Carbon monoxide poisoning — ACEM Fellowship MCQ
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Correct answer: D — Give high-concentration oxygen and obtain blood co-oximetry
The best answer is “Give high-concentration oxygen and obtain blood co-oximetry”. Conventional pulse oximetry cannot distinguish carboxyhaemoglobin from oxyhaemoglobin and may appear normal in severe poisoning. High-concentration oxygen is started immediately and co-oximetry measures carboxyhaemoglobin; collapse, neurological features, pregnancy and other severity factors prompt specialist discussion about hyperbaric treatment. Skin colour and PaO2 cannot safely exclude the diagnosis.
Reference: NSW Agency for Clinical Innovation: Burn patient management clinical practice guide: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0009/250020/ACI-Burn-Patient-Management-Clinical-Practice-Guide.pdf