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Carbon monoxide poisoning — RCPSC EM MCQ

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HardToxicologyCarbon monoxide poisoningRCPSC EM

A 38-year-old man is brought from a garage with headache, vomiting and confusion. Several co-workers are also unwell. Pulse oximetry is 99%, lactate is 2.8 mmol/L and carboxyhaemoglobin is 28%. What is the most appropriate initial management?

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Correct answer: D — Give high-flow oxygen and consult hyperbaric medicine for severe features

Carbon monoxide poisoning causes falsely normal pulse oximetry. High-flow oxygen is immediate treatment; hyperbaric therapy is considered for severe neurological features, pregnancy, marked levels or cardiac involvement.

Reference: Canadian poison centre guidance; environmental emergency medicine