Which are early signs of carbon monoxide exposure, and what is the EMS treatment?

• A. Headache, dizziness, confusion, nausea, tachycardia; treat with 100% oxygen and monitor closely
• B. Cough with fever; treat with antibiotics
• C. Nausea only; no oxygen therapy
• D. Severe chest pain; perform defibrillation

Answer: (A)

Carbon monoxide poisoning tends to present with nonspecific symptoms because CO deprives tissues of oxygen by binding to hemoglobin. Early signs include headache, dizziness, confusion, nausea, and often a fast heart rate as the body tries to compensate. The EMS treatment is to remove the person from the exposure and give 100% oxygen to rapidly displace CO from hemoglobin and restore oxygen delivery. Use a non-rebreather mask at high flow, or assist ventilation with a bag-valve device if the patient is not ventilating, and monitor vital signs closely. In more severe cases or if available, hyperbaric oxygen therapy may be considered, but the immediate EMS action is high-flow oxygen and monitoring. The other scenarios described—cough with fever would point toward an infection requiring antibiotics, nausea alone without oxygen therapy would leave CO in the system and is not adequate treatment, and severe chest pain with defibrillation is a cardiac-focused intervention and does not address the root cause of CO poisoning.