Akute kohlenmonoxidvergiftung: Ein alter hut in neuen schachteln

Abstract

Background: Poison information centers have observed an increasing number of cases of acute carbon monoxide (CO) intoxication. Objectives: Determination of the incidence and mortality, discussion of effects and clinical signs and presentation of treatment recommendations. Methods: The official statistics as well as remarkable cases reported in the news are analyzed. Basic literature and expert opinions are discussed. Results: In 2009 and 2010 fatalities due to CO increased by about 30% in Germany. New types of exposition, such as suicide by charcoal burning were numerous. The assessment of CO poisoning includes the level of consciousness and measurement of CO-hemoglobin (CO-Hb) saturation. A high partial pressure of oxygen is required for treatment. The effectiveness of hyperbaric oxygen remains unclear but may be assumed in cases of severe poisoning. Hyperbaric chambers are not continuously available (24/7) throughout Germany. Conclusions: A CO poisoning emergency yields new threats and challenges for emergency staff. To ensure the correct diagnosis and to determine the appropriate treatment, a blood sample should be taken immediately. Pulse CO oximeters facilitate the early triage of even larger numbers of patients. Sufficient oxygenation is essential. Severely poisoned patients should be admitted for hyperbaric oxygen therapy. © Springer-Verlag 2012.