ACUTE CARBON-MONOXIDE INTOXICATION - INDI CATION FOR HYPERBARIC-OXYGEN

Carbon monoxide intoxication continues to pose a differential diagnost ic gnostic and therapeutic problem. I Since the symptoms presenting ar e often unspecific, the chances that the condition will be wrongly dia gnosed, or the diagnosis delayed, are good, resulting in submaximal tr eatment. The measured COHb level in the blood frequently does not corr elate with the symptoms, and, in particular, permits no prediction to be made about the likelihood of Inter neurological deficits. Hyperbari c oxygen therapy can rapidly eliminate the CO, and in comparison with the administration of normobaric oxygen is accociated with a significa nt lowering of both mortality and long-term morbidity. For all of thes e reasons, the indication for hyperbaric oxygen treatment should be es tablished early on. When neurological symptoms are present, or transie nt loss of consciousness, and in pregnant victims, treatment with hype rbaric oxygen is indicated. Should the emergency physician receive ons ite hints of CO poisoning (information from victim or witnesses) or se e evidence of its possibility (smouldering fire in flat, victim in gar age, etc), he/she should contact the medical rescue centre to request suitable means of ensuring transport of the victim under oxygen treatm ent (helicopter, emergency ambulance) to the nearest specialised treat ment centre.