Toxicology/clinical policyClinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department with Acute Carbon Monoxide Poisoning
Section snippets
Abstract
This clinical policy focuses on critical issues concerning the management of adult patients presenting to the emergency department (ED) with acute symptomatic carbon monoxide (CO) poisoning. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are:
Should hyperbaric oxygen (HBO2) therapy be used for the treatment of patients with acute CO poisoning; and
Can clinical or laboratory criteria identify CO-poisoned patients who are most or least
Methodology
This clinical policy was created after careful review and critical analysis of the medical literature. MEDLINE searches for articles published between January 1980 and January 2006 were performed using a combination of key words and their variations, including “carbon monoxide poisoning,” and “hyperbaric oxygen.” Searches were limited to English-language sources. Additional articles were reviewed from the bibliography of articles cited and from published textbooks and review articles.
Critical Questions
Should HBO2 therapy be used for the treatment of patients with acute CO poisoning; and
Can clinical or laboratory criteria identify CO-poisoned patients who are most or least likely to benefit from this therapy?
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2020, American Journal of Emergency MedicineCitation Excerpt :In addition, although there is no general consensus, HBO2 therapy is often recommended in CO poisoning. However, no clinical parameter, including COHb level, has value in determining the cases in which to apply HBO2 therapy [11]. It is postulated that this therapy provides neurological improvement by significantly reducing the half-life of COHb.
Carbon monoxide poisoning in active or passive shisha smokers
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2020, Anaesthesia Critical Care and Pain MedicineCitation Excerpt :However, two international societies (the American College of Emergency Physicians and the International Society for Burn Injuries) reached more conservative conclusions. They stated that HBOT is often contraindicated in severe burns patients, owing to frequent haemodynamic or respiratory instability in the acute phase, creating technical difficulties with HBOT carrying significant risks [52,155]. The experts of the current recommendations suggest that the indication for HBOT should be evaluated on a case-by-case basis.
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Approved by the ACEP Board of Directors, October 5, 2007
Supported by the Emergency Nurses Association, December 9, 2007