Carbon Monoxide Poisoning

Peter M. Winter, MD; John N. Miller, MB, BS
JAMA. 1976;236(13):1502-1504. doi:10.1001/jama.1976.03270140054029.
Text Size: A A A
Published online

ACUTE carbon monoxide poisoning accounts for approximately 3,500 accidental or suicidal deaths per year in the United States. Many are preventable by medical management based on physiologic understanding.

Pathophysiology  Carbon monoxide poisoning and its mechanism have been known since Claude Bernard reported in 1857 that this gas caused death by hypoxia, consequent on its reversible combination with hemoglobin.1 The equilibrium reactions were well described by Haldane in 1895.2 Excellent reviews are available.3,4The effects of CO in concentrations encountered clinically are based entirely on its combination with hemoglobin, displacement of oxygen, and consequent disruption of the O2 transport system. Carbon monoxide competes with O2 for binding sites on the hemoglobin molecule, and carboxyhemoglobin (COHb) is without practical function as a carrier of O2. Because affinity of CO for hemoglobin is 230 to 270 times as great as that of O2, the latter is


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.