Inhalation of excessive carbon monoxide can lead to acute poisoning. Carbon monoxide enters the blood through the respiratory tract and combines with intracellular hemoglobin to form carboxyhemoglobin. The affinity of carboxyhemoglobin with red blood cells is 240 times greater than that of oxygen with red blood cells, but the dissociation degree is 3600 times slower. Therefore, carboxyhemoglobin aggregates, thus reducing the oxygen carrying capacity of red blood cells, causing tissue hypoxia and brain and heart damage. Mild symptoms include headache, dizziness, weakness of limbs, nausea, vomiting and lethargy, while serious symptoms include coma, loss of various reflexes, respiratory depression, shock, redness and blisters on the pressed parts of the skin. After the recovery of consciousness disorder, after a "false recovery period" of 2-60 days, patients may have mental consciousness disorder, tremor paralysis, hemiplegia, aphasia, blindness and secondary epilepsy again.

Psychological guidance

1. Suicides should persuade and encourage patients to face setbacks and disappointments correctly, adopt positive coping styles, understand patients' difficulties through communication, establish a good nurse-patient relationship, gain patients' trust, and try their best to help patients solve difficulties and contradictions;

2. Accidental poisoning, to comfort patients, eliminate their ideological concerns, actively cooperate with treatment and nursing.

Dietary guidance

1. In case of coma or dysphagia, give a light, digestible and nutritious nasal feeding diet to ensure the nutrition of patients and enhance the body's resistance;

There is no special taboo food for this disease. If you have upper gastrointestinal bleeding, you should fast.

Therapeutic guidance

1. Intravenous infusion of 20% mannitol is to reduce intracranial pressure and prevent brain edema. Pay attention to the patient's consciousness and pupil changes after medication.

2. Hypothermia therapy: The purpose is to reduce the brain metabolic rate, increase the brain's tolerance to hypoxia, and protect brain function. When using ice packs, pay attention to prevent frostbite and pressure sores, and pay attention to timely replacement to ensure the cooling effect.

3. Oxygen therapy: Oxygen inhalation can accelerate the dissociation of carboxyhemoglobin and increase the discharge of carbon monoxide. Hyperbaric oxygen chamber treatment can increase the dissolved oxygen in blood, increase the arterial oxygen partial pressure, make the oxygen capacity in capillaries diffuse into cells, and quickly correct tissue hypoxia, which has the advantages of good effect, high cure rate and few sequelae.

4. Hyperbaric oxygen therapy guidelines:

(1) Hyperbaric oxygen therapy is a method to treat diseases by placing patients in a closed special environment higher than 1 atmospheric pressure and breathing pure oxygen.

(2) Arrive 20 minutes in advance for each treatment, make good preparations before entering the cabin, and actively report the changes of the condition to the medical staff in the oxygen cabin for necessary observation, inspection and treatment.

(3) It is forbidden to carry matches, lighters, cigarettes, grease, alcohol, firecrackers, gasoline and electric toys. First, it is not advisable to wear clothes that are prone to electrostatic sparks, such as nylon, acrylic, polypropylene, wool, bulky yarn, etc. , and replace all cotton-padded jacket as required to prevent fire caused by electrostatic sparks.

(4) Hold the empty urine before entering the cabin.

(5) After entering the cabin, the pressure of the eustachian tube should be adjusted well during the pressurization process, and the swallowing action should be strengthened to promote the opening of the eustachian tube, so as to relieve the earache caused by the compression of the middle ear arch L during pressurization.

(6) Use oxygen mask correctly and fasten the fixing belt to avoid air leakage. The two hoses connected to the mask should not be folded, twisted or squeezed to keep breathing unobstructed and ensure effective treatment.

(7) Take oxygen in a quiet rest state. Don't talk, eat or take a deep breath when there is oxygen.

(8) If dizziness, sweating, nausea, facial tension or convulsions occur during oxygen inhalation, you can take off the mask and inhale the cabin air instead, and immediately report to the operator for timely treatment.

(9) If you have itchy skin, joint pain and excessive bleeding from the wound after you leave the cabin, you should inform the medical staff to deal with it in time.

(10) During the treatment, pay attention to strengthening nutrition and adopt a diet with high sugar, high protein, protein, vitamins and calories.

(1 1) Pay attention to rest, take a hot drink or bath, and help nitrogen to continue to be discharged.

Discharge guidance

1. Strengthen prevention. To publicize carbon monoxide poisoning, gas water heaters should be avoided to be installed indoors;

2. If there are manifestations of delayed encephalopathy such as decreased intelligence and memory, abnormal motor and sensory functions, you should see a doctor in time;

3. Continue to take brain cell regenerants, such as vitamin B and Naofukang, as prescribed by the doctor, and do not stop taking drugs at will within six months;

4. Give social and family support to maintain a happy mood and emotional stability;

5. 1-2 months to review EEG;

6. Patients who stay in bed for a long time should turn over, knock on their backs and massage to prevent complications.

Effect evaluation

1. Patients should master the disease-related knowledge and actively cooperate with the treatment;

2. Master the knowledge of disease prevention and change your behavior.