-----Original Message-----
From: maurice cross <[log in to unmask]>
To: INTERNET:[log in to unmask] <[log in to unmask]>
Date: 21 March 1999 22:16
Subject: CO Poisoning
>It is typical of the CO poisoning who has trivial exposure to have a
>variety of symptoms which are inexplicable. The fact that your patient was
>a hopepipe job yet has a GSC of 13 points to his having done a very
>inadequate 'job' since MOST CO poisonings are in fact succssful in kiling
>themselves.
I would agree as this is my third case in 19 years in the service and he has
been the only one which I manged to give any treatment to as the others,
unfortunately, were "well dead", because they were found too late.
>His shakes are quite untypical of CO, but might be related to
>other drugs, emotional state or some unknown mechanism. But if you are
>pulled from the car with a GCS of 13 before treatment then you are NOT very
>sevely intoxicated.
His GCS was probably lower on extrication, but was 13 on our arrival
probably because:
1. He had apparently started to gas himself and then decided to enter the
house to phone his wife. He then proceeded to return to the car and continue
with his intentions.
2. It took us at least 13 - 14 mins to arrive on scene, hence he was no
longer in the toxic atmosphere.
I also established from himself, his wife and evidence of the scene that no
other contibuting factors ie drugs had come into play.
>In severe CO poisoning, there is involvement of the basal ganglia of the
>brain. This is classically seen on CT scan. Even in these cases,. a
>parkinsonian outcome is rare.
>
>So your shakes may be many things.
>But I suspect it ani't directly due to CO
>
>Maurice Cross
>Plymouth.
>
Thank you for your input and I shall follow up this case on tomorrow night's
night shift.
John Nelson
Paramedic (NHSTD)
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