What is included in prehospital care for carbon monoxide (CO) toxicity?

Updated: Sep 18, 2018
  • Author: Guy N Shochat, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Prehospital care includes the following:

  • Promptly remove the patient from continued exposure and immediately institute oxygen therapy with a nonrebreather mask.

  • Perform intubation for the comatose patient or, if necessary for airway protection, and provide 100% oxygen therapy.

  • Institute cardiac monitoring. Pulse oximetry, although not useful in detecting carboxyhemoglobin (HbCO), is still important because a low saturation causes even greater apprehension in this setting.

  • Give notification to the emergency department for comatose or unstable patients because rapid or direct transfer to a hyperbaric center may be indicated.

  • If possible, obtain ambient carbon monoxide (CO) measurements from fire department or utility company personnel, when present.

  • Early blood samples may provide much more accurate correlation between HbCO and clinical status; however, do not delay oxygen administration to acquire them.

  • Obtain an estimate of exposure time, if possible.

  • Avoid exertion to limit tissue oxygen demand.

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