💨 Acute Carbon Monoxide Poisoning Management
This tool gives the oxygen and hyperbaric-oxygen direction for acute carbon monoxide poisoning, by hyperbaric indications and pregnancy.
Acute Carbon Monoxide Poisoning Management
Hyperbaric-oxygen indications (loss of consciousness/neurologic abnormality/myocardial ischemia/COHb ≥ 25%/severe acidosis)
Pregnancy
When to use
Use to start high-flow 100% oxygen for everyone and to decide who needs hyperbaric oxygen, with a lower threshold in pregnancy.
How it works
All → high-flow 100% oxygen until symptoms resolve and COHb < 10%. HBO if loss of consciousness/neurologic abnormality/myocardial ischemia/COHb ≥ 25%/severe acidosis, ideally within 6 h. Pregnancy → HBO at COHb ≥ 15–20% or fetal distress.
Key points
- Pulse oximetry cannot distinguish carboxyhemoglobin, so arterial COHb must be measured rather than relying on SpO₂. (original synthesis · not guideline verbatim)
- Hyperbaric oxygen targets reduction of delayed neurocognitive sequelae and is given as early as possible within 6 h.
- Enclosed-fire smoke inhalation raises suspicion of concomitant cyanide poisoning warranting hydroxocobalamin.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.