1
Q
Features of carbon monoxide poisoning?
A
CO poisoning:
Headache (most common Sx)
Malaise, nausea, and dizziness.
Loss of consciousness (Hx)
Altered mental status
Acute myocardial injury common.
Delayed neurological sequelae (delayed neuropsychiatric syndrome) feared outcome.
2
Q
Dx of CO poisoning:
A
Note caveats:
- Sats will be normal (probe measures oxyHb and carboxyHb).
- PaO2 will be normal - CO poisoning is a problem with Hb (high affinity for CO > O2).
ABG:
- Respiratory acidosis
- Often profound metabolic acidosis
- p50 low (ie. LEFT shift in Hb-O2 curve due to Hb’s high affinity for CO).
- CarboxyHb high (definitive).
Note: these ABG findings can be altered by hydroxycobalamin administered for suspected cyanide poisoning after smoke inhalation.
3
Q
Management of CO poisoning?
A
Management is supportive.
- High flow oxygen (accelerates displacement of CO from Hb).
- Hyperbaric oxygen therapy accelerated this process further - therefore used in severe / high risk cases.
- Isocapnic hyperpnoea if ventilated.
