Carbon Monoxide Toxicity in Emergency Medicine Follow-up

  • Author: Guy N Shochat, MD; Chief Editor: Asim Tarabar, MD   more...
 
Updated: May 19, 2011
 

Further Inpatient Care

  • Admitted patients generally require monitored settings, telemetry beds, or cardiac care unit/medical intensive care unit (CCU/MICU) beds for more severe cases.
  • Patients with cerebral edema may be most appropriately treated in a neurosurgical ICU setting; this may dictate transfer to another facility. Admission or consult by toxicology service is helpful in these cases.
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Further Outpatient Care

  • Asymptomatic patients with HbCO levels below 10% may be discharged.
  • Arrange early follow-up care with a medical toxicologist or hyperbaricist experienced in CO poisoning.
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Prognosis

  • Variability of clinical severity, laboratory values, and outcome limits prognostic accuracy.
  • Cardiac arrest, coma, metabolic acidosis, and high HbCO levels are associated with poor outcome.
  • Abnormal findings on CT scan are associated with persistent neurologic impairment.
  • Neuropsychiatric testing may have prognostic efficacy in determining delayed sequelae.
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Patient Education

  • Discuss the possibility of delayed neurologic complications, although they are much more common in admitted patients.
  • Suggest minimizing physical activity for 2-4 weeks.
  • Advise patient to stop smoking.
  • For excellent patient education resources, visit eMedicine's Poisoning Center. Also, see eMedicine's patient education article Carbon Monoxide Poisoning.
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Contributor Information and Disclosures
Author

Guy N Shochat, MD  Associate Clinical Professor of Emergency Medicine, University of California at San Francisco

Guy N Shochat, MD is a member of the following medical societies: Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Lucchesi, MD  Chair, Associate Professor, Department of Emergency Medicine, State University of New York at Brooklyn

Michael Lucchesi, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Peter MC DeBlieux, MD  Professor of Clinical Medicine and Pediatrics, Section of Pulmonary and Critical Care Medicine, Program Director, Department of Emergency Medicine, Louisiana State University School of Medicine in New Orleans

Peter MC DeBlieux, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Radiological Society of North America, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

John G Benitez, MD, MPH  Associate Professor, Department of Medicine, Medical Toxicology, Vanderbilt University Medical Center; Managing Director, Tennessee Poison Center

John G Benitez, MD, MPH is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, American College of Medical Toxicology, American College of Preventive Medicine, Society for Academic Emergency Medicine, Undersea and Hyperbaric Medical Society, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

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Monoplace hyperbaric chamber. Courtesy JG Benitez, MD, MPH.
 
 
 
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