Permanent Brain Damage Following Non-Fatal Carbon Monoxide Poisoning

Non-Fatal Carbon Monoxide Poisoning – Leaves Survivors in Distress

Non-Fatal Carbon Monoxide Poisoning can leave survivors with brain damage and numerous neuropsychiatric symptoms that may last a lifetime.

By Rebecca Martin

More than 100,000 people in the United States visit the emergency room annually due to accidental exposure to carbon monoxide fumes. Most of these people suffer non-fatal carbon monoxide poisoning. The most common sources of non-fatal carbon monoxide poisoning in the winter are furnaces and boilers, kerosene and propane heaters, stoves, gas ranges and other gas appliances, hot water heaters, lanterns, vehicles left running in attached garages, and burning charcoal or wood. The potential for carbon monoxide poisoning exists any time a fuel burning device is in use. Portable electric generators and other small gasoline powered power tools are always a danger.

This La Quinta Hotel in Rochester, Minnesota was the scene of a non-fatal carbon monoxide poisoning on November 4, 2023. See Attorney Gordon Johnson and the survivors being interviewed here. 

The most common place that carbon monoxide can occur is in your own home–especially in homes that use gas appliances and have attached garages. But even if your home is fuel-free and the risk has been reduced by safety features, you may still be at risk in many other locations. These can include workplaces, churches, pre-schools, educational facilities, theaters and basically any one of the numerous establishments we may frequent in our day to day lives.

On October 25, 2023, a shopping plaza in Southampton, MA was the scene of life-threatening levels of carbon monoxide. Emergency crews responded to the scene following a report that six members of a crew involved in epoxying the floor in a store in Red Rock Plaza were complaining of symptoms consistent with carbon monoxide poisoning. The machinery they had been using was being operated in an enclosed space without proper ventilation. Crews detected the presence of levels of carbon monoxide at the maximum level of detection devices, 299 ppm. Four people were transported to Baystate Medical Center for evaluation and two people refused treatment. No further information was available as to the wellbeing of anyone else present in the plaza, though everyone was able to exit safely prior to the arrival of emergency services. https://www.westernmassnews.com/2023/10/25/several-people-hospitalized-after-carbon-monoxide-incident-southampton-plaza/

Earlier in October, emergency crews responded to a hotel in Mesa, AZ. The initial report came from a guest complaining of a severe headache. Emergency responders detected elevated levels of carbon monoxide on the second floor. Ultimately the entire hotel was evacuated, and several people received treatment for suspected carbon monoxide poisoning and the original caller was transported to the hospital. No explanation was released as to the source of the carbon monoxide. https://www.abc15.com/news/region-southeast-valley/mesa/hotel-evacuated-during-carbon-monoxide-emergency-in-mesa

These types of news stories are not uncommon and follow up stories often describe injuries as non-life threatening. What often is not addressed is the fact that injuries from carbon monoxide poisoning can be long term and life changing and that the full impact of those injuries may not be apparent for days, weeks or months after the exposure occurred.

Hypoxic or anoxic brain injury occurs when the brain is deprived of oxygen. Hypoxic brain injury occurs when the amount of oxygen is insufficient for brain function, and anoxic brain injury is a complete loss of access to oxygen. The terms are interchangeable. When the supply of oxygen is completely interrupted, a loss of consciousness can occur in as little as 15 seconds and damage to the brain occurs in under four minutes.

The damage often involves a deterioration of neurological functioning. However, damage to the brain due to non-fatal carbon monoxide inhalation has an unusual component; the presence of damage may not be detected for days to weeks after the damage has occurred and the full impact of the damage may not be capable of a complete diagnosis for months after the exposure.

“The reason for this is not entirely clear, but changes in the white matter seem to be involved. It has been suggested that these may result from demyelination, in which there is loss of the fatty, insulating myelin sheath of the nerve axons, therefore impairing their ability to conduct electrical nerve impulses.” https://www.headway.org.uk/about-brain-injury/individuals/types-of-brain-injury/carbon-monoxide-poisoning/

While traditionally it is thought that the level of carbon monoxide in the blood coincides with the severity of symptoms, the levels are not a complete indicator of predicting the outcome. Neurologic deficits can occur immediately after the injury or take days to weeks to appear. This is called Delayed Neurological Syndrome or DNS.   For more on this delayed onset of brain damage, see our page on the delayed effects of carbon monoxide. The deficits can include memory problems, difficulty concentrating, problems with speech, problems with movement (parkinsonism), problems with balance, urinary incontinence, vision impairments, dementia-like symptoms, and depression.

Even though statistically, long term damage because of carbon monoxide is common, it is very likely to go undiagnosed after leaving the care of emergency responders or the emergency room. Patients might be advised to follow up with their family physician upon release. Symptoms may only become apparent upon return to school or work and often go undiagnosed by the medical community. Continuing neurological problems can give rise to psychological issues as coping skills become taxed. Depression, withdrawal, inability to process information and a decline in cognitive ability my occur. Changes in behavior and personality may be observed by coworkers, teachers, and family members.

Carbon monoxide exposure affects different parts of the population in different ways. Children, pregnant women, the elderly, and those with certain chronic conditions are more vulnerable to the effects of carbon monoxide. Unborn children are also vulnerable and may have a lower birth weight and even develop behavioral problems in the future. In extreme conditions, fetal death may occur.

It is essential to seek medical attention after exposure to dangerous levels of carbon monoxide. And to follow up with a doctor as directed by emergency services.  Any changes should be noted and relayed to your medical professional. Don’t assume that if you feel fine once you are out in the fresh air, or have received oxygen, that damage hasn’t occurred. Be aware of the neurological changes that might occur weeks or months after the incident. Just because your diagnosis is that you have survived a life-threatening occurrence without life-threatening injuries; it doesn’t follow that it might not turn into a life-changing incident.