BCEN CEN Practice Question

The priority intervention for a patient with suspected carbon monoxide poisoning, such as a victim of a house fire with neurological symptoms, is the administration of 100% oxygen via a non-rebreather mask. Carbon monoxide has a higher affinity for hemoglobin than oxygen, and it displaces oxygen, forming carboxyhemoglobin and leading to tissue hypoxia. Administering 100% oxygen significantly shortens the half-life of carboxyhemoglobin, accelerating its elimination and restoring the oxygen-carrying capacity of the blood. While obtaining IV access and blood work are important, they are not the immediate priority over correcting hypoxia. A standard pulse oximeter is unreliable in CO poisoning as it cannot differentiate between oxyhemoglobin and carboxyhemoglobin, so waiting for a co-oximetry result before starting oxygen would be an inappropriate delay in treatment.