ABSTRACT
Better Education of Physicians: This is essential if CO-poisoned patients are to be properly diagnosed and treated in the future. Several years ago I overheard a prominent emergency room physician say, “the standard of care for CO poisoning in the U.S. is less than the standard of care.” I estimate that in 80% of CO cases reviewed, one, two, or more mistakes were made in diagnosing and/or treating CO-poisoned patients. This may involve misdiagnosis, dependence on faulty pulse-oximetry data, administering NBO with the wrong
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to order when it was needed and possible, discharge of patients while still symptomatic, and so forth. Physicians should also be informed of the possible serious permanent health harm that chronic or lower-level acute CO poisoning can cause if not diagnosed immediately and treated fully. From my perspective, the CO cases that result from acute poisoning and those most likely to reach the media are actually the smaller fraction of all CO poisonings, while the chronic (i.e., occult) CO poisonings make up by far the largest fraction, and probably result in the most injuries, but they are the very group that physicians are least trained to properly deal with.
