3 (9 ppm) for 8 h 7 mg/m3 (6 ppm) for twenty-four h (for indoor air high quality, in order no longer to exceed 2% COHb for persistent exposure)[105]

Treatment

Time to remove 50% carboxyhemoglobin[106] Oxygen pressure О2 Time 21% oxygen at commonplace atmospheric strain (fresh air) Five hours 20 min 100% oxygen at customary atmospheric pressure (non-rebreather oxygen masks) 1 hours 20 min 100% hyperbaric oxygen (Three atmospheres absolute) 23 min

Initial treatment for carbon monoxide poisoning is to instantly remove the particular person from the publicity without endangering additional people. Those who are unconscious may require CPR on website.[38] Administering oxygen by means of non-rebreather mask shortens the half-life of carbon monoxide from 320 minutes, when respiring standard air, to handiest Eighty mins.[30] Oxygen accelerates the dissociation of carbon monoxide from carboxyhemoglobin, thus turning it again into hemoglobin.[14][107] Due to the imaginable serious effects in the baby, pregnant ladies are treated with oxygen for longer periods of time than non-pregnant folks.[108]

Hyperbaric oxygen An individual inside of a hyperbaric oxygen chamber

Hyperbaric oxygen is additionally utilized in the remedy of carbon monoxide poisoning, as it's going to hasten dissociation of CO from carboxyhemoglobin[14] and cytochrome oxidase[109] to a better extent than normal oxygen. Hyperbaric oxygen at thrice atmospheric stress reduces the half lifestyles of carbon monoxide to 23 (~80/Three mins) minutes, when put next to Eighty mins for oxygen at regular atmospheric strain.[14] It might also toughen oxygen transport to the tissues by plasma, partly bypassing the commonplace switch thru hemoglobin.[107] However, it is debatable whether or not hyperbaric oxygen in truth provides any additional benefits over normal excessive stream oxygen, in terms of increased survival or advanced long-term results.[110][111][112][113][114][115] There have been randomized managed trials in which the two treatment choices have been compared;[116][117][118][119][120][121] of the six performed, four found hyperbaric oxygen advanced consequence and two discovered no receive advantages for hyperbaric oxygen.[110] Some of these trials have been criticized for apparent flaws of their implementation.[122][123][124][125] A review of all the literature concluded that the role of hyperbaric oxygen is unclear and the to be had evidence neither confirms nor denies a medically meaningful receive advantages. The authors steered a big, smartly designed, externally audited, multicentre trial to evaluate normal oxygen with hyperbaric oxygen.[110]

Other

Further remedy for different headaches similar to seizure, hypotension, cardiac abnormalities, pulmonary edema, and acidosis is also required. Increased muscle task and seizures will have to be handled with dantrolene or diazepam; diazepam will have to only be given with appropriate breathing support.[38] Hypotension calls for remedy with intravenous fluids; vasopressors could also be required to deal with myocardial melancholy.[126]Cardiac dysrhythmias are treated with standard complicated cardiac lifestyles support protocols.[26] If severe, metabolic acidosis is handled with sodium bicarbonate. Treatment with sodium bicarbonate is arguable as acidosis might build up tissue oxygen availability.[127] Treatment of acidosis would possibly only need to consist of oxygen therapy.[26][31] The not on time development of neuropsychiatric impairment is one of the maximum severe headaches of carbon monoxide poisoning. Brain damage is confirmed following MRI or CAT scans.[25][128][129] Extensive apply up and supportive remedy is frequently required for not on time neurological harm.[30] Outcomes are ceaselessly difficult to expect following poisoning,[130] particularly individuals who have signs of cardiac arrest, coma, metabolic acidosis, or have excessive carboxyhemoglobin levels.[31] One learn about reported that approximately 30% of people with critical carbon monoxide poisoning will have a fatal outcome.[69] It has been reported that electroconvulsive therapy (ECT) may increase the likelihood of behind schedule neuropsychiatric sequelae (DNS) after carbon monoxide (CO) poisoning.[131] A device that still provides some carbon dioxide to stimulate quicker breathing (sold underneath the emblem title ClearMate) may also be used.[132]

Epidemiology

See additionally: Category:Deaths from carbon monoxide poisoning

The true quantity of instances of carbon monoxide poisoning is unknown, since many non-lethal exposures move undetected.[25][69] From the available data, carbon monoxide poisoning is the most not unusual motive of harm and death due to poisoning worldwide.[133] Poisoning is normally extra commonplace all the way through the wintry weather months.[16][134][135][136] This is due to increased domestic use of gasoline furnaces, gas or kerosene space warmers, and kitchen stoves all through the iciness months, which if inaccurate and/or used with out adequate ventilation, would possibly produce over the top carbon monoxide.[16][137] Carbon monoxide detection and poisoning also will increase all through power outages, when electric heating and cooking home equipment turn into inoperative and citizens may temporarily hotel to fuel-burning area warmers, stoves, and grills (some of which are safe only for outdoor use but however are errantly burned indoors).[138][139][140]

It has been estimated that more than 40,000 other folks according to 12 months search scientific attention for carbon monoxide poisoning in the United States.[141] 95% of carbon monoxide poisoning deaths in the United States are due to gasoline area warmers.[142][143] In many industrialized countries carbon monoxide is the reason of greater than 50% of fatal poisonings.[10] In the United States, approximately 200 folks die every yr from carbon monoxide poisoning related to home fuel-burning heating equipment.[97] Carbon monoxide poisoning contributes to the approximately 5613 smoke inhalation deaths each yr in the United States.[144] The CDC experiences, "Each year, more than 500 Americans die from unintentional carbon monoxide poisoning, and more than 2,000 commit suicide by intentionally poisoning themselves."[145] For the 10-year length from 1979 to 1988, 56,133 deaths from carbon monoxide poisoning happened in the United States, with 25,889 of those being suicides, leaving 30,244 unintentional deaths.[144] A document from New Zealand confirmed that 206 other people died from carbon monoxide poisoning in the years of 2001 and 2002. In total carbon monoxide poisoning was once responsible for 43.9% of deaths by way of poisoning in that country.[146] In South Korea, 1,950 people had been poisoned by carbon monoxide with 254 deaths from 2001 thru 2003.[147] A record from Jerusalem confirmed 3.53 consistent with 100,000 people were poisoned once a year from 2001 through 2006.[148] In Hubei, China, 218 deaths from poisoning had been reported over a 10-year duration with 16.5% being from carbon monoxide publicity.[149]

History

The earliest description of carbon monoxide poisoning dates to no less than two hundred BC through Aristotle.[150] Documented circumstances of carbon monoxide being used as one way of suicide date to at least A hundred BC in historic Rome.[150] In the AD 350s, the Roman emperor Julian suffered from carbon monoxide poisoning in Paris, and later described it in his paintings Misopogon: "though the winter weather prevailed and continually increased in severity, even so I did not allow my servants to heat the house, because I was afraid of drawing out the dampness in the walls; but I ordered them to carry in fire that had burned down and to place in the room a very moderate number of hot coals. But the coals, though there were not very many of them, brought out from the walls quantities of steam and this made me fall asleep. And since my head was filled with the fumes I was almost choked. Then I was carried outside."[151] This misunderstanding of the reasons of carbon monoxide poisoning will have caused the loss of life of Julian's successor, Jovian.

John Scott Haldane recognized carbon monoxide as the deadly constituent of afterdamp, the gas created by combustion, after inspecting many bodies of miners killed in pit explosions. Their skin used to be coloured cherry-pink from carboxyhaemoglobin, the strong compound shaped in the blood by means of reaction with the fuel. As a outcome of his analysis, he was able to design respirators for rescue employees. He examined the impact of carbon monoxide on his personal body in a closed chamber, describing the effects of his gradual poisoning. In the past due Nineties, he introduced the use of small animals for miners to stumble on unhealthy levels of carbon monoxide underground, both white mice or canaries. With a quicker metabolism, they confirmed the effects of poisoning before gas ranges turned into serious for the workers, and so gave an early caution of the drawback. The canary in British pits used to be changed in 1986 by way of the electronic gasoline detector.

As phase of the Holocaust all through World War II, German Nazis used gas vehicles at Chelmno extermination camp and elsewhere to kill an estimated over 700,000 prisoners via carbon monoxide poisoning. This approach was also used in the gas chambers of several loss of life camps reminiscent of Treblinka, Sobibor and Belzec. Gassing with carbon monoxide started in action T4, the programme developed through the Nazis in Germany to homicide the mentally sick and disabled other folks sooner than the conflict began in earnest. The gas used to be supplied through IG Farben in pressurized cylinders and fed by tubes into the fuel chambers built at various mental hospitals, reminiscent of Hartheim Euthanasia Centre. Many key workforce were recruited from the T4 programme to homicide much greater numbers of other people in the gasoline trucks and the particular fuel chambers utilized in the loss of life camps akin to Treblinka. Exhaust fumes from tank engines for instance, were used to provide the gas to the chambers.[152]

The worst accidental mass poisoning from carbon monoxide used to be the Balvano teach crisis which took place on 3 March 1944 in Italy, when a freight train with many illegal passengers stalled in a tunnel, leading to the death of over 500 other people.[153]

The use of oxygen as treatment began in 1868.[150] The use of hyperbaric oxygen in rats following poisoning was studied through Haldane in 1895 while its use in humans began in the 1960s.[150]

Research

Carbon monoxide is produced naturally via the frame as a byproduct of converting protoporphyrin into bilirubin. This carbon monoxide additionally combines with hemoglobin to make carboxyhemoglobin, however not at toxic levels.[26]

Small amounts of CO are advisable and enzymes exist that produce it at times of oxidative tension. Drugs are being advanced to introduce small quantities of CO right through certain kinds of surgical operation, these medicine are known as carbon monoxide-releasing molecules.[154]

References

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USS Yancey Yongala Zenobia Zealandia ZingaraCave divingsites Blauhöhle Blue hollow Blue Hole (Red Sea) Great Blue Hole Blue Hole (Guam) Cenote Chinhoyi Caves Devil's Throat at Punta Sur Engelbrecht Cave Fossil Cave Jordbrugrotta Piccaninnie Ponds Pluragrotta Pollatoomary Sistema Ox Bel Ha Sistema Sac Actun Sistema Dos Ojos Sistema Nohoch Nah ChichFreshwaterdives Dorothea quarry Dutch Springs Ewens Ponds Little Blue Lake Wazee lakeTraining sites Capernwray Dive Centre Deepspot Eccleston Quarry National Diving and Activity Centre Stoney CoveOpen oceandiving Blue-water diving Black-water divingDiving protection Human components in diving apparatus design Human elements in diving safety Life-support system Safety-critical system Scuba diving fatalitiesDivinghazards List of diving hazards and precautions Environmental Current Delta-P Entanglement danger Overhead Silt out Wave motion Equipment Freeflow Use of breathing apparatus in an underwater surroundings Failure of diving apparatus instead of breathing apparatus Single point of failure Physiological Cold surprise response Decompression Nitrogen narcosis Oxygen toxicity Seasickness Uncontrolled decompression Diver behaviour and competence Lack of competence Overconfidence impact Panic Task loading Trait nervousness Willful violationConsequences Barotrauma Decompression illness Drowning Hypothermia Hypoxia Hypercapnia Hyperthermia Divingprocedures Ascending and descending Emergency ascent Boat diving Canoe and kayak diving Buddy diving good friend test Decompression Decompression apply Pyle stop Ratio decompression Dive briefing Dive log Dive planning Scuba gas planning Diver communications Diving hand signals Diving line alerts Diver voice communications Diver rescue Diver coaching Doing It Right Drift diving Gas mixing for scuba diving Night diving Solo diving Water safetyRiskcontrol Checklist Hazard identity and chance evaluation Hazard analysis Job protection analysis Risk evaluation Risk keep watch over Hierarchy of hazard controls Incident pit Lockout–tagout Permit To Work Redundancy Safety knowledge sheet Situation awarenessDiving crew Bellman Chamber operator Diver clinical technician Diver's attendant Diving manager Diving techniques technician Gas guy Life help technician Stand-by diverEquipmentsafety Breathing gas quality Testing and inspection of diving cylinders Hydrostatic take a look at Sustained load cracking Diving regulator Breathing performance of regulatorsOccupationalsafety andhealth Approaches to safety Job safety research Risk evaluate Toolbox talk Housekeeping Association of Diving Contractors International Code of follow Contingency plan Diving laws Emergency process Emergency response plan Evacuation plan Hazardous Materials Identification System Hierarchy of danger controls Administrative controls Engineering controls Hazard removal Hazard substitution Personal protective equipment International Marine Contractors Association Occupational hazard Biological hazard Chemical danger Physical danger Psychosocial hazard Occupational hygiene Exposure overview Occupational publicity prohibit Workplace health surveillance Safety tradition Code of practice Diving protection officer Diving superintendent Health and safety consultant Operations guide Safety meeting Standard operating procedure Diving medicationDivingproblems List of signs and symptoms of diving problems Cramp Motion illness Surfer's earPressurerelated Alternobaric vertigo Barostriction Barotrauma Air embolism Aerosinusitis Barodontalgia Dental barotrauma Pulmonary barotrauma Compression arthralgia Decompression sickness DysbarismOxygen Freediving blackout Hyperoxia Hypoxia Oxygen toxicityInert gases Avascular necrosis Decompression sickness Isobaric counterdiffusion Taravana Dysbaric osteonecrosis High-pressure anxious syndrome Hydrogen narcosis Nitrogen narcosisCarbon dioxide Hypercapnia HypocapniaBreathing gascontaminants Carbon monoxide poisoning Immersionrelated Asphyxia Drowning Hypothermia Immersion diuresis Instinctive drowning response Laryngospasm Salt water aspiration syndrome Swimming-induced pulmonary edema Treatment Demand valve oxygen treatment First aid Hyperbaric medicine Hyperbaric treatment schedules In-water recompression Oxygen remedy Therapeutic recompressionPersonnel Diving Medical Examiner Diving Medical Practitioner Diving Medical Technician Hyperbaric nursingScreening Atrial septal defect Effects of drugs on health to dive Fitness to dive Psychological health to diveResearchResearchers indiving physiologyand drugs Arthur J. Bachrach Albert R. Behnke Paul Bert George F. Bond Robert Boyle Albert A. Bühlmann John R. Clarke Guybon Chesney Castell Damant Kenneth William Donald William Paul Fife John Scott Haldane Robert William Hamilton Jr. Leonard Erskine Hill Brian Andrew Hills Felix Hoppe-Seyler Christian J. Lambertsen Simon Mitchell Charles Momsen John Rawlins R.N. Charles Wesley Shilling Edward D. Thalmann Jacques TrigerDiving medicalresearchorganisations Aerospace Medical Association Divers Alert Network (DAN) Diving Diseases Research Centre (DDRC) Diving Medical Advisory Council (DMAC) European Diving Technology Committee (EDTC) European Underwater and Baromedical Society (EUBS) National Board of Diving and Hyperbaric Medical Technology Naval Submarine Medical Research Laboratory Royal Australian Navy School of Underwater Medicine Rubicon Foundation South Pacific Underwater Medicine Society (SPUMS) Southern African Underwater and Hyperbaric Medical Association (SAUHMA) Undersea and Hyperbaric Medical Society (UHMS) United States Navy Experimental Diving Unit (NEDU)Law Civil liability in leisure diving Diving rules Duty of care List of law regulating underwater diving Investigation of diving injuries UNESCO Convention on the Protection of the Underwater Cultural HeritageHistory of underwater diving History of decompression analysis and construction History of scuba diving List of researchers in underwater diving Lyons Maritime Museum Timeline of diving technology Underwater diving in in style cultureArcheologicalsites SS Commodore USS Monitor Queen Anne's Revenge Whydah GallyUnderwater artand artists The Diver Jason deCaires TaylorEngineersand inventors William Beebe Georges Beuchat John R. Clarke Jacques Cousteau Charles Anthony Deane John Deane Ted Eldred Henry Fleuss Émile Gagnan Joseph-Martin Cabirol Christian J. Lambertsen Yves Le Prieur John Lethbridge Ernest William Moir Joseph Salim Peress Auguste Piccard Willard Franklyn Searle Augustus Siebe Jacques TrigerEquipment Aqua-Lung RV Calypso SP-350 Denise Nikonos Porpoise regulator Standard diving dress Vintage scubaMilitary andcovert operations Raid on Alexandria (1941) Sinking of the Rainbow WarriorScientific initiatives 1992 cageless shark-diving expedition Mission 31IncidentsDive boat incidents Sinking of MV Conception Fire on MV Red Sea AggressorDiver rescues Alpazat cave rescue Tham Luang cave rescueEarly diving John Day (wood worker) Charles Spalding Ebenezer WatsonFreediving fatalities Loïc Leferme Audrey Mestre Nicholas Mevoli Natalia MolchanovaOffshorediving incidents Byford Dolphin diving bell accident Drill Master diving accident Star Canopus diving twist of fate Stena Seaspread diving accident Venture One diving coincidence Waage Drill II diving twist of fate Wildrake diving twist of fateProfessionaldiving fatalities Roger Baldwin John Bennett Victor F. Guiel Jr. Craig M. Hoffman Peter Henry Michael Holmes Johnson Sea Link coincidence Edwin Clayton Link Gerard Anthony Prangley Pier Skipness Robert John Smyth Albert D. Stover Richard A. Walker Lothar Michael Ward Joachim Wendler Bradley Westell Arne ZetterströmScuba divingfatalities Ricardo Armbruster Allan Bridge David Bright Berry L. Cannon Cotton Coulson Cláudio Coutinho E. Yale Dawson Deon Dreyer Milan Dufek Sheck Exley Maurice Fargues Fernando Garfella Palmer Guy Garman Steve Irwin Jim Jones Henry Way Kendall Artur Kozłowski Chris and Chrissy Rouse Kirsty MacColl Agnes Milowka François de Roubaix Dave Shaw Wesley C. Skiles Dewey Smith Rob Stewart Esbjörn Svensson Josef Velek PublicationsManuals NOAA Diving Manual U.S. Navy Diving Manual Basic Cave Diving: A Blueprint for Survival Underwater Handbook Bennett and Elliott's physiology and medication of diving Encyclopedia of Recreational Diving The new science of skin and scuba diving Professional Diver's Handbook Basic ScubaStandards andCodes of Practice Code of Practice for Scientific Diving (UNESCO) DIN 7876 IMCA Code of Practice for Offshore Diving ISO 24801 Recreational diving services and products — Requirements for the coaching of leisure scuba diversGeneral non-fiction The Darkness Beckons Goldfinder The Last Dive Shadow Divers The Silent World: A Story of Undersea Discovery and AdventureResearch List of Divers Alert Network publicationsDive guides Training and registrationDivertraining Competence and review Competency-based finding out Refresher training Skill evaluation Diver coaching standard Diving teacher Diving college Occupational diver coaching Commercial diver coaching Military diver coaching Public safety diver coaching Scientific diver coaching Recreational diver training Introductory diving Teaching manner Muscle memory Overlearning Stress exposure coachingSkills Combat sidestroke Diver navigation Diver trim Ear clearing Frenzel maneuver Valsalva maneuver Finning ways Scuba skills Buddy respiring Low affect diving Diamond Reef System Surface-supplied diving abilities Underwater searches RecreationalscubacertificationlevelsCore diving abilities Advanced Open Water Diver Autonomous diver CMAS* scuba diver CMAS** scuba diver Introductory diving Low Impact Diver Master Scuba Diver Open Water Diver Supervised diverLeadership abilities Dive chief Divemaster Diving teacher Master InstructorSpecialist skills Rescue Diver Solo diverDiver trainingcertificationand registrationorganisations European Underwater Federation (EUF) International Diving Regulators and Certifiers Forum (IDRCF) International Diving Schools Association (IDSA) International Marine Contractors Association (IMCA) List of diver certification organizations National Oceanic and Atmospheric Administration (NOAA) Nautical Archaeology Society Universal Referral Program World Recreational Scuba Training Council (WRSTC)Commercial divercertificationauthorities Australian Diver Accreditation Scheme (ADAS) Commercial diver registration in South Africa Divers Institute of Technology Health and Safety Executive (HSE) Department of Employment and LabourCommercial divingschools Divers Academy International Norwegian diver collegeFree-divingcertificationagencies AIDA International (AIDA) Confédération Mondiale des Activités Subaquatiques (CMAS) Performance Freediving International (PI) Scuba Schools International (SSI)Military trainingcentres Defence Diving School Underwater Escape Training UnitRecreational scubacertificationagencies American Canadian Underwater Certifications (ACUC) American Nitrox Divers International (ANDI) Association nationale des moniteurs de plongée (ANMP) British Sub-Aqua Club (BSAC) Comhairle Fo-Thuinn (CFT) Confédération Mondiale des Activités Subaquatiques (CMAS) Federación Española de Actividades Subacuáticas (FEDAS) Fédération Française d'Études et de Sports Sous-Marins (FFESSM) Federazione Italiana Attività Subacquee (FIAS) Global Underwater Explorers (GUE) International Association for Handicapped Divers (IAHD) International Association of Nitrox and Technical Divers (IANTD) International Diving Educators Association (IDEA) Israeli Diving Federation (TIDF) National Academy of Scuba Educators (NASE) National Association of Underwater Instructors (NAUI) Nederlandse Onderwatersport Bond (NOB) Professional Association of Diving Instructors (PADI) Professional Diving Instructors Corporation (PDIC) Sub-Aqua Association (SAA) Scuba Diving International (SDI) Scuba Educators International (SEI) Scottish Sub Aqua Club (ScotSAC) Scuba Schools International (SSI) Türkiye Sualtı Sporları Federasyonu (TSSF) United Diving Instructors (UDI) YMCA SCUBA ProgramScientific divercertificationauthorities American Academy of Underwater Sciences (AAUS) CMAS Scientific CommitteeTechnicalcertificationagencies American Nitrox Divers International (ANDI) British Sub-Aqua Club (BSAC) Confédération Mondiale des Activités Subaquatiques (CMAS) Diving Science and Technology (DSAT) Federazione Italiana Attività Subacquee (FIAS) International Association of Nitrox and Technical Divers (IANTD) Professional Association of Diving Instructors (PADI) Professional Diving Instructors Corporation (PDIC) Trimix Scuba Association (TSA) Technical Extended Range (TXR)Cavediving Cave Divers Association of Australia (CDAA) Cave Diving Group (CDG) Global Underwater Explorers (GUE) National Association for Cave Diving (NACD) National Speleological Society#Cave Diving Group (CDG) National Association of Underwater Instructors (NAUI) Technical Diving International (TDI) Underwater sportsSurface snorkeling FinswimmingSnorkeling/breath-hold Spearfishing Underwater soccer Underwater hockey Australia Turkey Underwater rugby Colombia United States Underwater goal shootingBreath-hold Aquathlon Apnoea finswimming Freediving Underwater ice hockeyOpen Circuit Scuba Immersion finswimming Sport diving Underwater cycling Underwater orienteering Underwater imagesRebreather Underwater photographySports governingorganisations and federations International AIDA International Confédération Mondiale des Activités Subaquatiques) National AIDA Hellas Australian Underwater Federation British Freediving Association British Octopush Association British Underwater Sports Association Comhairle Fo-Thuinn Federación Española de Actividades Subacuáticas Fédération Française d'Études et de Sports Sous-Marins South African Underwater Sports Federation Türkiye Sualtı Sporları Federasyonu Underwater Society of America)Competitions 14th CMAS Underwater Photography World ChampionshipUnderwater diversPioneersof diving Eduard Admetlla i Lázaro Aquanaut James F. Cahill Jacques Cousteau Billy Deans Dottie Frazier Trevor Hampton Hans Hass Dick Rutkowski Teseo Tesei Arne ZetterströmUnderwaterscientistsarchaeologists andenvironmentalists Michael Arbuthnot Robert Ballard George Bass Mensun Bound Louis Boutan Hugh Bradner Cathy Church Eugenie Clark James P. Delgado Sylvia Earle John Christopher Fine George R. Fischer Anders Franzén Honor Frost Fernando Garfella Palmer David Gibbins Graham Jessop Swietenia Puspa Lestari Pilar Luna Robert F. Marx Anna Marguerite McCann Innes McCartney Charles T. Meide David Moore Mark M. Newell Lyuba Ognenova-Marinova John Peter Oleson Mendel L. Peterson Richard Pyle William R. Royal Margaret Rule Gunter Schöbel Stephanie Schwabe Myriam Seco E. Lee Spence Robert Sténuit Peter ThrockmortonScuba recordholders Pascal Bernabé Jim Bowden Mark Ellyatt Sheck Exley Nuno Gomes Claudia Serpieri Krzysztof StarnawskiUnderwaterfilmmakersand presenters Samir Alhafith David Attenborough Ramón Bravo Jean-Michel Cousteau Richie Kohler Paul Rose Andy Torbet Ivan Tors Andrew WightUnderwaterphotographers Doug Allan Tamara Benitez Georges Beuchat Adrian Biddle Jonathan Bird Eric Cheng Neville Coleman Jacques Cousteau John D. Craig Ben Cropp Bernard Delemotte David Doubilet Candice Farmer John Christopher Fine Dermot FitzGerald Rodney Fox Ric Frazier Stephen Frink Peter Gimbel Monty Halls Hans Hass Henry Way Kendall Rudie Kuiter Joseph B. MacInnis Luis Marden Agnes Milowka Noel Monkman Pete Oxford Steve Parish Zale Parry Pierre Petit Leni Riefenstahl Peter Scoones Brian Skerry Wesley C. Skiles E. Lee Spence Philippe Tailliez Ron Taylor Valerie Taylor Albert Tillman John Veltri Stan Waterman Michele Westmorland John Ernest Williamson J. Lamar WorzelUnderwaterexplorers Caves Graham Balcombe Sheck Exley Martyn Farr Jochen Hasenmayer Jill Heinerth Jarrod Jablonski William Hogarth Main Tom Mount Jack Sheppard Bill Stone Reefs Arthur C. Clarke Wrecks Leigh Bishop John Chatterton Clive Cussler Bill Nagle Aristotelis ZervoudisAquanauts Andrew Abercromby Joseph M. Acaba Clayton Anderson Richard R. Arnold Serena Auñón-Chancellor Michael Barratt (astronaut) Robert L. Behnken Randolph Bresnik Timothy J. Broderick Justin Brown Berry L. Cannon Scott Carpenter Gregory Chamitoff Steve Chappell Catherine Coleman Robin Cook Craig B. Cooper Fabien Cousteau Philippe Cousteau Timothy Creamer Jonathan Dory Pedro Duque Sylvia Earle Jeanette Epps Sheck Exley Albert Falco Andrew J. Feustel Michael Fincke Satoshi Furukawa Ronald J. Garan Jr. Michael L. Gernhardt Christopher E. Gerty David Gruber Chris Hadfield Jeremy Hansen José M. Hernández John Herrington Paul Hill Akihiko Hoshide Mark Hulsbeck Emma Hwang Norishige Kanai Les Kaufman Scott Kelly Karen Kohanowich Timothy Kopra Dominic Landucci Jon Lindbergh Kjell N. Lindgren Michael López-Alegría Joseph B. MacInnis Sandra Magnus Thomas Marshburn Matthias Maurer Okay. Megan McArthur Craig McKinley Jessica Meir Simone Melchior Dorothy Metcalf-Lindenburger Andreas Mogensen Karen Nyberg John D. Olivas Takuya Onishi Luca Parmitano Nicholas Patrick Tim Peake Thomas Pesquet Marc Reagan Garrett Reisman Kathleen Rubins Dick Rutkowski Tara Ruttley David Saint-Jacques Josef Schmid Robert Sheats Dewey Smith Steve Squyres Heidemarie Stefanyshyn-Piper Robert Sténuit Hervé Stevenin Nicole Stott James Talacek Daniel M. Tani Robert Thirsk Bill Todd Mark T. Vande Hei Koichi Wakata Rex J. Walheim Shannon Walker John Morgan Wells Joachim Wendler Douglas H. Wheelock Peggy Whitson Dafydd Williams Jeffrey Williams Sunita Williams Gregory R. Wiseman Kimiya YuiWriters and journalists Michael C. Barnette Victor Berge Philippe Diolé Gary Gentile Bret Gilliam Bob Halstead Trevor Jackson Steve Lewis John MatteraRescuers Craig Challen Richard Harris Rick Stanton John VolanthenFrogmen Lionel Crabb Ian Edward Fraser Sydney Knowles James Joseph MagennisCommercial salvors Keith JessopScience of underwater divingDivingphysics Breathing performance of regulators Buoyancy Archimedes' principle Neutral buoyancy Concentration Diffusion Molecular diffusion Force Oxygen fraction Permeation Psychrometric constant Solubility Henry's law Saturation Solution Supersaturation Surface stress Hydrophobe Surfactant Temperature Torricellian chamber Underwater acoustics Modulated ultrasound Underwater vision Snell's law Underwater pc vision Weight Apparent weightGas rules Amontons's regulation Boyle's law Charles's law Combined fuel regulation Dalton's regulation Gay-Lussac's regulation Ideal fuel legislationPressure Absolute stress Ambient strain Atmospheric strain Gauge strain Hydrostatic pressure Metre sea water Partial stress Divingphysiology Artificial gills Cold surprise response Diving reflex Equivalent narcotic intensity Lipid Maximum working intensity Metabolism Physiological response to water immersion Tissue Underwater visionCirculatorysystem Blood shift Patent foramen ovale Perfusion Pulmonary circulation Systemic moveDecompressiontheory Decompression fashions: Bühlmann decompression algorithm Haldane's decompression fashion Reduced gradient bubble fashion Thalmann algorithm Thermodynamic type of decompression Varying Permeability Model Equivalent air depth Equivalent narcotic intensity Oxygen window in diving decompression Physiology of decompressionRespiration Blood–air barrier Breathing CO₂ retention Dead space Gas alternate Hypocapnia Respiratory change ratio Respiratory quotient Respiratory system Work of respiring DivingenvironmentClassification List of diving environments by sort Altitude diving Benign water diving Confined water diving Deep diving Inland diving Inshore diving Muck diving Night diving Open-water diving Black-water diving Blue-water diving Penetration diving Cave diving Ice diving Wreck diving Recreational dive websites Underwater surroundingsImpact Environmental have an effect on of recreational diving Low affect divingEnvironmentalelements Algal bloom Currents: Current Longshore waft Ocean current Rip current Tidal race Undertow Upwelling Ekman shipping Halocline Reef Coral reef Stratification Thermocline Tides Turbidity Wind wave Breaking wave Surf Surge Swell Wave shoalingOther Bathysphere Defense towards swimmer incursions Diver detection sonar Offshore survey Rugged compact camera Underwater area consciousnessAwards and events Hans Hass Award International Scuba Diving Hall of Fame London Diving Chamber Dive Lectures NOGI AwardsDeep-submergencevehicle Aluminaut DSV Alvin American submarine NR-1 Bathyscaphe Archimède FNRS-2 FNRS-3 Harmony category bathyscaphe Sea Pole-class bathyscaphe Trieste II Deepsea Challenger Ictineu 3 JAGO Jiaolong Konsul-class submersible Russian submarine Losharik Mir Nautile Pisces-class deep submergence car DSV Sea Cliff DSV Shinkai DSV Shinkai 2000 DSV Shinkai 6500 DSV Turtle DSV-5 NemoDeep-submergencerescue automobile LR5 LR7 MSM-1 Mystic-class deep-submergence rescue vehicle DSRV-1 Mystic DSRV-2 Avalon NATO Submarine Rescue System Priz-class deep-submergence rescue automobile Russian deep submergence rescue vehicle AS-28 Russian submarine AS-34 ASRV Remora SRV-300 Submarine Rescue Diving Recompression System Type 7103 DSRV URF (Swedish Navy) Specialinterestgroups Artificial Reef Society of British Columbia CMAS Europe Coral Reef Alliance Diving Equipment and Marketing Association Divers Alert Network Green Fins Historical Diving Society Karst Underwater Research Nautical Archaeology Program Nautical Archaeology Society Naval Air Command Sub Aqua Club Project AWARE Reef Check Reef Life Survey Rubicon Foundation Save Ontario Shipwrecks SeaKeys Sea Research Society Society for Underwater Historical Research Society for Underwater Technology Underwater Archaeology Branch, Naval History & Heritage CommandSubmarine escapeand rescue Escape trunk International Submarine Escape and Rescue Liaison Office McCann Rescue Chamber Submarine Escape and Rescue gadget (Royal Swedish Navy) Submarine break out coaching facility Submarine Escape Training Facility (Australia) Submarine rescue shipEscape set Davis Submerged Escape Apparatus Momsen lung Steinke hood Submarine Escape Immersion Equipment Neutral buoyancyfacilities forAstronaut training Neutral Buoyancy Laboratory Neutral buoyancy pool Neutral buoyancy simulation as a training help Neutral Buoyancy Simulator Space Systems Laboratory Yuri Gagarin Cosmonaut Training CenterOther Nautilus Productions Category Commons Glossary Indexes: Dive websites Divers Diving Outline Portal Retrieved from "https://en.wikipedia.org/w/index.php?title=Carbon_monoxide_poisoning&oldid=1016665214"

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