Carbon Monoxide Poisoning

Question 1

Define carbon monoxide poisoning.

Answer 1

Carbon monoxide overload in system, leading to insufficient uptake of oxygen.

Question 2

Summarise the epidemiology of carbon monoxide poisoning.

Answer 2

Approximately 50 people die from accidental carbon monoxide poisoning each year in the UK. Poisoning may be more common during the winter months when heating devices are more likely to be used. Used as a method of suicide.

Question 3

Recognise the presenting signs and symptoms of carbon monoxide poisoning.

Answer 3

• Headache (90%)
• Vertigo (50%)
• N&V (50%)
• Confusion (30%)
• Subjective weakness (20%)
• “Pink” skin and mucosa, hyperpyrexia, arrhythmia

Question 4

Recognise the signs of carbon monoxide poisoning on physical examination.

Question 5

Identify appropriate investigations for carbon monoxide poisoning and interpret the results.

Answer 5

Normal/high pulse oximetry (falsely high) > do ABG/VBG

Typical carboxyhaemoglobin levels:

• Non-smokers < 3%
• Smokers < 10%
• CO poisoning 10-30% (severe >30%)

Question 6

Generate a management plan for carbon monoxide poisoning.

Answer 6

100% high-flow oxygen via a NRB mask (continuing for a minimum of six hours) > target 100% SpO2

Hyperbaric oxygen (limited evidence base)