Last reviewed: May 2020
Last updated: March  2018

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
More 1st investigations to order

Investigations to consider

  • creatine kinase
  • Mini Mental State Examination
  • CT head
More investigations to consider

Emerging tests

  • magnetic resonance spectroscopy
More emerging tests

Treatment algorithm

Contributors

Associate Professor of Clinical Emergency Medicine

University of California, San Francisco

San Francisco

CA

Disclosures

PG declares that she has no competing interests.

Peer reviewersVIEW 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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