Join/Renew

ACEP ID:

Carbon Monoxide Poisoning

Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning

Scope of Application

This guideline is intended for physicians working in emergency departments.

Inclusion Criteria

This guideline is intended for adult patients presenting to the emergency department with suspected or diagnosed acute carbon monoxide poisoning.

Exclusion Criteria

This guideline is not intended to be used for out-of-hospital emergency care patients, pediatric populations, pregnant patients and fetal exposures, those with chronic carbon monoxide poisoning, or patients with delayed presentations (more than 24 hours after cessation of exposure) of carbon monoxide poisoning.

Recommendations offered in this policy are not intended to represent the only diagnostic and management options that the emergency physician should consider. ACEP recognizes the importance of the individual physician’s judgment and patient preferences.

Critical Questions

  • In emergency department patients diagnosed with acute carbon monoxide (CO) poisoning, does hyperbaric oxygen (HBO2) therapy, compared with normobaric oxygen therapy, improve long-term neurocognitive outcomes?

    Recommendations
    Level A Recommendations
    None specified.
    Level B Recommendations

    None specified.

    Level C Recommendations

    In symptomatic CO poisoning, selected patients may benefit from HBO2 treatment based on severity of symptoms and availability (distance and time).

    Level A Recommendations
    None specified.
    Level B Recommendations

    None specified.

    Level C Recommendations

    In symptomatic CO poisoning, selected patients may benefit from HBO2 treatment based on severity of symptoms and availability (distance and time).

Download the Policy

PDF Icon CarbonMonoxide-cp.pdf December 2024

eCME Credit Available

Check your available credits through eCME learning portal.
Open eCME

Findings and Strength of Recommendations

Clinical findings and strength of recommendations regarding patient management were made according to the following criteria:
Level A recommendations
Generally accepted principles for patient care that reflect a high degree of clinical certainty (eg, based on evidence from 1 or more Class of Evidence I or multiple Class of Evidence II studies).
Level B recommendations
Recommendations for patient care that may identify a particular strategy or range of strategies that reflect moderate clinical certainty (eg, based on evidence from 1 or more Class of Evidence II studies or strong consensus of Class of Evidence III studies).
Level C recommendations
Recommendations for patient care that are based on evidence from Class of Evidence III studies or, in the absence of adequate published literature, based on expert consensus. In instances in which consensus recommendations are made, “consensus” is placed in parentheses at the end of the recommendation.
There are certain circumstances in which the recommendations stemming from a body of evidence should not be rated as highly as the individual studies on which they are based. Factors such as heterogeneity of results, uncertainty about effect magnitude, and publication bias, among others, might lead to a downgrading of recommendations.
[ Feedback → ]