EM · Carbon monoxide poisoning

Carbon monoxide poisoning

Also known as CO poisoning · Carboxyhaemoglobinaemia · The silent killer

Carbon monoxide poisoning — the colourless, odourless gas that binds haemoglobin about 240 times more avidly than oxygen, left-shifting the oxyhaemoglobin dissociation curve and producing tissue hypoxia with a falsely normal pulse oximetry. The sources (the faulty heater, the car exhaust, the enclosed fire, the indoor barbecue), the clinical (the headache, the nausea, the confusion, the flu-like illness in multiple household members, the rare cherry-red skin), the diagnosis (the venous carboxyhaemoglobin level), and the management (100 per cent oxygen via a non-rebreather mask; hyperbaric oxygen for the severe — the loss of consciousness, the neurological deficit, the pregnancy, the COHb over 25 per cent). The delayed neurological sequelae — the cognitive impairment and the parkinsonism at 2 to 40 days. ACEM-primary, globally tagged.