The Management of Carbon Monoxide Poisoning Continues to Evolve

Background: Carbon monoxide (CO) poisoning results in 50,000 emergency department visits annually and is a leading cause of poisoning death. The past years have seen an enormous expansion in knowledge regarding pathophysiology, diagnosis, and management of CO poisoning. Objective: To review current information. Methods: Consensus expert opinion document, using data drawn from published, peer-reviewed literature, with emphasis on studies that most closely mirror clinical practice. Summary: The pathophysiology of CO toxicity is due to many mechanisms beyond hypoxemia from carboxyhemoglobin (COHb) formation, including direct intracellular toxicity and inflammation, and so be clear that COHb levels in themselves merely confirm the diagnosis in a patient with potential exposure to a CO source and do not predict symptoms or outcome. It is absolutely incorrect that certain symptoms correlate closely with COHb levels. Symptoms are usually nonspecific, commonly headache, dizziness, nausea/vom more...