Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • nausea
  • headache
  • vomiting
  • blurred vision
  • dizziness
  • cutaneous blistering
  • tachycardia
  • hypotension
  • cardiac arrhythmias
  • pulmonary oedema
  • confusion
  • coma

Other diagnostic factors

  • seizures
  • focal neurological abnormalities (e.g., hemiplegia)

Risk factors

  • exposure to incomplete combustion of carbon-containing material
  • exposure to methylene chloride

Diagnostic investigations

1st investigations to order

  • carboxyhaemoglobin (CO-Hb) level
  • CXR
  • ECG
  • cardiac monitoring
  • blood glucose
  • lactate
  • ​​cardiac biomarkers
Full details

Investigations to consider

  • creatine kinase
  • Mini Mental State Examination
  • CT head
Full details

Emerging tests

  • magnetic resonance spectroscopy
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Associate Professor of Clinical Emergency Medicine

University of California, San Francisco

San Francisco

CA

Disclosures

PG declares that she has no competing interests.

Peer reviewers VIEW ALL

Director

Florida Poison Center

Miami

FL

Disclosures

RSW declares that he has no competing interests.

Resident Physician

Department of Emergency Medicine

University of California

San Diego

CA

Disclosures

SPN declares that he has no competing interests.

Director

Department of Emergency Medicine

Mount Sinai School of Medicine

New York

NY

Disclosures

PH declares that he has no competing interests.

Consultant Physician and Clinical Toxicologist

Regional Drugs and Therapeutics Centre

Newcastle-upon-Tyne

UK

Disclosures

RT declares that he has no competing interests.

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