When should I consider referring a patient with carbon monoxide poisoning to a specialist or for hyperbaric oxygen therapy?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with carbon monoxide poisoning to a specialist or for hyperbaric oxygen therapy if they exhibit severe symptoms such as loss of consciousness, neurological deficits, cardiac ischemia, or if they are pregnant.

Referral is also appropriate if the patient has a high carboxyhemoglobin level, persistent symptoms despite normobaric oxygen therapy, or if there is evidence of significant hypoxaemia or ventilatory failure.

Specialist assessment is important to determine the need for hyperbaric oxygen therapy, which can reduce the risk of delayed neurological sequelae.

Educational content only. Always verify information and use clinical judgement.