carbon monoxide poisining

Question 1

symptoms

Answer 1

Symptoms: Headache, vomiting, pulse increased, tachypnoea, and,
if COHb >50%, fits, coma, and cardiac arrest.

Question 2

diagnosis

Answer 2

Despite hypoxaemia skin is pink (or pale), not blue, as carboxyhaemoglobin
(COHb) displaces O2 from Hb binding sites. For the same reasons SpO2 from a pulse oximeter may be normal. Check ABG in a co-oximeter (ie ensure it measures haemoglobin, SaO2, Meth-Hb and COHb) which will show low SaO2 and
high CoHb (normal <5%).

Question 3

CO poisining treatment.

Answer 3

Remove the source. Give 100% O2 until COHb 20%, patient has neurological or psychological
features, or cardiovascular impairment, fails to respond to treatment, or
is pregnant consider hyperbaric O2: discuss with the poisons service.