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Chapter 23 — 3
TREATMENT
The diver should be rapidly
isolated
from the contaminated gas and have
100% O
2
administered by mask. The administer
basic life support
(see Chapter 42) including CPR
should be applied where appropriate.
Hyperbaric O
2
(HBO)
is the treatment of choice. The high partial pressure of O
2
, which
occurs in a hyperbaric chamber, will dissolve enough O
2
in the blood plasma to meet the
bodies needs without participation of the haemoglobin system. Oxygen is breathed at a partial
pressure of 2 ATA or more to sustain life while the CO slowly detaches from the
haemoglobin and is breathed out through the lungs, allowing the haemoglobin to resume its
normal O
2
transport role.
If hyperbaric O
2
is to be of value it should be instituted as soon as possible, preferably within
6 hours of poisoning. Delay in treatment may result in irreversible and progressive brain
damage.
PREVENTION
The major danger to any diver is from carbon monoxide contamination of the compressed air
supply. Sources of contamination include:
!
Direct contamination by CO from gasoline engine exhausts.
This may come either from the compressor motor itself, or from other nearby motors or gas
exhaust outlets. The classic case occurs where the compressor air inlet hose is located
downwind from the compressor motor exhaust.
!
Contamination produced by the breakdown of unsuitable
lubricants.
The incorrect use of hydrocarbon-based lubricants used to lubricate an air compressor is a
common cause, however it may also result from overheating of the compressor. Both carbon
and nitrogen oxides can be formed.
!
The intake of polluted atmospheric air
to fill air cylinders.
It is important for suppliers of compressed air to regularly check the quality of the air being
compressed, to ensure that this and other pollutants are not included in divers' air supplies.
Adequate filtration systems are necessary on all compressors, and these should always be
properly maintained.