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Smoke inhalation — DipIMC MCQ

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HardEnvironmental MedicineSmoke inhalationDipIMC

A patient rescued from an enclosed house fire has headache, confusion, soot around the mouth and a pulse-oximeter reading of 98% on room air. What is the best interpretation and immediate treatment?

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Correct answer: C — Give high-concentration oxygen and assess airway and carbon-monoxide exposure

The best answer is “Give high-concentration oxygen and assess airway and carbon-monoxide exposure”. Standard pulse oximetry cannot distinguish oxyhaemoglobin from carboxyhaemoglobin and may look reassuring in carbon-monoxide poisoning. Give high-concentration oxygen promptly, assess for evolving thermal airway injury and obtain co-oximetry and toxicology or hyperbaric advice as indicated. A normal displayed saturation neither excludes tissue hypoxia nor justifies delayed treatment.

Reference: British Thoracic Society, Oxygen use in healthcare and emergency settings: https://www.brit-thoracic.org.uk/clinical-resources/guidelines/emergency-oxygen/