injuries poisoning
Carbon Monoxide Poisoning
Treatment of CO Poisoning
100% oxygen Possibly hyperbaric oxygen Patients should be removed from the source of carbon monoxide (CO) and stabilized as necessary. They are given 100% oxygen (by nonrebreather mask) and treated supportively. Although its use is becoming increasingly controversial, Recompression Therapy (in a chamber at 2 to 3 atmospheres of 100% oxygen) typically should be considered for patients who have any of the following: Life-threatening cardiopulmonary complications Ongoing chest pain Altered consciousness Loss of consciousness (no matter how brief) A carboxyhemoglobin level>25% Hyperbaric oxygen therapy should also be considered for pregnant patients, possibly at lower serum CO levels than in nonpregnant patients. Hyperbaric oxygen therapy may decrease the incidence of delayed neuropsychiatric symptoms. However, this therapy may cause barotrauma and, because therapy is not available at most hospitals, may require transfer of patients, who may not be stable; also a chamber may not be available locally. Evidence for the efficacy of hyperbaric oxygen therapy is becoming more controversial, with some studies suggesting harm. In cases where hyperbaric oxygen therapy is considered, consultation with a poison control center or hyperbaric expert is strongly recommended. 