Daily Bolus of LR: Indications for Hyperbaric Treatment in CO Poisoning

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November 18, 2011 by dailybolusoflr

Indications for Hyperbaric Treatment in CO Poisoning

The use of hyperbaric treatment for CO poisoning is a controversial topic. Literature, of variable quality, both supports and refutes its success in reducing the development of long term cognitive sequelae. A Cochrane review in 2005 did not support its use.

* 100% oxygen administered by NRB is uniformly recommended
* Remember also that the COHgb level in the ED may underrepresent the peak level that the patient had at any given point during an exposure

The Undersea and Hyperbaric Medical Society recommends hyperbaric oxygen therapy for the following patients with CO poisoning:

* Transient or prolonged LOC
* Focal neurologic signs or symptoms
* Cardiovascular dysfunction
* Severe acidosis
* CO level of > 25%
* Pregnant patients with CO level of > 10%

Ref: NEJM 2009. 360(12):1217-1225

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