Carbon monoxide poisoning: an A&E perspective.

Carbon monoxide (CO) is a colourless, odourless, tasteless and non-irritating gas and may therefore be inhaled in large quantities by the victim without his realizing it. The toxic effect of CO is not exclusively the result of the binding of haemoglobin; the primary mechanism appears to be inhibition of cellular respiration. Carboxyhaemoglobin (COHb) is excreted fairly rapidly from the body, therefore blood levels do not necessarily reflect the severity of CO poisoning. Airway support and adequate ventilation are the primary objectives of the nursing and medical team. Oxygen is the only antidote to CO. Continuous monitoring of the patient's neurological state is necessary; conscious level is the most important guide to the patient's progress. Nurses must be aware of the clinical indications and contraindications for HBO therapy to ensure that their patients receive optimal treatment.