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Carbon Monoxide Poisoning

Henry DeYoung, MD, Natalie Slepski, MD, MPH and Robert J. Krause, MD, MPH, CIME Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Carbon monoxide (CO) is an odorless, tasteless, colorless gas produced during the incomplete combustion of carbon-based compounds. If inhaled, CO may cause nonspecific symptoms and i...

DIAGNOSIS

  • Clinical triad of (i) relevant symptoms, (ii) history of CO exposure, (iii) and elevated COHb levels (1)

  • An elevated carboxyhemoglobin level of >3% in a nonsmoker and >10% in smokers co...

TREATMENT

GENERAL MEASURES

  • Prompt removal from the CO source

  • Supportive care as necessary

  • Intubation and mechanical ventilation may be necessary for severe intoxication, particularly if the patient is un...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • All patients treated for acute CO poisoning should follow up in 1 to 2 months after discharge (1),(4).

  • If there are behavioral or cognitive concerns, pursue neurop...

REFERENCES

1
Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med.  2017;195(5):596–606. [View Abstract on...

ADDITIONAL READING

CODES

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 effect of carb monx from mtr veh exhaust, ac...

CLINICAL PEARLS

  • CO poisoning warrants a high index of suspicion, especially in patients exposed to fire; during the winter months, in young patients with chest pain; and when patients present as a gro...

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