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CO poisoning: nurses urged to help stamp out the silent killer

Lynn Griffiths

The recent high-profile tragedy in which two young children lost their lives during a family holiday in Corfu has once again highlighted the danger of carbon monoxide (CO) poisoning.
It is thought that a faulty boiler was to blame for the fatal gas leak, which killed Christianne Shepherd, 7, and her brother Robert, 6, while they slept, leaving their father and his partner unconscious and a family destroyed.
My children and I were all poisoned by CO for nearly 11 years, so I know only too well the devastating effects this silent killer can have on family life.
CO has no taste, colour or odour, but it can kill in minutes; it is produced when gas, coal, wood or oil fails to burn correctly. Depending on the levels inhaled, it can cause permanent damage to your health.
The only way to confirm CO poisoning is by a specialised test. This may be done using a breath test or using a device called a CO-oximeter (a light probe placed on the finger - not the same as a normal pulse oximeter), or with a small blood sample (this is only available in hospitals). There is no other way of ruling out CO poisoning. It is also important to know that measurable levels start to fall once breathing clean air, so a test should be done as soon as possible to prove not being poisoned. If anyone suspects CO poisoning they should not be given oxygen until CO has been ruled out by either a breath test or a CO-oximeter test.
CO-awareness will be campaigning soon to have a breath test monitor and/or a CO-oximeter available in all Accident & Emergency departments and GP surgeries and for paramedics to carry them.

Who is at risk?
Deaths from CO poisoning are rising, but alarmingly it is still not recognised as part of the postmortem examination. Senior citizens, those with heart and lung problems, pregnant mothers and young children are particularly vulnerable. According to the 2001 census, there are over 97, 000 children under the age of 16 providing care for a relative. Surely the time has come to include education on how to prevent CO poisoning and its symptoms on the national curriculum for schools.
CO is harmful because it displaces the levels of oxygen within the blood, resulting in the death of cells and damage to major organs, which are subsequently starved of oxygen. CO poisoning produces a wide range of symptoms, which can be easily misdiagnosed as flu, food poisoning or even a simple virus. The medical professionals need to ask more searching questions when a patient exhibits signs of flu, for example:

  • Do you feel better when you are away from home?
  • Are other people or pets sharing your home suffering from any illnesses?

Advising a patient to "keep warm" could in fact be placing their lives at increased risk. Keeping warm involves turning on potentially lethal heating appliances.

Long-term effects
The long-term effects of CO poisoning are devastating on family life and can be extremely serious. It can cause permanent damage to major organs within the body, such as the heart, lungs and brain. It is thought that the hippocampus section of the brain that deals with new memories is particularly susceptible to long-term damage.
The effects of CO poisoning over the long term may be subtle or very severe, depending on the extent of poisoning. Victims have reported a wide range of medical problems, such as amnesia, headaches, memory loss, personality and behavioural changes, loss of muscle and bladder control, and impairment of coordination and vision. Although the majority of people who suffer long-term effects from CO poisoning can recover in time, there are those that will suffer permanent organ and brain damage and even be left confined to a wheelchair.
Many of these long-term effects are not immediate and may present themselves several weeks or months after exposure. In most cases, victims don't realise that they are exposed to CO. Sometimes the symptoms decline, but the long-term effects of low-level exposure are still unknown, so it can often be difficult to ascertain how this will affect a person's life. There also seems to be no treatment or even aftercare made available to those poisoned by CO.
Knowledge is the key to preventing CO poisoning. Box 1 lists the achievements of CO-Awareness over the past year. Please help CO-Awareness in our campaign to raise awareness about the dangers of this silent killer. It is vital that GPs, PCTs, health visitors, nurses, social services and housing organisations take responsibility for ensuring the public's safety against exposure to CO in order to avoid serious medical problems or death. Could the predictable rise in deaths during the winter months also be linked to an increase in the use of heating appliances? What do you think?