Cardiopulmonary resuscitation should be performed as required. The goals of treating CO poisoning specifically are to (1) maximize oxygen delivery and (2) decrease oxygen consumption until the CO has been eliminated through the pulmonary circulation. Oxygen is the mainstay for CO therapy and should be administered through a nonrebreather mask with a reservoir so that inspired air is 100% oxygen. If a patient requires intubation, he should be ventilated with 100% oxygen. Oxygen therapy should be continued until the COHb level is < 3% and the patient is asymptomatic. To optimize the blood’s oxygen-carrying capacity, clinicians should have a low threshold for correcting anemia in severe CO poisoning.72 To decrease oxygen consumption, patients should be placed on bed rest and anxiety-provoking activities should be avoided as much as possible. This may be accomplished by allowing a child to sit with his or her parent, dimming the lights, utilizing child life specialists when available, and minimizing noncritical medical interventions. Anxiolytics should be avoided in patients with altered mental status.
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