In carbon monoxide poisoning, what therapy may be considered in addition to high-flow oxygen if indicated?

• A. Hyperbaric therapy.
• B. Intravenous antibiotics.
• C. Diuretic therapy.
• D. Nebulized bronchodilator.

Answer: (A)

Carbon monoxide poisons by binding to hemoglobin and preventing oxygen delivery. The first priority is high-flow, 100% oxygen to displace CO from hemoglobin and speed its elimination. Hyperbaric oxygen therapy may be considered in addition when indicated because the very high pressure significantly increases dissolved oxygen in plasma and accelerates removal of CO from hemoglobin and other tissues, which can reduce the risk of delayed neurologic injury. This approach is especially considered for patients with neurologic involvement (altered mental status, seizures, focal deficits), very high CO levels, or pregnancy.

Antibiotics, diuretics, and nebulized bronchodilators do not counteract CO binding or improve tissue oxygen delivery in CO poisoning, so they are not standard treatments for this condition unless there’s another separate issue present.