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

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.