Carbon Monoxide Exposure
Purpose: These guidelines will provide direction for EMS responders using transcutaneous carbon monoxide monitors (optional equipment) while treating patients or while monitoring firefighter exposure at the fire ground.
INDICATIONS:
- Smoke inhalation
- Thermal burns
- Altered level of consciousness with no clearly identifiable cause
- Assessment of fire ground personnel (fires, hazardous materials incidents, hydrocarbon-powered equipment in a closed environment)
RESULTS:
SpCO level |
Clinical Manifestations | Fire Rehab Considerations |
| < 5% | Mild headache | Refer to your department SOPs |
| 10% | Mild headache, shortness of breath with exertion | |
| 10% - 20% | Moderate headache, shortness of breath | |
| 20% - 30% | Worsening headache, nausea, dizziness, fatigue | |
| 30% - 40% | Severe headache, vomiting, vertigo, altered judgment | |
| 40% - 50% | Confusion, syncope, tachycardia | |
| 50% - 60% | Seizures, shock, apnea, coma |
SPECIAL NOTE:
Always confirm high reading by measuring on more than one finger on each hand. If the values differ significantly, use an average reading.
CONCURRENT USE OF PULSE OXIMETER AND CAPNOGRAPHY:
Medics may use transcutaneous carbon monoxide monitoring devices concurrently with pulse oximetry and capnography. However, the presence of carbon monoxide in the bloodstream produces artificially high pulse oximetry readings. Low oximetry readings suggest ineffective oxygenation, direct injury to the airway or lungs, severe underlying lung disease, or any combination of these factors.
Treatment Considerations
