Carbon monoxide poisoning: a comprehensive review for prehospital specialists

As one of the leading causes of poisonings worldwide, it is imperative that prehospital specialists are aware of carbon monoxide (CO) poisoning and its management. Awareness of the epidemiology, and the common presentations of CO poisoning may lead to prompt evaluation and early initiation of life-saving therapy. Children under 5 years of age have the highest incidence of CO-related ER visits and are at greatest risk of CO toxicity. The clinical features are nonspecific and misdiagnoses are common. Therefore, prehospital providers should have a high index of suspicion for CO intoxication in patients that experience headache, vomiting, or altered level of consciousness following exposure to hydrocarbon combustion within an enclosed space. A carboxyhaemoglobin level is a quick and reliable way to diagnose CO exposure. To prevent complications such as altered cerebellar function, seizures, rhabdomyolysis and dysrhythmias, early recognition and treatment is imperative. Removal from the source of exposure and the provision of 100% oxygen form the cornerstone of management. Preventive strategies should also be explored in susceptible populations.

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