Treatment of carbon monoxide poisoning in children

Carbon monoxide, do you know how it is produced? The most common way in rural areas is the incomplete combustion of firewood when burning, which will produce a lot of black smoke. The largest component in it is carbon monoxide. Carbon monoxide is very harmful to our health. Excessive inhalation can cause breathing difficulties. In more serious cases, it can cause carbon monoxide poisoning and even death. Therefore, it is a very harmful gas. Some children will suffer from carbon monoxide poisoning at ordinary times. In this case, you must hurry up to treat it. What are the treatments for children's carbon monoxide poisoning?

1. Treatment

Give oxygen immediately. Treatment principles.

1. Move away from the poisoning site

Immediately move the patient away from the poisoning scene and place him in a quiet, fresh-air environment.

2. Criteria for emergency care

Respiratory failure, circulatory failure, altered consciousness (coma or convulsion), or no altered consciousness but HbCO value 40%.

In the emergency intensive care unit, vital signs were measured once an hour, and oxygen and carbon dioxide partial pressures and blood gas changes were monitored. Apply ECG monitoring and electroencephalogram. Note changes in the myocardial enzyme CPK and check for the presence of myoglobinuria in the urine.

3. Hyperbaric oxygen therapy

(1) Therapeutic principle: By increasing the dissolved oxygen in plasma, tissue oxygenation is improved; the CO elimination rate is increased; it is beneficial for reducing cerebral edema and intracranial hypertension.

(2) Selection criteria: If conditions permit, HbCO25% can be used even if there are mild symptoms. If there are no equipment conditions, HbCO40% should be arranged immediately if there are symptoms. Literature reports that if treatment is started within 6 hours of poisoning, the mortality rate will drop to 13.5%, otherwise it can reach 30.1%.

(3) Hyperbaric oxygen therapy: There is no consistent opinion on duration and pressure. Usually pure oxygen is given at 2, 2.5 or 3 atmospheres of pressure for 45 to 120 minutes. Undersea et al. recommend applying 2.5 to 3 atmospheres of pressure for 90 minutes. Children only need to use it once, and it is best to do it immediately after poisoning. The time allocation was a 15-min compression phase, 1 hour of 2 atmospheres treatment, and a 15-min decompression period. For infants under 3 months old, the intermediate compression period should be 20 to 30 minutes.

(4) Side effects: Mainly lung lesions and neurological symptoms, in addition to damage to the eyes. Pulmonary hemorrhage or pulmonary edema, epilepsy, pancreatitis, renal failure, etc. may be seen.

4. Symptomatic treatment

(1) Treatment of cerebral edema: give dehydration drugs.

(2) Maintain body metabolism: Provide high-tonic glucose and vitamin C to ensure calorie and water-electrolyte balance.

(3) Fresh blood transfusion or blood exchange therapy: Comatose patients can receive fresh blood transfusion or blood exchange therapy.

(4) Antibiotics: prevent and control infection.

(II) Prognosis

Severe poisoning and delayed treatment may result in death or cause sequelae. For patients with mild to moderate poisoning, the prognosis is good if they receive active treatment.

From the above treatment methods, it can be seen how serious carbon monoxide poisoning is for children. The treatment process is complicated and long, and it requires a long period of recovery and prognosis. Therefore, parents should try not to take their children to places with oil smoke to avoid children inhaling too much carbon monoxide and causing poisoning. Here, we also hope that children with carbon monoxide poisoning will not worry too much, and everything will be fine.