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Smoke inhalation and carbon monoxide poisoning — SCE Respiratory MCQ

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HardRare/MiscellaneousSmoke inhalation and carbon monoxide poisoningSCE Respiratory

A 40-year-old man is rescued from a house fire with soot around his mouth, hoarse voice and confusion. SpO2 reads 100% on pulse oximetry while ABG co-oximetry shows carboxyhaemoglobin 28%. What is the most appropriate management?

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Correct answer: C — High-flow oxygen and urgent assessment for hyperbaric oxygen indications

Carbon monoxide poisoning can give falsely normal pulse oximetry, and high-flow oxygen is immediate treatment with hyperbaric assessment in severe cases. Hoarseness and soot also require airway vigilance for inhalational injury. Normal SpO2 on standard oximetry is misleading because it cannot distinguish oxyhaemoglobin from carboxyhaemoglobin.

Reference: BTS Oxygen Guideline 2017; UK National Poisons Information Service Guidance