Carbon Monoxide Inhalation

Symptoms depend on CO level (carboxyhemoglobin)

• CO: 20-40%: Dizziness, headache, weakness, disturbed judgement, decreased visual acuity
• CO: 40-60%: Tachycardia, tachypnea, ataxia, syncope, seizures
• CO: >60%: Coma, death

Diagnosis

• To get CO level, get ABG with carboxyhemoglobin
• Standard pulse oximetry (SpO2) CANNOT screen for CO exposure, as it does not differentiate carboxyhemoglobin from oxyhemoglobin
• ECG, troponin if CO intoxication confirmed.

Management

• Treat with 100% O2 by tight-fitting mask or ET tube
• Intubation can be considered in severe cases (carboxyhemoglobin > 25%)
• Hyperbaric Oxygen if CO>25%
• Measure CO level q2-4h until <10%
• Must continue treating until carboxyhemoglobin is <5%
• Call Poison control

Source: Uptodate: CO poisoning