Carbon monoxide poisoning

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources

When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Evidence last reviewed: 16 Mar 2026
Topic last updated: 13 Jan 2026

Summary

Definition

Анамнез и осмотр

Ключевые диагностические факторы

  • exposure to incomplete combustion of carbon-containing material
  • exposure to fire with smoke inhalation
  • nausea
  • headache
  • vomiting
  • blurred vision
  • dizziness
  • vertigo
  • altered consciousness
  • dyspnea
  • tachycardia
  • hypotension or hypertension
  • cardiac arrhythmias
  • pain
  • weakness
  • sleep changes
  • irritability
  • flu-like symptoms
Полная информация

Другие диагностические факторы

  • exposure to methylene chloride
  • delayed neuropsychiatric features
  • other severe neurologic symptoms
  • cutaneous blistering
  • pulmonary edema
  • cardiac arrest
  • focal neurologic abnormalities (e.g., hemiplegia, truncal ataxia)
  • disseminated intravascular coagulation
Полная информация

Факторы риска

  • exposure to incomplete combustion of carbon-containing material
  • exposure to fire with smoke inhalation
  • exposure to methylene chloride
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • carboxyhemoglobin (CO-Hb) level
  • ECG
  • cardiac monitoring
  • blood glucose
  • complete blood count
  • urea and electrolytes
  • creatinine
  • lactate
  • pH level
  • cardiac biomarkers
  • creatine kinase
Полная информация

Исследования, проведение которых нужно рассмотреть

  • chest x-ray
  • Mini Mental State Examination
  • CT head
  • magnetic resonance imaging and spectroscopy
  • liver function tests
  • pregnancy test
Полная информация

Алгоритм лечения

Острый

all patients

Составители

Эксперты-консультанты

Richard Moon, MD

Professor of Anesthesiology

Professor of Medicine

Division of Pulmonary, Allergy and Critical Care Medicine

Duke University

Durham

NC

Раскрытие информации

RM has been reimbursed by Merck for contributions to the Merck Manual.

Выражение благодарностей

Dr. Richard Moon would like to gratefully acknowledge Dr Jason Rose and Dr Prasanthi Govindarajan, previous contributors to this topic.

Раскрытие информации

PG declares that she has no competing interests. JR is a co-inventor on patent applications for the use of heme-based molecules as antidotes for CO poisoning. JR is a shareholder, officer, and director of Globin Solutions, Inc. Globin Solutions, Inc. has an exclusive license to this technology. Globin Solutions, Inc. had an option agreement to technology directed at using hydroxycobalamin for CO poisoning from Virginia Commonwealth University in the last 12 months. JR is an author of publications cited within this topic.

Рецензенты

Richard S. Weisman, PharmD

Director

Florida Poison Center

Miami

FL

Раскрытие информации

RSW declares that he has no competing interests.

Sean Patrick Nordt, MD, PharmD

Resident Physician

Department of Emergency Medicine

University of California

San Diego

CA

Раскрытие информации

SPN declares that he has no competing interests.

Paul Hamilton, MD

Director

Department of Emergency Medicine

Mount Sinai School of Medicine

New York

NY

Раскрытие информации

PH declares that he has no competing interests.

Ruben Thanacoody, MD, FRCP(Edin)

Consultant Physician and Clinical Toxicologist

Regional Drugs and Therapeutics Centre

Newcastle-upon-Tyne

UK

Раскрытие информации

RT declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Hampson NB, Piantadosi CA, Thom SR, et al. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012 Dec 1;186(11):1095-101.Полный текст  Аннотация

Centers for Disease Control and Prevention. Clinical guidance for carbon monoxide poisoning following disasters and severe weather. Jul 2024 [internet publication].Полный текст

Wolf SJ, Maloney GE, Shih RD, et al; American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Carbon Monoxide Poisoning. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann Emerg Med. 2017 Jan;69(1):98-107.e6.Полный текст  Аннотация

Weaver LK. Carbon monoxide poisoning (reprinted from the 2023 hyperbaric indications manual 15(th) edition). Undersea Hyperb Med. 2024 Third Quarter;51(3):253-76. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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