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Carbon Monoxide..


Nonsmokers have 1% to 3% carboxyhe­moglobin (COHb) levels

Smokers have 1% to 8% COHb level

Fire victims near 100% CO levels

Frequent imme­diate cause of death

CO affinity for hemoglobin 250 times that of O2

Even small amounts of CO can produce equal levels of oxyhemoglobin and COHb

Pulse oximeter reads COHB as O2HB..you need Co-oximeter or you should measure the SaO2

Causes left shift of oxyhemoglobin dissociation curve (less O2 released to bloodstream)

Early treatment with O2 decreases mortality

Continue 100% oxygen therapy until the patient is asymptomatic and HbCO levels are below 10%. In patients with cardiovascular or pulmonary compromise, lower thresholds of 2% have been suggested.

Consider immediate transfer of patients with levels above 40% or cardiovascular or neurologic impairment to a hyperbaric facility, if feasible. Persistent impairment after 4 hours of normobaric oxygen therapy necessitates transfer to a hyperbaric center. Pregnant patients with lower carboxyhemoglobin levels (above 15%) should be considered for hyperbaric treatment.
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