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Carbon Monoxide Poisoning, Pediatric

Kevin C. Osterhoudt, MD, MS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Carbon monoxide (CO) is an odorless gas produced via incomplete combustion of carbonaceous fuels.

  • CO poisoning occurs when carboxyhemoglobin and CO accumulation leads to impaired phys...

DIAGNOSIS

Many emergency medical services crews carry CO detectors. 

HISTORY

  • Health of family members?

    • CO is an environmental gas that often sickens multiple household members.

  • Use of furnace or space hea...

TREATMENT

GENERAL MEASURES

  • Recognize CO exposure.

  • Remove patient from source of CO.

  • Initial stabilization

    • Administer 100% oxygen at least until patient is asymptomatic and carboxyhemoglobin level is <5...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Delayed neurologic sequelae may develop 2 to 40 days after exposure. 

PROGNOSIS

  • Acute mortality appears to be caused by carboxymyoglobin formation and ischemic vent...

ADDITIONAL READING

  • Baum CR. What’s new in pediatric carbon monoxide poisoning? Clin Pediatr Emerg Med.  2008;9:43–46. [View Abstract on OvidInsights]

  • Macnow TE, Waltzman ML. Carbon monoxide poison...

CODES

ICD9

986 Toxic effect of carbon monoxide 

ICD10

  • T58.91XA Toxic effect of carb monx from unsp source, acc, init

  • T58.8X1A Toxic effect of carb monx from oth source, accidental, init

  • T58.01XA Toxic effe...

FAQ

  • Q: At what carboxyhemoglobin level should hyperbaric oxygen therapy be recommended?

  • A: In practice, most dissociation of carboxyhemoglobin occurs with administration of normal pressure oxygen befor...

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