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Carbon Monoxide Poisoning (Acute - Adult)

Critical Issues in the Management of Adult Patients Presenting to the Emergency Department with Acute Carbon Monoxide Poisoning (February 2008)

Complete Clinical Policy on Carbon Monoxide Poisoning (PDF)

Scope of Application. This clinical policy is intended for physicians working in hospital-based emergency departments (EDs) in a location at which hyperbaric oxygen (HBO2) therapy is an available treatment option (whether on site or by reasonably practical patient transfer).

Inclusion Criteria. This clinical policy is intended for adult patients presenting to the ED with acute carbon monoxide (CO) poisoning.

Exclusion Criteria. This clinical policy is not intended for application to a pediatric population, for fetal exposures, for patients with chronic CO poisoning, or patients with delayed presentations (greater than 24 hours after cessation of exposure) of CO poisoning.

Critical Question

1. Should HBO2 therapy be used for the treatment of patients with acute CO poisoning; and 
Can clinical or laboratory criteria identify CO-poisoned patients who are most or least likely to benefit from this therapy?

  • Level A recommendations. None specified.


  • Level B recommendations. None specified.


  • Level C recommendations. (1) HBO2 is a therapeutic option for CO-poisoned patients; however, its use cannot be mandated.
    (2) No clinical variables, including carboxyhemoglobin levels, identify a subgroup of CO-poisoned patients for whom HBO2 is most likely to provide benefit or cause harm.

Purpose of ACEP's Clinical Policies

Clinical Findings and Strength of Recommendations