Carbon Monoxide Poisoning

Introduction to Carbon Monoxide Poisoning

Carbon Monoxide, chemically abbreviated as "CO," is one of the most common and toxic substances in the aviation environment.
Due to its colorless, odorless, and tasteless properties, it can quietly build, resulting in deadly consequences.
It is, therefore, critical that pilots recognize carbon monoxide poisoning.
If discovered, pilots must take immediate action to treat those symptoms before they get worse.
Despite carbon monoxide being a persistent threat in aviation, there are steps pilots can take to detect and prevent its presence.
Carbon monoxide poisoning can happen to anyone, as illustrated by several case studies in which pilots found themselves in trouble.
Think you've got a solid understanding of carbon monoxide? Don't miss the carbon monoxide quiz below and the topic summary.
WARNING:
All aeromedical topics are GENERALIZED.
Always consult with a doctor or physician to understand your specific situation.

Carbon Monoxide Sources

Carbon monoxide is a by-product of the incomplete combustion of carbon-containing materials, such as aviation fuel.
While carbon monoxide poisoning can occur with or without the operation of environmental control systems, heating units are the most likely source of the problem.
- Most aircraft heaters in light aircraft work by routing air over the exhaust manifold before flowing into the cabin.
- Use of these heaters, while exhaust fumes are escaping through manifold cracks and seals, is responsible every year for several nonfatal and fatal aircraft accidents from carbon monoxide poisoning.
It is also possible to have a large amount of CO in your blood just from your environment, including polluted air and spending time around smokers, which can reduce your tolerance before takeoff.
Regardless of the source of carbon monoxide, pilots must know how to recognize the onset of carbon monoxide poisoning.

Carbon Monoxide Poisoning

Recognizing Carbon Monoxide Poisoning

Carbon Monoxide Symptoms
Carbon Monoxide Poisoning Symptoms:
- Compounded with additional cues, knowing and recognizing the symptoms in your passengers can be a key indicator.
- Carbon Monoxide has an affinity of 240 times that of oxygen, which means it will more readily attach itself to your blood cells.
- Low concentrations over time can produce high blood concentrations, impeding the ability of blood to transport oxygen.
  - As little as 10% of carboxyhemoglobin (carbon monoxide in the blood) decreases peripheral and night vision.
- Symptoms will mirror those of hypoxia, as an increase of CO in the blood implies you are suffering from hypemic hypoxia.
- Victims could expect: [Figure 1/2]
  - Sense of pressure in the head.
  - Drowsiness.
  - Dizziness.
  - Roaring/ringing sensation in the ears.
  - Confused and unable to think clearly.
  - Drunk appearance.
  - Vomiting.
  - Incontinent.
  - Convulsions.
  - Bounding pulse.
  - Cherry red lips.
  - Dilated pupils.
  - Incapacitation.
Carbon Monoxide Symptoms
Carbon Monoxide Exposure
Amazon, Carbon Monoxide Detector
Carbon Monoxide Exposure
Amazon, Hand-Held
Carbon Monoxide Detector
Carbon Monoxide Detection:
- Due to Carbon Monoxide resulting from incomplete combustion, there will usually be odors or colors that can provide cues.
  - For example, the smell of exhaust indicates a leak and possible contamination.
- Since carbon monoxide is odorless, it may be challenging to detect carbon monoxide until you or your passengers are experiencing symptoms, at which point any delay can be life-threatening.
- Therefore, Carbon Monoxide detectors [Amazon] are cheap insurance that you would rather have and not need than need and not have.
- Choosing a Carbon Monoxide Detector:
  - As demonstrated in the case studies, carbon monoxide is a life-threatening poison.
  - Especially when impaired, detectors can trigger a pilot's cognitive ability to recognize the problem.
  - Carbon Monoxide detectors come in many designs, but generally speaking, you'll have the choice of passive or electronic detectors.
  - Passive Detectors:
    
    The Quantum Eye Carbon Monoxide Detector is the most basic choice [Figure 3]
    
    Advantages of Passive Detectors:
    
    Low cost.
    
    Operates independently of electrical power.
    
    Passive Detector Disadvantages:
    
    Pilots must monitor the indicator as it will not produce an alarm.
    
    It is attached to something in view.
  - Amazon, Carbon Monoxide Detector
  - Electronic Detectors:
    
    Electronic detectors such as the Pocket Carbon Monoxide Detector [Amazon] are the more advanced types of detectors. [Figure 4]
    
    Electronic Detector Advantages:
    
    Audible alarms when carbon monoxide rises.
    
    Convenient enough to be carried at home or in a vehicle.
    
    Electronic Detector Disadvantages:
    
    Generally, more expensive than passive detectors.
    
    Requires batteries.
    
    Amazon, Hand-Held
    Carbon Monoxide Detector
- A CO detector, though not required by the Federal Aviation Regulations (FARs), provides a layer of safety not otherwise available..
- Detector installation shall be per the manufacturer's recommendations.
If carbon monoxide is detected or suspected, don't wait for further confirmation; instead, take immediate action to treat the symptoms.

Carbon Monoxide Poisoning

Immediate Action and Treatment of Carbon Monoxide Poisoning

If detected or suspected CO is entering the cabin, perform the appropriate immediate actions.
Identify possible sources and attempt to isolate them.
Open the air vents and attempt to flush the cabin with fresh air.
- CO exposure is compounding and takes a long time to get rid of.
- After removal from the CO source, the body only removes about 0.5% of the CO from the blood every 4 hours.
Use 100% oxygen and open windows to circulate fresh air.
Monitor for further respiratory distress.
- Tell ATC that you suspect CO poisoning.
- Declare an emergency if you feel the situation warrants.
Land as soon as possible!.
Once resolved, have the aircraft inspected by a certified mechanic before its next flight to determine the source of the problem.
Once resolved, have the aircraft inspected by a certified mechanic before its next flight.
No amount of preventable carbon monoxide intrusion is acceptable, making prevention the best way to avoid exposure and treatment.

Carbon Monoxide Poisoning

Carbon Monoxide Poisoning Prevention

The straightforward statement is to follow appropriate maintenance procedures.
Carry a personal carbon monoxide detector [Amazon], especially when renting.
Pilots must pay special attention to the sources of carbon monoxide in the fall and winter months, as damage may have occurred months before, but it does not manifest itself until cold weather arrives.
Most important is a thorough preflight to find potential sources.
Treat CO poisoning as a constant possibility, as it often occurs throughout the year across all geographic locations.

Carbon Monoxide Poisoning

Carbon Monoxide Poisoning-Related Airman Certification Standards

Private Pilot (Airplane) Human Factors Airman Certification Standards
- Objective: To determine whether the applicant exhibits satisfactory knowledge, risk management, and skills associated with personal health, flight physiology, and aeromedical and human factors related to the safety of flight.
- References: AIM; FAA-H-8083-2 (Risk Management Handbook), FAA-H-8083-3 (Airplane Flying Handbook), FAA-H-8083-25 (Pilot Handbook of Aeronautical Knowledge).
- Private Pilot (Airplane) Human Factors Lesson Plan.
Private Pilot (Airplane) Human Factors Knowledge:
The applicant demonstrates an understanding of:
- PA.I.H.K1:
  Symptoms, recognition, causes, effects, and corrective actions associated with aeromedical and physiological issues, including:
  
  PA.I.H.K1a:
  Hypoxia.
  
  PA.I.H.K1b:
  Hyperventilation.
  
  PA.I.H.K1c:
  Middle ear and sinus problems.
  
  PA.I.H.K1d:
  Spatial Disorientation.
  
  PA.I.H.K1e:
  Motion sickness.
  
  PA.I.H.K1f:
  Carbon monoxide poisoning.
  
  PA.I.H.K1g:
  Stress.
  
  PA.I.H.K1h:
  Fatigue.
  
  PA.I.H.K1i:
  Dehydration and nutrition.
  
  PA.I.H.K1j:
  Hypothermia.
  
  PA.I.H.K1k:
  Optical Illusions.
  
  PA.I.H.K1l:
  Dissolved nitrogen in the bloodstream after scuba dives.
- PA.I.H.K2:
  Regulations regarding the use of alcohol and drugs.
- PA.I.H.K3:
  Effects of alcohol, drugs, and over-the-counter medications.
- PA.I.H.K4:
  Aeronautical Decision-Making (ADM) to include using Crew Resource Management (CRM) or Single-Pilot Resource Management (SRM), as appropriate.
Private Pilot (Airplane) Human Factors Risk Management:
The applicant demonstrates the ability to identify, assess, and mitigate risks encompassing:
- PA.I.H.R1:
  Aeromedical and physiological issues.
- PA.I.H.R2:
  Hazardous attitudes.
- PA.I.H.R3:
  Distractions, task prioritization, loss of situational awareness, or disorientation.
- PA.I.H.R4:
  Confirmation and expectation bias.
Private Pilot (Airplane) Human Factors Skills:
The applicant exhibits the skills to:
- PA.I.H.S1:
  Associate the symptoms and effects for at least three of the conditions listed in K1a through K1l above with the cause(s) and corrective action(s).
- PA.I.H.S2:
  Perform self-assessment, including fitness for flight and personal minimums, for actual flight or a scenario given by the evaluator.
Commercial Pilot (Airplane) Human Factors Airman Airman Certification Standards
- Objective: To determine whether the applicant exhibits satisfactory knowledge, risk management, and skills associated with personal health, flight physiology, and aeromedical and human factors related to the safety of flight
- References: AIM; FAA-H-8083-2 (Risk Management Handbook), FAA-H-8083-3 (Airplane Flying Handbook), FAA-H-8083-25 (Pilot Handbook of Aeronautical Knowledge).
- Commercial Pilot (Airplane) Human Factors Lesson Plan.
Commercial Pilot (Airplane) Human Factors Knowledge:
The applicant demonstrates an understanding of:
- CA.I.H.K1:
  Symptoms, recognition, causes, effects, and corrective actions associated with aeromedical and physiological issues, including:
  
  CA.I.H.K1a:
  Hypoxia.
  
  CA.I.H.K1b:
  Hyperventilation.
  
  CA.I.H.K1c:
  Middle ear and sinus problems.
  
  CA.I.H.K1d:
  Spatial disorientation.
  
  CA.I.H.K1e:
  Motion sickness.
  
  CA.I.H.K1f:
  Carbon monoxide poisoning.
  
  CA.I.H.K1g:
  Stress.
  
  CA.I.H.K1h:
  Fatigue.
  
  CA.I.H.K1i:
  Dehydration and nutrition.
  
  CA.I.H.K1j:
  Hypothermia.
  
  CA.I.H.K1k:
  Optical illusions.
  
  CA.I.H.K1l:
  Dissolved nitrogen in the bloodstream after scuba dives.
- CA.I.H.K2:
  Regulations regarding the use of alcohol and drugs.
- CA.I.H.K3:
  Effects of alcohol, drugs, and over-the-counter medications.
- CA.I.H.K4:
  Aeronautical Decision-Making (ADM) to include using Crew Resource Management (CRM) or Single-Pilot Resource Management (SRM), as appropriate.
Commercial Pilot (Airplane) Human Factors Risk Management:
The applicant is able to identify, assess, and mitigate risks associated with:
- CA.I.H.R1:
  Aeromedical and physiological issues.
- CA.I.H.R2:
  Hazardous attitudes.
- CA.I.H.R3:
  Distractions, task prioritization, loss of situational awareness, or disorientation.
- CA.I.H.R4:
  Confirmation and expectation bias.
Commercial Pilot (Airplane) Human Factors Skills:
The applicant exhibits the skills to:
- CA.I.H.S1:
  Associate the symptoms and effects for at least three of the conditions listed in K1a through K1l with the cause(s) and corrective action(s).
- CA.I.H.S2:
  Perform self-assessment, including fitness for flight and personal minimums, for actual flight or a scenario given by the evaluator.

Carbon Monoxide Poisoning

Carbon Monoxide Case Studies

National Transportation Safety Board (NTSB) Identification: CHI96LA101:
- The NTSB determines the probable cause(s) of this accident to be: An inadequate annual inspection by maintenance personnel, a deteriorated muffler, and pilot incapacitation due to carbon monoxide.
National Transportation Safety Board Identification: ANC16FA065:
- The NTSB determines the probable cause(s) of this accident to be: The pilot's severe impairment from carbon monoxide poisoning in flight, which resulted in a loss of control and a subsequent collision with trees and terrain.

Carbon Monoxide Poisoning

Carbon Monoxide Poisoning Knowledge Quiz

Carbon Monoxide Poisoning

Carbon Monoxide Poisoning Conclusion

Carbon Monoxide Poisoning is a silent killer.
Realize it's not a sudden exposure that is of primary concern, but rather the slow onset of symptoms that go unrecognized.
It is incumbent on the pilot to conduct a thorough preflight, which includes the exhaust/heating components, to spot irregularities.
After CO poisoning, it can take up to 24 hours to recover.
- If symptoms are severe or continue after landing, seek medical treatment.
Especially in the winter months, refresh your knowledge on Carbon Monoxide and conduct an extra thorough preflight.
- The heater system may have gone unused for months.
Symptoms are not linear, and a pilot's cognitive ability will be affected first.
Ensure the Carbon Monoxide detector is in serviceable condition.
Detectors are not infallible and may produce false positives.
- Unless easily determined to be a false positive, normalization of deviance develops when warnings are present but ignored with a quick explanation or denial of the problem.
Consider including aeromedical factors as part of the passenger briefing.
Consider reviewing the Pilot Workshop promo regarding CO poisoning.
For more information, see the Federal Aviation Administration (FAA) brochure called Carbon Monoxide: A Deadly Menace.
If appropriate, report CO incidents via the Service Difficulty Reporting Service.
Still looking for something? Continue searching:

Carbon Monoxide Poisoning

Carbon Monoxide Poisoning

Introduction to Carbon Monoxide Poisoning

Carbon Monoxide Sources

Recognizing Carbon Monoxide Poisoning

Carbon Monoxide Poisoning Symptoms:

Carbon Monoxide Detection:

Choosing a Carbon Monoxide Detector:

Passive Detectors:

Advantages of Passive Detectors:

Passive Detector Disadvantages:

Electronic Detectors:

Electronic Detector Advantages:

Electronic Detector Disadvantages:

Immediate Action and Treatment of Carbon Monoxide Poisoning

Carbon Monoxide Poisoning Prevention

Carbon Monoxide Poisoning-Related Airman Certification Standards

Private Pilot (Airplane) Human Factors Airman Certification Standards

Private Pilot (Airplane) Human Factors Knowledge:

PA.I.H.K1:

PA.I.H.K1a:

PA.I.H.K1b:

PA.I.H.K1c:

PA.I.H.K1d:

PA.I.H.K1e:

PA.I.H.K1f:

PA.I.H.K1g:

PA.I.H.K1h:

PA.I.H.K1i:

PA.I.H.K1j:

PA.I.H.K1k:

PA.I.H.K1l:

PA.I.H.K2:

PA.I.H.K3:

PA.I.H.K4:

Private Pilot (Airplane) Human Factors Risk Management:

PA.I.H.R1:

PA.I.H.R2:

PA.I.H.R3:

PA.I.H.R4:

Private Pilot (Airplane) Human Factors Skills:

PA.I.H.S1:

PA.I.H.S2:

Commercial Pilot (Airplane) Human Factors Airman Airman Certification Standards

Commercial Pilot (Airplane) Human Factors Knowledge:

CA.I.H.K1:

CA.I.H.K1a:

CA.I.H.K1b:

CA.I.H.K1c:

CA.I.H.K1d:

CA.I.H.K1e:

CA.I.H.K1f:

CA.I.H.K1g:

CA.I.H.K1h:

CA.I.H.K1i:

CA.I.H.K1j:

CA.I.H.K1k:

CA.I.H.K1l:

CA.I.H.K2:

CA.I.H.K3:

CA.I.H.K4:

Commercial Pilot (Airplane) Human Factors Risk Management:

CA.I.H.R1:

CA.I.H.R2:

CA.I.H.R3:

CA.I.H.R4:

Commercial Pilot (Airplane) Human Factors Skills:

CA.I.H.S1:

CA.I.H.S2:

Carbon Monoxide Case Studies

Carbon Monoxide Poisoning Knowledge Quiz

Carbon Monoxide Poisoning Conclusion

Carbon Monoxide Poisoning References