COpoisoning in afya

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Carbon monoxide high affinity for haemoglobin and myoglobin resulting in a left-shift of the oxygen dissociation curve and tissue hypoxia. 
50 deaths per year  from accidental carbon monoxide poisoning in the UK

Questions may hint at badly maintained housing e.g. student houses (2008 DoH guidelines)

''Features'' of carbon monoxide toxicity 
headache: 90% of cases
nausea and vomiting: 50%
vertigo: 50%
confusion: 30%
subjective weakness: 20%
severe toxicity: 'pink' skin and mucosae, hyperpyrexia, arrhythmias, extrapyramidal features, coma, death

''Typical carboxyhaemoglobin levels''
< 3% non-smokers
< 10% smokers
10 - 30% symptomatic: headache, vomiting
> 30% severe toxicity

''Management''
100% oxygen
hyperbaric oxygen

''Indications for hyperbaric oxygen''
loss of consciousness at any point
neurological signs other than headache
myocardial ischaemia or arrhythmia
pregnancy

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