The sudden death of six primary school students in a school in Pu County, Shanxi Province on December 4 shocked the nation. A time about the cause of death of all kinds of discussion and speculation is incomprehensible, after the police investigation and experiments confirmed that the six young lives died in the dormitory only a board of a 3000-watt generator running carbon monoxide. 1, the generator is how to produce carbon monoxide, leading to the death of people? Carbon monoxide is one of the most common colorless, odorless, tasteless, non-irritating harmful gases, known as the invisible killer. Any carbon-containing substance can produce carbon monoxide when it burns incompletely. As we know, generators usually generate electricity by burning fuel to produce power. As with car engines, generators also produce large amounts of carbon monoxide exhaust when they are running, and they consume large amounts of oxygen in the environment. Carbon monoxide poisoning caused by the operation of generators is particularly common in developed countries. According to information, even with good education for residents to prevent carbon monoxide poisoning, the United States in 2005 or in the warm August when Hurricane Katrina landed in Florida, due to power outages, people have used small generators to generate electricity, according to incomplete statistics within only 2 days led to 28 people carbon monoxide poisoning. And in the United States Alabama and Texas Katrina and Rita two hurricanes landfall due to the same reason has led to 78 people carbon monoxide poisoning, of which 10 people died. According to the investigation, these generators are installed outdoors, only with the living room windows or vents closer to lead to so many poisoning incidents. It is not surprising that a tragedy occurred when a 3,000-watt generator and six young lives were placed in the same room in a relatively more confined room in the colder region of Shanxi, China. This incident has once again taught us the lesson of blood to sound the alarm – invisible killers are everywhere, carbon monoxide is all around us, we should always be alert to carbon monoxide poisoning. 2. What are the new forms of carbon monoxide poisoning? Carbon monoxide poisoning is the most common form of harmful gas poisoning in many countries around the world, including developed countries. In the north of China, especially before the 1980s, because people burned coal for heating and cooking, frequent poisoning deaths occurred at that time, commonly known as gas poisoning, people are not unfamiliar with carbon monoxide poisoning, and often remain highly alert. 1990s, with the continuous improvement of people’s living standards, the improvement of people’s living environment, gas instead of burning coal, coal burning caused by the Carbon monoxide poisoning is decreasing day by day, and people’s awareness of preventing carbon monoxide poisoning is gradually becoming indifferent. The invisible killer of carbon monoxide has never been far away from our daily life, and with the improvement of modern material life, this invisible killer is hiding around us quietly in many new forms, probably in a more intimate way than before. The following forms are now common to be able to: gas water heaters, oil and gas heating, charcoal fire: such as charcoal hot pot, charcoal fire pit; gas stove: such as gas stove, LPG stove, natural gas stove; internal combustion engine: such as car engines, generators, etc.. The early 1990s, with the improvement of living conditions in China’s urban residents and the improvement of people’s living standards, people gradually moved out of the bungalow into the building, for the convenience of bathing have installed a gas water heater. Due to economic factors early water heaters are usually not high grade, no airtight into the exhaust system, security is not strong. Coupled with unreasonable installation, most were installed in the living room, and some were even installed in the bathroom, resulting in a large number of carbon monoxide poisoning incidents. At that time, deaths due to gas water heater poisoning occurred from time to time, and there are even the whole family closed the tragic case. At present, with the improvement of our people’s living standards, the residents of northern cities have improved their awareness of the safety of gas water heaters, gradually eliminating the early gas water heaters and replacing them with safer closed gas water heaters or electric water heaters, this cause of carbon monoxide poisoning patients in large cities is occurring less and less. However, in small and medium-sized cities and rural areas, especially in many areas in the south of China, carbon monoxide poisoning from this cause is still on the rise. For example, on November 28 this year in Wuhu City, Anhui Province, China, the founder of the famous “fool’s melon” Nian Guangjiu’s eldest son and a woman died mysteriously in the room. After a meticulous investigation by the Wuhu City Police, it was confirmed that the two died of carbon monoxide poisoning caused by the prolonged use of LPG water heaters in a closed environment. In addition, with the increasing application of gas facilities, such as gas stoves, gas heaters, etc. and the aging after a long time of use, this safety hazard should be given great attention in both urban and rural areas of China. At present, with the increasing number of cars owned by residents of different cities in China, the incidence of carbon monoxide poisoning caused by the exhaust gas of car engine combustion is gradually increasing momentum. Some information shows that there are currently about 2,000 cases of carbon monoxide poisoning in the United States each year, and most of the patients in the car due to carbon monoxide poisoning caused by car exhaust. Especially in winter, closed windows, open car warm air, stay inside the car for a long time or car start state for a long time parked in the garage can lead to serious carbon monoxide poisoning occur. Also in the cold winter, people like to hide in the closed room to eat charcoal hot pot, not knowing that the burning process of charcoal can produce a lot of carbon monoxide, leading to serious carbon monoxide poisoning, which also kills people. Such poisoning cases are not only in the north of China, but also in the south of the country. Especially when you drink 2 or 2 while eating hot pot, dazed and confused, the early symptoms of poisoning are not easy to cause people to be alerted, and the danger is more insidious. For example, in July this year, four people in Xuanwu District, Beijing, due to eating hot pot in the box led to collective carbon monoxide poisoning. In December last year, 12 diners eating hot pot in a restaurant in Maoming City, Guangdong Province were taken to hospital for treatment of carbon monoxide poisoning en masse. In addition, at present, urban cottage areas and rural residents usually use “earth heating” stove for house heating, due to the existence of counterfeit stoves, called by the people “killer stove” and stove installation is not reasonable, and the living room is not completely isolated or stove room and living room left The main form of carbon monoxide poisoning is also caused by the presence of a large number of carbon monoxide poisoning incidents. Most of the southern areas in China do not have heating facilities, and the people usually use charcoal fire pots for heating during the cold winter is also one of the causes of carbon monoxide poisoning. In short, to educate our people to always be highly vigilant and to always prevent carbon monoxide poisoning that may occur in their lives. 3. What are the symptoms of carbon monoxide poisoning? There are acute and chronic carbon monoxide poisoning. Most of what we usually say about carbon monoxide poisoning refers to acute carbon monoxide poisoning. The symptoms of acute carbon monoxide poisoning are related to the degree of poisoning, the patient’s previous health status, and the activity status at the time of poisoning. Patients with mild poisoning show severe headache, dizziness, weakness of limbs, nausea, vomiting, confusion, and drowsiness. Patients with coronary heart disease may have angina attacks; in moderate poisoning, patients appear to be comatose, still respond to painful stimuli, pupil-to-light and corneal reflexes exist, tendon reflexes are weakened, respiration, blood pressure and pulse rate may change; in severe poisoning, patients appear to be in deep coma, incontinent, and various reflexes disappear. Patients with severe intoxication may suffer from deep coma, incontinence and loss of reflexes. In addition, although the above-mentioned patients with moderate to severe carbon monoxide poisoning disappear clinically after active resuscitation and self-perception returns to normal, there will be some patients who will appear again after a period of time (usually 2-60 days), which we call “pseudo-healing period”, with indifferent expression, unresponsiveness, delirium, no autonomous request, dementia or even coma, etc. The patients may also experience stiffness of limbs, unstable walking, incontinence, and tremor paralysis syndrome. Some patients may also have seizures followed by coma and other manifestations. This is collectively referred to as carbon monoxide poisoning delayed encephalopathy. Although a considerable number of patients can recover to varying degrees or even be cured by systematic treatment, the condition is painful, the course of treatment is long, and the disability rate is high, bringing serious economic and social burdens to society and families. 4. What is the pathological mechanism of carbon monoxide poisoning? Carbon monoxide poisoning is mainly caused by carbon monoxide entering the body and binding firmly with hemoglobin, reducing or even depriving the blood of its ability to carry oxygen and causing tissue hypoxia. 85% of CO inhaled into the body combines with hemoglobin in the red blood cells to form stable carboxyhemoglobin. Since the affinity between carbon monoxide and hemoglobin is 240 times greater than the affinity between oxygen and hemoglobin. Even if the inhalation of a low concentration of carbon monoxide can produce a large amount of carboxyhemoglobin, carboxyhemoglobin can not carry oxygen, and is not easy to dissociate, 3600 times smaller than the dissociation speed of oxygenated hemoglobin. Then a large amount of hemoglobin once combined with carbon monoxide will lose the ability to carry oxygen. The blood loses its oxygen-carrying function, and a series of pathological changes occur in the body when the tissues are not supplied with oxygen, which may even endanger life. The degree of carbon monoxide poisoning in patients is proportional to the concentration of carbon monoxide in the patient’s environment and time. In other words, if the concentration of carbon monoxide in the environment is very high, it can kill a person even in a few minutes. Sometimes, although the concentration of carbon monoxide in the environment is not high, but the patient stays in the environment for a long time can also lead to serious carbon monoxide poisoning. 5.What to do once carbon monoxide poisoning occurs? In the treatment of carbon monoxide poisoning patients, always keep in mind that time is life, where time means: the sooner the patient gets out of the poisoned gas, the better; keep the patient’s airway open and effectively improve oxygen deprivation, the sooner the better; try to keep the patient quiet and still, the quieter the better; escort the patient to a hospital with a hyperbaric chamber and hand him over to professional medical staff for treatment, the sooner the better. To pay attention to the following aspects: ① After the occurrence of carbon monoxide poisoning, first of all, we must quickly open the windows to change the air, close the source of poison, and quickly evacuate the poisoned environment if possible; ② To place the patient in a well-ventilated environment with attention to warmth, unbutton the collar, clean the patient’s mouth of vomit and foreign objects such as dentures to keep his or her airway open, and keep him or her lying down, reducing all unnecessary activities and stimuli to reduce the body’s ③ When possible, the patient should be given high-flow oxygen through the nasal tube quickly; ④ Contact with emergency personnel and send the patient to the hospital with hyperbaric oxygen chamber as quickly as possible; ⑤ Never use the folklore methods of vinegar, cold water and grounding to the patient, the consequences of which are endless; practice has proved that most patients, even if the degree of poisoning is very serious, as long as the treatment is timely and reliable, the patient’s prognosis is still The prognosis is good. 6. How to prevent carbon monoxide poisoning? In the past, the people knew more about carbon monoxide poisoning caused by traditional coal fires, and the methods used were economical, such as: reasonable installation of wind hoppers, attention to ventilation of the living room, frequent inspection and cleaning of coal stove fire doors and flue. And now in urban life we have to change according to the change of living environment and possible sources of carbon monoxide poisoning, more enhanced awareness of safety to prevent carbon monoxide poisoning, to every resident know that with the modern gas, fuel oil, heating and living room sealing conditions improve, once the carbon monoxide generation and leakage, its concentration is higher, wider and more harmful. To call for the construction of scientific prevention facilities for carbon monoxide poisoning. The main points to note are as follows: ① Install carbon monoxide alarms in necessary places, such as: kitchens, living rooms and all areas with carbon monoxide poisoning sources; ② Regularly ask professionals to check the safety of gas pipes, stoves, gas and fuel instruments to ensure that they are in safe working condition; ③ Pay attention to the absolute isolation of living rooms and poison sources, and do not make the mistake of putting people and generators in the same room in the tragic case of Pu County, Shanxi Province; ④ Do not eat carbon hot pot or light a charcoal pot in a closed room; ⑤ Do not rely on engine heating in a closed car for a long time, and do not sleep in the car in the state of continuous engine combustion; ⑥ Pay attention to keep the ventilation in the car when staying in the car with the engine on and stagnant for a long time; ⑦ Do not leave the car engine on for a long time in the garage, to ensure the safety of the garage unified wind; ⑧ Check all exhaust gas frequently ⑧ Always check the smoothness of all exhaust gas discharge pipes to ensure that the exhaust gas discharge is unobstructed.