Materiały źródłowe

• #1 The Diagnosis and Treatment of Carbon Monoxide Poisoning

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6381775/

  The symptoms of carbon monoxide (CO) poisoning are nonspecific, ranging from dizziness and headache to unconsciousness and death. […] In patients with severe carbon monoxide poisoning, an ECG should be obtained and biomarkers for cardiac ischemia should be measured. […] The state of the evidence on the diagnosis and treatment of this condition is not entirely clear. […] The diagnosis of CO poisoning is based on clinical symptoms and suspected or confirmed exposure. […] For the purposes of verification, carboxyhemoglobin (COHb) should be measured in a blood gas analysis (BGA). […] Confirmation of COHb does not differ to a clinically relevant degree in arterial and venous specimens. […] If concomitant cardiac symptoms occur, a 12-lead ECG should be conducted and cardiological biomarkers determined.

• #1 Clinical Guidance for Carbon Monoxide Poisoning Following Disasters and Severe Weather | Carbon Monoxide Poisoning | CDC

  https://www.cdc.gov/carbon-monoxide/hcp/clinical-guidance/index.html

  The symptoms and signs of carbon monoxide poisoning are variable and nonspecific. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and altered mental status. […] Diagnosis is based on a suggestive history and physical findings coupled with confirmatory testing. Patients should be examined for other conditions, including smoke inhalation, trauma, medical illness, or intoxication. […] An elevated carboxyhemoglobin (COHgb) level of 2% for non-smokers and 9% COHgb level for smokers strongly supports a diagnosis of CO poisoning. […] The key to confirming the diagnosis is measuring carboxyhemoglobin (COHgb) level. […] COHgb levels do not correlate well with severity of illness, outcomes or response to therapy so it is important to assess clinical symptoms and history of exposure when determining type and intensity of treatment. […] Other testing, such as a fingerstick blood sugar, alcohol and toxicology screen, head CT scan or lumbar puncture may be needed to exclude other causes of altered mental status when the diagnosis of carbon monoxide poisoning is inconclusive.

• #1 Carbon-Monoxide Poisoning | Health & Human Services

  https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/carbon-monoxide

  Carbon monoxide poisoning can be difficult to diagnose because the symptoms mimic other illnesses. […] Concrete confirmation of carbon-monoxide poisoning comes from a carboxyhemoglobin test. This blood test measures the amount of carbon monoxide bound to hemoglobin. […] In the absence of some concrete reason to suspect carbon monoxide poisoning, the disorder is often misdiagnosed as migraine headache, stroke, psychiatric illness, food poisoning, alcohol poisoning, or heart disease. […] Taken with other symptoms of carbon-monoxide poisoning, carboxyhemoglobin levels of over 25 percent in healthy people, over 15 percent in patients with a history of heart or lung disease, and over 10 percent in pregnant women usually indicate the need for hospitalization. […] Immediate treatment is to remove victims from the source of carbon monoxide gas and get them into fresh air. […] In severe cases of carbon-monoxide poisoning, patients are given hyperbaric oxygen therapy. […] The speed and degree of recovery from carbon-monoxide poisoning depends on the length and duration of exposure to the gas.

• #1 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/432

  Carbon monoxide (CO) poisoning results in significant morbidity and mortality. […] Diagnosis is based on a clinical triad: history of CO exposure, elevated carboxyhemoglobin levels, and symptoms/signs consistent with CO poisoning. […] Key diagnostic factors include exposure to incomplete combustion of carbon-containing material, exposure to fire with smoke inhalation, nausea, headache, vomiting, blurred vision, dizziness, vertigo, altered consciousness, dyspnea, tachycardia, hypotension or hypertension, cardiac arrhythmias, pain, weakness, sleep changes, irritability, and flu-like symptoms. […] Other diagnostic factors include exposure to methylene chloride, delayed neuropsychiatric features, other severe neurologic symptoms, cutaneous blistering, pulmonary edema, cardiac arrest, and focal neurologic abnormalities (e.g., hemiplegia, truncal ataxia).

• #1 Carbon Monoxide Poisoning: Diagnosis, Prognostic Factors, Treatment Strategies, and Future Perspectives

  https://www.mdpi.com/2075-4418/15/5/581

  Carbon monoxide (CO) poisoning may be accurately diagnosed using appropriate diagnostic equipment. Pulse CO-oximetry is a rapid, non-invasive method of measuring carboxyhaemoglobin (COHb) levels, however, it may be less precise than arterial blood samples. […] The gold standard for measuring COHb levels is arterial blood gas (ABG) measurement, which validates the severity of the poisoning. […] Carboxyhaemoglobin (COHb) levels are crucial in detecting carbon monoxide poisoning, with typical values of less than 2% in non-smokers and 5–10% in smokers. […] COHb values can help determine poisoning severity and guide treatment methods. […] Addressing the challenges of carbon monoxide (CO) poisoning necessitates many critical solutions. First, education and awareness are critical for increasing public and healthcare professionals’ understanding of CO poisoning symptoms, hazards, and preventative actions, resulting in early detection.

• #1 What to Know About Carboxyhemoglobin Tests

  https://www.webmd.com/a-to-z-guides/what-to-know-about-carboxyhemoglobin-tests

  A carboxyhemoglobin test is used to diagnose carbon monoxide poisoning. […] A carboxyhemoglobin test can help you get the treatment you need if you’ve inhaled too much carbon monoxide. […] Carbon monoxide poisoning is generally diagnosed at a carboxyhemoglobin level of over 10%. Severe poisoning occurs at levels over 20%. […] If your carboxyhemoglobin test shows that you have carbon monoxide poisoning, your doctor will determine treatment based on a few factors: […] Mild cases of carbon monoxide poisoning can resolve on their own once you start breathing fresh air. Moderate or severe cases may require hospitalization and devices such as an oxygen concentrator or a hyperbaric oxygen chamber.

• #1 Carbon monoxide poisoning – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carbon-monoxide/diagnosis-treatment/drc-20370646

  Treatment is likely to start right away for anyone brought to an emergency room with suspected carbon monoxide poisoning. […] To confirm the diagnosis, the healthcare team might test a blood sample for carbon monoxide. This test should be done as soon as possible after removing the person from the suspected exposure environment. But the test shouldn’t delay treatment. […] At the hospital, treatment may involve: […] Getting treatment in an oxygen chamber. This is called hyperbaric oxygen therapy. It involves breathing pure oxygen in a chamber for a set amount of time. The air pressure inside the chamber is 2 to 3 times higher than the pressure outside. This helps replace carbon monoxide with oxygen in the blood. […] Hyperbaric oxygen therapy might be used for severe carbon monoxide poisoning. It helps protect heart and brain tissue from carbon monoxide damage. Hyperbaric oxygen therapy also might be used for pregnant people to protect unborn babies from damage from carbon monoxide poisoning. […] If you or someone you’re with has symptoms of carbon monoxide poisoning, get into fresh air immediately and call 911 or emergency medical help. Symptoms can include headache, dizziness, nausea, shortness of breath, weakness and confusion.

• #1 Carbon Monoxide Poisoning – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/poisoning/carbon-monoxide-poisoning

  Carbon monoxide (CO) poisoning is caused by inhalation of carbon monoxide gas. […] Diagnosis is by carboxyhemoglobin levels and arterial blood gases (ABGs), including measured oxygen saturation. […] Because symptoms can be vague, nonspecific, and variable, the diagnosis of carbon monoxide (CO) poisoning is easily missed. […] If CO poisoning is suspected, the carboxyhemoglobin level in the blood is measured with a CO-oximeter; venous samples can be used because arteriovenous differences are trivial. […] Arterial blood gases (ABGs) are not measured routinely. […] Noninvasive CO detectors have not been shown to be accurate or useful in the diagnosis of CO exposure or toxicity. […] Although elevated carboxyhemoglobin levels are clear evidence of poisoning, levels may be falsely low because they decrease rapidly after CO exposure ends, particularly in patients treated with supplemental oxygen. […] Metabolic acidosis can be a clue to the diagnosis.

• #1 Carbon Monoxide Toxicity Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/819987-workup

  The clinical diagnosis of acute CO poisoning should be confirmed by demonstrating an elevated level of HbCO. Either arterial or venous blood can be used for testing. […] A 2012 study showed that noninvasive pulse CO oximetry correlates with more rapid diagnosis and initiation of HBO therapy than laboratory CO oximetry. However, the impact on clinical outcome is still not proven. […] The ACEP recommends obtaining an electrocardiogram and cardiac biomarker levels in emergency department patients with moderate to severe CO poisoning (level B recommendation). […] Other test results include the following: […] Blood lactate level – Elevation is an indication of severity, and may correlate with neurologic outcomes; if the source of the CO was a house fire and the lactate level is 10 mmol/L or higher, the patient may have concomitant cyanide poisoning.

• #1 Carbon monoxide poisoning – UpToDate

  https://www.uptodate.com/contents/carbon-monoxide-poisoning

  Carbon monoxide poisoning will be reviewed here. […] The diagnosis of CO poisoning should be suspected in fire victims, in patients with flu-like symptoms in cold climates, especially if any other cohabitants or pets are also feeling ill, and patients with unexplained altered mental status or lactic acidosis. […] The diagnosis of CO poisoning is made in patients with known or suspected CO exposure in conjunction with an elevated carboxyhemoglobin (COHb) level measured by co-oximetry of a blood gas sample. […] COHb levels confirm exposure but may not tell extent – A COHb measurement is essential for determining exposure, but levels correlate imprecisely with the degree of poisoning. […] Standard pulse oximetry is not useful – Standard pulse oximetry (SpO2) cannot screen for CO exposure, as it does not differentiate COHb from oxyhemoglobin.

• #1 GMS | GMS German Medical Science — an Interdisciplinary Journal | S2k guideline diagnosis and treatment of carbon monoxide poisoning

  https://www.egms.de/en/journals/gms/2021-19/000300.shtml

  This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning. […] The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. […] The diagnosis ought to be made on the basis of clinical symptoms, patient history, the circumstances in which the patient is found, and symptoms. […] The diagnosis of CO poisoning is essentially based on clinical symptoms and suspected or proven exposure. […] Patients with CO poisoning are not admitted to emergency departments exclusively by ambulance. Patients with CO poisoning also present of their own accord. Therefore, a differential diagnosis of CO poisoning should be considered in emergency departments for patients with nonspecific symptoms such as clouding of consciousness, dizziness, nausea, or vomiting.

• #1 Current challenges in carbon monoxide poisoning diagnosis from an analytical perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10662327/

  Correct diagnosis and treatment in these cases is very difficult. […] The main disadvantage of using COHb as a biomarker is that it does not fully account for the toxicodynamic effects of CO, it limits the diagnostic principle to the CO bound to Hb. […] Therefore, an alternative direct CO biomarker was investigated, which is TBCO. TBCO measures the amount of both CO bound to Hb and of the free CO present in blood (40). […] The use of TBCO as a biomarker could therefore improve diagnosis of these low-level chronic exposures, given the higher measurement accuracy. […] Further studies are necessary to confirm the accuracy of TBCO as a more complete biomarker for CO poisoning diagnosis, ideally with studies aimed at sampling blood as close as possible to the time of exposure, either directly at the scene or in the ambulance, and comparing the results for COHb and TBCO in these cases.

• #1 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/432

  1st tests to order include carboxyhemoglobin level, ECG, cardiac monitoring, blood glucose, complete blood count, urea and electrolytes, creatinine, lactate, pH level, cardiac biomarkers, and creatine kinase. […] Tests to consider include chest x-ray, Mini Mental State Examination, CT head, magnetic resonance imaging and spectroscopy, liver function tests, and pregnancy test.

• #1 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000169

  Carbon monoxide poisoning can cause hypoxia, cell damage, and death. Approximately one third of severe poisonings are fatal. […] Make a clinical diagnosis based on the history and symptoms. Use a blood gas analysis to confirm the diagnosis based on the carboxyhaemoglobin level. […] Key diagnostic factors include risk of carbon monoxide exposure, headache, nausea, vomiting, vertigo, altered consciousness, weakness, dizziness, dyspnoea, pain, hypotension or hypertension, sleep changes, irritability, and flu-like symptoms. […] 1st investigations to order include blood gas analysis, 12-lead ECG, cardiac monitoring, glucose, full blood count, urea and electrolytes, creatinine, troponin, and creatine kinase.

• #1 Carbon Monoxide Toxicity Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/819987-workup

  Positive CT scan findings generally predict neurologic complications. In one study, 53% of patients hospitalized for acute CO intoxication had abnormal CT scan findings; all of these patients had neurologic sequelae. […] Formal neuropsychologic testing of concentration, fine motor function, and problem solving consistently reveal subtle deficits in even mildly poisoned patients. […] Research indicates a specific link to deficits in context-aided memory in CO poisoning.

• #1 Carbon Monoxide Poisoning • LITFL • CCC Toxicology

  https://litfl.com/carbon-monoxide-poisoning/

  Carbon monoxide poisoning may be acute or chronic […] Chronic CO poisoning may have an insidious presentation (e.g. intermittent headaches), and a high index of suspicion is required in at-risk groups (e.g. fires inside the home) […] Clinical effects occur within 2 hours of exposure at concentrations as low as 0.01% (100 ppm) […] Tobacco smokers have higher baseline concentrations of COHb (3 to 10%) and therefore will reach toxic concentrations earlier in any exposure […] Symptoms are usually non-specific but can include headache, personality changes, poor concentration, dementia, psychosis, Parkinsonism, ataxia, peripheral neuropathy and hearing loss […] HbCO (elevated levels are significant, but low levels do not rule out exposure) […] CT/MRI brain: may demonstrate cerebral oedema, cerebral atrophy, basal ganglia injury or cortical demyelination […] Anyone with a neurological deficit will require neuropsychiatric testing in 1-2 months […] Complications are present in 30% of survivors at 1 month and 6-10% at 12 months.

• #1 Carbon Monoxide Toxicity: Diagnosis : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/carbon-monoxide-toxicity-diagnosis/

  Carbon Monoxide (CO) is a colourless, odourless, tasteless gas formed from the incomplete combustion of hydrocarbons. […] Diagnosis can be difficult, as chronic exposures can present with vague or nonspecific symptoms and patients may not be aware of their exposure history. […] CO Toxicity is a clinical diagnosis, which requires the following: History of potential CO exposure. Symptoms consistent with CO toxicity. Elevated carboxyhemoglobin level – although given the time-sensitive nature of this test, a normal COHb cannot always rule out the diagnosis. […] Once diagnosis is established, patient signs and symptoms guide management, not levels – so repeat measurements are generally unnecessary.

• #1 Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning | Journal of Anesthesia, Analgesia and Critical Care | Full Text

  https://janesthanalgcritcare.biomedcentral.com/articles/10.1186/s44158-022-00041-y

  The universally recognized value of the measurement of blood carboxyhemoglobin is only to confirm that the subject has come into contact with carbon monoxide in the previous hours, a sort of memory of the link between it and hemoglobin. […] It is important to remember that chronic exposures can lead to some of the most serious sequelae, although often presenting with not markedly high levels of carboxyhemoglobin. […] The possible state of pregnancy of a patient must always be investigated and the lack of information about a state of pregnancy should be an unacceptable error. […] A good practice would be for the doctor at the scene to take an initial blood sample with a heparinized syringe. […] Carbon monoxide poisoning can be confirmed by the detection on a blood sample of a quantity of carboxyhemoglobin of at least 34% in the non-smoker, greater than 10% in the smoker.

• #1 Carbon Monoxide Poisoning in Children — Pediatric EM Morsels

  https://pedemmorsels.com/carbon-monoxide-poisoning-in-children/

  Carbon Monoxide Poisoning is the leading cause of poisoning deaths in children in the USA. […] Carbon Monoxide binds to hemoglobin with an affinity 210 times that of oxygen. […] After acute Carbon Monoxide Poisoning, those who survive can have lasting consequences: Symptoms = chronic headache, mood disorders, personality changes, memory loss, focal neurologic deficits, hypoxic brain injury. […] Children are more susceptible to the effects of Carbon Monoxide Toxicity. […] Clinical picture is variable and symptoms do not necessarily correlate with COHb level. […] Common Symptoms are not specific for Carbon Monoxide Poisoning and a high index of suspicion is required. […] Severe Clinical Course associated with: Clinical Features: Low GCS (8), Altered Mental Status, Being Found Unresponsive, Seizures.

• #1 Pediatric Carbon Monoxide Toxicity: Diagnosis, Treatment In The Emergency Room, Hyperbaric Oxygen | EB Medicine

  https://www.ebmedicine.net/topics/toxicology-environmental/pediatric-carbon-monoxide

  Approximately 5000 children present to the emergency department annually with unintentional carbon monoxide poisoning. Children may be more vulnerable to carbon monoxide poisoning because of their increased metabolic demand and their inability to vocalize symptoms or recognize a dangerous exposure, and newborn infants are more vulnerable to carbon monoxide poisoning because of the persistence of fetal hemoglobin. Mild carbon monoxide poisoning may present as viral symptoms in the absence of fever. While headache, nausea, and vomiting are the most common presenting symptoms in children, the most common symptom in infants is consciousness disturbance. This review discusses the limitations of routine pulse oximetry and carboxyhemoglobin measurement in determining carbon monoxide exposure, and notes effects of co-ingestions and comorbidities.

• #1 Carbon Monoxide Poisoning in Children

  https://www.nationwidechildrens.org/conditions/health-library/carbon-monoxide-poisoning-in-children

  Carbon monoxide poisoning is an illness that occurs from breathing in carbon monoxide (CO) gas. It’s a medical emergency and needs treatment right away. […] The health care provider will ask about your child’s symptoms and health history. They may ask about recent exposure to fuel-burning appliances. A provider often diagnoses CO poisoning based on known exposure. They will give your child a physical exam. The physical exam may include a test of mental status. The key to being sure about the diagnosis is measuring the patient’s level of carboxyhemoglobin in the blood. This means how much carbon monoxide is attached to hemoglobin in the red blood cells. […] Your child may also have tests to check oxygen levels in the blood. […] Sometimes an image test like a CT scan or an MRI may be advised to identify any brain damage. […] For patients with severe CO poisoning, it may be important to perform an EKG. This test measures troponin and cardiac enzymes in the blood to check for damage to the heart.

• #1 Carbon monoxide intoxication – diagnosis and treat

  https://acutecaretesting.org/en/articles/carbon-monoxide-intoxication–diagnosis-and-treat

  The treatment, therefore, is initially the same as at any scene of emergency. […] In cases of suspected CO intoxication, the patient should have oxygen until a definitive diagnosis has been established at the hospital. […] The importance of oxygen treatment is supported by the observation that the dissociation rate of COHb is exponential. […] The half-life of COHb for a patient breathing atmospheric air is 230 – 320 min. When pure oxygen is breathed, the half-life is reduced to 90 min. […] A committee under Undersea and the Hyperbaric Medical Society has concluded that the cost of HBO treatment in these conditions is modest, since it is a primary mode of therapy. […] According to Danish regulations a CO exposed patient should be considered for HBO treatment if the patient has at least one of the characteristics.

• #1 S2k guideline diagnosis and treatment of carbon monoxide poisoning | Publisso

  https://books.publisso.de/en/journals/gms/volume19/000300

  Patients in the prehospital or emergency department setting can be left on site as affected individuals or discharged home from the emergency department, respectively, following CO exposure and a thorough clinical examination that reveals no symptoms, as well as instrument-based diagnostics, after consideration of the individual risk constellation and an evaluation of relevant possible differential diagnoses. […] The primary goal of treatment is to eliminate CO from the body in order to prevent acute and long-term sequelae. Treatment must be continued until the COHb level has dropped to normal values (3%) and the patient is symptom-free. […] Nevertheless, based on the literature review and the consensus discussion conducted by the guideline group, there is no clear correlation between the level of COHb, COHb clearance, and the patients clinical symptoms.

• #1 Diagnosis of Carbon Monoxide Exposure – Diagnosing carbon monoxide poisoning is very difficult. It’s not only homeowners who may find it difficult to diagnose, carbon monoxide poisoning is very challenging for health professionals to diagnose as well

  https://www.coresearchtrust.org/diagnosis-of-carbon-monoxide

  Diagnosing carbon monoxide poisoning is very difficult. It’s not just homeowners who may find it difficult to diagnose. Carbon monoxide poisoning is also very challenging for health professionals to diagnose. […] There is no reliable biomarker to aid the diagnosis of carbon monoxide poisoning. This means that it’s hard to prove/diagnose should you suspect you’ve been exposed to carbon monoxide. […] Given the limitations of carboxyhaemoglobin, a new biomarker must be found to make diagnosis easier, ensure that those who need treatment receive it, and ensure that all cases of carbon monoxide exposure are identified. […] However, even if carbon monoxide exposure is suspected, it is very difficult for medical professionals to confirm the diagnosis.

• #2 Carbon Monoxide Poisoning: Diagnosis, Prognostic Factors, Treatment Strategies, and Future Perspectives

  https://www.mdpi.com/2075-4418/15/5/581

  Carbon monoxide (CO) poisoning is a significant public health issue, with diagnosis often complicated by non-specific symptoms and limited access to specialised tools. Early detection is vital for preventing long-term complications. […] The review examines diagnostic challenges, prognostic factors, management strategies, and future advancements in CO poisoning. It highlights the limitations of current diagnostic techniques such as blood carboxyhaemoglobin levels and pulse CO-oximetry, while exploring emerging methods for rapid detection. […] A complete clinical examination, a full patient history, and the identification of probable exposure sources and risk factors are required for an accurate diagnosis. […] Patients with CO poisoning sometimes present with vague symptoms, making diagnosis difficult. Common symptoms include headaches, dizziness, weakness, nausea, disorientation, and changed mental state.

• #2 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/432

  Carbon monoxide (CO) poisoning results in significant morbidity and mortality. […] Diagnosis is based on a clinical triad: history of CO exposure, elevated carboxyhemoglobin levels, and symptoms/signs consistent with CO poisoning. […] Key diagnostic factors include exposure to incomplete combustion of carbon-containing material, exposure to fire with smoke inhalation, nausea, headache, vomiting, blurred vision, dizziness, vertigo, altered consciousness, dyspnea, tachycardia, hypotension or hypertension, cardiac arrhythmias, pain, weakness, sleep changes, irritability, and flu-like symptoms. […] Other diagnostic factors include exposure to methylene chloride, delayed neuropsychiatric features, other severe neurologic symptoms, cutaneous blistering, pulmonary edema, cardiac arrest, and focal neurologic abnormalities (e.g., hemiplegia, truncal ataxia).

• #2 Symptoms and Common Misdiagnoses of Carbon Monoxide Poisoning – Wyatt Law Firm, PLLC

  https://www.wyattlawfirm.com/symptoms-and-common-misdiagnoses-of-carbon-monoxide-poisoning/

  Common misdiagnoses for CO poisoning’s vague symptoms include: […] By far, the flu is the number one misdiagnosis for CO poisoning. However, carbon monoxide poisoning victims who experience flu-like symptoms such as headaches, fatigue, nausea, and vomiting do not experience fevers. […] If you suspect you have carbon monoxide poisoning, seek medical evaluation immediately. If a medical professional gives you an unfitting diagnosis, request a blood test for your carboxyhemoglobin. Your carboxyhemoglobin represents the percentage of carbon monoxide metabolized by your body.

• #2 Carbon monoxide poisoning – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/432/carbon-monoxide-poisoning

  Carbon monoxide (CO) poisoning results in significant morbidity and mortality. […] Diagnosis is based on a clinical triad: history of CO exposure, elevated carboxyhemoglobin levels, and symptoms/signs consistent with CO poisoning.

• #2 Clinical Guidance for Carbon Monoxide Poisoning Following Disasters and Severe Weather | Carbon Monoxide Poisoning | CDC

  https://www.cdc.gov/carbon-monoxide/hcp/clinical-guidance/index.html

  The symptoms and signs of carbon monoxide poisoning are variable and nonspecific. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and altered mental status. […] Diagnosis is based on a suggestive history and physical findings coupled with confirmatory testing. Patients should be examined for other conditions, including smoke inhalation, trauma, medical illness, or intoxication. […] An elevated carboxyhemoglobin (COHgb) level of 2% for non-smokers and 9% COHgb level for smokers strongly supports a diagnosis of CO poisoning. […] The key to confirming the diagnosis is measuring carboxyhemoglobin (COHgb) level. […] COHgb levels do not correlate well with severity of illness, outcomes or response to therapy so it is important to assess clinical symptoms and history of exposure when determining type and intensity of treatment. […] Other testing, such as a fingerstick blood sugar, alcohol and toxicology screen, head CT scan or lumbar puncture may be needed to exclude other causes of altered mental status when the diagnosis of carbon monoxide poisoning is inconclusive.

• #2 How to Test for Carbon Monoxide and Diagnose CO Poisoning

  https://www.verywellhealth.com/carbon-monoxide-poisoning-diagnosis-4161054

  As symptoms become more severe, the levels of carboxyhemoglobin (COHgb) increase in the blood. […] Blood gas tests measure the amount of atmospheric gases usually oxygen and carbon dioxide in the bloodstream by drawing blood from the arteries. […] Blood gas tests are considered more accurate than pulse CO-oximetry. Even though oximetry is useful for identifying patients at the scene who potentially have carbon monoxide poisoning, blood gases should be obtained to confirm carboxyhemoglobin levels. […] Testing for carbon monoxide includes measuring CO in the home and in the body. CO exposure and poisoning are diagnosed by assessing symptoms, doing blood tests, and possibly imaging tests to determine the level of exposure. […] An elevated COHgb level of 2% for non-smokers and greater than 9% for smokers strongly supports a diagnosis of CO poisoning.

• #2 Carbon monoxide poisoning – Wikipedia

  https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning

  Carbon monoxide poisoning typically occurs from breathing in carbon monoxide (CO) at excessive levels. Symptoms are often described as „flu-like” and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion. […] Diagnosis is typically based on a HbCO level of more than 3% among nonsmokers and more than 10% among smokers. […] The ratio of carboxyhemoglobin to hemoglobin molecules in an average person may be up to 5%, although cigarette smokers who smoke two packs per day may have levels up to 9%. […] As many symptoms of carbon monoxide poisoning also occur with many other types of poisonings and infections (such as the flu), the diagnosis is often difficult. A history of potential carbon monoxide exposure, such as being exposed to a residential fire, may suggest poisoning, but the diagnosis is confirmed by measuring the levels of carbon monoxide in the blood.

• #2 Carbon Monoxide Poisoning in Children — Pediatric EM Morsels

  https://pedemmorsels.com/carbon-monoxide-poisoning-in-children/

  Carboxyhemoglobin level 25% is deemed to be consistent with a Severe Poisoning, but, the COHb level has not been found to be an independent factor in predicting clinical course. […] Lactate may prove to be more useful in predicting clinical course than COHb levels, but results are conflicting. […] For the critically ill, ECMO may be an option! […] Myocardial injury is a well known complication of CO poisoning. […] If the CO exposure was due to a significant fire, Cyanide may also be the cause of the patients critical state.

• #2 Carbon Monoxide Poisoning – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/poisoning/carbon-monoxide-poisoning

  Carbon monoxide (CO) poisoning is caused by inhalation of carbon monoxide gas. […] Diagnosis is by carboxyhemoglobin levels and arterial blood gases (ABGs), including measured oxygen saturation. […] Because symptoms can be vague, nonspecific, and variable, the diagnosis of carbon monoxide (CO) poisoning is easily missed. […] If CO poisoning is suspected, the carboxyhemoglobin level in the blood is measured with a CO-oximeter; venous samples can be used because arteriovenous differences are trivial. […] Arterial blood gases (ABGs) are not measured routinely. […] Noninvasive CO detectors have not been shown to be accurate or useful in the diagnosis of CO exposure or toxicity. […] Although elevated carboxyhemoglobin levels are clear evidence of poisoning, levels may be falsely low because they decrease rapidly after CO exposure ends, particularly in patients treated with supplemental oxygen. […] Metabolic acidosis can be a clue to the diagnosis.

• #2 Carbon monoxide poisoning – Wikipedia

  https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning

  Carbon monoxide may be quantitated in blood using spectrophotometric methods or chromatographic techniques in order to confirm a diagnosis of poisoning in a person or to assist in the forensic investigation of a case of fatal exposure. […] A CO-oximeter can be used to determine carboxyhemoglobin levels.

• #2 The Diagnosis and Treatment of Carbon Monoxide Poisoning

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6381775/

  The symptoms of carbon monoxide (CO) poisoning are nonspecific, ranging from dizziness and headache to unconsciousness and death. […] In patients with severe carbon monoxide poisoning, an ECG should be obtained and biomarkers for cardiac ischemia should be measured. […] The state of the evidence on the diagnosis and treatment of this condition is not entirely clear. […] The diagnosis of CO poisoning is based on clinical symptoms and suspected or confirmed exposure. […] For the purposes of verification, carboxyhemoglobin (COHb) should be measured in a blood gas analysis (BGA). […] Confirmation of COHb does not differ to a clinically relevant degree in arterial and venous specimens. […] If concomitant cardiac symptoms occur, a 12-lead ECG should be conducted and cardiological biomarkers determined.

• #2 The Diagnosis and Treatment of Carbon Monoxide Poisoning

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6381775/

  The mere CO measurement correlates poorly with the severity of the clinical manifestation. […] The decision in favor of hyperbaric oxygen therapy should be made if a patient with carbon monoxide poisoning presents with impaired consciousness, cardiac ischemia, neurological deficits, pregnancy, or very high COHb concentrations. […] Patients with CO poisoning should continue to be treated according to the standards of emergency medicine.

• #2 S2k guideline diagnosis and treatment of carbon monoxide poisoning | Publisso

  https://books.publisso.de/en/journals/gms/volume19/000300

  The diagnosis of CO poisoning requires clinical symptoms and proven or probable exposure to CO. […] The diagnosis ought to be made on the basis of clinical symptoms, patient history, the circumstances in which the patient is found, and symptoms. […] Negative COHb levels should not result in the exclusion of CO poisoning if history and symptoms are consistent with this phenomenon. […] The diagnosis of CO poisoning is essentially based on clinical symptoms and suspected or proven exposure. […] Patients with CO poisoning are not admitted to emergency departments exclusively by ambulance. Patients with CO poisoning also present of their own accord. Therefore, a differential diagnosis of CO poisoning should be considered in emergency departments for patients with nonspecific symptoms such as clouding of consciousness, dizziness, nausea, or vomiting.

• #2 CO Toxicity: A Potentially Elusive Diagnosis – emDocs

  https://www.emdocs.net/co-toxicity-potentially-elusive-diagnosis/

  Due to the non-specific signs and symptoms of carbon monoxide poisoning, the diagnosis can be delayed and mistaken for other pathologies. […] In the ED, historical clues such as winter time, exposure to CO in a fire, gas appliances in the home, and multiple patients from the same household presenting with similar symptoms can help the emergency physician narrow the differential diagnosis down to carbon monoxide poisoning. Once suspected, as always, ABCs should be evaluated and supported. […] CO-Oximetry should be obtained in CO toxicity is on the differential. Elevated carbon monoxide levels via CO-Oximetry can help make the diagnosis. Because pulse oximetry cannot distinguish between carboxyhemoglobin and oxyhemoglobin, pulse oximetry readings can be normal in carbon monoxide poisoning.

• #2 CO Toxicity: A Potentially Elusive Diagnosis – emDocs

  https://www.emdocs.net/co-toxicity-potentially-elusive-diagnosis/

  Once the diagnosis of carbon monoxide poisoning is made, oxygen supplementation should be started. For mild to moderate toxicity, supplemental oxygen via non-rebreather can be considered. For more severe toxicity, or in select patient populations (pregnancy), hyperbaric oxygen can be considered. […] The clinical policy evaluates three questions: 1) In emergency department patients with suspected acute carbon monoxide poisoning, can noninvasive carboxyhemoglobin measurement be used to accurately diagnose carbon monoxide toxicity? – With level B evidence, the ACEP clinical policy does not recommend the use of noninvasive COHb measurement to diagnose CO toxicity with suspected acute CO poisoning. 2) In emergency department patients diagnosed with acute carbon monoxide poisoning, does hyperbaric oxygen therapy as compared with normobaric oxygen therapy improve long-term neurocognitive outcomes? – With Level B recommendations, the authors recommend that HBO2 therapy or high-flow normobaric therapy should be used by emergency physicians for acute CO-poisoned patients but that the effects of HBO2 versus normobaric therapy on long-term neurocognitive outcomes remain unclear. 3) In emergency department patients diagnosed with acute carbon monoxide poisoning, can cardiac testing be used to predict morbidity or mortality? – With Level B recommendations, the authors recommend that an ECG and cardiac biomarker levels be obtained in ED patients with moderate to severe CO poisoning to identify acute myocardial injury.

• #2 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000169

  Carbon monoxide poisoning can cause hypoxia, cell damage, and death. Approximately one third of severe poisonings are fatal. […] Make a clinical diagnosis based on the history and symptoms. Use a blood gas analysis to confirm the diagnosis based on the carboxyhaemoglobin level. […] Key diagnostic factors include risk of carbon monoxide exposure, headache, nausea, vomiting, vertigo, altered consciousness, weakness, dizziness, dyspnoea, pain, hypotension or hypertension, sleep changes, irritability, and flu-like symptoms. […] 1st investigations to order include blood gas analysis, 12-lead ECG, cardiac monitoring, glucose, full blood count, urea and electrolytes, creatinine, troponin, and creatine kinase.

• #2 Carbon monoxide poisoning – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/432

  1st tests to order include carboxyhemoglobin level, ECG, cardiac monitoring, blood glucose, complete blood count, urea and electrolytes, creatinine, lactate, pH level, cardiac biomarkers, and creatine kinase. […] Tests to consider include chest x-ray, Mini Mental State Examination, CT head, magnetic resonance imaging and spectroscopy, liver function tests, and pregnancy test.

• #2 Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning | Journal of Anesthesia, Analgesia and Critical Care | Full Text

  https://janesthanalgcritcare.biomedcentral.com/articles/10.1186/s44158-022-00041-y

  Acute carbon monoxide poisoning is the leading cause of intoxication from exogenous substances in the world. It is also a major cause of morbidity and mortality due to poisoning in the USA. In the USA, it determines to 50,000 visits per year in emergency departments with a mortality ranging from 1 to 3%. […] Although prevalence and incidence data reveal the large impact of carbon monoxide poisoning on public health, some studies have shown that errors in its diagnosis have a high incidence (30%) and that awareness campaigns have allowed the reduction of the same to 5%. […] In addition, many diagnostic and/or therapeutic errors were found both in small first aid situations and in the context of rescue units belonging to prestigious hospitals. […] To formulate a diagnosis, the collection of clues from the environment in which the patient is found is essential.

• #2 Carbon Monoxide Poisoning • LITFL • CCC Toxicology

  https://litfl.com/carbon-monoxide-poisoning/

  Carbon monoxide poisoning may be acute or chronic […] Chronic CO poisoning may have an insidious presentation (e.g. intermittent headaches), and a high index of suspicion is required in at-risk groups (e.g. fires inside the home) […] Clinical effects occur within 2 hours of exposure at concentrations as low as 0.01% (100 ppm) […] Tobacco smokers have higher baseline concentrations of COHb (3 to 10%) and therefore will reach toxic concentrations earlier in any exposure […] Symptoms are usually non-specific but can include headache, personality changes, poor concentration, dementia, psychosis, Parkinsonism, ataxia, peripheral neuropathy and hearing loss […] HbCO (elevated levels are significant, but low levels do not rule out exposure) […] CT/MRI brain: may demonstrate cerebral oedema, cerebral atrophy, basal ganglia injury or cortical demyelination […] Anyone with a neurological deficit will require neuropsychiatric testing in 1-2 months […] Complications are present in 30% of survivors at 1 month and 6-10% at 12 months.

• #2 Recover from Carbon Monoxide Poisoning’s Long-Term Effects

  https://www.cognitivefxusa.com/blog/carbon-monoxide-poisoning-long-term-effects

  Symptoms and potential exposure not carboxyhemoglobin levels should guide diagnosis. Medical staff should be particularly aware of CO poisoning in fire victims, patients with unexplained altered mental status, or if more than one person in the household is experiencing similar symptoms. […] If you believe you or your loved ones have been exposed to high levels of CO and are experiencing symptoms like headache, dizziness, nausea, shortness of breath, weakness, and confusion, you need to call emergency medical services immediately. […] At the hospital, treatment for CO poisoning may involve: Breathing pure oxygen. In the emergency room, treatment for CO poisoning involves breathing 100% oxygen through a mask placed over the patients nose and mouth. […] Hyperbaric oxygen therapy can be particularly useful for severe cases of CO poisoning, reducing the incidence of persistent symptoms. The best results occur when patients receive their first session less than six hours after the poisoning event. […] Diagnosis is possible if patients seek medical treatment immediately after exposure.

• #2 Carbon monoxide poisoning – UpToDate

  https://www.uptodate.com/contents/carbon-monoxide-poisoning

  The following tests are obtained selectively after diagnosis of CO poisoning: Electrocardiogram (ECG) – Obtain in all symptomatic patients. […] The key interventions in the management of the CO-poisoned patient are prompt removal from the source of CO and provision of high-flow oxygen. […] In a patient with suspected or confirmed CO poisoning, we recommend initial treatment with high-flow (100 percent) normobaric oxygen via nonrebreathing face mask, regardless of pulse oximetry or arterial PO2. […] In patients with the following indications, we suggest treating with hyperbaric oxygen therapy (HBO) in addition to normobaric 100 percent oxygen: COHb level >25 percent, COHb level >15 percent in pregnant patient, Loss of consciousness, Severe metabolic acidosis (pH <7.25), Evidence of end-organ ischemia. [...] The diagnosis of CO poisoning is made in patients with known or suspected exposure in conjunction with an elevated COHb level measured by co-oximetry of a venous blood gas sample.

• #2 Pediatric Carbon Monoxide Toxicity: Diagnosis, Treatment In The Emergency Room, Hyperbaric Oxygen | EB Medicine

  https://www.ebmedicine.net/topics/toxicology-environmental/pediatric-carbon-monoxide

  Approximately 5000 children present to the emergency department annually with unintentional carbon monoxide poisoning. Children may be more vulnerable to carbon monoxide poisoning because of their increased metabolic demand and their inability to vocalize symptoms or recognize a dangerous exposure, and newborn infants are more vulnerable to carbon monoxide poisoning because of the persistence of fetal hemoglobin. Mild carbon monoxide poisoning may present as viral symptoms in the absence of fever. While headache, nausea, and vomiting are the most common presenting symptoms in children, the most common symptom in infants is consciousness disturbance. This review discusses the limitations of routine pulse oximetry and carboxyhemoglobin measurement in determining carbon monoxide exposure, and notes effects of co-ingestions and comorbidities.

• #2 The Diagnosis and Treatment of Carbon Monoxide Poisoning (24.12.2018)

  https://di.aerzteblatt.de/int/archive/article/203936

  The treatment should be continued until the COHb measurement has dropped to normal values. […] The higher the provided partial pressure of oxygen (pO2), the quicker the CO will be eliminated. […] Because the studies available so far are subject to great heterogeneity, no clear, generally accepted recommendation exists for what should be done. […] The intracellular and extracellular effects of carbon monoxide poisoning affect in particular the organs without oxygen reserves (heart, brain). […] The study evidence for the benefit of HBOT in adults with regard to neurological sequelae subsequent to CO poisoning is inconclusive. […] In sum, on the basis of the randomized controlled trials published to date, no superiority can be confirmed for HBOT over normobaric oxygen therapy.

• #2 Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning | Journal of Anesthesia, Analgesia and Critical Care | Full Text

  https://janesthanalgcritcare.biomedcentral.com/articles/10.1186/s44158-022-00041-y

  The relationship between the severity of clinical signs and symptoms of acute carbon monoxide poisoning and COHb levels is not well correlated. […] The clinical scene in which carbon monoxide poisoning occurs is extremely varied in terms of symptoms and severity, as well as totally non-specific. […] One study showed that 35% of patients who presented to the emergency room had covert exposure to carbon monoxide not recognized at scene. […] Due to the non-specificity of the symptoms and signs, great care must be taken in setting the differential diagnosis with other pathologies. […] The most frequently reported diagnostic errors in the literature are shown in Table 3. […] Chronic exposures to carbon monoxide seem far from infrequent and can represent a real pitfall for the clinician as they can give more nuanced symptoms as well as present low and unjustifiably reassuring values of carboxyhemoglobin (COHb).

• #2 Carbon Monoxide Poisoning: Diagnosis, Prognostic Factors, Treatment Strategies, and Future Perspectives

  https://www.mdpi.com/2075-4418/15/5/581

  Carbon monoxide (CO) poisoning may be accurately diagnosed using appropriate diagnostic equipment. Pulse CO-oximetry is a rapid, non-invasive method of measuring carboxyhaemoglobin (COHb) levels, however, it may be less precise than arterial blood samples. […] The gold standard for measuring COHb levels is arterial blood gas (ABG) measurement, which validates the severity of the poisoning. […] Carboxyhaemoglobin (COHb) levels are crucial in detecting carbon monoxide poisoning, with typical values of less than 2% in non-smokers and 5–10% in smokers. […] COHb values can help determine poisoning severity and guide treatment methods. […] Addressing the challenges of carbon monoxide (CO) poisoning necessitates many critical solutions. First, education and awareness are critical for increasing public and healthcare professionals’ understanding of CO poisoning symptoms, hazards, and preventative actions, resulting in early detection.

• #3

  https://scholars.duke.edu/publication/753889

  Carbon monoxide (CO) poisoning is a common occurrence in today’s society. Most such poisonings are a direct consequence of inhaling the toxic byproducts of combustion. Exposure to toxic amounts of CO occurs most often during inhalation of automobile exhaust or smoke resulting either from faulty heating systems or industrial accidents. CO poisoning is associated primarily with injury to the brain and the heart because the gas binds to hemoglobin and interferes with these organs’ need for a continuous supply of oxygen. Prompt recognition of CO poisoning and treatment of the patient with oxygen are essential to prevent long-term damage and delayed neurologic sequelae.

• #3 Carbon monoxide poisoning – UpToDate

  https://www.uptodate.com/contents/carbon-monoxide-poisoning

  Carbon monoxide poisoning will be reviewed here. […] The diagnosis of CO poisoning should be suspected in fire victims, in patients with flu-like symptoms in cold climates, especially if any other cohabitants or pets are also feeling ill, and patients with unexplained altered mental status or lactic acidosis. […] The diagnosis of CO poisoning is made in patients with known or suspected CO exposure in conjunction with an elevated carboxyhemoglobin (COHb) level measured by co-oximetry of a blood gas sample. […] COHb levels confirm exposure but may not tell extent – A COHb measurement is essential for determining exposure, but levels correlate imprecisely with the degree of poisoning. […] Standard pulse oximetry is not useful – Standard pulse oximetry (SpO2) cannot screen for CO exposure, as it does not differentiate COHb from oxyhemoglobin.

• #3 Carbon monoxide toxicity – WikEM

  https://wikem.org/wiki/Carbon_monoxide_toxicity

  Must have high clinical suspicion (esp in coma, altered mental status, or anion gap acidosis) […] Comatose patients removed from fire should be assumed to have CO poisoning […] Carboxyhemoglobin Level […] Interpretation must take into account time since exposure and O2 treatment […] Normal value in non-smokers is ~1%, normal value in smokers may be up to 10% […] Symptoms and COhemoglobin levels do not always correlate well […] Pulse oximetry is unreliable […] COhemoglobin registers the same as O2hemoglobin so will have artificially high SpO2 […] O2 saturation gap reflects discordance of SpO2 by pulse oximeter vs by VBG.

• #3 Current challenges in carbon monoxide poisoning diagnosis from an analytical perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10662327/

  Diagnosis of CO poisoning occurs through evaluation of the symptoms and the case history by a clinician in the emergency department (ED) in combination with a confirmation through measurement of a biomarker. The main biomarker used for diagnosis confirmation is carboxyhaemoglobin (COHb) (9, 10). […] However, there are several issues faced during CO poisoning diagnosis from both a clinical and analytical perspective. […] While in many cases the measured COHb concentration is in agreement with the symptoms and can lead to administration of the proper treatment for the patient, there is also a relatively high number of cases where measured COHb levels and reported symptoms are controversial. […] Despite COHb being a direct biomarker of CO exposure, often low COHb levels are measured in patients with CO exposure suspicion or with symptoms that are normally associated to higher COHb levels (13, 15, 16).

• #3 Carbon monoxide intoxication – diagnosis and treat

  https://acutecaretesting.org/en/articles/carbon-monoxide-intoxication–diagnosis-and-treat

  The suspicion of CO intoxication may be based on the patients history and the history of the accident. […] A blood gas sample is essential for determining CO intoxication, and the parameter of interest is carboxyhemoglobin. […] Pulse oximetry does not provide any information since the method can not distinguish between oxyhemoglobin (O2Hb) and COHb. The clinical picture is the guideline for further treatment. […] Many handbooks describe a correlation between increased signs of intoxication with increasing COHb. However these tables are based on experimental research and have little reference to the clinical situation. […] When the patient is received in hospital, a further course of treatment is planned. Besides symptomatic treatment of respiration and circulation, a blood sample should be analyzed for COHb and biochemical signs of muscle necrosis.

• #3 CO Toxicity: A Potentially Elusive Diagnosis – emDocs

  https://www.emdocs.net/co-toxicity-potentially-elusive-diagnosis/

  Once the diagnosis of carbon monoxide poisoning is made, oxygen supplementation should be started. For mild to moderate toxicity, supplemental oxygen via non-rebreather can be considered. For more severe toxicity, or in select patient populations (pregnancy), hyperbaric oxygen can be considered. […] The clinical policy evaluates three questions: 1) In emergency department patients with suspected acute carbon monoxide poisoning, can noninvasive carboxyhemoglobin measurement be used to accurately diagnose carbon monoxide toxicity? – With level B evidence, the ACEP clinical policy does not recommend the use of noninvasive COHb measurement to diagnose CO toxicity with suspected acute CO poisoning. 2) In emergency department patients diagnosed with acute carbon monoxide poisoning, does hyperbaric oxygen therapy as compared with normobaric oxygen therapy improve long-term neurocognitive outcomes? – With Level B recommendations, the authors recommend that HBO2 therapy or high-flow normobaric therapy should be used by emergency physicians for acute CO-poisoned patients but that the effects of HBO2 versus normobaric therapy on long-term neurocognitive outcomes remain unclear. 3) In emergency department patients diagnosed with acute carbon monoxide poisoning, can cardiac testing be used to predict morbidity or mortality? – With Level B recommendations, the authors recommend that an ECG and cardiac biomarker levels be obtained in ED patients with moderate to severe CO poisoning to identify acute myocardial injury.

• #3 Diagnostics | Special Issue : Diagnosis, Prognosis and Management of Illnesses Caused by Carbon Monoxide Poisoning

  https://www.mdpi.com/journal/diagnostics/special_issues/B4S7Y9I4TP

  Diagnosis, Prognosis and Management of Illnesses Caused by Carbon Monoxide Poisoning […] Carbon monoxide is a poisonous gas causing debilitating-to-lethal intoxication by binding hemoglobin and heme-containing proteins throughout the body. Carbon monoxide poisoning causes neurocognitive sequelae and various organ injuries, such as to the heart and kidney. Also, a diagnosis of carbon monoxide poisoning is often difficult due to the nonspecific symptoms and clinical signs and the normalized carboxyhemoglobin level after time passes. Once diagnosed, carbon monoxide poisoning is treated with normobaric oxygen and, in selected cases, with hyperbaric oxygen. […] This Topic intends to gather updates on carbon monoxide poisoning, especially regarding its diagnosis, prognosis, and treatment, and various organ injuries caused by it. We will include both clinical and experimental research.

• #3 Diagnostics | Special Issue : Diagnosis, Prognosis and Management of Illnesses Caused by Carbon Monoxide Poisoning

  https://www.mdpi.com/journal/diagnostics/special_issues/B4S7Y9I4TP

  This Topic will evaluate original research and high-quality reviews focusing on the following fields: diagnosis (training of technical and healthcare personnel; prehospital diagnosis; new biomarkers; and triage); prognosis (neurological outcomes, mortality, other organ-injury-related outcomes, and long-term outcomes); treatment (normobaric vs. hyperbaric oxygen; early referral; prevention and follow-up of delayed neurologic sequelae; and other treatment modalities); various organ injuries (diagnosis, prognosis, treatment, and basic research).

• #3 Carbon monoxide poisoning: a clinical case report | International Journal of Emergency Medicine | Full Text

  https://intjem.biomedcentral.com/articles/10.1186/s12245-024-00777-0

  Carbon monoxide (CO) poisoning is a serious yet frequently overlooked condition with diverse and nonspecific clinical presentations. […] The diagnostic challenge in CO poisoning is underscored in these cases. The triad of symptoms consistent with CO poisoning, a history of exposure, and elevated carboxyhemoglobin (COHb) levels is crucial for diagnosis. […] Given that no single symptom is pathognomonic for CO poisoning, arterial blood gas analysis and measurement of COHb levels are indispensable for diagnosis. The clinical diagnosis of acute CO poisoning should be confirmed by demonstrating an elevated carboxyhemoglobin level. […] CO poisoning can manifest long-term effects despite receiving treatment. Both patients exhibited long-term cognitive and psychological effects post-CO poisoning, highlighting the potential for delayed neuropsychological sequelae (DNS).

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