Overview
Carbon Monoxide as a Hidden Oxygen-Delivery Problem
Carbon monoxide poisoning is an oxygen delivery emergency that can hide behind a normal looking saturation.
Carbon monoxide poisoning is an oxygen-delivery emergency that can hide behind a normal-looking saturation. A patient may be breathing adequately and have a normal PaO2 while CO has occupied haemoglobin and disrupted cellular respiration. Headache, dizziness, nausea, confusion, syncope, or chest symptoms after combustion exposure should therefore be taken seriously, particularly when several people from the same environment become ill. The first clinical decision is not which test to order. It is whether the patient can be removed safely from the source and placed on 100% oxygen without delay. COHb measurement helps confirm exposure and estimate risk, but the number must be interpreted with the patient’s neurologic, cardiac, and perfusion findings because COHb can fall after time in fresh air or after oxygen is started.